Complementary and alternative medicine. Integrative medicine: business risks and opportunities.

Much of the buzz over integrative medicine is well deserved. The opportunities seem to outweigh the risks, but superior management skills are needed to guide these programs through adolescence into clinical and business maturity. By carefully considering the staffing, team building, compensation methods, marketing, and program evaluation and development issues explored in this article, health care and physician executives should be able to steer between the rocks on their way to integrative medicine decisions that are right for their organizations. Many claim that integrative medicine has the potential to reshape health care delivery in a more patient-centered direction. While this may be true, such programs must prove themselves from financial and clinical operational perspectives in order to achieve this potential. Luminary clinical skills are not enough to guarantee the survival of such programs--a strong clinical base of expertise in alternative therapies is a key success factor. As with any health care venture, there are no substitutes for clinical excellence or sound management.     

Building the Complementary Board. The Work of the Plc Chairman

This article addresses the critical issue of board effectiveness, and in particular the conditions under which chairmen as well as other non-executives can make an effective and positive contribution to the strategic direction and control of companies. It is informed by qualitative interview-based research with chairmen, chief executives and non-executive directors in major UK companies which focused on the now typically separate role and work of the company chairman. The article argues that in the governance debate too much attention has been given to issues of board structure and composition to the neglect of issues related to the knowledge and motives of individual non-executives, and how their energies are combined in processes of board accountability. Drawing upon directors’ experiences, the article examines the bases that underpin and the positive potential of what are termed ‘complementary’ board relationships, through which a chairman can contribute directly to the performance of the chief executive, as well as create the conditions for other non-executives to contribute to the performance of the executive team. The article also explores the negative dynamics of what are termed ‘complimentary’ relationships between executives and non-executive directors and how these sometimes inadvertently come to weaken board accountability and create the conditions for an external crisis of confidence.     

The microprocessor and medicine

Technology continues to accelerate at an amazing pace. Where have we been, where are we going, and what do these technology enhancements mean to the health care industry? We are entering the era of the personal computer becoming the window to the multimedia digital world of cyberspace. Microprocessors will continue to improve from one generation to the next to make cyberspace as realistic as possible-and with their improving capabilities will come myriad applications for health care services, either not cost-effective, or not even contemplated, until now. As a leader of an organization, one who approves substantial budgets for information technology, you must ask yourself what new products and services these startling technological advances will create. How will they change health and medical care?     

The Complementary Roles of Mitigation and Insurance in Managing Catastrophic Risks

This paper examines the impact that insurance coupled with specific risk mitigation measures (RMMs) could have on reducing losses from hurricanes and earthquakes as well as improving the solvency position of insurers who provide coverage against these hazards. We first explore why relatively few individuals adopt cost-effective RMMs by reporting on the results of empirical studies and controlled laboratory studies. We then investigate the impact that an RMM has on both the expected losses and those from a worst case scenario in two model cities—Oakland (an earthquake-prone area) and Miami/Dade County (a hurricane-prone area) which were constructed respectively with the assistance of two modeling firms. The paper then explores three programs for forging a meaningful public-private sector partnership: well-enforced building codes, insurance premium reductions linked with long-term loans, and lower deductibles on insurance policies tied to mitigation. We conclude by briefly examining four issues for future research on linking mitigation with insurance.     

The emerging medical/industrial complex. The industrialization of medicine

Until recently, the traditional practice of medicine has been thought of as a cottage industry practiced by individuals or small partnership groups. The transition of practice settings to large groups, multi-specialty groups, and corporations has paved the way to industrialization, with even larger health care organizations primarily managed by non-physicians. The similarities of these events to the industrial revolution and its impact on crafts guilds are striking. In order to understand this point of view, this article explores the function and influence of crafts guilds during stages of industrial development and the dynamics of the changes of employment needs and employability in an industrial environment as a comparison to what is happening in the health care field.     

The challenge for women physician executives

After half a century of constituting 5 percent of the physician population, women will soon make up more than one-third of U.S. physicians. Women now practice in virtually every specialty. This enormous change has created both opportunities and tensions. Within the broader context of the changing role of women in U.S. society, women physicians are exploring new career paths--paths that are both similar to and different from those of their male colleagues. A future challenge for women physicians will be achieving significant representation in the medical management ranks.     

Technological Diversification and Organizational Divisionalization: The Moderating Role of Complementary Assets

This study uses data on 582 electronics and information technology firms in Taiwan for the period 1997–2005 to investigate the hypothesis that technological diversification increases the extent of organizational divisionalization under firm growth. This study applies competence‐based theory to argue that firms spread the technological competence base to achieve firm growth. However, in the face of firm growth, managers of multi‐technology firms often utilize a multi‐division structure to manage their various technologies based on their operating characteristics or needs. Furthermore, the findings of this study indicate that complementary assets moderate the negative relationship between technological diversification and organizational divisionalization. For firms with specialized complementary assets, multi‐technology firms may be observed to consolidate related‐technology activities into fewer divisions, facilitating the utilization of these complementary assets in conjunction with other divisions.     

免费商品对互补产品扩散的影响

本文基于互补产品扩散模型,在考虑价格策略以及重复购买与批量购买的消费者行为下,建立了免费商品赠送对互补产品扩散影响的优化模型群。通过模拟计算,分析结果表明免费商品的赠送对互补产品的扩散有促进作用,同时赠送互补产品优于仅赠送其中一种产品。在产品引入前进行免费商品赠送的边际效应要高于在其他时期赠送,形成"首期赠送效应"。当消费者有批量购买行为时,企业值得赠送更多的免费商品来提高消费者对产品的了解程度,以获得更高的利润。在对首期赠送水平的参数灵敏度分析后,给出了扩散过程中各个参数选取对于赠样水平的影响趋势与范围。在此基础上,为企业在实际促销决策中给出了具体的应用步骤。     

The marriage of medicine and computers

Although computers, in one form or another have been around for several decades, they have only recently acquired the power, the simplicity of operation, and the cost-effectiveness to make their widespread application in health care a reality. But a reality it is, and no manager can be successful without a working understanding of how computers and information technology mesh with the information needs of health care delivery. Computer literacy is no longer a nice add-on--it is a basic weapon in every health care professional's armamentarium.     

Care management challenge is the toughest yet.

The newest health care trend involves changing the core business--health care delivery and the resources involved--through better care management. This impacts every practitioner all day, every day. This issue truly belongs to the physicians, and thus to physician executives. Care management is the latest frontier, the place where the delivery of quality care, in the most efficient way, at the best possible cost, all come together. And physician executives are being challenged to make it happen, to change the way medicine is practiced and health care is delivered across the country, to move from treating episodes of care to a true preventive mindset and population-based methodologies. This column outlines the skills in care management that systems-based physician executives will need to develop or enhance to remain competitive--effective communication skills and team-building capabilities are critical attributes for those who hope for success.     

Practice guidelines. Cookbook medicine

A large measure of the confusion and doubt currently being sowed in the ongoing debate over the advisability and effectiveness of practice guidelines is a matter of terminology. In deference to the wishes and fears of physicians, the term "requirements" is not used. But requirements they are. Their quality and the degree to which they are useful will depend on their level of detail and the degree to which they are based on positive outcomes. Regardless, attorneys and others will always view and use them as requirements.     

Being flexible and accommodating diversity: The challenge for multinational management

This article presents an opposing view to the current populist position that corporate culture can be utilised to bind the multinational together. It critically examines the appropriateness of corporate culture as a ‘soft’ control mechanism, concluding that highly committed, inculcated managers (believers) may actually be a barrier to the goals of flexibility, responsiveness and innovativeness in the face of rapidly changing, diverse global operations. However, the calculatively compliant manager is not proferred as an alternative. Rather, we argue that the quest for conformity to a given corporate culture may be counterproductive. The real challenge for multinationals is to develop mechanisms that encourage mixed voices and messages, and support a diversity of perspectives. It is suggested that multinationals might even look at the university model, in which it has long been recognised that knowledge advances in a climate of critique and dissent.     

Health care trends, Part I. The promise and perils of evidence-based medicine ... panel discussion.

Numerous studies have demonstrated that there are wide variations in the way physicians manage similar patients. This suggests that an evidence-based approach could lead to better outcomes with less cost. But practicing evidence-based medicine requires new skills, such as using computerized databases and applying the rules of evidence to primary and integrative studies in the medical literature. The progress of evidence-based medicine will depend in large measure on how quickly these new skills can be developed and integrated into the practice environment. Here's how six experts see the promise and the perils of evidence-based medicine, now and in the new millennium. Part 2 of the panel discussion will explore the new provider team, which includes nurses and, more recently, pharmacists, who are collaborating with physicians to provide disease management and drugs therapy management services.     

Knowledge Accession and Knowledge Acquisition in Strategic Alliances: The Impact of Supplementary and Complementary Dimensions

This paper advances the concepts of knowledge accession and knowledge acquisition in strategic alliances by identifying supplementary and complementary dimensions to these knowledge transfer modes. Complementary knowledge transfer reflects the similarity of knowledge that the partners have and is conducted in pursuit of higher efficiency and productivity to enhance partner firms' existing competitiveness. Supplementary knowledge transfer occurs when partners each possess distinctive core competences and the information that is acquired or accessed increases the business scope of partners. As knowledge accession entails knowledge amalgamation that does not involve organizational learning, costs associated with the transfer process are lower and trust is easier to establish than in the case of knowledge acquisition. The paper reviews the implications of these transfer modes on trust building in alliances and their costs implications and presents a number of propositions for further exploration.