Hold or fold?

This article examines some of the problems of the health care organizations we serve and that support us. While external problems can besiege an organization, the fundamental building block for success is to develop physician buy-in and a well-functioning team. The author describes how his IPA failed because the physicians in his organization didn't bond sufficiently, and for a sustained period, to carry out business operations. What are the warning signals that might help you decide whether to stay or move on? An IPA must have: (1) A clearly articulated vision of what success will look like, one that is accepted by its members; (2) effective leadership; (3) clear evidence of adaptability and flexibility; (4) financial stability; and (5) good data available to physicians. There can be other evidence of trouble you need to watch for. In some areas, hospitals and health plans are hostile to physician initiatives. Don't rely on politically motivated decisions--they are too easily changed. If you plan to be a leader for your physician organization, focus on creating or revising the internal architecture of the group.     

Strategic vision or strategic con?: Rhetoric or reality?

Major companies devote considerable effort to communicating corporate visions and missions. Yet three recent surveys suggest that much of this effort has been counter-productive. A gap has emerged between rhetoric and reality. Arenas of confrontation have arisen between directors and managers, head offices and business units, holding companies and their subsidiaries, and between specialists and generalists. A widespread desire for corporate transformation is not matched by understanding of how to bring it about. The lack of top management commitment and of communication skills are major barriers to change. More competent directors and more effective boards are needed. The article suggests key roles for the chairman and the chief executive. It examines how best to share a compelling vision, and identifies a requirement for new attitudes and approaches to communication.     

Doing or being?

The founder of Aikido, Morihei Ueshiba, would occasionally distill the essence of the art into three simple shapes--a circle, a square, and a triangle. These are three basic ways of dealing with what's coming at you. The square is the simplest. It is about, essentially, doing nothing. The saying here is from the old spiritual: "I shall not be moved." You meet the challenge head on. The triangle is about forward motion--attack, cutting right to the heart of what is coming at you, or cutting right past it to the space beyond. The circle is often the most interesting space. The circle is not about standing ground or cutting through. The circle is about dancing with whatever is headed your way. The real danger lies in being stuck in any one mode--perpetually intransigent, always flailing away in attack mode, or forever slip-sliding through one dance step after another. It is only when our response is embodied in who we are that we will have the power truly to lead other people.     

Senior physician slowdown-problem or opportunity?

Examine a plan for physician slowdown or relief of call and learn how it can extend the professional lives of experienced physicians at a time when practices are facing a physician shortage.     

按闹分配or依法治国?

正甘肃永昌县一名初一少女自杀,在新年之交搅动了舆论场。经警方调取监控录像与调查取证,时间线如下:2015年12月28日13时许,少女赵某进入超市;13时31分,赵某过安检门时触发警报,在其身上发现德芙巧克力等物品,价值     

Returns to Tenure or Seniority?

This study documents two empirical facts using matched employer–employee data for Denmark and Portugal. First, workers who are hired last, are the first to leave the firm. Second, workers' wages rise with seniority, where seniority is defined as a worker's tenure relative to the tenure of his colleagues. Controlling for tenure, the probability of a worker leaving the firm decreases with seniority. The increase in expected seniority with tenure explains a large part of the negative duration dependence of the separation hazard. Conditional on ten years of tenure, the wage differential between the 10th and the 90th percentiles of the seniority distribution is 1.1–1.4 percentage points in Denmark and 2.3–3.4 in Portugal.     

Is leadership born or made?

Is leadership born or made? By profiling three colleagues who made the transition from clinician to top-flight executive in a health care organization, the author provides case studies from which to discuss leadership issues. An evolutionary pattern has developed with respect to physicians changing careers: The first model was the medical director, followed by the vice president for medical affairs, and finally the move to managing the health care system, group practice, or managed care organization. Are physician executives fundamentally different from clinicians in terms of leadership characteristics? What are the essential qualities needed to lead health care organizations? These questions are explored in-depth.     

Network Stability: Opportunity or Obstacles?

Scholars of public management have begun to focus on networking as a key component of managerial activity ((Agranoff and McGuire, 2001); (Milward and Provan, 2001); (O'Toole and Meier, 1999)). Although the study of networks has garnered considerable academic attention, few studies have worked to bridge previous knowledge about hierarchical organizations with the research on the network. This study introduces the concept of stability into the network, arguing that stability should be a core value in networks, as the function of the network largely depends on repeat interactions. Texas school districts serve as the units of analysis, with the superintendent as the manager of interest. Findings suggest that stability may not always provide the benefits expected in traditional, hierarchical organizations.     

专利联盟:馅饼or陷阱?

专利联盟作为一种重要的专利管理模式,对企业在国际产业竞争中赢得竞争制高点发挥着越来越重要的作用。本文回顾了有关专利联盟竞争效应各角度的研究,并对我国专利联盟发展现状进行介绍,最后从政府和企业两个层面对我国企业组建有利于竞争和增进社会福利水平的专利联盟提出相应的对策建议,使专利联盟成为人见人爱的"馅饼"而非人人躲避的"陷阱",增强我国在国际专利联盟中的话语权。     

Physician-led: good idea or not?

Whether physicians or not, leaders must possess certain skills and qualities to achieve success. Take a look at what's required to be an effective leader.     

慢下来的中国经济软着陆or硬着陆

7月13日,国家统计局发布最新统计数据,今年上半年我国GDP增速7．8％,三年来首次跌破8％,其中二季度增速7．6％,连续6个季度回落。“增速为何‘破八’？”、“7．6％是否是‘谷底’？”未来中国经济如何着陆成为全球关注的焦点。《人民日报》发表评论,一个大国迈向强国的过程,从不会一帆风顺,路口有花环,路上就必有荆棘。中国很难,中国也很有信心。     

Push or Pull? Auctioning Supply Contracts

Consider a buyer, facing uncertain demand, who sources from multiple suppliers via online procurement auctions (open descending price‐only auctions). The suppliers have heterogeneous production costs, which are private information, and the winning supplier has to invest in production capacity before the demand uncertainty is resolved. The buyer chooses to offer a push or pull contract, for which the single price and winning supplier are determined via the auction. We show that, with a pull contract, the buyer does not necessarily benefit from a larger number of suppliers participating in the auction, due to the negative effect of supplier competition on the incentive of supplier capacity investment. We thus propose an enhanced pull mechanism that mitigates this effect with a floor price. We then analyze and compare the outcomes of auctions for push and (enhanced) pull contracts, establishing when one form is preferred over the other based on the buyer's profits. We also compare our simple, price‐only push and pull contract auctions to the optimal mechanisms, benchmarking the performance of the simple mechanisms as well as establishing the relative importance of auction design and contract design in procurement auctions.     

Distance Learning: Education or Economics?

Sir John Daniel, Vice Chancellor of the Open University in England, pronounced that American universities are in a crisis of access, flexibility and cost. His solution is that American Universities and Colleges should employ educational technologies that allow students to earn college degrees without visiting the college campus (distance learning). The argument is that distance learning is a cost-effective way of providing more students with access to higher education. Sir John's argument illustrates a crisis in neither access, flexibility, nor cost. On further inspection, distance learning degree programs appear to be a strategy for reducing the cost of higher education by replacing professors with computers and part-time teachers. This strategy offers limited educational benefits for the student and may present a financial danger to smaller colleges and universities, if they succumb to the pressure to develop distance, learning degree programs. This revised version was published online in July 2006 with corrections to the Cover Date.     

Generalists or specialists--who does it better?

Managed care companies encourage primary care physicians to limit referrals to specialists and provide as much of the needed services themselves. As a result, generalist and specialist physicians are now in direct competition with one another. Is the care provided by generalist and specialist physicians different in terms of quality and cost? The authors reviewed the literature over the past five years and found 21 articles comparing the care between specialists and generalists. They realized asking who does it better, the generalists or the specialists, is the wrong question to explore. Physicians must come together to design systems of care that maximize the long-term health of patients and deliver care in a coordinated and efficient manner. The emphasis should be on creating value for the consumer across the continuum of providers and through time. Competition between generalists and specialists in a fragmented system only serves to further weaken the position of physicians in the health care industry.     

The Founder's Legacy: Hangover or Inheritance?

The legacy of organizational founders is a comparatively under‐studied topic. Through two in‐depth case studies, this article explores the factors which influence whether founding strategic visions, objectives or decisions influence present‐day strategic choice. Furthermore, the study identifies and explores a number of factors which influence whether a strategic legacy is categorized as either an inheritance or a hangover. The article begins with an overview of existing research into the role of the founder, commitment and strategic inertia, which suggests that additional research is required to clarify the legacy of company founders. After a review of the research design and methodology adopted for the study, the findings of two case studies are presented. The findings suggest that the initial establishment of a strong organizational culture, continuing perceptions of success as well as successive family control all contribute to an adherence to the founding strategy, mission or objectives. In addition, the study indicates that the flexibility of the original strategy and environmental issues impact on the extent to which the strategic legacy is classified as an inheritance or a hangover. The article culminates in a series of conclusions and implications.     

The physician-patient privilege: friend or foe?

The physician-patient privilege that has been enacted in most states has usually been seen as having the benign, even salutary, effect of protecting confidences that patients have entrusted to their physicians in the course of obtaining medical care and treatment. However, case decisions in one state have turned the privilege into a sword that plaintiffs can use to interfere with physicians' and hospitals' defense of cases against them by denying their counsel access to key defense witnesses. This development could occur in many other states that have taken a similar general approach in analyzing the privilege.