Coping with bad news: the physician executive's role in a lawsuit

In these days of doctors, lawyers and lawsuits, chances of an American physician finishing his or her career without a malpractice claim are growing more remote. Every physician executive overseeing the activities of a group of peers knows this and should be prepared to assist the physician who is sued. Examine four key ways to help your physicians deal with the stress of a lawsuit.     

Exploring turnover intentions among three professional groups of employees

Abstract

Although considerable research effort has been devoted to understanding work attitudes, behaviours and outcomes regarding turnover intentions, little has been done to explore it across different professions. This study takes a step in this direction and examines the effect of affective commitment, job satisfaction and job performance on turnover intentions across three professions. To this end, we surveyed three professional groups of employees and managers: financial officers and social workers employed in the public sector and lawyers employed in the private sector. The results of these three studies show that turnover intentions vary across these professions. Social workers exhibit lower turnover intentions than financial officers and lawyers, who tend to exhibit high turnover intentions. In addition, we found that job satisfaction and affective commitment are negatively associated with turnover intentions, while no significant relationship was found to exist between job performance and turnover intentions. The implications of this study suggest that both researchers and practitioners should take into consideration not only the organizational context, but also the occupational context while exploring the process of voluntary turnover.     

Internes Karriere-Coaching für High-Potentials in einer Wirtschaftskanzlei

The International Law Firm Hogan Lovells has developed an internal coaching program for their associates. The Career Coaching supports lawyers to develop important non-juristic competencies. With this program Hogan Lovells established the Employer Brand “The People Development Firm” to attract legal High Potentials in the war for talents. By means of the skills profile and typical coaching topics it is shown how a tailor-made personnel development can be offered.     

Situationen gestalten,um Ärzte am Krankenhaus zu halten

The situation at work in a hospital is often exhausting for medical doctors. Besides deteriorating health, doctors report a diminishing quality of their work. As a consequence, the willingness to change the hospital one is employed by is increased. Aside from important political decisions, doctors and others of responsibility can design their working situation more positively. The authors discuss the doctors’ challenges based on a current survey and introduces situational design—an approach to design working situations optimally so that they positively enhance wellbeing and productivity.     

ABMT (autologous bone marrow transplantation): a microcosm of the U.S. health care system

The continuing controversy over appropriate utilization of high-dose chemotherapy (HCDT)-autologous bone marrow transplantation (ABMT) in the treatment of cancer epitomizes the debate in this country over increasing expenditures for the application of health care technology. The debate includes all imaginable constituencies--patients, physicians, hospitals, payers, employers, lawyers, economists, and the media. The issue is fascinating, as it continually presents new twists and turns. Additionally, the way in which the HCDT-ABMT controversy is resolved (or not resolved) will presage the manner in which similar issues are addressed in the 1990s.     

The Determinants of Foreign Multinational Enterprise Firms' Board Governance in Caribbean Offshore Island Economies

Using a unique sample of 171 listed firms in the Caribbean region, this paper explores the influence of post-entry ownership of foreign MNEs on the board composition of subsidiaries. Our findings reveal higher ownership is a means of enhancing the security of property rights while simultaneously creating a liability of foreignness. This causes subsidiaries to externally contract for resources, leading to the hiring of more lawyers and fewer accountants. The opposite is true for progressively lower levels of foreign MNE ownership. Firms' adoption of shareholder rights governance amplifies these findings, while state formal institutional quality reverses them.     

Preparing to tack: when physicians change careers

Because of the progressive health care revolution that gives all the power to the managed care insurance companies, the usurpation of physician autonomy, and the replacement of the physician-patient relationship with HMO policies, doctors are looking at other career choices. Many doctors have never considered life after medicine and have made no plans for that time in their future. Despite their ample education, some doctors say, "I don't know how to do anything else. I am trapped in this system, and I can't get out. If I knew what else I could do, I would definitely change careers." Many doctors feel that it is too late in their lives to make such a change. However, it is becoming more and more acceptable to switch or modify a medical career. A number of physicians have switched careers successfully without disgrace and have discovered that there is indeed a life after the first career choice. It isn't always easy, but it can be done.     

Engaging Professionals in Sustainable Workplace Innovation: Medical Doctors and Institutional Work

This paper investigates the role of medical professionals in the success and longevity of the implementation of workplace innovation and organizational change in the Accident and Emergency (A&E) Departments of two large public hospitals, in Australia and Canada, during the introduction of process improvement using Lean Management (LM) methodologies. We ask why and how doctors resist, influence or enable LM initiatives in healthcare. Using a qualitative methodology, we contribute to institutional work theory by unpacking the complex forms of boundary and practice work undertaken by key actors who effectively use their professional status and power to enable practice changes to be embedded. Our findings lend support to the importance of the involvement and ownership of senior doctors in the design, introduction and implementation of successful workplace innovation and organizational change. Senior doctors use their professional expertise, positional and political power at the industry, organization and workplace levels to influence strategically the use of resources designated for workplace innovation to improve efficiencies, quality of patient care and maintain their dominance. The significant organizational change achieved reflected the ownership and leadership of the workplace innovation by senior doctors in ‘hybrid roles’ who captured the rhetoric and minimized adversarialism among key stakeholders.     

Coaching für niedergelassene Ärztinnen Ein kognitiv-verhaltenstherapeutischer Ansatz

The article states special aspects for coaching office-based women doctors, because their problems in managing a doctor’s office are originated in their typical female socialisation. First these burdening factors of managing a doctor’s office were collected phenomenologically in women doctors’ perspective, then the underliing cognitions – internalized ?driver and blocker“ – were highlighted and explained by psychoanalysis. To change these gender cognitions a coaching approach based on cognitive behavioral therapy was presented and differentiated from a therapeutical method.     

医生的信息-情感交互模式对移动问诊服务满意度的影响——基于“激励-保健”理论的分析

移动问诊服务日益成熟,但患者满意度仍有待提高。现有研究对医患交互过程关注不足,且忽略患者不满意评价的影响因素。为此,本文引入"激励-保健"理论视角,研究医生的信息-情感交互模式对移动问诊服务满意及不满的影响机制。本文筛选国内某领先移动问诊平台中的300次医患沟通记录,采用"先定性后定量"的混合研究方法对数据进行分析。其中,定性研究旨在识别医生交互模式的细分维度,定量研究则用于提出并验证不同交互模式与患者满意及不满的关系。研究发现,医生的信息交互模式是移动问诊服务满意度的保健因素,而情感交互模式是激励因素。结论丰富了移动问诊服务患者满意度的研究框架,对改善医生行为和医疗服务APP设计提供了指导。     

Work performance and health of junior hospital doctors a review of the literature

Concern has been expressed for a number of years about the long working hours and consequent sleep loss often experienced by junior hospital doctors. In recent months there has been renewed pressure for the demanding work schedules, common in many hospitals, to be changed. Concern centres on two related areas, namely the potential effects on the doctors work performance and the effects on their health. This paper reviews the literature relating to both areas and assesses how far the expressed need for change is supported by existing evidence. In addition attention is drawn to aspects of sleep loss and work performance requiring further investigation.     

Poll finds that physicians long for political action

The latest ACPE survey explores physician executive participation in politics, and the need for doctors to make an impact on health care policy.     

Who supports physicians in malpractice cases?

Malpractice suits have a devastating emotional impact on physicians. Learn about a unique service offered by the HealthTexas Provider Network to help doctors deal with the shock and sadness.     

Case study: using control charts to track physician productivity

Learn how control charts are being used to gauge physician productivity in a Shriners hospital in Kentucky. The charts provide a fair and accurate analysis that doctors appreciate.     

Keeping score. Scorecards, profiles and report cards rapidly expanding to track physician performance

Not all doctors like them, some even ignore them, but nevertheless the use of physician scorecards is growing and the scores may soon be widely available to the general public.     

Outpatient appointment scheduling problem considering patient selection behavior: data modeling and simulation optimization

Journal of Combinatorial Optimization - In medical outpatient services, due to patients’ imbalanced selection for doctors of different levels and for different visiting periods, inefficiency...     

Malpractice insurance rates reach boiling point. Physicians burned by lawyers, lawsuits and jury awards

Costs of medical malpractice insurance are soaring. Major insurers are refusing to write policies. And doctors are struggling to pay their premiums. Find out what's behind the insurance crisis.     

The new management competencies: a global perspective

How will tighter controls over health expenditures, an increased supply of qualified doctors, and clinical acumen becoming more critical in allocating health resources under market-driven, capitated payment-type plans affect physicians? Throughout the world, they will play a greater role in the management of health facilities and services. To train doctors to provide leadership in these new, more market driven environments, education should focus more on the integration and coordination of clinical and managerial processes, an approach outside the scope of most curricula now offered. New managerial competencies will be required by the paradigm shift away from simply delivering quality health services to tighter cost containment efforts. Physicians will play an increasing role in how medical facilities and services are organized and financed--the blending of clinical and managerial-financial-information science processes will be paramount in these educational pursuits.     

Foundational Issues in Risk Assessment and Risk Management

This is a perspective article on foundational issues in risk assessment and management. The aim is to discuss the needs, obstacles, and challenges for the establishment of a renewed, strong scientific foundation for risk assessment and risk management suited for the current and future technological challenges. The focus is on (i) reviewing and discussing the present situation and (ii) identifying how to best proceed in the future, to develop the risk discipline in the directions needed. The article provides some reflections on the interpretation and understanding of the concept of “foundations of risk assessment and risk management” and the challenges therein. One main recommendation is that different arenas and moments for discussion are needed to specifically address foundational issues in a way that embraces the many disciplinary communities involved (from social scientists to engineers, from behavioral scientists to statisticians, from health physicists to lawyers, etc.). One such opportunity is sought in the constitution of a novel specialty group of the Society of Risk Analysis.     

Palliative medicine in Britain

In Britain, Palliative Medicine was recognized as a subspecialty of Internal Medicine exactly 20 years after Cicely Saunders founded St Christopher's, at exactly the same time that government was at last recognizing the worth and the needs of general practice. Both had far-reaching effects and implications for patients, doctors, and the future of medicine. For Palliative Medicine it meant units wishing to train specialists going through a rigorous selection process; the development of an equally rigorous training program for the doctors who had already gained a higher qualification before starting Palliative Medicine, demonstrating the need for and benefits of palliative medicine to the sceptics in the profession and, now, continuing to recruit the staff for the steadily increasing number of new services. Today there are more Palliative Medicine consultants/specialists than there are oncologists and neurologists combined, with Hospital Palliative Care Teams in every major hospital and cancer center. With nine Chairs in Palliative Medicine, there is now a drive for research and professional education. The specialty faces major challenges, however, ranging from training to care for patients with non-malignant disease to enabling patients to die in the place of their choice-something that rarely happens today; from defining what is distinctive or unique about palliative medicine to clarifying the respective place of general practice and the specialty. Most would agree that the biggest challenge for the young, thriving specialty is how to share its principles with other doctors wherever they work.