The case. Bad care, good care, and spiritual preservation

A cancer patient learning to walk again finds that his relationships with his two physical therapists affect his recovery. One woman gives hope as well as instruction. He advises healers to meet their patients as equals, "to take down as many barriers as they can, give away as many distancing privileges as possible."     

Women,conflict, and culture in former Yugoslavia

The civil war in the former Yugoslavia has taken a toll on the women's movement which has disintegrated across male-defined nationalist borders. The women's movement in this area got its start during the Second World War but was disbanded under communism until women's groups began to form in the 1970s. Today the women's movement has lost the power to oppose the war and has been unable to prevent widespread violence perpetuated against women. Some feminists who have refused to embrace nationalism and patriotism have been vilified and have had to seek refuge abroad. Recently, however, hundreds of nongovernmental organizations have been formed to provide support to women and children victimized by the war. Women have been raped and impregnated as a strategy of male warfare, and raped women who refused an abortion were ostracized. War-related rape has yet to be fully recognized as an international human rights violation, and the issue is being used as political propaganda in the former Yugoslavia while it is ignored elsewhere. Sensationalist reporting of these rapes has further victimized women and made them unable to give voice to their trauma. War also increases women's suffering by destroying economic and social welfare systems. Oxfam is helping women record their testimonies of war and reconstruct the fabric of their societies through programs which provide income-generation and training in micro-enterprises. In addition, Oxfam is strengthening electronic communication and networking among women's groups throughout the region.     

A hospital protocol to resolve complaints against staff physicians

Complaints of discrimination or harassment in the workplace have become almost commonplace in recent years, increasing in both frequency and variety. In the hospital setting, this trend is manifested in allegations against members of the medical staff by hospital employees as well as by patients or their families. Whether real or fancied, such allegations are reflective of a potentially disruptive undercurrent of organizational tensions. Left unresolved, they can erode the essential partnership between staff physicians and other members of the health care delivery team. Unsatisfactory patient experiences may also damage the reputation of the institution and thereby undermine its viability. With either group of complainants, allegations of malfeasance that are not resolved at the source in a timely manner are far more likely to result in expensive, time-consuming, and potentially damaging litigation.     

《新西兰文化与认同感·序言》

《新西兰文化与认同感·序言》大卫·诺维茨比尔·威尔莫特著涂开益徐永安译编选本书的初衷,源出编者在讨论新西兰民族认同感与文化的基本命题时,对于人们所持方式的关注。我们俩人一致认为,当时的争论有两点失之偏颇：一是如何准确理解被称之为文化的这种奇特现象,二...     

Physician glut. Physicians--the next victims of "downsizing?"

Should physicians really be polishing up their CVs or preparing to enter another line of work? In a word: No. What a recent survey makes clear is that, while managed care is driving physicians from some markets, jobs are still available in other markets traditionally underserved by physicians. This is not to suggest that the physician employment market has gone unchanged. Many physicians, particularly specialists, have taken income hits, and some specialists truly are in need of work. Primary care physicians, however, have seen their stars rise and are now in a position to work wherever they want. Physicians may no longer be able to practice within 50 miles of where they were raised or where they were trained, as has been their wont. Instead, they will have to do what other professionals have long done--go where job opportunities take them. In short, they will have to add a career strategy to their scientific mindset, and that means an aggressive job search, coupled with a strong consumer orientation.     

Matching anonymous pre-posttests using subject-generated information

Sensitive research issues call for anonymous questionnaires. This makes accurately matching pretests with posttests difficult or impossible. Various subject-generated coding schemes have been developed, but their accuracy has been unknown. This anonymous study, with 745 students, used subject-generated coding to match pretests with posttests. The matching was verified for accuracy with the use of a collateral, anonymous, sticker identification system. The coding system was able to accurately match 75.2% of all the pretest-posttest pairs. An additional 22.1% of the pairs were left unmatched and only 2.7% were matched incorrectly. Subject-generated coding systems can be very effective where confidentiality is important to protect.     

Coming out

Self-knowledge is the beginning of integrity, of coming out of the closet, and is a prerequisite for dealing well with change. Integrity is not just about not lying. Integrity means as on the inside, so on the outside. The Latin roots of integrity refer to touch. To have integrity is to be untouched, undivided, whole, integrated, integral. There is a tight relationship between integrity and the ability to change, because integrity is about knowing yourself, about being transparent. Integrity allows you to move with tremendous speed when the time comes to move. An organization that wants to learn to dance with change must come to know itself and its environment thoroughly. To do this, it must make use of all the knowledge of every member--and all of their learning capability. It must be built into the culture that new information and different points of view are powerful, are welcomed.     

Health care futures. Part 2: The future of physician executives? Panel discussion

What is the future of health care in America? This is Part 2 of The Physician Executive panel discussion that explores the future of health care in America. To narrow this ambitious focus somewhat, the future is defined as five to 10 years hence. In Part 1, which was published in the May/June issue, Russell C. Coile, Jr., Barbara LeTourneau, MD, MBA, FACPE, James Reinertsen, MD, Uwe Reinhardt, PhD, Marshall Ruffin, MD, MPH, MBA, FACPE, and David Vogel, MS, shared their opinions about what the future holds in managed care, information technology, and biotechnology. In Part 2, Susan Cejka, Barbara LeTourneau, MD, MBA, FACPE, John Henry Pfifferling, PhD, Uwe Reinhardt, PhD, and James Todd, MD, share their views on the future of medical education and physician executives.