Physician leadership. How do physician executives view themselves?

Most physician executives today have acquired substantial management training and experience, and many have worked with and relied on the expertise of mentors for their career guidance and development. Physician executives are actually becoming executives who happen to be physicians. They view themselves first as leaders, then as physicians, and finally as managers. That is a remarkable transformation in perception. To chronicle this process, Witt/Kieffer, Ford, Hadelman & Lloyd conducted a national survey this spring among senior physician executives in both payer and provider organizations. The data provide a "snapshot" of their role, and may also suggest some future scenarios for the industry. The primary reasons for choosing to pursue a management role noted by most participants include a desire to be part of the health care solution and an interest in management and leadership challenges.     

Getting started as a physician executive

In clinical practice, technical skills often outweigh interpersonal and leadership skills as success factors--you can be a great doctor and a so-so person. But the reverse seems to be true in the physician executive role; it is precisely the intangible leadership skills that contribute to and determine potential success. And they can be tough to master, especially when you focus on them for the first time, partway through an already-successful career. Practicing leadership is like practicing medicine. It's not just a matter of learning some new things--if it were only that, physicians are known to be excellent learners. Nor is it just a matter of determination or application--this is not a battle that sweat and effort alone can win. Most physicians will want to "try on" the executive role before making strategic moves in that direction. But be clear about what you want to get out of any project or activity before you jump in. If you're seeking a management degree, the best approach is to tie together developing your technical and interpersonal skills, as well as the formal credentials.     

A Comparison of Trans Women,Trans Men,Genderqueer Individuals,and Cisgender Brothers and Sisters on the Bem Sex-Role Inventory: Ratings by Self and Siblings

A U.S. national sample of 295 transgender adults (trans women, trans men, and genderqueer individuals) and their cisgender siblings completed the Bem Sex-Role Inventory about their siblings as well as themselves, which enabled a comparison between self-perceptions and sibling’s perceptions of personality characteristics. Self-reported personality characteristics scored as feminine of trans women were not statistically different from those of their cisgender sisters, but they were significantly higher than self-reported femininity scores of trans men, genderqueer individuals, and cisgender brothers. Self-reported personality characteristics scored as masculine of trans men did not differ significantly from those of their cisgender brothers, but they were higher than those of trans women. Trans men and cisgender brothers were viewed by their siblings in a more sex-typed way than they rated themselves, whereas trans women and cisgender sisters were rated by their siblings in a less sex-typed way than they viewed themselves.     

Multiple Choice Knapsack Problem: Example of planning choice in transportation

Transportation programming, a process of selecting projects for funding given budget and other constraints, is becoming more complex as a result of new federal laws, local planning regulations, and increased public involvement. This article describes the use of an integer programming tool, Multiple Choice Knapsack Problem (MCKP), to provide optimal solutions to transportation programming problems in cases where alternative versions of projects are under consideration. In this paper, optimization methods for use in the transportation programming process are compared and then the process of building and solving the optimization problems is discussed. The concepts about the use of MCKP are presented and a real-world transportation programming example at various budget levels is provided. This article illustrates how the use of MCKP addresses the modern complexities and provides timely solutions in transportation programming practice. While the article uses transportation programming as a case study, MCKP can be useful in other fields where a similar decision among a subset of the alternatives is required.     

Coaching Family Caregivers to Become Better Problem Solvers When Caring for Persons with Advanced Cancer

Family caregivers of persons with advanced cancer often take on responsibilities that present daunting and complex problems. Serious problems that go unresolved may be burdensome and result in negative outcomes for caregivers’ psychological and physical health and affect the quality of care delivered to the care recipients with cancer, especially at the end of life. Formal problem-solving training approaches have been developed over the past several decades to assist individuals with managing problems faced in daily life. Several of these problem-solving principles and techniques were incorporated into ENABLE (Educate, Nurture, Advise, Before Life End), an “early” palliative care telehealth intervention for individuals diagnosed with advanced cancer and their family caregivers. A hypothetical case resembling the situations of actual caregiver participants in ENABLE that exemplifies the complex problems that caregivers face is presented, followed by presentation of an overview of ENABLE’s problem-solving key principles, techniques, and steps in problem-solving support. Though more research is needed to formally test the use of problem-solving support in social work practice, social workers can easily incorporate these techniques into everyday practice.     

Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex

Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood “safer sex,” the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.     

An application of graph theory to a computer storage problem in residual analysis

The r test procedure for adequacy of the multiple regression model is extended for moderate sample sizes by approximating the moments of the distribution of the test statistic with those of the distribution of the Durbin and Watson (1950) upper-bounding variable. The computation of these moments is simplified by the application of some elementary graph theory. Recommendations con-cerning the selection of near-neighbor pairs are suggested in order to reduce computer storage and execution time.     

Post‐secondary transitions of youth emancipated from foster care

This study investigated the extent to which KnowHow2Go (KH2Go), a national college access campaign developed for first‐generation students in the USA, would resonate with youth who had aged out of foster care. Interviews were conducted with 27 youth who were enrolled in a post‐secondary programme following emancipation from foster care. We found KH2Go to have a close fit with the experiences of youth who had been in foster care. Four topics emerged as particularly important for youth in our study: money management, work, parenting and transportation. Finally, the study identified attributes these youth demonstrated that contributed to their resilience during the transition process. This study and the data presented pertain to youth living in the south‐eastern USA.