Thriving in change

The turbulent state of health care and the rapid changes that show no sign of abating point to many career-related challenges for physician executives. How can you predict the impact of these changes on your career? What measures can be taken to prevent any negative impact of change? And how can you prevail when dealt a negative blow like job loss? The signs that foreshadow the unraveling of a physician executive's career are described. The warning signs are: Not keeping up with change, losing your influence; getting negative feedback; turning your "concerns" into complaints; the economy working against you; and being blindsided because we think leaders operate logically. Being proactive puts more control in your hands and leaves less to chance. You can prevent being blindsided if you: develop your people skills; get comfortable and involved with e-business; stay abreast of health care trends; pick up the pace; and develop "You, Inc." There is a final component to prevailing over adverse circumstances--find your work-related passion and apply it to your career.     

Are you ready for generation X?

Generational analysis considers the differences in world view and attitude between various generations of Americans and uses this information to develop insight and business strategies. The much discussed generation gap between the Baby Boomers and their elders during the 1960s and 1970s is equaled or exceeded by the differences between Generations X and Y and the Boomers. Generation X physicians will be coming into practice over the next two decades. Successful medical leaders must understand Gen-Xers to create clinical environments that meet their unique needs and concerns. This article describes some of the philosophical and attitudinal differences between the generations and what these differences may mean to the future of medicine and health care organizations.     

Hired, fired, and not retired: an interview with a physician executive who has run the career gauntlet. Interview by Richard L. Reece

Richard L. Reece, MD, interviewed Robert J. Hudson, MD, on April 24, 2000 to discuss his experiences as a physician executive who has made the career transition from practicing physician to managed care executive to biotech entrepreneur. Along the way, he's hired and fired others, and been fired himself. Painful as it is, many physician executives' career realities include being fired. Organizations, after all, are living organizations--they grow, wither, and molt. And as they molt, organizations shed and regrow new skin. What do physician executives do when they've been fired? They go through their own cycle and retreat, reflect, and re-emerge, often reinventing themselves as they go. An essential part of this process is looking within to plumb likes and dislikes, strengths and weaknesses, nightmares and dreams, and positive and negative experiences. For most executives, out of these experiences has come a circle of friends and a Rolodex. Start by reaching out to the circle, by going through your Rolodex, and you can broadcast the news of your rebirth.     

Measuring living standards with proxy variables

Very few demographic surveys in developing countries have gathered information on household incomes or consumption expenditures. Researchers interested in living standards therefore have had little alternative but to rely on simple proxy indicators. The properties of these proxies have not been analyzed systematically. We ask what hypotheses can be tested using proxies, and compare these indicators with consumption expenditures per adult, our preferred measure of living standards. We find that the proxies employed in much demographic research are very weak predictors of consumption per adult. Nevertheless, hypothesis tests based on proxies are likely to be powerful enough to warrant consideration.     

Effectiveness of an educational intervention to increase knowledge and reduce use of risky behaviors associated with cumulative trauma in office workers

OBJECTIVE: This pilot project assessed the effectiveness of an intervention to increase knowledge and reduce risky behaviors related to cumulative trauma disorders (CTD) in office workers. STUDY DESIGN: All 124 employees from the administrative offices of a health maintenance organization were invited to participate. Subjects were followed across time using an identification number. Data were collected via questionnaire in June 1994 (pretest1) (N=84), August 1994 (pretest II) (N= 63) and September 1995 (posttest) (N=40). The yearlong intervention focused on functional activities to prevent CTD. RESULTS: of chi-square analyses for the 40 subjects who completed all surveys indicated this intervention significantly increased overall knowledge of CTD (p =.002). Significant changes in self-reported hand/wrist (p =.016) and neck/shoulder (p =.003) posture were also found. CONCLUSIONS: This study is a first step in identifying effective educational interventions to increase knowledge and reduce risk factors related to CTD in office workers.     

Urban forest cover of the Chicago region and its relation to household density and income

Urban forests and herbaceous open space play a vital role in the environmental and aesthetic health of cities, yet they are rarely identified in land-use inventories of urban areas. To provide information on urban forests and other vegetative land cover in Illinois cities, Landsat Thematic Mapper (TM) data from June 27, 1988, were classified for the Chicago metropolitan region (9,717 km²). Ten land-cover classes were identified, including two types of forestland (occupying 5.8% of the total area), residential land with trees (14.6%) or without trees (7.8%), cropland (37.5%), two types of grassland (7.7%), urban with impervious surfaces (23.1%), water (1.6%), and miscellaneous vegetation (2.1%). Correlation analyses indicated that household income and household density are strongly related to land covers in the region, particularly those with tree cover and urbanized land. Population changes for 1980–1985 and 1985–2010 (projected) show a pattern of increasing density in the urbanized zone concurrent with continued urban sprawl, primarily into current cropland.     

Effects of societal intergration, period, region, and culture of suicide on male age-specific suicide rates: 20 developed countries, 1955-1989

Multiple indicators of societal integration and proxies for the culture of suicide form the model used to explain variation in male age-specific suicide rates from 1955 to 1989 in 20 developed countries. The hypothesis that certain determinants of suicide rates have changed over the period between 1955 and 1989 was rejected, as was the hypothesis that there are effects of period, net of measured predictors. The determinants of suicide rates do vary by age, with the culture of suicide playing an especially important role in the 35-64 age group.     

Codes of ethics and firm size: A stakeholder approach to strategic planning

A firm's capital budgeting and strategic planning decisions have the potential to affect many groups of people called stakeholders. A stakeholder is any group or individual who can affect or is affected by the achievement of the firm's objectives. This study examines whether the presence of a code of ethics that specifically addresses capital budgeting/strategic planning decisions will significantly raise the awareness of social responsibility during the long-run planning process. This study also examines whether firm size is associated with the awareness of social responsibility during the long-run planning process. Support was found that a code of ethics that addresses long-range planning is associated with higher awareness during the planning process. Firm size was not found to be statistically different.     

What Determines Trust in Information About Food-Related Risks? Underlying Psychological Constructs

Trust in risk information about food related-hazards may be an important determinant of public reactions to risk information. One of the central questions addressed by the risk communication literature is why some individuals and organizations are trusted as sources of risk information and others are not. Industry and government often lack public trust, whereas other sources (for example, consumer organizations, the quality media, medical doctors) are highly trusted. Problematically, previous surveys and questionnaire studies have utilized questions generated by the investigators themselves to assess public perceptions of trust in different sources. Furthermore, no account of the hazard domain was made. In the first study reported here, semistructured interviewing was used to elicit underpinning constructs determining trust and distrust in different sources providing food-related risk information ( n = 35). In the second study, the repertory grid method was used to elicit the terminology that respondents use to distinguish between different potential food-related information sources ( n = 35), the data being submitted to generalised Procrustes analysis. The results of the two studies were combined and validated in survey research ( n = 888) where factor analysis indicated that knowledge in itself does not lead to trust, but that trusted sources are seen to be characterised by multiple positive attributes. Contrary to previous research, complete freedom does not lead to trust—rather sources which possess moderate accountability are seen to be the most trusted.