Clinical program renovation management

The day-to-day management of medical practice is so heavily influenced by tactical imperatives that few physicians have the time to think strategically. Traditionally, the difference between tactics and strategy is not a major concern of most physician executives. The realm of tactics is the short run, when managers must make do with the fixed resources at hand. Strategy addresses the long run, when all resources and markets are variable. A tactical focus is understandable, maybe even acceptable, in industries where nothing challenges traditional approaches to production of an established product or service. However, medical care in the 1990s is changing so fast that a physician executive must devote an incredible amount of time and effort just to stay confused about what is going on.     

Introduction

In the introduction to this special issue on temporary worker programs, the author defines the term temporary worker and reviews worldwide research, writings, and policies to date pertaining to temporary workers. Labor market and economic effects, socio-administrative conditions, and effects on the labor-sending societies are discussed. Noting that mutually exclusive arguments are presented within one issue of the journal, the author introduces the authors of the individual articles and their subjects. It is determined that the temporary worker phenomenon is now global and that having an understanding of these workers is increasingly central to understanding key socioeconomic and political processes affecting modern industrial and nonindustrial societies.     

Aspects of occupational mobility and attainment among immigrants in Australia

The occupational distributions of the native-born and foreign-born in the Australian labor market differ greatly. The disparity between the occupational distributions is greatest among the middle age-bracket, and among immigrants from Eastern Europe and the Mediterranean region. Analysis of occupational attainment using unit record data from the 1981 Census shows that as duration of residence in Australia lengthens, the occupational distribution of the overseas-born converges toward that of the Australian-born. Moreover, birthplace groups differ in the degree of upward mobility associated with length of residence in Australia: immigrants from non-English-speaking countries tend to make greater occupational advances than their counterpart from English-speaking countries. This suggests a higher degree of international transferability of human capital skills among immigrants from English-speaking countries. The analysis also highlights the concentration of immigrants from non-English speaking countries in low-ranked occupations, and the relatively minor influence of education on the occupational attainment of immigrants from these birth place regions.     

Community,Family, and Race/Ethnic Differences in Health Status in Rural Areas1

Abstract Many race-specific differences in health outcomes that have been observed in previous research have been attributed to class and racebased group differences which either facilitate or constrain health opportunities and behaviors. These include such variables as different rates of poverty, health insurance coverage, and access to medical care. However, these relationships have been inadequately examined in rural communities where minority status may be even more detrimental to health than in urban areas, due to various constraints on access to health care. We present an analysis that assesses the effects of community, family structure, sociodemographic, and medical care variables on self-reported health status among Hispanics, Mrican Americans, and non-Hispanic whites in six rural communities in Florida. Community structural characteristics had a significant effect on self-reported health, as did some of the measures of how respondents “experience” community. These relationships held even when other sets of variables were added to the models. Family/household characteristics and sociodemographic and medical care variables were less important in explaining self-reported health status. These findings suggest that community continues to be important in explaining differences in health status in rural areas.     

Cohort size effects and migration

"This article explores whether changes in the size of [U.S.] cohorts entering the labor force affect the propensity to migrate and the socioeconomic circumstances of migrants at destination. The flow of young in-migrants to large SMSAs declined during the 1965-76 period, but the relative socioeconomic standing of migrants at destination was unaffected by either cohort size or regional differentials in economic growth. It is suggested that a significant reduction in the volume of migration among members of the baby boom cohort was the primary adjustment mechanism, hence reducing the need for degrading the opportunities available to migrants."     

An innovative approach to selecting an executive director

As a guide for how to select a new executive director, a family agency adopted the search committee process from higher education. The approach included clarifying agency goals and the director's qualifications, a board-staff screening, and interviews held jointly with public representatives before final board selection.