U.K. competition policy evaluated

This paper surveys the application of U.K. monopoly policy and examines its general impact on industrial structure and market processes. It considers the effects of the Competition Act 1980 in relation to U.K. monopoly control and concludes that unless further measures are introduced, competitive pressures are likely to be weakened over the longer term.     

Museums, friends, and lovers in the New South: Laura's Web, 1909-1931

Laura Bragg, a member of the first graduating class at Simmons College, journeyed to Charleston as a New Woman in 1909. As the first woman director of a major scientific museum in the United States, Bragg transformed the Charleston Museum into a public education institution and became an innovative leader in museum education. This article documents Bragg's contributions within the context of antebellum culture where the Southern Belle was placed on a Victorian pedestal and Boston marriages were an unknown phenomenon. Using extensive and hitherto unpublished correspondence, the authors detail Bragg's lesbian relationships and describe her network within the homosexual male community during the era of the Charleston Renaissance.     

Wife killing: risk to women as a function of age

Younger women, relative to older women, incur elevated risk of uxoricide-being murdered by their husbands. Some evolutionary theorists attribute this pattern to men's evolved sexual proprietariness, which inclines them to use violence to control women, especially those high in reproductive value. Other evolutionary theorists propose an evolved homicide module for wife killing. An alternative to both explanations is that young women experience elevated uxoricide risk as an incidental byproduct of marriage to younger men who commit the majority of acts of violence. We used a sample of 13,670 uxoricides to test these alternative explanations. Findings show that (a) reproductive-age women incur an elevated risk of uxoricide relative to older women; (b) younger men are overrepresented among uxoricide perpetrators; and (c) younger women, even when married to older men, still incur excess risk of uxoricide. Discussion examines competing explanations for uxoricide in light of these findings.     

Aggressive behavior among women sexually abused as children

Although research shows that sexually abused children appear to be at risk of subsequent aggressive behavior, few investigations address whether such behavior persists beyond childhood. This research describes the self-reported adolescent and adult fighting behavior of 136 women sexually abused as children and examines the role of intervening variables in the risk of such behavior. The women are part of a longitudinal study of 206 primarily low-income, urban women whose abuse was documented at the time it occurred. Fighting was common, particularly during adolescence. Adult aggression was strongly associated with being a victim of violence by an intimate partner. A history of exposure to other forms of violence significantly increased the risk of fighting while strong maternal attachments mitigated the risk, primarily by reducing the likelihood of involvement in an abusive intimate relationship.     

Don't fix it

Next to doing nothing, fixing a problem is often the worst thing you could do with it. Fix a problem but miss the context, and you still have the problem--only it's bigger, it's weirder, it costs more, and everybody's grumpy. When something comes at you with a "problem" label, use it as an opportunity to connect things up, to explore, to ask the bigger questions, to find the new possibilities. When we react to a problem, we put ourselves into a dilemma. To find fruitful and creative solutions, we need to be in a place of choice, with many possibilities. Real participation--giving people real choice--is the only way you can bring people's intelligence and life experiences to bear on the situation at hand.     

Navigating the job search superhighway

The recent Cyberforum on "Navigating the Job Search Superhighway" gave 131 American College of Physician Executive members the opportunity to discuss the job search process, addressing questions and sharing what they've learned through their experiences in the medical management job market. Several comments that convey the essence of the discussion are listed, representing the various viewpoints of the participants. The words are from physician executives who have gone through the job search process and from some who have been involved in hiring decisions. The topics range from the value of experience to the importance of having a management degree to tips on networking to preparing for the interview. The final section on contract negotiation is a composite of comments on the subject during the Cyberforum.     

A new industrial order for physicians: a talk with Jeff C. Goldsmith, PhD. Interview by Richard L. Reece

Richard L. Reece, MD, interviewed Jeff C. Goldsmith, PhD, President of Health Futures, Inc. on October 12, 1999 to discuss how the Internet will affect health care delivery in the millennium. One of the most profound changes that he sees is how the relationship between physicians and patients will be altered. Empowered consumers are where the real revolution is happening--a trend sometimes overlooked by physicians. Goldsmith says, "The key thing physicians have missed is that the patient is in charge of the process.... The Internet has enabled patients to aggregate their collective experience across disease entities." But there is too much information. "It is almost universally acknowledged by patients and physicians that there is a terrible quality problem. Getting from information to knowledge is a huge commercial opportunity for somebody." He doesn't think that people have put enough emphasis on the collective learning part of this new technology.     

Believing is seeing

Useful, well-demonstrated, well-vetted ideas in clinical practice, disease management, health care management, ideas that would save lives, save money, and make life better for the patient, are sometimes simply ignored, dismissed as radical, as completely unfounded, dangerous, and without merit. Why are new ideas so slow to spread in medicine and health care? Because believing is seeing. We do not look for something we don't believe in. In fact, we do not even see a thing if we don't believe in it. We have dedicated ourselves so powerfully to medicine, to health care as we know it, that we often do not even see any alternatives. A combination of factors makes it likely that, in the coming decade or two, we will change almost everything that is fundamental about health care and medicine. In a time of such rapid change, we desperately need to root out and question our deep assumptions and beliefs, to get off the tracks laid down by training and experience and ask questions we have never asked before.