Enrich marital inventory: a discriminant validity and cross-validation assessment

To assess the validity and clinical utility of the marital inventory ENRICH, a discriminant validity study was conducted using a national sample of 5039 married couples. The sample was randomly split in order to form a cross-validation group. ENRICH is a multidimensional scale and two types of analysis were conducted to assess the value of these various scales. Results from discriminant analysis indicated that using either the individual scores or couples' scores, happily married couples could be discriminated from unhappily married couples with 85–95% accuracy. These results were cross-validated with a second sample. Using regression analysis, it was clearly demonstrated that background factors account for little of the variance in discriminating happy from unhappily married couples compared to their relationship dynamics, i.e., scale scores. All ENRICH scales except equalitarian roles proved significant, indicating the validity of a multidimensional inventory.     

You have the job you wanted--now what?

We've had calls from physicians who finally have the medical management job they always wanted and then a month later they wondered why they wanted it. I asked seven physician executives to come together as a group and talk to me about this issue. I also asked them what skills they needed most when they first got the job and, as time passed, which skills continued to be most useful. I have not used their names because they were open enough to talk about some very sensitive issues.     

Organizational effectiveness. Primary care and the congruence model

The congruence model is a framework used to analyze organizational strengths and weaknesses and pinpoint specific areas for improving effectiveness. This article provides an overview of organizations as open systems, with examples in the primary care arena. It explains and applies the congruence model in the context of primary care issues and functions, including methods by which the model can be used to diagnose organizational problems and generate solutions. Changes needed in primary care due to the managed care environment, and areas of potential problems and sensitivities requiring organizational changes to meet market and regulatory demands now placed on PCOs are examined.     

Organizational politics: did you hear?

How do you define organizational politics? The underground system of communication, the grapevine, what's really going on in the organization, rumors, knowing who really has the power? However you define it, all sources agree you'd better not ignore it. According to one physician executive: "Organizational politics is how things really get done, who really has the power, how decisions get made. Things are not always what they appear to be on the organizational chart." Presented here are some thoughts about organizational politics from physician executives and their stories of when it helped or hurt their careers or prevented them from accomplishing something in their organizations.     

Interviewing from the organization's perspective

Hiring medical professionals is an expensive process. It is important to conduct an effective interview to help you determine the qualifications of a candidate and to persuade the candidate to join your organization if that's what you decide you want.     

Manipulating motivating operations to facilitate the emergence of mands for a child with autism

Research on the functional independence of verbal operants (Skinner, 1957) has demonstrated inconsistent findings. One explanation may be that these studies have not manipulated the motivating operation (MO) to facilitate the emergence of mands (Hall & Sundberg, 1987; Lamarre & Holland, 1985). In the current study, 1 participant, diagnosed with autism, was taught to tact high-preference and low-preference leisure items, and emergence of mands was tested under varying MO conditions. Results showed the emergence of mands following periods of arranged deprivation, and greater maintenance for a highly preferred relative to a less preferred stimulus. However, mands only emerged when presession tact trials were conducted. These results suggest that in a state of deprivation, transfer of stimulus control from discriminative to motivational conditions may occur without direct training.     

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.