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The paper aims to analyse how the medical profession, the pro‐competition organisation, and the rural community have responded to the rural doctor shortage with reference to international medical graduates (IMGs) as reported in Australian newspapers.

Utilising the commercially available database LexisNexis during 2003, the author keyed in “overseas trained doctors” and retrieved 641 Australian newspaper articles. The qualitative data analysis software NVivo2 has assisted the author to organise the data, informed by critical realism and narrative analysis.

While the medical profession is undoubtedly committed to serving the health needs of the Australian public, the medical community is less than united in addressing the rural doctor shortage, especially through the employment of large numbers of IMGs. The handling of IMGs has led to tensions not only between the locally trained and IMGs, but also between rural and non‐rural doctors, and between younger and established doctors. The medical professional institutions seemed relatively detached from the adverse consequences of the shortage of doctors in the rural community. This contrasts the efforts demonstrated by the Rural Doctors Association and the rural community.

This paper concludes with a critical realist and narrative analysis and resolving of the rural doctor shortage and recommends close communication and consultation among the diverse interest groups rather than their engaging in blaming one another. This would be an obvious starting point to address the rural doctor shortage, which may partly be achieved by the effective use of services by IMGs.

Euthanasia and assisted suicide is about changing the law to enable doctors, under certain circumstances, to intentionally kill patients. For proponents the issues have been determining what are “appropriate circumstances” for such activity and gathering up enough political support to win the day on numbers. The community and medical profession have been exposed to years of misinformation about euthanasia, and advocates have become so vocal that contrary positions are now barely heard. Nevertheless, there are enormous adverse implications for all healthcare professionals. Clinical management in the twenty-first century has moved well past scenarios painted to justify killing the patient. The inclusion of killing in the therapeutic armamentarium will cause an inexorable erosion of what is at present an absolute protection for the patient, the doctor, and other healthcare professionals.

Visit time is a crucial aspect of patient–physician interaction; its inadequacy can negatively impact the efficiency of treatment and diagnosis. In addition, visit time is a fundamental demand of patients, and it is one of the rights of every patient. The purpose of this paper is to determine factors influencing the consultation length of physicians and to compare consultation length in different countries.

MEDLINE (PubMed), Web of Science, Cochrane, ProQuest, Scopus, and Google Scholar were searched. In addition, references of references were checked, and publication lists of individual scholars in the field were examined. We used data sources up to June 2018, without language restriction. We used a random-effects model for the meta-analyses. Meta-analyses were conducted using Comprehensive Meta-Analysis Version (CMA) 3.0.

Of 16,911 identified studies, 189 studies were assessed of which 125 cases (67 percent) have been conducted in the USA. A total of 189 studies, 164 (86.77 percent) involved face-to face-consultations. The effects of three variables, physician gender, patient gender, and type of consultation were analyzed. According to moderate and strong evidence studies, no significant difference was found in the consultation lengths of female and male doctors (Q=42.72, df=8, I²=81.27, p=0.891) and patients’ gender (Q=55.98, df=11, I²=80.35, p=0.314). In addition, no significant difference was found in the telemedicine or face-to-face visits (Q=41.25, df=5, I²=87.88, p=0.170).

In this systematic review and meta-analysis, all of physicians’ visits in 34 countries were surveyed. The evidence suggests that specified variables do not influence the length of consultations. Good relationship is essential to a safe and high-quality consultation and referral process. A high-quality consultation can improve decisions and quality of visits, treatment effectiveness, efficiency of service, quality of care, patient safety and physician and patient satisfaction.

The impact of bullying and undermining behaviours on the National Health Service on costs, patient safety and retention of staff was well understood even before the Illing report, published in 2013, that reviewed the efficacy of training interventions designed to reduce bullying and harassment in the outputs. The purpose of this paper is to provide an example of a good programme well evaluated.

The methodology follows a broad realist approach, by specifying the underlying programme assumptions and intention of the designers. Three months after the event, Q-sort methodology was employed to group participants into one of three contexts – mechanism – output groups. Interviews were then undertaken with members of two of these groups, to evaluate how the programme had influenced each.

Q-sort identified a typology of three beneficiaries from the Stopit! workshops, characterised as professionals, colleagues and victims. Each group had acted upon different parts of the programme, depending chiefly upon their current and past experiences of bullying in hospitals.

The paper demonstrates the effectiveness of using Q-sort method to identify relevant CMOs in a realist evaluation framework.

The paper considers the effectiveness of the programme to reduce bullying, rather than teach victims to cope, and how it may be strengthened based upon the research findings and Illing recommendations.

Workplace bullying is invariably implicated in scandals concerning poor hospital practice, poor patient outcomes and staff illness. All too frequently, the sector responds by offering training in resilience, which though helpful, places the onus on the victim to cope rather than the employer to reduce or eliminate the practice. This paper documents and evaluates an attempt to change workplace practices to directly address bullying and undermining.

The paper describes a new programme broadly consistent with Illing report endorsements. Second, it illustrates a novel evaluation method that highlights rigorously the contexts, mechanisms and outcomes at the pilot stage of an intervention identifies contexts and mechanisms via factor analysis using Q-sort methodology.

The purpose of the paper is to examine the levels of job satisfaction among doctors who work in Greek public hospitals, to determine the factors that may influence their satisfaction, to examine the contribution that staff support makes to job satisfaction and to investigate the potential impact that an economic recession might have on job satisfaction.

The sampling process used was stratified sampling and it was applied to all health regions in Greece. An official request to carry out the study was sent to 45 hospitals for the approval of their management. Through random sampling, 5% of the doctors' population was selected from each participating hospital, with the resulting sample consisting of 458 doctors from all the health regions of Greece. An anonymous questionnaire was administered to the sample of medical doctors to gather data on their perception of the work they do in public hospitals.

Empirical results showed that (1) the most important factor in doctors' job satisfaction appears to be the nature of their job and the high levels of autonomy that they have, and (2) doctors' level of commitment is maintained by enhancing their positive emotions and sense of professional well-being.

A deeper understanding of important concepts of an organization's behavior such as job satisfaction, staff support and their connection with internal organizational structures will facilitate policy makers and those who make decisions on the strategic management of medical staff in public hospitals.

This paper aims to compare anticoagulant management in secondary care for the year prior to the introduction of near‐patient testing in a general practice, and in the subsequent year after it was introduced.

This paper is a retrospective, paired before‐after study. Details of test results in the two‐year‐long periods on the 46 patients who met the inclusion criteria were collected and analysed pairwise.

Despite an increase in the frequency of testing this set of patients were controlled as well in general practice as they had been with a secondary‐care service, and better that in a number of studies in the literature.

This research reviews a recently introduced service at a single centre. Further research of patient satisfaction and adverse events in a multi‐centre longer‐term trial are desirable.

Technology now allows the increasing amount of individuals on anticoagualtion to be controlled with near‐patient testing in general practice. This study shows that satisfactory control can be maintained in patients who transfer from a secondary care‐based to a primary care‐based service.

This paper demonstrates that a single general practice can provide a high quality anticoagulant service using near‐patient testing and computer‐based decision support. This adds to the already available evidence and will hopefully encourage other practices to adopt the same.

The purpose of this paper is to survey the prevalence of exposure to workplace violence (WPV) including physical violence, verbal abuse, bullying as well as its related factors among physicians and medical students attending teaching hospitals of Kurdistan University of Medical Sciences (KUMS).

This is a descriptive analytic as well as a cross-sectional study which was carried out on all physicians (general and specialists) and medical students attending teaching hospitals of KUMS in 2014. Overall, 400 participated in this study and data were gathered using a standard questionnaire. Then, data were analyzed using SPSS 20, χ² and Fisher’s exact tests as well as univariate and adjusted logistic regression.

The prevalence of physical violence, verbal abuse and bullying among medical students was reported 4.5, 59 and 0.8 percent, respectively. In addition, the prevalence of these violence among general practitioners was 6.9, 72.4 and 0 percent, respectively. Moreover, 11.5, 42.3 and 3.8 percent of specialists had experienced physical violence, verbal abuse and bullying, respectively. Patients and their relatives were the main sources of the violence. Based on the results of multivariate logistic regression, male sex (AOR=2.60, CI: 1.56–4.32) and having shift work (AOR=3.13, CI: 1.67–5.84) were the most significant risk factors for total WPV.

The WPV experienced by physicians and medical students attending teaching hospitals of MUK is high. Health sector authorities should develop and implement proper strategies and interventions aiming at reducing or preventing from incidence of WPV.

The purpose of the research was to develop a tool for measuring antecedents of customer aggressive behavior (CAB) in healthcare service settings, by identifying its roots in organizational and interpersonal dynamics.

Four studies were conducted. In Studies 1 and 2, antecedents of CAB were identified through analysis of internet reader comments and a questionnaire was distributed to students. In Study 3, scenarios were used to validate the findings of the previous studies. Finally, in Study 4, a scale was developed and validated for measuring organization- and person-related triggers of CAB using samples of 477 employees and 579 customers.

The concept of CAB was conceptualized and validated. In total, 18 items were identified across five dimensions: personal characteristics, uncomfortable environment, aggressive role models, reinforcement of aggressive behavior and aversive treatment. The scale demonstrated good psychometric results.

The research relies mainly on customer perspective. Employees and additional stakeholders should be included to achieve more accurate information that could contribute to a better understanding of CAB and its roots.

Exploring social and organizational antecedents that trigger CAB could help healthcare managers evaluate and proactively manage CAB and its implications within their organization.

This measurement scale is the first comprehensive tool, based on Bandura’s social learning theory (1973), that may identify and measure antecedents of CAB, and could be used to reduce CAB in healthcare service settings.