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Book part
Publication date: 30 October 2004

Susan W. Hinze

Drawing upon the 5% Public-Use Microdata Sample (PUMS) from the 1990 and 2000 Censuses (with comparisons to the 1980 Census through the work of Uhlenberg & Cooney, 1990)…

Abstract

Drawing upon the 5% Public-Use Microdata Sample (PUMS) from the 1990 and 2000 Censuses (with comparisons to the 1980 Census through the work of Uhlenberg & Cooney, 1990), this paper examines the changing characteristics of the U.S. young physician labor force (aged 30–49). Currently, over 45% of medical degrees are earned by women, but gendered work-family patterns persist. Measures examined include income, hourly wages, mean work hours, part-time and overtime work, practice setting, marital status, and children. For a sub-sample of physicians married to physicians, I also examine income and work hour differentials. Close attention is paid to whether a marriage premium and/or a motherhood penalty in wages exists and persists over time. Implications of the documented workforce diversity are discussed for organizations within which physicians are employed.

Details

Diversity in the Work Force
Type: Book
ISBN: 978-0-76230-788-3

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Book part
Publication date: 3 November 2005

Eric Mykhalovskiy and Karen Farrell

This paper investigates the informal learning processes through which family physicians develop an understanding of the social context shaping the health of marginalized…

Abstract

This paper investigates the informal learning processes through which family physicians develop an understanding of the social context shaping the health of marginalized patients. The paper is based on the results of a qualitative study, informed by institutional ethnography, involving individual interviews with 10 family physicians working in and around Halifax, Nova Scotia, Canada. The analysis explores what knowledge of social context is for family physicians, emphasizing its hybrid, socio-clinical character. We also explore key aspects of the informal processes through which this knowledge is developed including learning about ‘the other,’ the reflexive unlearning of medical school training, and learning from clinical doing where we discuss patient-based epiphanies and learning from other health care providers.

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Health Care Services, Racial and Ethnic Minorities and Underserved Populations: Patient and Provider Perspectives
Type: Book
ISBN: 978-0-76231-249-8

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Article
Publication date: 12 March 2014

Fern Brunger, Pauline S. Duke and Robyn Kenny

Access to a continuum of care from a family physician is an essential component of health and wellbeing. Refugees have particular barriers to accessing medical care. The…

Abstract

Purpose

Access to a continuum of care from a family physician is an essential component of health and wellbeing. Refugees have particular barriers to accessing medical care. The MUN MED Gateway Project is a medical student initiative in partnership with a refugee settlement agency that provides access to and continuity of health care for new refugees, while offering medical students exposure to cross-cultural health care. This paper aims to report on the first six years of the project.

Design/methodology/approach

Here the paper reports on: client patient uptake and demographics, health concerns identified through the project, and physician uptake and rates of patient-physician matches.

Findings

Results demonstrate that the project integrates refugees into the health care system and facilitates access to medical care. Moreover, it provides learning opportunities for students to practice cross-cultural health care, with high engagement of medical students and high satisfaction by family physicians involved.

Originality/value

Research has shown that student run medical clinics may provide less than optimum care to marginalized patients. Transient staff, lack of continuity of care, and limited budgets are some challenges. The MUN MED Gateway Project is markedly different. It connects patients with the mainstream medical system. In a context of family physician shortage, this student-run clinic project provides access to medical care for newly arrived refugees in a way that is effective, efficient, and sustainable.

Details

International Journal of Migration, Health and Social Care, vol. 10 no. 1
Type: Research Article
ISSN: 1747-9894

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Book part
Publication date: 28 February 2007

Anil Gupta and Kisalaya Basu

Abstract

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Modelling Our Future: Population Ageing, Health and Aged Care
Type: Book
ISBN: 978-1-84950-808-7

Content available
Article
Publication date: 28 June 2019

Sabina Abou Malham, Mélanie-Ann Smithman, Nassera Touati, Astrid Brousselle, Christine Loignon, Carl-Ardy Dubois, Kareen Nour, Antoine Boivin and Mylaine Breton

Centralized waiting lists (CWLs) for patient attachment to a primary care provider have been implemented across Canada, including Quebec. Little is known about the…

Abstract

Purpose

Centralized waiting lists (CWLs) for patient attachment to a primary care provider have been implemented across Canada, including Quebec. Little is known about the implementation of CWLs and the factors that influence implementation outcomes of such primary care innovations. The purpose of this paper is to explain variations in the outcomes of implementation by analyzing the characteristics of CWLs and contextual factors that influence their implementation.

Design/methodology/approach

A multiple qualitative case study was conducted. Four contrasting CWLs were purposefully selected: two relatively high-performing and two relatively low-performing cases with regard to process indicators. Data collected between 2015 and 2016 drew on three sources: 26 semi-structured interviews with key stakeholders, 22 documents and field notes. The Consolidated Framework for Implementation Research was used to identify, through a cross-case comparison of ratings, constructs that distinguish high from low-performing cases.

Findings

Five constructs distinguished high from low-performing cases: three related to the inner setting: network and communications; leadership engagement; available resources; one from innovation characteristics: adaptability with regard to registration, evaluation of priority and attachment to a family physician; and, one associated with process domain: engaging. Other constructs exerted influence on implementation (e.g. outer setting, individual characteristics), but did not distinguish high and low-performing cases.

Originality/value

This is the first in-depth analysis of CWL implementation. Results suggest important factors that might be useful in efforts to continuously improve implementation performance of CWLs and similar innovations.

Details

Journal of Health Organization and Management, vol. 33 no. 5
Type: Research Article
ISSN: 1477-7266

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Book part
Publication date: 30 August 2019

Jennifer McDonald and Claudia Chaufan

To shed light on how gender norms are reproduced in medical training and practice through an exploration of representations of the problem of “work–life balance.” Women…

Abstract

Purpose

To shed light on how gender norms are reproduced in medical training and practice through an exploration of representations of the problem of “work–life balance.” Women physicians and women physician-researchers (WPs/WPRs) in Canada and in the United States experience social and health inequities when compared to their men colleagues. Despite current medical school acceptance parity, upon entering the medical workforce, women work harder than men to succeed within the historically male-dominated structures and value system of the medical profession.

Methodology

We performed a critical discourse analysis of articles retrieved from academic databases and leading Anglo-American journals that discussed “work–life balance,” to investigate how the discourse contributed to, or challenged, the reproduction of gender norms in medicine.

Findings

While the medical literature acknowledges that the social and health inequities experienced by WP/WPR result from discriminatory norms and practices, it neglects to challenge built-in gendered inequities in benchmarks for success in the profession. Instead, proposed solutions require that WP/WPR themselves learn to cope and make better lifestyle choices, including downloading domestic responsibilities on socially disadvantaged – racialized and poor – women. Authors’ gender appears to make no difference.

Research Limitations

Our search was limited to the Anglo-American literature, often retrieved articles inaccessible via our university library, excluded informal venues (e.g., blogs), and did not include cases of same-sex couples or interviews of WP/WPR. All these may have challenged components of our argument by revealing more nuanced debates, occurring under different political, cultural, and economic contexts.

Policy Implications

While individual choices of WP/WPR are important to the protagonists, to successfully address the very real problem of work–life balance experienced by WP/WPR, patriarchal norms should be challenged, failure to comply with these norms should be rejected as explanations for work–life balance challenges, and norms themselves should become the focus of analysis and intervention.

Originality/Value

The medical language used by physicians of both genders normalizes gendered inequities, favoring the success of medical men over women, and reproducing the professional and personal disadvantages experienced by the latter, further burdening socially disadvantaged women.

Details

Underserved and Socially Disadvantaged Groups and Linkages with Health and Health Care Differentials
Type: Book
ISBN: 978-1-83867-055-9

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Article
Publication date: 13 March 2009

Ronald Burke, Mustafa Koyuncu and Lisa Fiksenbaum

The purpose of this paper is to investigate gender differences in work experiences, satisfactions and psychological health among physicians in Turkey.

Abstract

Purpose

The purpose of this paper is to investigate gender differences in work experiences, satisfactions and psychological health among physicians in Turkey.

Design/methodology/approach

Data were collected from 237 male and 194 female physicians using an anonymously completed questionnaire. Measures included personal demographic and work situation characteristics, stable individual difference factors (e.g. workaholism components, Type A behavior, optimism), job behaviors (e.g. perfectionism, hours worked), work and extra‐work satisfactions, indicators of work engagement, and psychological wellbeing.

Findings

There were few differences in personal demographic and work situation characteristics. Female physicians had less professional tenure and worked fewer hours and extra‐hours per week. Female and male physicians were similar on stable individual difference factors, job behaviors, work outcomes, extra‐work satisfactions and psychological wellbeing, with a few exceptions. Female physicians reported more work‐family conflict and more psychosomatic symptoms and tended to be absent more.

Research limitations/implications

Data were collected using self‐report questionnaires raising the possibility of response set tendencies. It is also not clear to what extent these findings generalize to male and female physicians in other countries.

Originality/value

Despite previous studies showing considerable gender differences in the work experiences and wellbeing of female and male physicians in other countries, female and male physicians in Turkey reported generally similar job behaviors, satisfactions, quality of life and emotional wellbeing. This suggests that an emphasis on gender similarities rather than gender differences might be warranted.

Details

Gender in Management: An International Journal, vol. 24 no. 2
Type: Research Article
ISSN: 1754-2413

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Book part
Publication date: 9 November 2006

Laurence B. McCullough

Matthew Wynia and his co-authors and Charmers Clark, in their two chapters, take on thorny issues concerning the moral responsibilities of physicians – and, by…

Abstract

Matthew Wynia and his co-authors and Charmers Clark, in their two chapters, take on thorny issues concerning the moral responsibilities of physicians – and, by implication, all health care professionals – regarding preparation for and response to epidemics (Clark, 2006; Wynia, Kurlander, & Green, 2006). Their chapters are especially timely, inasmuch as they address ethical challenges associated with bioterrorism, which, should it occur, could create an epidemic of catastrophic proportions, at least for the locality or localities in which the bioterrorism occurs. In this commentary, I provide a critical assessment of their chapters. I begin with a review of the foundational concept of the Wynia et al. chapter, social-trustee professionalism, and of the Clark chapter, a covenant of public trust. I then take up four issues: the moral demands of social-trustee professionalism and how the social-contract theory of medical ethics advocated by the framers of the 1847 American Medical Association Code of Ethics (American Medical Association, 1847) should be understood; social-role related obligations as ethically-justified limits on fiduciary responsibility in bioterrorism events and how such obligations should be addressed in a preventive ethics fashion by health care organizations; legitimate self-interests as ethically-justified limits on fiduciary responsibility and how such interests should be distinguished from mere self-interests and be addressed in a preventive ethics fashion by health care organizations; and the nature and limits of the standard of care in the large-scale emergencies that bioterrorism events could create.

Details

Ethics and Epidemics
Type: Book
ISBN: 978-1-84950-412-6

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Article
Publication date: 1 August 2001

Revital Gross, Hava Tabenkin and Shuli Brammli‐Greenberg

Assesses the degree of self‐reported implementation of gatekeeping in clinical practice, and gains insight into primary care physicians’ attitudes toward gatekeeping and…

Abstract

Assesses the degree of self‐reported implementation of gatekeeping in clinical practice, and gains insight into primary care physicians’ attitudes toward gatekeeping and their perceptions of necessary conditions for implementation of gatekeeping in daily practice. A self‐administered questionnaire was mailed to a national sample of 800 primary care physicians in Israel, with a response rate of 86 per cent. Multivariate analysis indicated that sick fund affiliation was the main predictor of self‐reported implementation of gatekeeping, while specialty training predicted primary care physicians’ attitude toward this role. Close communication with specialists, continuous medical education, and management support of physician decisions were identified by respondents as being important conditions for gatekeeping. Discusses strategies to gain the cooperation of primary care physicians, which is necessary for implementing an effective gatekeeping system.

Details

Journal of Management in Medicine, vol. 15 no. 4
Type: Research Article
ISSN: 0268-9235

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Article
Publication date: 1 July 2006

Kent V. Rondeau, Louis H. Francescutti and Garnet E. Cummings

The purpose of this paper is to report on gender differences in emergency physicians with respect to their attitudes, knowledge, and practices concerning health promotion…

Abstract

Purpose

The purpose of this paper is to report on gender differences in emergency physicians with respect to their attitudes, knowledge, and practices concerning health promotion and disease prevention.

Design/methodology/approach

A mail survey of 325 male and 97 female Canadian emergency physicians.

Findings

Results suggest female emergency physicians report having greater knowledge of health promotion topics, spend more time with each of their patients in the emergency setting, and engage in more health promotion counseling in the emergency setting than do their male counterparts.

Originality/value

The paper argues that in the future, educating and socializing emergency physicians, both male and female, in the practice of health promotion will enhance the potential of the emergency department to be a more effective resource for their community.

Details

Journal of Health Organization and Management, vol. 20 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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