Search results

1 – 10 of over 67000
To view the access options for this content please click here
Article
Publication date: 1 April 1993

Brenda Leese, Paul Kind, Ian Cameron and Jennie Carpenter

A postal questionnaire was successfully used to determine generalpractitioner views about the quality of the health care servicesavailable to their patients. In the case…

Abstract

A postal questionnaire was successfully used to determine general practitioner views about the quality of the health care services available to their patients. In the case of hospital services, 75 of the 112 respondents (67 per cent) chose orthopaedics and 52 (46 per cent) chose ophthalmology as services in need of improvement. Other hospital‐based services, chosen by at least ten general practitioners, were gynaecology, gastroenterology/endoscopy, medicine for the elderly, radiology/ultrasound, psychiatry and physiotherapy. Only 74 general practitioners chose community services, with health visiting being chosen by 25 respondents, district nursing by 24, physiotherapy by 20 and chiropody by 18, as being in need of improvement. The survey was intended to provide a basis for a dialogue between clinicians, managers and general practitioners, about how the quality of services could be improved and how they might be developed in the future.

Details

Journal of Management in Medicine, vol. 7 no. 4
Type: Research Article
ISSN: 0268-9235

Keywords

To view the access options for this content please click here
Article
Publication date: 1 June 2001

Roger Paxton, Fiona MacDonald, Rory Allott, Peter Mitford, Susan Proctor and Margaret Smith

Standards for assessing and managing suicide risk were developed and incorporated into a guidance manual for general practitioners. The effects of the manual on opinions…

Downloads
892

Abstract

Standards for assessing and managing suicide risk were developed and incorporated into a guidance manual for general practitioners. The effects of the manual on opinions and practice were evaluated using a quasi‐experimental controlled before/after design, comparing participating general practitioners with others who did not use the manual. Thirty four general practitioners participated over a six‐month period. The intervention group showed changes in perceptions, with increased satisfaction with their own methods and in their recognition and assessment of suicide risk. Their practice changed, with increased recording of relevant factors in notes. The comparison group did not change in these ways. It is concluded that general practitioners’ practice and opinions in assessing and managing suicide risk were significantly improved using a minimal intervention. Given the importance of the topic and the small size of this study, further research is needed, examining changes in professional practice, knowledge and attitudes.

Details

International Journal of Health Care Quality Assurance, vol. 14 no. 3
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article
Publication date: 6 January 2021

Verna Smith

Policymakers implementing pay-for-performance schemes within general practice should seek to design schemes which work with rather than against the professional values and…

Abstract

Purpose

Policymakers implementing pay-for-performance schemes within general practice should seek to design schemes which work with rather than against the professional values and goals of general practitioners. In this way, schemes are more likely to enhance the practitioners' engagement. The purpose of this paper is to show how this was done in two case studies of pay-for-performance design and present the lessons from this study for policymakers.

Design/methodology/approach

A Most Similar Systems collective case study of the design of two pay-for-performance schemes for general practitioners, the United Kingdom's Quality and Outcomes Framework (QOF) and the New Zealand’s Performance Management Programme (PMP) was undertaken, involving 26 semi-structured interviews with policymakers, documentary and literature analysis.

Findings

Innovation in processes was found in both case studies which facilitated engagement by general practitioners in the formulation and implementation of these schemes. These were careful selection of highly skilled design teams, use of principle-based negotiation techniques and academic mediation of indicator selection. In addition, in England the majority of members in the combined QOF design team were general practitioners. The evidence from these two case studies reinforces approaches to scheme design which seek to harness rather than challenge medical professional values and which maximise the participation of general practitioners in the design process. Achieving funder/practitioner collaboration should be a key goal in the policymaking process.

Practical implications

Pay-for-performance scheme designers can improve their ability to engage general practitioners in scheme design and scheme uptake by adopting approaches which actively engage general practitioners as designers and users of such schemes.

Originality/value

This study compares two contemporaneous processes of pay-for-performance scheme design and implementation in similar systems of general practice funding and delivery at the national level, offering a rare quasi-experimental opportunity for learning lessons from comparative analysis.

Details

Journal of Health Organization and Management, vol. 35 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

To view the access options for this content please click here
Article
Publication date: 1 September 1999

Usha R. Rout

Examines the sources of stress associated with high levels of job dissatisfaction and mental health among practice managers and women general practitioners, and compares…

Downloads
1813

Abstract

Examines the sources of stress associated with high levels of job dissatisfaction and mental health among practice managers and women general practitioners, and compares the job satisfaction, mental health and job stress among practice managers and women general practitioners. Women general practitioners (n = 75) and practice managers (n = 51) completed anonymous questionnaires. Lack of communication and co‐operation between colleagues and staff were the main sources of dissatisfaction and lack of mental wellbeing for both groups. In addition, wishful thinking coping factor was predictive of job dissatisfaction and mental ill‐health. There was no significant difference between practice managers and women general practitioners on the mental health scale. Women general practitioners experienced less job satisfaction with regard to the amount of work, and hours of work than the practice managers. There may be substantial benefit in initiating a support network system for these professionals.

Details

Women in Management Review, vol. 14 no. 6
Type: Research Article
ISSN: 0964-9425

Keywords

To view the access options for this content please click here
Article
Publication date: 1 February 1993

Sybil Myerson

Investigates the effects of policy change‐the Government NewContract (1990) – on the workload and lives of family doctors,using an open‐ended interview approach and…

Downloads
69

Abstract

Investigates the effects of policy change‐the Government New Contract (1990) – on the workload and lives of family doctors, using an open‐ended interview approach and numerical research adapted from it. Provides an account of 20 urban general practitioners′ perceptions of their stresses in general practice under the new 1990 contract. Uses an open‐ended, emic, interview approach in order to reflect the perspectives of the participants rather than the assumptions of the researcher. Considers some of the problems and assets of the methodology. Uncovered many stresses during the interviews but focuses on the main ones which involve the effects of the new contract on being “on call”; nightwork; administration and increased paperwork; financial problems; relationships; inherent practice stresses; and job satisfaction. Involves a quantitative component to the survey, which consisted of a postal questionnaire designed from the findings of the preliminary open‐ended interviews; and includes results from the questionnaire findings. Also notes some of the comments given in answer to two open‐ended questions on the form. The preliminary interviews and quantitative findings suggest that it is important to be aware of the effects of the new contract on the general practitioner′s life and work as it is perceived by the doctors themselves, for many feel it has affected their adaptability and may alter the balance between their stresses and their ability to do their job in the most satisfactory spirit for their patients, staff, the administration and their family and personal life.

Details

Journal of Management in Medicine, vol. 7 no. 2
Type: Research Article
ISSN: 0268-9235

Keywords

To view the access options for this content please click here
Article
Publication date: 1 September 1997

Albert Caruana and Claire Carey

Many professionals abhor the thought of marketing their services. Marketing is assumed to be merely advertising and it is widely believed that advertising commercialises…

Abstract

Many professionals abhor the thought of marketing their services. Marketing is assumed to be merely advertising and it is widely believed that advertising commercialises and hence demeans professional services (Chan, 1992; Darling and Hackett, 1978). Although restrictions on advertising have been removed or relaxed in a number of countries, many professionals and their associations still regard advertising with suspicion and regulate its use. This is perhaps nowhere more so than with medical professionals. A fundamental rule set by medical professional associations in European and North American countries is that the doctor's job is not a business. More explicitly, the Medical Council in Luxembourg specifies that medicine cannot be exercised ‘as a business’. While it is perfectly acceptable for other professions to declare that profit is the enterprise's driving force, such a statement would go completely against the professional conscience of the medical profession. Medical practitioners are expected to observe a high ethical code. Respect for life should come before any other consideration. However, the medical professional's ability to survive depends as much on marketing as on his specialised technical skills. A different marketing approach from that used conventionally in the business sector may be needed, but the utility of marketing cannot be denied. Like businesspersons, medical practitioners also network with their market by being active within the community. These and other actions all contribute to make the individual a well‐known figure within the area of his practice (Gelb, Smith and Gelb, 1988). Medical practitioners in the various countries frequently belong to national medical professional associations. These often have legal standing, and are empowered to issue regulations and sanction non compliance on many aspects relating to the profession including advertising. This study first aims to position within a North American and European perspective the approach to advertising adopted by the Malta Medical Council. Secondly, it seeks to empirically investigate (1) the attitude of Maltese medical practitioners towards advertising by their profession, and (2) the attitude of the Maltese general public towards advertising by medical practitioners. In America, the general public have been found to have a more positive attitude towards advertising than medical practitioners and professionals in general (Darling and Hackett, 1978; Dyer and Shimp, 1980; Miller and Waller, 1979). Similarly, we expect that in Malta medical practitioners will exhibit a more negative attitude towards advertising than the general public.

Details

Management Research News, vol. 20 no. 9
Type: Research Article
ISSN: 0140-9174

To view the access options for this content please click here
Article
Publication date: 1 June 1998

Mark Hackett

The development of locality commissioning models combined with demographic, therapeutic and service changes are driving new professional relationships between general

Downloads
286

Abstract

The development of locality commissioning models combined with demographic, therapeutic and service changes are driving new professional relationships between general practitioners and acute Trusts. To ensure a Trust releases its strategy in this environment, stakeholders must understand the benefits to be gained from these new levels of relationships. A review of the literature is undertaken and the conditions for successful partnerships between acute Trusts and general practitioners defined. The article determines that for acute Trusts it will mean an examination of core competences combined with a drive to “review” their organisations.

Details

Journal of Management in Medicine, vol. 12 no. 3
Type: Research Article
ISSN: 0268-9235

Keywords

To view the access options for this content please click here
Article
Publication date: 1 May 1995

Valerie J. Sutherland

The impact of a major organizational change on generalpractitioners in the UK was assessed using a postal questionnaire duringJuly‐August 1990. The results were compared…

Downloads
1427

Abstract

The impact of a major organizational change on general practitioners in the UK was assessed using a postal questionnaire during July‐August 1990. The results were compared with those obtained in a previous survey in November 1987. A total of 917 (61 per cent response rate) general practitioners completed the questionnaire measuring aspects of the job causing stress, job satisfaction and mental wellbeing. Compared with 1987, doctors in 1990 experienced significantly decreased levels of job satisfaction and reported levels of somatic anxiety and depression were higher. The stress associated with the demands of the job and patients′ expectations, practice administration and routine medical work, role stress and the use of social support as a coping strategy were the strongest predictors of job dissatisfaction and poor psychological wellbeing.

Details

Journal of Managerial Psychology, vol. 10 no. 3
Type: Research Article
ISSN: 0268-3946

Keywords

Content available
Article
Publication date: 27 April 2020

Riccardo Stacchezzini, Francesca Rossignoli and Silvano Corbella

This article investigates the implementation of a compliance programme (CP) in terms of how practitioners conceive of and execute the responsibilities arising from this…

Downloads
1415

Abstract

Purpose

This article investigates the implementation of a compliance programme (CP) in terms of how practitioners conceive of and execute the responsibilities arising from this corporate governance mechanism.

Design/methodology/approach

This study involves a practice lens approach forms the case study analysis and interpretation, involving both interviews and documentary materials collected from an Italian company with prolonged compliance experience. Schatzki's (2002, 2010) practice organisation framework guides the interpretation of CP as a practice organised by rules, practical and general understandings and teleoaffective structures.

Findings

CP practice evolves over time. A practical understanding of daily actions required to accomplish the CP and a general understanding of the responsibilities connected with the CP, such as the attitudes with which the CP is performed, are mutually constitutive and jointly favour this evolution. Dedicated artefacts – such as IT platforms, training seminars and compliance performance indicators – help spread both of these types of understanding. These artefacts also align practitioners' general understanding with the CP's teleoaffective structures imposed, including the CP's assigned objectives and the desired reactions to them.

Research limitations/implications

The findings have theoretical and practical implications by revealing the relevance of practitioners' understanding of corporate governance mechanisms in their implementation processes.

Originality/value

This study reveals the potential benefits of practice lens approaches in corporate governance studies. It responds to the call for qualitative studies that demonstrate corporate governance as implemented in daily activities.

Details

Accounting, Auditing & Accountability Journal, vol. 33 no. 4
Type: Research Article
ISSN: 0951-3574

Keywords

To view the access options for this content please click here
Article
Publication date: 30 October 2018

Tara Officer, Jackie Cumming and Karen McBride-Henry

The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on…

Abstract

Purpose

The purpose of this paper is to lay out how advanced practitioner development occurs in New Zealand primary health care settings. The paper specifically focuses on mechanisms occurring across policy creation and in practice leading to successful role development.

Design/methodology/approach

The authors applied a realist approach involving interviews, document review and field log observations to create refined theories explaining how successful development occurs.

Findings

Three final mechanisms were found to influence successful advanced practitioner role development: engagement in planning and integrating roles; establishing opportunities as part of a well-defined career pathway; and championing role uptake and work to full scopes of practice.

Research limitations/implications

This research focuses on one snapshot in time only; it illustrates the importance of actively managing health workforce change. Future investigations should involve the continued and systematic evaluation of advanced practitioner development.

Practical implications

The successful development of advanced practitioner roles in a complex system necessitates recognising how to trigger mechanisms occurring at times well beyond their introduction.

Social implications

Potential candidates for new roles should expect roadblocks in their development journey. Successfully situating these roles into practice through having a sustainable and stable workforce supply provides patients with access to a wider range of services.

Originality/value

This is the first time a realist evaluation has been undertaken, in New Zealand, of similar programmes operating across multiple sites. The paper brings insights into the process of developing new health programmes within an already established system.

Details

Journal of Health Organization and Management, vol. 33 no. 1
Type: Research Article
ISSN: 1477-7266

Keywords

1 – 10 of over 67000