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The purpose of this paper is to examine the physicians’ attitude toward branded generic drugs in prescribing those drugs in some selective medical conditions and to identify the factors that influence physicians’ behavior toward prescribing branded generic drugs in the said selective medical conditions.

The study was carried out across six major cities in eastern India with 301 physicians. The current study introduced some significant elements into the modified technology acceptance model (TAM) with title the extended tam for product usage (TETPU) to analyze the prescribing factors that influence physicians in five common yet serious medical conditions in India. Out of nine factors considered here, seven were selected from the previous literature studies of different product segments and two were proposed by the authors. Demographic factor was proposed as the confounding variable.

The results indicated that apart from the factors “perceived no need” and “physicians’ perception and need achievement” rest of the factors showed satisfactory to excellent results.

The current study findings may enable the pharmaceutical managers to revise or modify their current marketing communication and other brand-building strategies so as to achieve a superior performance that offers them a competitive advantage.

The paper fulfils a need for advancing the knowledge on the physician’s prescription influencing factors by introducing the newer aspects of the concept and offers a theoretical framework for the academia and practical framework for the managers who desire to implement the strategies to achieve competitive advantage.

Fellowship by Assessment of the Royal College of General Practitioners was first introduced in 1989. This followed the ‘What Sort of Doctor?’ initiative, which explored the potential for educationally‐based peer review visits to practices. Building on this work, college faculties — in particular those in the north‐west and south‐west of England — helped to design and pilot criteria that would be suitable for use as a measure of the highest quality of UK general practice.

Shared decision making (SDM) prioritises joint deliberation between practitioner and service user, and a respect for service-users’ experiential knowledge, values and preferences. The purpose of this paper is to review the existing literature pertaining to key stakeholders’ attitudes towards SDM in mental health. It examines whether perceived barriers and facilitators differ by group (e.g. service user, psychiatrist, nurse and social worker) and includes views of what facilitates and hinders the process for service users and practitioners.

This review adopts the principles of a qualitative research synthesis. A key word search of research published between 1990 and 2016 was undertaken. Qualitative, quantitative and mixed methods studies were included.

In total, 43 papers were included and several themes identified for service user and practitioner perspectives. Both practitioners and service users see SDM as an ethical imperative, and both groups highlight the need to be flexible in implementing SDM, suggesting it is context dependent. A range of challenges and barriers are presented by both practitioners and service users reflecting complex contextual and cultural features within which interactions in mental health take place. There were qualitative differences in what service users and practitioners describe as preventing or enabling SDM. The differences highlighted point towards different challenges and priorities in SDM for service users and practitioners.

The presentation of nuanced views and attitudes that practitioners and service users hold represent an important and under reported area and offer insight into the reasons for the gap between idealised policy and actual practice of SDM in mental health settings.

Little is known about the effects of education on the practice of PR. This chapter aims at demonstrating the differences between economics-educated practitioners and communication-educated practitioners. Based on a quantitative survey among 790 practitioners working in non-profits in Austria, the research presented here sheds light on the influences of education on thinking and acting by practitioners in communication practice. Although public relations are not a protected profession, education has become an on-going topic in public relations literature and practice. Furthermore, education for public relations increasingly takes place in various environments. Courses available range from one-day seminars at community colleges to PR-specific studies. Furthermore, public relations are not only a topic in communications-related studies, but also in economics and humanities. The results highlight the differences in practice in relation to the education.

Older patients are at high risk of hospital readmission, which has led to an increasing number of screening and intervention programs. Knowledge on implementing screening tools for preventing readmissions in emergency department (ED), where the primary focus is often the present-day flow of patients, is scant. The purpose of this paper is to explore whether a new screening tool for predicting readmissions and functional decline in medical patients>65 years of age could be implemented and its influence on cross-continuum collaborations between the primary and secondary sectors.

The study took place in an ED in Denmark, in collaboration with the surrounding municipalities. An evaluation workshop with nurses and leaders from the ED and the surrounding municipalities took place with the aim of investigating the organizational changes that occurred in daily practice after the implementation of the screening tool. The workshop was designed and analyzed using cultural historical activity theory (CHAT).

The results showed that it was possible to develop collaboration between the two sectors during the test period. However, the screening tool created different transformations for the municipality employees and in the ED. The contradictions indicated that the screening tool did not mediate a general and sustained transformation in the cross-continuum collaboration.

Screening tools are not objective, neutral or “acontexual” artifacts and must always be adapted to the local context and sectors. CHAT offers a perspective to understand the collective object when working with organizational transformations and implementation.

The study have shown that screening tools are not objective, neutral or “acontexual” artifacts and must always be adapted to the local context. This is called adaption process. This adaption requires time and resources that should be taken into consideration from the beginning of introduction of new screens.

This paper contributes with knowledge about CHAT which offers a way to understand the leading collective object when working with organizational transformations and implementation. CHAT focuses not only on the structural changes but also on the cultural aspects of organizational changes, which is important if we want to reach a sustained change and implement the new screening tool in different sectors.

Managing patients in advanced age is complex, especially when it comes to multi-morbidities and polypharmacy. The purpose of this qualitative study is to investigate challenges, opportunities and potential solutions from a primary healthcare provider perspective.

Fifty-seven participants joined in group discussions on challenges and opportunities of working with advanced age. Participants included general practitioners (GPs), practice nurses, students and administration staff working in ten general practices. A thematic analysis was developed, supported by NVivo software.

Poor lines of communication and fragmentation of services between differing levels of health care services available for older people were highlighted. This has implications for quality of care and equity of services. Participants also reported challenges in treatment and funding regimes.

The small sample size and regional nature of the study, along with the semi-structured nature of the group discussions and rigorous thematic analysis, indicate that this qualitative data is transferable, dependable, confirmable and credible. Comparing the views of tertiary and community services would be useful.

A range of potential strategies and solutions to the current fragmented services was offered by GPs. For example, adequately funded and staffed community-based health hubs; IT platforms enabling timely flow of patient information between primary and tertiary health providers and creation of medical, nursing and allied health roles aimed at improving synergy between GP and tertiary services.

Obtaining the perspectives of general practice highlights the challenges and complexities of caring for those in advanced age brings. These insights have not been previously been explored in-depth within this setting in New Zealand.

The formulated proposals for this legal principle in the trade battern of the European Community have again appeared in the EEC draft Directive. It has been many years in coming, indicating the extreme difficulties encountered in bringing some sort of harmony in the different laws of Member‐states including those of the United Kingdom, relating to the subject. Over the years there were periods of what appeared to be complete inactivity, when no progress was being made, when consultations were at a stand‐still, but the situation was closely monitored by manufacturers of goods, including food and drink, in the UK and the BFJ published fairly detailed reviews of proposals being considered — in 1979 and 1981; and even as recently as the last few months — in “Consumerism in the Community”, the subject was briefly discussed.

International migrants frequently struggle to obtain access to local primary care practices. The purpose of this paper is to explore factors associated with rejecting and accepting migrant patients into Canadian primary care practices.

Mixed methods study. Using a modified Delphi consensus approach among a network of experts on migrant health, the authors identified and prioritized factors related to rejecting and accepting migrants into primary care practices. From ten semi-structured interviews with the less-migrant-care experienced practitioners, the authors used qualitative description to further examine nuances of these factors.

Consensus was reached on practitioner-level factors associated with a reluctance of practitioners to accept migrants − communication challenges, high-hassle factor, limited availability of clinicians, fear of financial loss, lack of awareness of migrant groups, and limited migrant health knowledge – and on factors associated with accepting migrants − feeling useful, migrant health education, third party support, learning about other cultures, experience working overseas, and enjoying the challenge of treating diseases from around the world. Interviews supported use of interpreters, community resources, alternative payment methods, and migrant health education as strategies to overcome the identified challenges.

This Delphi network represented the views of practitioners who had substantive experience in providing care for migrants. Interviews with less-experienced practitioners were used to mitigate this bias.

This study identifies the facilitators and challenges of migrants’ access to primary care from the perspective of primary care practitioners, work that complements research from patients’ perspectives. Strategies to address these findings are discussed.

The purpose of this paper is to present the results of exploratory research designed to develop an awareness of healthcare behaviors, with a view toward improving the customer satisfaction with healthcare services. It examines the relationship between healthcare providers and their consumers/patients/clients.

The study uses a critical incident methodology, with both effective and ineffective behavioral specimens examined across different provider groups.

The effects of these different behaviors on what Berry (1999) identified as the common core values of service organizations are examined, as those values are required to build a lasting service relationship. Also examined are categories of healthcare practice based on the National Quality Strategy priorities.

The most obvious is the retrospective nature of the method used. How accurate are patient or consumer memories? Are they capable of making valid judgments of healthcare experiences (Berry and Bendapudi, 2003)? While an obvious limitation, such recollections are clearly important as they may be paramount in following the healthcare practitioners’ instructions, loyalty for repeat business, making recommendations to others and the like. Further, studies have shown retrospective reports to be accurate and useful (Miller et al., 1997).

With this information, healthcare educators should be in a better position to improve the training offered in their programs and practitioners to better serve their customers.

The findings would indicate that the human values of excellence, innovation, joy, respect and integrity play a significant role in building a strong service relationship between consumer and healthcare provider.

Berry (1999) has argued that the overriding importance in building a lasting service business is human values. This exploratory study has shown how critical incident analysis can be used to determine both effective and ineffective practices of different medical providers. It also provides guidelines as to what are effective and ineffective behaviors in healthcare.

The purpose of this paper is to analyze patterns of health services utilization – visits to family practitioner and visits to an emergency room – by recent immigrants (those who have lived in Canada for less than ten years) and “established” immigrants (those who have resided in Canada for ten years or longer) relative to their Canadian-born counterparts.

The 2009/2010 files of the Canadian Community Health Survey were used for the analysis. A logit model was used to analyze utilization while a zero-inflated negative binomial model was used to measure the intensity of health services utilization.

Results suggest that relative to native-born Canadians, recent immigrants are more likely to visit an emergency room and are less likely to visit a family/general practitioner. The opposite effect is observed for “established” immigrants. In terms of intensity of use, native-born Canadians are more likely to use physicians’ services intensively compared with either recent or established immigrants.

The paper’s findings suggest that provincial governments in Canada will need to focus effort to ensure that recent immigrants have access to a family/general practitioner. This will be necessary given the recent primary care reform initiatives introduced across Canada that emphasize the physician as the first point-of-contact with the health system.