Search results

The healthcare system is undergoing rapid change as medical centers are confronted with constricted reimbursements for healthcare services while adapting to growth in medical knowledge, major technological advances in medical practice, and a changing regulatory environment. Academic medical centers thought themselves immune to the forces that shape most service enterprises but are forced to compete based on customer service and the efficiency, quality, and safety of medical care, while continuing to compete in the academic world. These challenges are not unique to academic medicine, but these institutions are, perhaps, least suited to the leadership challenges posed by this environment. Certain attributes of these centers raise barriers to successful adaptation to the changing healthcare environment. The need for systemic change in academic medicine requires commitment to programs that create change agents willing to assume leadership roles and to guide institutional evolution. In academic medicine, traditional one-on-one relationships between mentors and trainees do not provide the breadth of guidance needed in the complex environment of research, medical practice, and teaching. A structured system of “matrix mentorship” and structured evaluation will advance institutional values, provide leaders with an essential set of skills and values consistent with institutional goals, and provide competitive advantage for medical centers in academic healthcare.

This chapter explores the rise in genetic approaches to health disparities at the turn of the twenty-first century.

Analysis of public health policies, genome project records, ethnography of project leaders and leading genetic epidemiologists, and news coverage of international projects demonstrates how the study of health disparities and genetic causes of health simultaneously took hold just as the new field of genomics and matters of racial inequality became a global priority for biomedical science and public health.

As the U.S. federal government created policies to implement racial inclusion standards, international genome projects seized the study race, and diseases that exhibit disparities by race. Genomic leaders made health disparities research a central feature of their science. However, recent attempts to move toward analysis of gene-environment interactions in health and disease have proven insufficient in addressing sociological contributors to health disparities. In place of in-depth analyses of environmental causes, pharmacogenomics drugs, diagnostics, and inclusion in sequencing projects have become the frontline solutions to health disparities.

The chapter argues that genetic forms of medicalization and racialization have taken hold over science and public health around the world, thereby engendering a divestment from sociological approaches that do not align with the expansion of genomic science. The chapter thus contributes to critical discussions in the social and health sciences about the fundamental processes of medicalization, racialization, and geneticization in contemporary society.

Eric Williams and his colleagues review the literature on both physician burnout and physician–patient communication. A major contribution in this chapter is a model based on these two literatures, which outlines the impact that physician burnout can have on the physician–patient interaction and, therefore, patient outcomes. When physicians become emotionally exhausted, they begin to depersonalize to cope and focus on biomedical issues rather than communicating with the patient. When the patient is approached with this communication style from their physicians, they become less satisfied, trusting, and compliant. Less compliance results in worsened clinical outcomes, especially for patients with chronic disease. The authors discuss both the implications of this model and future directions for research.

Drawing on an interdisciplinary scholarship, this study seeks to explore and explain the nature and characteristics of the emerging phenomenon of “consumer nationalism” and its critical impact on corporate reputation in the global marketplace.

The paper sets out to define the concept of consumer nationalism and then formulate an analytical framework of consumer nationalism dynamics that provides a deeper, more precise understanding of the various elements at play in a consumer nationalism crisis and the process by which multinational businesses and their corporate reputation might be affected by such nationalistic advocacy. Based on the proposed model, the paper identifies and discusses management options to protect and maintain corporate reputation in the event of consumer nationalistic outbursts. In conclusion, the paper outlines general recommendations for pursuing public/corporate diplomacy and for proactively managing consumers' perception of brands' national association as part of pre‐crisis communication strategy.

As nationalism goes hand‐in‐hand with globalization, consumer nationalism cannot be ignored.

The study provides a deeper understanding of what consumer nationalism is and how it may affect multinational businesses. It offers a comprehensive account of this emerging phenomenon by integrating existing perspectives on the nationalistic consumer base and “focusing events”, and introduces the concept of corporate susceptibility and its components. The study also highlights the centrality of corporate reputation during consumer nationalistic outbursts, and offers suggestions as to how multinational businesses may take steps to fend off the damage consumer nationalism events may do to their reputation.

In reviewing proxy contests and tender offers of the past, the author concludes that the former has been inferior as a form of corporate conflict mechanism to the latter. However, he also underscores the important role that the proxy contest has played in the development of its competitor — the tender offer.

The purpose of this paper is to establish the relationship between managerial competence, managerial risk-taking behaviour and financial service outreach of microfinance institutions (MFIs).

In this cross-sectional and correlational study, the authors surveyed 52 branches of MFIs from a population of 60 branches of 20 MFIs in eastern Uganda. Two respondents, a branch manager and a senior loan officer, were the units of enquiry for each branch. The authors put forward and tested four hypotheses relating to the significance of the relationship between perceived managerial competence, risk-taking behaviour and financial service outreach using SPSS version 20. The authors established the hypothesized relationships using Pearson correlation coefficients and obtain a mediating effect of risk-taking behaviour using partial corrections and regression analysis.

The results suggest positive and significant relationships between perceived managerial competence, risk-taking behaviour and financial service outreach. However, while the direct relationship between managerial competence and financial service outreach without the mediation effect of risk-taking behaviour of managers was found to be significant, its magnitude reduces when mediation of risk-taking behaviour is allowed. Thus the entire effect does not only go through managerial competence but majorly also, through risk-taking behaviour of managers.

This study did not control for environmental factors such as laws and regulations. As such the model may have been under fitted. Nevertheless, the study has introduced a clearer understanding that outreach performance in MFIs rests with competent managers in strategic positions operating in synergy with their risk-taking behaviour. The study informs policy makers that outreach performance of the MFIs depends on the quality of the competence managers have in addition to their risk-taking propensities.

Efforts by the stakeholders to improve financial service outreach must be matched with appropriate competences and risk-taking behaviour of managers.

The results contribute to extant literature by investigating two explanatory variables for financial service outreach and provide initial evidence of the mediating effect of intrinsic high risk-taking behaviour of managers. Results add to the conceptual improvement in risk-taking behaviour and lend considerable support for the behavioural perspective in the study of financial service outreach of MFIs.

Purpose – Ecological cohousing communities, or ecovillages, are emerging as contemporary housing models that attempt to recreate a sense of community and encourage an environmentally sustainable lifestyle. This chapter analyzes a rural ecovillage (Ecovillage at Ithaca – EVI) to find out how the community conceptualizes and practices sustainability. The chapter also examines whether and how the community incorporates issues of equity and social justice into its activities.

Design/methodology/approach – The chapter uses a multi-method approach. It is a case study; however, participant observation was conducted at the site. In addition, interviews with residents were conducted and archival materials from the community's newsletters as well city government documents were also used.

Findings – As practiced at EVI, the green lifestyle emphasizes comfortable living that is both esthetically appealing and good for the environment. In making the decision to focus on building a community for the middle class, residents have limited their engagement with social justice issues and have struggled with incorporating minorities and the poor into their community.

Originality/value – This is one of the first papers to analyze the ecovillages from an environmental justice perspective. It shows where there are overlaps between the ecovillage and environmental justice movements. The chapter also fits into a growing body of scholarship that examines the concept of sustainability from a social justice perspective also.

Self-regulatory organizations (SROs) can be found in education, healthcare, and other not-for-profit sectors as well as in the accounting, financial, and legal professions. DeMarzo et al. (2005) show theoretically that SROs can create monopoly market power for their affiliated agents, but that governmental oversight, even if less efficient than oversight by the SRO, can largely offset such market power. We provide an experimental test of this conjecture. For carefully rationalized parameterizations and implementation details, we find that the predictions of DeMarzo et al. (2005) are borne out.