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Article
Publication date: 22 June 2010

Gil‐Soo Han

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…

Abstract

Purpose

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.

Design/methodology/approach

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.

Findings

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.

Originality/value

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.

Details

Journal of Health Organization and Management, vol. 24 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Book part
Publication date: 27 October 2005

Janice McCabe

Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as…

Abstract

Medicalization is the increasing social control of the everyday by medical experts. It is a key concept in the sociology of health and illness because it sees medicine as not merely a scientific endeavor, but a social one as well. Medicalization is a “process whereby more and more of everyday life has come under medical dominion, influence, and supervision” (Zola, 1983, p. 295); previously these areas of everyday life were viewed in religious or moral terms (Conrad & Schneider, 1980; Weeks, 2003). More specifically, medicalization is the process of “defining a problem in medical terms, using medical language to describe a problem, adopting a medical framework to understand a problem, or using a medical intervention to ‘treat’ it” (Conrad, 1992, p. 211). Sociologists have used this concept to describe the shift in the site of decision-making and knowledge about health from the lay public to the medical profession.

Details

Sociological Studies of Children and Youth
Type: Book
ISBN: 978-0-76231-256-6

Article
Publication date: 7 September 2012

Songge Ma

This paper aims to explore what Chinese doctors have learned in authentic medical practice, what they want to learn, and the dynamics behind their professional learning in…

Abstract

Purpose

This paper aims to explore what Chinese doctors have learned in authentic medical practice, what they want to learn, and the dynamics behind their professional learning in working contexts.

Design/methodology/approach

The paper uses Narrative Inquiry, qualitative data which were collected by open‐ended face‐to‐face interviews and participative observation. Seven doctors from three hospitals in Shandong province were purposefully invited. Each participant was interviewed at least once, and all interview recordings were transcribed into research texts. The author narrated and re‐narrated stories of one chosen participant named Li Hengyang (pseudonym).

Findings

The paper finds that Chinese doctors divided their learning into two kinds: “professional” and “non‐professional”. The intrinsic‐motive‐driven learning of medical knowledge and techniques was attributed to “professional” and the extrinsic‐motive‐driven learning of “other things” was treated as “non‐professional”. The resultant force of intrinsic and extrinsic motives caused a performance disorder, a vague sense of professional identity, and involuntary expressive behaviours. The author finally pointed out that Chinese doctors' professional learning in working contexts is, to some extent, identity‐oriented.

Research limitations/implications

Single theoretical perspective constrained the analysis; future research may use different theoretical perspectives besides Goffman's theatrical performance theory.

Practical implications

The paper presents identity‐oriented learning of Chinese doctors and the dynamics behind it, which have practical implications for Chinese doctors, medical professional educators and national medical policy makers.

Originality/value

Although Chinese doctors' training and education have been explored a lot, their professional learning in working contexts was rarely studied before.

Details

Journal of Workplace Learning, vol. 24 no. 7/8
Type: Research Article
ISSN: 1366-5626

Keywords

Article
Publication date: 5 March 2018

Muhammad Khalilur Rahman, Suhaiza Zailani and Ghazali Musa

This study aims to investigate the perceived role of the Islamic medical care practice of Muslim doctors in Malaysian Muslim-friendly private hospitals.

Abstract

Purpose

This study aims to investigate the perceived role of the Islamic medical care practice of Muslim doctors in Malaysian Muslim-friendly private hospitals.

Design/methodology/approach

Data were collection through self-administered questionnaires voluntarily submitted by the respondents. The survey covered selected major Muslim-friendly private hospitals in the country in the states of Kedah, Johor, Penang, Selangor, Kelantan and Kuala Lumpur. The non-probability purposive sampling was used, as the respondents and locations of the survey areas were predetermined.

Findings

Five dimensions of the Muslim-friendly medical care practice were identified, namely, medical etiquettes, physical examination, proper cleansing process of blood and body fluids, proper handling and treatment of infectious diseases and doctors’ advice to Muslim patients. The findings also indicate that the scale development analysis produced excellent results which can be used for reproducible or repetitive medical care purposes and for integration facts and figures for inclusion into wider medical care policy and practices.

Practical implications

The results from the study can further develop Islamic medical care practices and enable medical service providers to upgrade their performances to an enviable strategic status.

Originality/value

Islamic medical care is a new mode of healthcare service market, as there are very few studies on this topic from the perspective of Muslim patients or no obvious facts are known. This study has first explored Muslim doctors’ perceived role in Islamic medical care practice in Malaysian Muslim-friendly private hospitals. This empirical study can immensely contribute to the further development of Islamic medical care practice for Muslim doctors in particular and for the Muslim-friendly hospital service marketing strategy in general.

Details

Journal of Islamic Marketing, vol. 9 no. 1
Type: Research Article
ISSN: 1759-0833

Keywords

Article
Publication date: 20 September 2019

Emily Maile, Judy McKimm and Alex Till

“Becoming” a doctor involves the acquisition of medical knowledge, skills and professional identity. Medical professional identity formation (MPIF) is complex…

Abstract

Purpose

“Becoming” a doctor involves the acquisition of medical knowledge, skills and professional identity. Medical professional identity formation (MPIF) is complex, multi-factorial and closely linked to societal expectations, personal and social identity. Increasingly, doctors are required to engage in leadership/management involving significant identity shift. This paper aims to explore medical professional identity (MPI) and MPIF in relation to doctors as leaders. Selected identity theories are used to enrich the understanding of challenges facing doctors in leadership situations and two concepts are introduced: medical leader identity (MLI) and medical leader identity formation (MLIF) and consideration given to how they can be nurtured within medical practice.

Design/methodology/approach

A rapid conceptual review of relevant literature was carried out to identify a set of relevant concepts and theories that could be used to develop a new conceptual framework for MLI and MLIF.

Findings

MLIF is crucial for doctors to develop as medical leaders, and, like MPIF, the process begins before medical school with both identities influenced, shaped and challenged throughout doctors’ careers. Individuals require support in developing awareness that their identities are multiple, nested, interconnected and change over time.

Originality/value

This paper draws on concepts from wider literature on professional identity, in relation to how doctors might develop their MLI alongside their MPI. It offers a new perspective on MPI in the light of calls on doctors to “become and be healthcare leaders” and introduces the new concepts of MLI and MLIF.

Details

Leadership in Health Services, vol. 32 no. 4
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 13 November 2020

Prakash Subedi, Jill Aylott, Naushad Khan, Niki Shrestha, Dayaram Lamsal and Pamela Goff

The purpose of this paper is to outline the “Hybrid” “International” Emergency Medicine (HIEM) programme, which is an ethical pathway for the recruitment, employment and…

Abstract

Purpose

The purpose of this paper is to outline the “Hybrid” “International” Emergency Medicine (HIEM) programme, which is an ethical pathway for the recruitment, employment and training of Emergency Medicine doctors; with a rotation through the NHS on a two-year medical training initiative with a Tier 5 visa, “earn, learn and return” programme. The HIEM programme offers an advantage to the Tier 2 visa by combining training, education and employment resulting in new learning to help improve the health system in Nepal and provide continued cultural support, clinical and leadership development experience in the UK NHS. Finally, this programme also provides a Return on Investment to the NHS.

Design/methodology/approach

A shortage of doctors in the UK, combined with a need to develop Emergency Medicine doctors in Nepal, led to a UK Emergency Medicine Physician (PS) to facilitate collaboration between UK/Nepal partners. A mapping exercise of the Royal College of Emergency Medicine curriculum with the competencies for the health system and quality improvement leaders and partners with patients produced a “HIEM programme”. The HIEM programme aims to develop first-class doctors to study in Emergency Departments in the UK NHS while also building trainee capability to improve the health system in Nepal with a research thesis.

Findings

The HIEM programme has 12 doctors on its programme across years one and two, with the first six doctors working in the UK NHS and progressing well. There are reports of high levels of satisfaction with the trainees in their transition from Nepal to the UK and the hospital is due to save £720,000 (after costs) over two years. Each trainee will earn £79,200 over two years which is enough to pay back the £16,000 cost for the course fees. Nepal as a country will benefit from the HIEM programme as each trainee will submit a health system improvement Thesis.

Research limitations/implications

The HIEM programme is in its infancy as it is two years through a four-year programme. Further evaluation data are required to assess the full impact of this programme. In addition, the HIEM programme has only focussed on the development of one medical speciality which is Emergency Medicine. Further research is required to evaluate the impact of this model across other medical and surgical specialties.

Practical implications

The HIEM programme has exciting potential to support International Medical Graduates undertake a planned programme of development while they study in the UK with a Tier 5 visa. IMGs require continuous support while in the UK and are required to demonstrate continued learning through continuous professional development (CPD). The HIEM programme offers an opportunity for this CPD learning to be structured, meaningful and progressive to enable new learning. There is also specific support to develop academic and research skills to undertake a thesis in an area that requires health system improvement in Nepal.

Originality/value

This is the first time an integrated clinical, leadership, quality improvement and patient partnership model curriculum has been developed. The integrated nature of the curriculum saves precious time, money and resources. The integrated nature of this “hybrid” curriculum supports the development of an evidence-based approach to generating attitudes of collaboration, partnership and facilitation and team building in medical leadership with patient engagement. This “hybrid” model gives hope for the increased added value of the programme at a time of global austerity and challenges in healthcare.

Details

Leadership in Health Services, vol. 34 no. 3
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 3 April 2017

Toyin Ajibade Adisa, Chima Mordi and Ellis L.C. Osabutey

Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. The purpose of this paper is to…

4086

Abstract

Purpose

Whilst significant evidence of western work-life balance (WLB) challenges exists, studies that explore Sub-Saharan Africa (SSA) are scarce. The purpose of this paper is to explore how organisational culture in Nigerian medical organisations influences doctors’ WLB and examine the implications of supportive and unsupportive cultures on doctors’ WLB.

Design/methodology/approach

The paper uses qualitative data gleaned from semi-structured interviews of 60 medical doctors across the six geo-political zones of Nigeria in order to elicit WLB challenges within the context of organisational culture.

Findings

The findings show that organisational culture strongly influences employees’ abilities to use WLB policies. Unsupportive culture resulting from a lack of support from managers, supervisors, and colleagues together with long working hours influenced by shift work patterns, a required physical presence in the workplace, and organisational time expectations exacerbate the challenges that Nigerian medical doctors face in coping with work demands and non-work-related responsibilities. The findings emphasise how ICT and institutions also influence WLB.

Originality/value

The paper addresses the underresearched SSA context of WLB and emphasises how human resource management policies and practices are influenced by the complex interaction of organisational, cultural, and institutional settings.

Details

Personnel Review, vol. 46 no. 3
Type: Research Article
ISSN: 0048-3486

Keywords

Article
Publication date: 14 February 2020

Po-Chien Chang, Ting Wu and Juan Du

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and…

Abstract

Purpose

The purpose of this study is to examine the dual effects of the violation of psychological contract on patient’s antisocial behaviour via the mediator of patient trust and the role of doctor-patient communication as a critical contingent variable in the psychological contract violation of patient’s antisocial behaviour relationship.

Design/methodology/approach

The data were collected from 483 hospitalized patients distributed in Shanxi province, China by using a self-administered survey.

Findings

The results indicated that psychological contract violation is positively associated with patient antisocial behaviour via patient trust. Moreover, the study found that doctor-patient communication moderates the mediated effects of psychological contract violation on patient’s antisocial behaviour through patient trust; that is, the mediated effect on antisocial behaviour is weaker when both doctor and patients have more communication.

Research limitations/implications

Due to a cross-sectional design in nature, the causal relationship cannot be developed based on the results. Despite the limitation, the present study provides insights for improving doctor-patient relationship by emphasizing the importance of increasing patient trust and doctor-patient communication.

Practical implications

To improve the quality of doctor-patient relationship, this study addresses the significance of properly showing understandings and care to regain mutual trust and reducing the likelihood of patient’s antisocial behaviour.

Social implications

The research findings have implications for both the health system and medical schools in China to reinforce the professional ethics and improve their medical humanities as the main concerns to generate a more sustainable doctor–patient relationship.

Originality/value

This study includes patient trust as a mediator and doctor-patient communication as a moderator to investigate the moderated mediation relationship among patients and medical professionals. By further examining the doctor-patient relationship, the results may not only help improve the efficient implementation of medical practices but also support the institutes and develop medical professionals for more positive doctor-patient relationships.

Details

International Journal of Conflict Management, vol. 31 no. 4
Type: Research Article
ISSN: 1044-4068

Keywords

Article
Publication date: 23 May 2011

Abel Chikanda

The paper seeks to investigate the leading causes of physician migration from Zimbabwe and to highlight the patterns of physician migration over the past‐two decades.

Abstract

Purpose

The paper seeks to investigate the leading causes of physician migration from Zimbabwe and to highlight the patterns of physician migration over the past‐two decades.

Design/methodology/approach

A mixed methods approach, involving a survey and interviews, was used to collect data for the study.

Findings

The paper demonstrates that personal networks, not recruitment agencies, are the main drivers of physician migration from the country. However, the importance of recruitment agencies as channels of information about job opportunities abroad has grown substantially over the last decade. The research findings suggest that Zimbabwe will continue losing physicians to other countries until economic and political stability has been restored in the country.

Originality/value

By highlighting the patterns and causes of physician migration from Zimbabwe, the paper makes a contribution to the implementation of policy measures aimed at retaining physicians in the country.

Details

International Journal of Migration, Health and Social Care, vol. 7 no. 2
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 4 May 2010

John Clark and Kirsten Armit

The purpose of this paper is to explore the use of competences in medical education and training and to discuss some existing standards, curricula and competency…

4466

Abstract

Purpose

The purpose of this paper is to explore the use of competences in medical education and training and to discuss some existing standards, curricula and competency frameworks used by the medical profession in both the UK and internationally to inform leadership development.

Design/methodology/approach

This research reinforces the message delivered by the medical profession and policy makers in recent years that all doctors should attain management and leadership competences in addition to clinical knowledge and skills to be an effective and safe practitioner. In the UK, this message and research has helped inform the development of a Medical Leadership Competency Framework (MLCF) published by The Academy of Medical Royal Colleges[1] and NHS Institute for Innovation and Improvement[2].

Findings

Widespread acceptance of the MLCF is now resulting in the integration of leadership and management competences into all undergraduate and postgraduate curricula.

Practical implications

Other countries with similar histories of low medical engagement in planning, delivery and transformation of services may also benefit from the research undertaken and the MLCF

Originality/value

The paper shows that the MLCF may well inspire more doctors in the future to seek formal leadership positions.

Details

Leadership in Health Services, vol. 23 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

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