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Book part
Publication date: 17 October 2011

Kelly Joyce

This chapter presents a sociological analysis of the work involved in producing neuroimaging scans used in clinical practice. Drawing on fieldwork in magnetic resonance…

Abstract

This chapter presents a sociological analysis of the work involved in producing neuroimaging scans used in clinical practice. Drawing on fieldwork in magnetic resonance imaging (MRI) units in hospitals and free-standing imaging centers; in-depth interviews with technologists, radiologists, and neurologists; and reviews of relevant medical literatures, this analysis demonstrates how assembly line techniques structure neuroimaging work. Neuroimages (after being ordered by the referring clinician) are created in an image production line where scans of brains, breasts, livers, and other body parts are all produced: although some facilities may focus on one area of the body, most create an array of scans. Following MRI scans as they are produced demonstrates how medical work emphasizes repetition, specialization, and efficiency – key features of mass production. On the medical assembly line, the organization of work aims to transform patients into objects – ones that multiply as scans are created and circulated. Neurologists, radiologists, and technologists are positioned as skilled workers who manage the flow of bodies and the production of knowledge with the aim of producing health or, at the very least, knowledge of illness. Patients are also actors who actively impact the imaging production process. Previous scholarship has shown that diagnostic work involves a distributed form of expertise; one that involves patients, other medical professionals, machines, and neurologists. This chapter demonstrates that the deployment and synchronization of this expertise is a form of labor, involving distinct professions, professional hierarchies, and reimbursement systems. Working conditions are central to the production of MRI scans as knowledge and contribute to the social shaping of neuroimaging techniques.

Details

Sociological Reflections on the Neurosciences
Type: Book
ISBN: 978-1-84855-881-6

Article
Publication date: 1 June 2004

J.L. Foote, N.H. North and D.J. Houston

Hospital waiting lists are a feature of publicly funded health services that result when demand appears to exceed supply. While much has been written about surgical…

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Abstract

Hospital waiting lists are a feature of publicly funded health services that result when demand appears to exceed supply. While much has been written about surgical waiting lists, little is known about the dynamics of radiology waiting lists, which is surprising given that rational treatment, and indeed the medical profession's claim to expertise, rests on establishing a diagnosis. This paper reports the findings of a case study of a problematic ultrasound waiting list. In particular, this paper highlights how the management of the ultrasound waiting list served to subordinate the needs of waiting patients and their general practitioners to the interests and values of radiologists. Radiologist concern to protect specialist expertise from encroachment by outpatient clinicians and sonographers is implicated in the growth of the ultrasound waiting list. It is argued that an adequate understanding of ultrasound waiting lists depends on grasping how radiologists are successful in structuring problems of access in ways that enhance radiologist control over ultrasound imaging. The case study reported helps to shed light on why increasing funding to clear waiting lists proves ineffective.

Details

Journal of Health Organization and Management, vol. 18 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 24 October 2019

Cagri Topal

The purpose of this paper is to answer the question of how continuity and change coexist in the work of institutional actors who can combine maintenance, disruption and/or…

Abstract

Purpose

The purpose of this paper is to answer the question of how continuity and change coexist in the work of institutional actors who can combine maintenance, disruption and/or creation. Past studies mention this coexistence without an explanation.

Design/methodology/approach

The paper develops a perspective through literature review.

Findings

Institutional actors are both socialized into the norm-oriented space of continuity and maintenance through their reciprocal relations and associated social knowledge and roles and disciplined into the goal-oriented space of change and disruption/creation through their power relations and associated expert discourse and subject positions. Their institutional existence indicates a particular combination of reciprocity and power and thus their work includes changing degrees of maintenance, disruption and creation, depending on the nature of this combination.

Research limitations/implications

The paper points out research directions on the relational conditions of the actors, which facilitate or constrain their work toward institutional continuity or change.

Practical implications

Organizations whose concern is to continue the existing practices in a stable environment should emphasize reciprocal relations whereas organizations whose concern is to change those practices for more effectiveness in a dynamic environment should emphasize power relations. Also, too much emphasis on either relations leads to inflexibility or instability.

Originality/value

The paper provides an explanation on the sources of coexistence of continuity and change in institutional work. It also contributes to the discussions on contingency of institutions, resistance productive of institutional change, reflexivity of institutional actors and intersubjective construction of institutional work.

Details

Baltic Journal of Management, vol. 15 no. 1
Type: Research Article
ISSN: 1746-5265

Keywords

Book part
Publication date: 13 November 2002

Chloe E. Bird, Martha E. Lang, Benjamin Amick and Jocelyn Chertoff

Despite a substantial body of research on physician incomes and hours, there has been surprisingly little study of part-time work in the professions or on the…

Abstract

Despite a substantial body of research on physician incomes and hours, there has been surprisingly little study of part-time work in the professions or on the organizational structures that support or inhibit part-time arrangements. To assess the factors associated with the presence and prevalence of part-time work in radiology practices, we conducted structured interviews with 69 practice administrators and 13 self-employed or retired radiologists. Patterns of part-time work are heavily gendered; men use it as a transition to retirement while women seek it early in their careers to balance work and family needs. As hypothesized, larger practices, academic practices, and those affiliated with larger organizations were significantly more likely to have part-time radiologists. Controlling for level of competition between practices, those that had recently experienced increased competition were less likely to have part-time radiologists. Neither difficulty recruiting radiologists to the practice nor length of the average workweek for full-time radiologists were associated with having part-time radiologists in the practice. Practices that had a senior partner or administrator who supported the concept of part-time work were more likely to offer this option to physicians. We expected that radiology practices would have explicit policies regarding part-time work; however few of the practices had any formal policies on this career option. As a result, radiologists seeking part-time work early in their careers were at a distinct disadvantage in negotiations. Fear of the stigma and related career consequences may restrain male radiologists from seeking part-time work early in their careers. Despite acceptance in some practices and a growing presence of part-time radiologists in the specialty as a whole, there are significant and persistent barriers to part-time work arrangements other than as a transition to retirement.

Details

Social Inequalities, Health and Health Care Delivery
Type: Book
ISBN: 978-1-84950-172-9

Article
Publication date: 27 September 2021

Mohammad Ayasrah

Many international radiology societies, including American College of Radiologists (ACR), have established guidelines for optimum forms and contents of medical imaging…

Abstract

Purpose

Many international radiology societies, including American College of Radiologists (ACR), have established guidelines for optimum forms and contents of medical imaging reports to ensure high quality and to guarantee the satisfaction of both the referring physician and the patient. Therefore, this study aims to analyze the criteria of magnetic resonance imaging (MRI) reports in Jordan according to the standards of the ACR.

Design/methodology/approach

This cross-sectional study was conducted in early January 2021 for two weeks. An invitation letter was sent to 85 MRI centers of various health-care sectors in Jordan to participate in the study. Each invitee was requested to send at least ten different MRI reports. The study used a questionnaire containing the checklist of the latest edition 2020 of ACR’s practice parameter to communicate the diagnostic imaging results and the demographic information of the participating MRI centers. Seven basic elements were assessed for content-related quality of MRI reports, which are administrative data, patient demographics, clinical history, imaging procedures, clinical symptoms, imaging observations and impressions. Statistical analyses were used to evaluate the data.

Findings

Forty-one MRI centers participated in the study with 386 different MRI exam reports. The majority (92%) of the reports were computer-generated. Free texted unstructured reports and head-structured reports had an almost equal percentage of around 40%. Exam and radiologist demography as well as exam findings criteria were 100% available in all reports. The percentage of exam conclusion, and exam description and techniques were 2% and 4.9%, respectively (N = 368). There was a positive association between computer-generated reports and the presence of picture archiving and communication systems (PACS)/health information systems r = 0.443.

Originality/value

Structured and free text unstructured reporting were the common types of MRI exam reports in Jordan. Handwriting exam reporting existed in few MRI centers, particularly in those that had no PACS and radiology information systems.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 1 December 2002

Christopher S. Keeling‐Roberts

The aim of this study was to devise a simple proforma for reporting staging CT scans of the thorax, to ensure that all essential information is included on the report, in…

Abstract

The aim of this study was to devise a simple proforma for reporting staging CT scans of the thorax, to ensure that all essential information is included on the report, in a logical manner, and that a TNM classification and tumour stage is given. Once the design of the proforma had been agreed, its utilisation and effectiveness was audited. In an initial six month period, every proforma filled in had resulted in a TNM classification being given, although in only 20 out of 40 (50 per cent) had a tumour stage been given. In a subsequent six month period, 39 out of 44 patients (89 per cent) with lung cancer undergoing a staging CT scan had proformas completed, and a TNM classification and tumour stage given (95 per cent CI is (0.75, 0.96)). Therefore, a proforma can be a useful aid to reporting staging scans, and is an effective method of ensuring that tumours are staged as fully as possible, radiologically. In addition, relevant information is presented in a clear format that allows accurate collection of data for audit purposes.

Details

British Journal of Clinical Governance, vol. 7 no. 4
Type: Research Article
ISSN: 1466-4100

Keywords

Article
Publication date: 19 July 2011

Nir Kshetri

Industrialized world‐based healthcare providers are increasingly off‐shoring low‐end healthcare services such as medical transcription, billing and insurance claims…

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Abstract

Purpose

Industrialized world‐based healthcare providers are increasingly off‐shoring low‐end healthcare services such as medical transcription, billing and insurance claims. High‐skill medical jobs such as tele‐imaging and tele‐pathology are also being sub‐contracted to developing countries. Despite its importance, little theory or research exists to explain what factors affect industry growth. The article's goals, therefore, are to examine economic processes associated with developing economies' shift from low‐ to high‐value information technology enabled healthcare services, and to investigate how these differ in terms of legitimacy from regulative, normative and cognitive institutions in the sending country and how healthcare services differ from other services.

Design/methodology/approach

This research is conceptual and theory‐building. Broadly, its approach can be described as a positivistic epistemology.

Findings

Anti off‐shoring regulative, normative and cognitive pressures in the sending country are likely to be stronger in healthcare than in most business process outsourcing. Moreover, such pressures are likely to be stronger in high‐value rather than in low‐value healthcare off‐shoring. The findings also indicate that off‐shoring low‐value healthcare services and emergent healthcare industries in a developing economy help accumulate implicit and tacit knowledge required for off‐shoring high‐value healthcare services.

Research limitations/implications

The approach lacks primary data and empirical documentation.

Practical implications

The article helps in understanding industry drivers and its possible future direction. The findings help in understanding the lens through which various institutional actors in a sending country view healthcare service off‐shoring.

Originality/value

The article's value stems from its analytical context, mechanisms and processes associated with developing economies' shift to high‐value healthcare off‐shoring services.

Details

International Journal of Health Care Quality Assurance, vol. 24 no. 6
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 June 2021

Ibrahim Alghanimi

This paper aims to summarize the radiological interventions that can be used by obstetricians and gynecologists.

Abstract

Purpose

This paper aims to summarize the radiological interventions that can be used by obstetricians and gynecologists.

Design/methodology/approach

E-health systems apply in all hospital sectors in the world; interventional radiology (IR) now includes transcatheter and percutaneous techniques that can be applied to various organ systems, including the female reproductive system and pelvis. Interventional radiologists can now offer many services to obstetricians and gynecologists. With the advent of new procedures and refinement of existing techniques, there are now a number of procedures that can be used to treat both vascular and non-vascular diseases. This review summarizes the radiological interventions that can be used by obstetricians and gynecologists.

Findings

This review is intended to help gynecologists and obstetricians understand the role of IR in their specialty. Many valuable vascular and nonvascular interventional services can be provided by radiologists for both obstetric and gynecological indications. Many of these IR procedures are minimally invasive with less risk to the patients.

Originality/value

IR is now being used to treat some conditions encountered in obstetrics and gynecology, in particular, uterine leiomyomas, placenta accreta, postpartum hemorrhage and pelvic congestion syndrome. Moreover, with the help of IR, radiologists can also manage several nonvascular pathologies, including drainage of pelvic abscesses, fallopian tube recanalization, image-guided biopsy and fluid collections involving ovarian lesions. The major challenges faced when performing obstetric IR procedures are reduction of radiation exposure for the patient and fetus and preservation of fertility. This review highlights the role of IR in the treatment of various vascular and nonvascular pathologies encountered in obstetrics and gynecology.

Details

International Journal of Human Rights in Healthcare, vol. 15 no. 2
Type: Research Article
ISSN: 2056-4902

Keywords

Article
Publication date: 27 April 2012

Mehmet Tolga Taner, Bulent Sezen and Kamal M. Atwat

This paper aims to apply the Six Sigma methodology to improve workflow by eliminating the causes of failure in the medical imaging department of a private Turkish hospital.

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Abstract

Purpose

This paper aims to apply the Six Sigma methodology to improve workflow by eliminating the causes of failure in the medical imaging department of a private Turkish hospital.

Design/methodology/approach

Implementation of the design, measure, analyse, improve and control (DMAIC) improvement cycle, workflow chart, fishbone diagrams and Pareto charts were employed, together with rigorous data collection in the department. The identification of root causes of repeat sessions and delays was followed by failure, mode and effect analysis, hazard analysis and decision tree analysis.

Findings

The most frequent causes of failure were malfunction of the RIS/PACS system and improper positioning of patients. Subsequent to extensive training of professionals, the sigma level was increased from 3.5 to 4.2.

Research limitations/implications

The data were collected over only four months.

Practical implications

Six Sigma's data measurement and process improvement methodology is the impetus for health care organisations to rethink their workflow and reduce malpractice. It involves measuring, recording and reporting data on a regular basis. This enables the administration to monitor workflow continuously.

Social implications

The improvements in the workflow under study, made by determining the failures and potential risks associated with radiologic care, will have a positive impact on society in terms of patient safety. Having eliminated repeat examinations, the risk of being exposed to more radiation was also minimised.

Originality/value

This paper supports the need to apply Six Sigma and present an evaluation of the process in an imaging department.

Details

International Journal of Health Care Quality Assurance, vol. 25 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 4 April 2016

Naglaa Mostafa Elsayed Abdallah

The purpose of this paper is to highlight the relation between radiology and sustainable development with emphasis on the UK and European countries, and to spotlight its…

Abstract

Purpose

The purpose of this paper is to highlight the relation between radiology and sustainable development with emphasis on the UK and European countries, and to spotlight its possible application in the developing countries.

Design/methodology/approach

This is a review paper where data about sustainable development and radiology are collected from selected journals, websites, articles and conferences, e.g. Royal College of Radiology, European Society of Radiology, World Health Organization and other different radiology societies.

Findings

Adoption of sustainable diagnostic radiology by many countries in Europe and the UK helps to provide imaging services efficiently and effectively, with simultaneous preservation of the natural resources, patient health and environment much better than before. The developing and underdeveloped countries should follow this knowledge hoping to reach the same goals.

Practical implications

Limiting the use of radiologic examinations, guide the clinicians to use clinical skills before rushing to radiology examinations will save money, preserve equipment and protect patients from possible radiation hazards. The use of teleradiology will indirectly reduce global warming, and will deliver medical services to poor countries.

Social implications

Improving the health of people of poor countries will improve their socioeconomic level.

Originality/value

This paper focuses on the value of applying sustainable development in radiology not only in general medicine.

Details

World Journal of Science, Technology and Sustainable Development, vol. 13 no. 2
Type: Research Article
ISSN: 2042-5945

Keywords

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