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Book part
Publication date: 5 August 2011

Renee Hosang

Purpose – This chapter has three major points. First, I present the legal context that guides pediatric clinical interactions in the United States. Second, I argue that…

Abstract

Purpose – This chapter has three major points. First, I present the legal context that guides pediatric clinical interactions in the United States. Second, I argue that pediatric care is incomplete if the child patient is not identified as a knowledgeable and serious resource, thereby illustrating the concept called child inclusion. Third, it recognizes the child as a research participant.

Methodology – This chapter will present an argument for the concept of child inclusion by presenting limited data from research at a private clinic in the state of Florida, USA. It will present recommendations for the inclusion of children in the pediatric setting and comment on the child-centered method used for this research. The concept of child inclusion acknowledges the agency of a child in health care and places the child at the forefront of research. It presents qualitative data from ongoing research on indicators for child inclusion in a pediatric clinical setting, assuming that such indicators can only manifest in a partnership model of clinical interaction, where physician authority does not dominate clinical care and patients are actively involved in the negotiation of their health care.

Findings – I present recommendations for the inclusion of children in the pediatric setting and comment on the child-centered method used for this research. The concept of child inclusion acknowledges the agency of a child in health care and places the child at the forefront of research. This work calls for the child to no longer be in the background of pediatric care and social science research.

Details

The Well-Being, Peer Cultures and Rights of Children
Type: Book
ISBN: 978-1-78052-075-9

Keywords

Article
Publication date: 15 March 2022

Jian-Jun Wang, Huiyuan Liu and Jiao Ye

Online medical teams (OMTs) are gaining popularity as a new form of online health service to provide patients with prompt and guaranteed treatment. While the effective…

Abstract

Purpose

Online medical teams (OMTs) are gaining popularity as a new form of online health service to provide patients with prompt and guaranteed treatment. While the effective development of an OMT depends on physicians’ active participation, there is insufficient research on how a doctor gains from the OMT, especially from the multilevel and cross-level perspectives. In attempting to narrow this knowledge gap, the authors hypothesize multilevel and cross-level professional capital determinants of physicians’ performance in online health-care communities (OHCs) through the lens of social exchange theory.

Design/methodology/approach

This study develops a cross-level model to explain the effects of individual and team professional capital on physicians’ performance. To test the research model and hypotheses, the authors leverage data of 10,398 physicians engaged in 2,611 popular OMTs in China in conjunction with the hierarchical linear model approach.

Findings

The results indicated that physicians’ status capital (SC) and decisional capital (DC) are positively related to their performance. The SC and DC of an OMT not only increase physicians’ performance but also indirectly strengthen the positive effect of physicians’ SC on their performance. In contrast, OMTs’ SC and DC lessen the importance of physicians’ DC in promoting their performance.

Originality/value

By studying the mechanism between professional capital and physicians’ performance, this study provides several contributions to theory and practice. Specifically, this study contributes to the extant professional capital research by uncovering the influencing pathways of professional capital on physicians’ performance from a cross-level perspective. These findings suggest physicians pay close attention to the strength and mechanism of OMTs’ professional capital in improving their online performance.

Details

Internet Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1066-2243

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Article
Publication date: 2 May 2008

Joseph S. Guarisco and Stefoni A. Bavin

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables…

1413

Abstract

Purpose

The purpose of this paper is to provide a case study testing the Primary Provider Theory proposed by Aragon that states that: disproportionate to any other variables, patient satisfaction is distinctly and primarily linked to physician behaviors and secondarily to waiting times.

Design/methodology/approach

The case study began by creating incentives motivating physicians to reflect and improve behaviors (patient interactions) and practice patterns (workflow efficiency). The Press Ganey Emergency Department Survey was then utilized to track the impact of the incentive programs and to ascertain any relationship between patient satisfaction with the provider and global patient satisfaction with emergency department visits by measuring patient satisfaction over an eight quarter period.

Findings

The findings were two‐fold: firstly, the concept of “pay for performance” as a tool for physician motivation was valid; and secondly, the impact on global patient satisfaction by increases in patient satisfaction with the primary provider was significant and highly correlated, as proposed by Aragon.

Practical implications

These findings can encourage hospitals and physician groups to place a high value on the performance of primary providers of patient care, provide incentives for appropriate provider behaviors through “pay for performance” programs and promote physician understanding of the links between global patient satisfaction with physician behaviors and business growth, malpractice reduction, and other key measures of business success.

Originality/value

There are no other case studies prior to this project validating the Primary Provider Theory in an urban medical center; this project adds to the validity and credibility of the theory in this setting.

Details

Leadership in Health Services, vol. 21 no. 2
Type: Research Article
ISSN: 1751-1879

Keywords

Article
Publication date: 23 March 2010

Ulrike Burkhardt, Astrid Erbsen and Marjam Rüdiger‐Stürchler

The hospitalist concept aims for integration and continuity of care in inpatient treatment. The purpose of this paper is to understand how the hospitalist function emerges…

Abstract

Purpose

The hospitalist concept aims for integration and continuity of care in inpatient treatment. The purpose of this paper is to understand how the hospitalist function emerges and unfolds on wards. Therefore, the paper aims to focus on interaction patterns and the role of the hospitalist.

Design/methodology/approach

Building on methodological approaches in health care team research, this process‐oriented case study used participatory observations and semi‐structured interviews. Over a year, 14 observational days were conducted, simultaneously accompanying hospitalists, nurses and surgeons. Observational data illustrate the findings.

Findings

The hospitalist function was perceived to have a positive impact. He/she serves as an informal leader by taking up five interrelated, mostly coordinative roles, which help to cope with different organisational gaps. The interaction patterns are bilateral, ad hoc, reactive, repetitive and dependent on chance and people. Roles, tasks and responsibilities are continuously negotiated.

Research limitations/implications

Hospitalist research should make use of the debate in health care team research about overlapping roles, tasks and responsibilities. Additionally, one could look at the origins behind the evolvement of interaction patterns and the hospitalist's roles.

Practical implications

The sole creation of the hospitalist function is not sufficient to tap its full potential. Organisational issues concerning the interaction processes need to be addressed. In so doing, the professions' orientations must be taken into account.

Originality/value

This paper addresses theoretical and methodological gaps in hospitalist research. Using a process‐oriented qualitative design, the findings question the prominent stimulus‐response assumption. The focus on the interplay of functions and the hospitalists' roles lead to a more comprehensive picture of the patient‐related interaction processes.

Details

Journal of Health Organization and Management, vol. 24 no. 1
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 10 June 2021

Sergio Riotta and Manfredi Bruccoleri

This study formulates a new archetypical model that describes and re-interprets the patientphysician relationship from the perspective of two widespread phenomena in the…

Abstract

Purpose

This study formulates a new archetypical model that describes and re-interprets the patientphysician relationship from the perspective of two widespread phenomena in the healthcare delivery process: value co-creation (VCC) and defensive medicine (DM).

Design/methodology/approach

Grounded in the existing literature on VCC and DM, the authors designed and conducted 20 in-depth interviews with doctors (and patients) about their past relationships with patients (and doctors). After putting the recorded interviews through qualitative analysis with a three-level coding activity, the authors built an empirically informed model to classify patientphysician relationships.

Findings

The authors identified four archetypes of patientphysician relationships. Each archetype is described along with its representing characteristics and explained in terms of its consequences as they relate to VCC and DM.

Research limitations/implications

This research contributes to the literature on both VCC in healthcare and DM, in addition to the patientphysician's relationship literature.

Practical implications

Being aware of patientphysician relationship mechanics, building long-term relations with patients and investing in service personalization and patient-centred care can effectively mitigate the risks of DM behaviours on one side while increasing the likelihood of VCC actualization on the other.

Originality/value

Although strictly linked to the interactions between patients and doctors, VCC and DM are typically considered disentangled. In this research paper, the authors identified four archetypes of patientphysician relationships in relation to these two phenomena.

Details

Journal of Service Theory and Practice, vol. 31 no. 6
Type: Research Article
ISSN: 2055-6225

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Article
Publication date: 1 June 1997

Rachel Fleishman

Describes a study designed to develop instruments for examining the quality of routine care of hypertension among the elderly and, using non‐medical predictors of quality…

580

Abstract

Describes a study designed to develop instruments for examining the quality of routine care of hypertension among the elderly and, using non‐medical predictors of quality ‐ such as elderly patient and doctor variables and doctor‐patient interaction variables ‐ to explain the variance in the quality of care. The study population comprised 352 elderly people (92 per cent) in one Jerusalem neighbourhood who were members of Israel’s largest sick fund. Interviews, screening, observation and examination of records were the sources of information. Multivariate analysis was performed. The findings indicated a plethora of deficiencies in the quality of routine care, mostly in the quality of surveillance and the control of hypertension. It was found that the outcome of care is primarily a result of the physicianpatient interaction, rather than of a lack of patient compliance. Proposes a national programme using the instruments developed.

Details

International Journal of Health Care Quality Assurance, vol. 10 no. 3
Type: Research Article
ISSN: 0952-6862

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Book part
Publication date: 29 July 2009

Eric S. Williams, Ericka R. Lawrence, Kim Sydow Campbell and Steven Spiehler

The physicianpatient relationship is the cornerstone of care quality. Unfortunately, it may be adversely affected by physician burnout, which is becoming more prevalent…

Abstract

The physicianpatient relationship is the cornerstone of care quality. Unfortunately, it may be adversely affected by physician burnout, which is becoming more prevalent according to the literature. We present a model, based on the burnout and physicianpatient communication literatures, which delineates the impact of physician burnout on the physicianpatient interaction and ultimately on patient outcomes. In short, when physicians use depersonalization to cope with emotional exhaustion, their communication style becomes more biomedically oriented. Faced with this communication style when interacting with their physician, patients are less satisfied, trusting, and adherent. The implications of this model and directions for future research are presented.

Details

Biennial Review of Health Care Management: Meso Perspective
Type: Book
ISBN: 978-1-84855-673-7

Article
Publication date: 28 July 2021

Scott Comber, Lisette Wilson, Scarlett Kelly and Lori McCay-Peet

The purpose of this study is to better understand social media (SM) factors that physician leaders need to consider, as they adapt their cross-boundary practices to engage…

Abstract

Purpose

The purpose of this study is to better understand social media (SM) factors that physician leaders need to consider, as they adapt their cross-boundary practices to engage with colleagues and patients. Firstly, this study explores why SM is being used by physicians to cross horizontal (physician to physician) and stakeholder (physician to patient) boundaries prior to COVID-19. Secondly, based on the studies reviewed, this study provides insights on the practical SM implications for physician leaders working in the COVID-19 environment to actively enhance their practices, reduce public confusion and improve patient care, thus informing health-care practices.

Design/methodology/approach

A systematic literature review was used to conduct a structured transparent overview of peer reviewed articles that describe physicians’ use of cross-boundary SM across several disciplines (e.g. health, information science). As a baseline assessment prior to COVID-19, the review synthesized 47 articles, identified and selected from six databases and Novanet. This study used NVivo 12 to thematical code the articles, leading to the emergence of four broad factors that influence SM use.

Findings

A key reason noted in the literature for physicians use of SM to cross horizontal boundaries is to share knowledge. Regarding stakeholder boundaries, the most cited reasons are to improve patient’s health and encourage behavioural changes. Insights garnered on the practical SM implications include the need for physicians to be stronger leaders in presenting trustworthy and consistent facts about health information to the public and fellow peers. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts.

Research limitations/implications

As this was a literature review, the authors did not collect primary data to further explore this rapidly changing and dynamic SM world. Next steps could include a survey to determine firstly, how physicians currently use SM in this COVID-19 environment, and secondly, how they could leverage it for their work. Findings from this survey will help us better understand the role of physician leaders as health-care influencers and how they could better create trust and inform the Canadian public in the health information that is being conveyed.

Practical implications

Physician leaders can play a key role in positively influencing institutional support for ethical and safe SM use and engagement practices. Physicians need to participate in developing regulations and guidelines that are fundamentally to physician leader’s SM use. Central to this research would be the need to understand how physicians cross-boundary practices have changed during and potentially post COVID-19. Physician leaders also need to monitor information sources for credibility and ensure that these sources are protected. As role models for the effective use of SM tools, physician leaders can mentor and coach their colleagues and counterparts in this area.

Originality/value

Although there have been studies of how physicians use SM, fewer studies explore why physician leaders’ cross boundaries (horizontal and stakeholder) using SM. Important insights are gained in physician leaders practical use of SM. Key themes that emerged included: organizational and individual, information, professional and regulations and guideline factors. These factors strengthen physician leaders understanding of areas of foci to enhance their cross-boundary interactions. There is an urgency to study the complexity of SM and the effectiveness of regulations and guidelines for physicians, who are being required, at an accelerated rate, to strengthen and increase their cross-boundary practices.

Details

Leadership in Health Services, vol. 34 no. 4
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 19 August 2020

Yan Wan, Yifan Zhang and Mengling Yan

Online trust is a key factor for successful online transactions. To some extent, online health consultation can be considered an online transaction. Owing to the unique…

Abstract

Purpose

Online trust is a key factor for successful online transactions. To some extent, online health consultation can be considered an online transaction. Owing to the unique physicianpatient relationship, patients' choice of physicians within an online health consultation setting may not only be based on rational judgments but also considerably affected by their feelings. Hence, the purpose of this study was to explore which physicians' attributes affect patients' cognitive and affective trust in physicians, as well as how these two variables and their association affect patients' willingness to choose.

Design/methodology/approach

Based on the broad conceptual framework of online trust, this paper proposed a set of hypotheses that were tested through analyzing survey data using structural equation modeling techniques.

Findings

Results showed that physicians' ability had a significant positive influence on patients' cognitive trust in the physician; physicians' integrity and benevolence had a significant positive influence on patients' affective trust in the physician; cognitive and affective trust had a significant positive impact on patients' willingness to choose and there were significant positive interactions between affective and cognitive trust.

Originality/value

This study theoretically enriches the generic model of online trust. From the practical perspective, it will provide physicians working in online health consultation platforms and relevant practitioners with baseline information on the topic and advice for decision-making toward service enhancement and clientele improvements.

Details

Industrial Management & Data Systems, vol. 120 no. 12
Type: Research Article
ISSN: 0263-5577

Keywords

Article
Publication date: 14 March 2022

Peng Ouyang and Jian-Jun Wang

The impact of image is widely investigated in various research fields. However, its effect in online health communities is rarely studied. In this research, the authors…

Abstract

Purpose

The impact of image is widely investigated in various research fields. However, its effect in online health communities is rarely studied. In this research, the authors develop a theoretical model to assess the impact of physicians' image on patients' choices in online health communities.

Design/methodology/approach

The authors developed a web crawler based on R language program to collect more than 40,000 physicians' images and other related information from their homepages in Haodf.com–a leading online health community in China. The features of physicians' images are computed by Face++ Application Programming Interface (API) through the following variables: beauty, smile and skin status.

Findings

The empirical results derive the following findings: (1) physician's beauty or physical attractiveness has no significant effect on patients’ choice; (2) Smile has a positive effect on patients’ choices; (3) Physician's skin status also positively affects patients' choices; (4) Physician's professional capital strengthens the effect of beauty, smile and skin status on patients' choices; (5) Beauty and skin status are the substitutes for each other, and smile and skin status are the substitutes for each other too.

Research limitations/implications

Also, this study provides implications for both physicians and online health community platform managers.

Originality/value

This study provides new evidence in understanding the impact of physician's online image and contributes to the literature on signaling theory, impression management theory and patients' choices.

Details

Internet Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1066-2243

Keywords

1 – 10 of over 5000