Towards an enabling history for the child day care profession in Canada

Canadian early childhood educators and child care professionals must seek to understand in what ways they perpetuate facets of their own professional malaise. From rationalizations that make of poverty wages a virtue, to an underassessment of the skills and knowledge required to create developmentally appropriate and individually sensitive learning environments, the field must squarely face those restrictions it has placed on itself if it is to move forward on behalf of children and families. This article addresses one facet of that self-imposed, restrictive environment — the perpetuation of a history that is neither ennobling nor enabling and presents the proposition that an alternative is available.     

Theoretical perspectives on medicine and the medical profession: an anthropological approach

The medical field and profession are studied from the theoretical point of view of the social sciences. The most representative works on this subject are presented. The analysis shows that conservative positivism and orthodox Marxism are the main obstacles to development in this field of study. At the same time it suggests the concept of culture and the anthropological method of research as the best means for the overcoming of some of the main contradictions which paralyse its progress.     

The gender earnings gap in medicine: Evidence from Canada

Despite the gender gap in physician earnings being of concern to many in Canada, its existence is far from universally accepted and there are no studies covering all physicians/regions or addressing earnings rather than billings. This may explain the lack of serious consideration or remedial action by medical associations and governments in negotiations, or tariff and compensation processes. Our study employs 2016 Canadian Census data linked to Canada Revenue Agency taxation records. Rather than focusing on gross billings, we model physician net earnings (after overhead expenses and controlling for hours/weeks of work) including dividends from corporations. Using OLS, and unconditional quantile regression to document the gap across the earnings distribution, we observe that Canadian female physicians, on average, earn 9.3% less than their male counterparts. The average adjusted gap is slightly smaller for family physicians (8.5%) than other specialists (10.2%). Beyond averages, at the top of the income distribution the gap is double that at the median for both family physicians and other specialists. The gap also varies across provinces, from 6.6% in Quebec to 19.8% in Manitoba. Although our results yield somewhat smaller estimates than those from studies using billings/self-reported income, the magnitudes remain appreciable. The findings substantiate the claim that the gender pay gap in Canadian medicine is pervasive.     

国内外科医师执业范围现状研究

目的循证评价我国外科医师执业范围的现状,对我国外科手术分级管理提供借鉴。方法检索CNKI、VIP和CBM等数据库和中华人民共和国卫生部、中国医师协会等网站,检索时间截止2008年7月。全面搜集有关手术分级、医师分级、手术管理、手术操作等方面的文献。结果通过对河北省、江苏省、河南省、深圳市、内蒙古自治区和上海市的手术分级管理规范进行合并分析显示:(1)手术根据手术过程的复杂程度、技术难度和风险分为四级。(2)手术医师根据其取得的卫生技术任职资格及其相应受聘职务,从事相应技术岗位的年限和临床工作经验开展相应级别手术。(3)不同级别医院开展相应级别手术。(4)规定了不同级别手术的审批权和术前手术通知单的签发权。结论通过界定手术分类分级和各级医院、医师手术范围及手术审批权限,规范医师行医行为,控制手术质量,降低手术风险,减少医疗纠纷,提高各级医院卫生资源利用效率,使有限的医疗资源配置更加合理、利用更加有效。     

The Kur in West Germany as an interface between naturopathic and allopathic ideologies

In countries where biomedicine developed from earlier medical knowledge, medical pluralism provides unusual cultural parameters and perspectives on biomedical epistemologies. Past therapy traditions, which are still salient in the biomedical system of West Germany today, are examined historically and ethnomedically. The Kur, now part of a complex system of rehabilitation medicine utilizing medical bathing and environmental stimuli, illustrates divergent ideologies in the contemporary German health care system. The influence of cultural, social, and political-economic factors on therapeutic eclecticism and directions are discussed as cultural dynamics of the biomedical system in general.     

The medical profession and alternative medicine in The Netherlands: its history and recent developments

At the end of 1993, the Dutch parliament passed the Individual Health Care Professions Bill which replaced existing legislation. The new Act brings to an end the monopoly of the Dutch medical profession. The former prohibition on alternative practitioners to practice medicine was abolished. This article addresses the question of whether the Act affects the position of medical dominance in Dutch health care. It will be argued that the new Act preserves the present position of medical dominance to a large extent. Although alternative therapies have gained greater social recognition, there is little indication that the cultural and social authority of medicine is yet being challenged in the Netherlands. However, it could be argued that the Dutch health care system is moving in a more pluralistic direction.     

The scope for preventive medicine in general practice in the East End

Primary care is seen as an obvious setting for preventive programmes, but a number of studies present a negative view of inner city primary care, with criticism directed particularly at older single-handed GPs. This may not be justified. A survey of 56 of the 84 GPs in the inner London borough of Tower Hamlets, found a higher than average proportion of single-handed GPs over 60 and a high level of dissatisfaction with premises. Half said they carried out some kind of preventive programme, usually hypertension screening, and three quarters were interested in doing so. Only one practice had a patient support group, but 70 per cent thought they were a good idea. Given support and help, more GPs would consider preventive programmes and set up patient support groups.