Physicians and advertising.

In this study, although the majority of responding physicians seemed to perceive advertising as not having an impact on the medical marketplace, the results concerning the medical profession appear quite different. In addition to soundly rejecting advertising as a communication mode in their profession, the physicians felt strongly that it would damage the profession's public image, plus promote fraud and hucksterism. A majority of respondents even went so far as to state that advertising would cause the quality of care to deteriorate. A majority also felt that advertising is ethically wrong for physicians. From these results, it seems that these physicians were not as concerned about the evils of advertising, per se, as the manner in which advertising would be applied by their colleagues to undermine the profession. It is very clear from the factor analysis that the major dimension of these physicians' attitudes toward advertising pertained to concern for the image of the profession, although economic and media communications aspects were of some importance. The question items loading most heavily on the IMAGE factor reflect perceptions that advertising will impact on the quality of care, promote fraud and hucksterism, convey a negative public image, etc. Thus, the primary focus of the physicians' negative attitudes does not seem to be toward the economic consequences, nor toward advertising as a societal entity. But, the major element for negativity is the way in which advertising would be applied by medical practitioners. More specifically, physicians believed that it would be applied in an unprofessional, unethical manner. Results of the factor analysis imply that the negativity focused upon advertising is really directed toward uncertainty pertaining to the ethics of medical practitioners and the way in which these ethics would be projected through media and other communications vehicles.     

Physicians and collective bargaining

This article discusses both the history of physician collective bargaining and the applicability of the 1974 health amendments of the National Labor Relations Act to this subject. Gordon outlines the issues for housestaff programs as well as for hospital-based professionals. The scope of physician bargaining includes: wages, hours, working conditions and issues related to the quality of patient care. Housestaff collective bargaining often addresses the issues of on-duty meals, free laundry and uniforms, subsidized housing, parking facilities, and on-call rooms. The concerns of staff physicians include tenure, pensions, and insurance benefits. Gordon suggests that the difficulty and novelty of physician/ hospital collective bargaining will frequently result in an impasse. He states that the propriety or impropriety of a doctors' strike depends upon: (l) the patient-care implications of the grievance causing the strike; (2) the gravity of the grievance leading to work stoppage; (3) the consequences of the strike for patient care; and (4) the other alternatives available. In the view of the author, a doctors' strike may be justified when it arises from a grievance relating to patient care as well as to self-aggrandizement. He states,"...if the strike is the only effective method of making known conditions prejudicial to patient care, including conditions which regularly and systematically cause loss of health and life, the physician may be obliged to engage in such a strike, rather than desist from such action." He concludes that as professionals shift from being private entrepreneurs to salaried employees, they will be compelled to use a collective bargaining approach for professional as well as economic concerns.     

军地医院医师防御性医疗行为比较

目的比较军队、地方医院医师防御性医疗行为现状,为卫生管理政策部门及医院管理者提供有价值的参数及理论依据。方法自制调查问卷,随机抽样调查部队医院5家、地方医院4家,SPSS软件进行统计分析。结果下发问卷600份,回收有效问卷512份,其中部队医院医师337名,地方医院医师175名。军队、地方医院医师的防御性医疗行为有显著差异。结论防御性医疗行为在我国医师群体中普遍存在,军队医院医师防御性医疗行为更具倾向性。     

Physicians and medical innovation

Previous attempts to model some aspects of physician behaviour include those of Evans, Sloan and Feldman and Wolfson. It is suggested that the introduction of knowledge as a distinct element in a microeconomic model of physician behaviour is preferable to the inclusion of a variable called 'discretionary influence' or 'quality of care' in the physician's utility function. This is because the properties of functions containing either of these variables appear to be indeterminate. By comparison the properties of the knowledge constraints can be specified with some confidence. The factors affecting a physician's demand for treatment on behalf of patients are identified as (1) the physician's objective function, (2) his knowledge and (3) the availability of medical resources. Furthermore, the knowledge element can be sub-divided into two parts: the set of prior probabilities and the set of likelihood functions. The former may be identified with the physician's local knowledge, whereas the latter may be associated with the physician's medical training. A significant fraction of the growing demand for hospital care has been attributed to changes in medical technology. During the late fifties and afterwards 'more cases became treatable' and physicians, it is argued, cannot resist the 'technological imperative'. The paper shows that the model may be used to generate testable hypothesis regarding the adoption by physicians of both process and product innovations. The discussion of the physician's medical knowledge is fundamental to the inducement mechanism. The policy instruments available to achieve an optimal diffusion of innovations are reviewed.     

Infants' attention to synthesised baby music and original acoustic music

The distinct music genre known as baby music is based on the premise that infants benefit from music ‘re-orchestrated for their little ears’ (‘Baby Einstein Takealong Tunes’. (2012). Retrieved December 11, 2012, from http://www.babyeinstein.com/en/products/product_explorer/theme/music/62350/Takealong_Tunes.html). We completed a study with 12- and 13-month-olds (n?=?24) to explore infants' preferential attention to music engineered specifically for them and the original acoustic music upon which the baby versions were created. The results of an infant-controlled preference procedure showed that infants were equally attentive to both types of music. However, infants who listened to relatives playing instruments at home (n?=?10) attended longer to the baby music version than to the original acoustic version, whereas the opposite was true for infants who did not have such opportunity. The results of the study raise questions regarding the need to re-orchestrate music intended for babies and alter the original instrumentations as set by the composers.