The U.S. health care system has innovated over the past decade in ways aimed at improving quality of while increasing managerial control how medicine is practiced. Two key issues examining innovation implementation extent to which physicians may experience deskilling as part use and what they actively participate this through adaptations make accommodate take advantage innovations their everyday work.Interviews with 78 primary were conducted. Data transcribed computer analyzed an interactive...

The organization and economics of health care in the United States are midst profound change. Yet we know little about how individual physicians cope with respond to this change on a daily basis. This article examines primary doctors two different work settings see professionals attempt actively deal structural developments their environment. findings show complex, uncertain, ongoing process professional adaptation characteristics specific context play mediating role adaptation. They also...

Managed care is cultivating a variety of new work careers within the medical profession, and it worth asking whether they will function as long- or shorter-term career options for individuals who participate in them. This paper uses specific case hospitalist physicians to explore how surrounding social economic contexts contribute two individual-level outcomes that inform issue longevity: concepts burnout intent stay career. The findings national survey hospitalists reveal job remain are...

Physician satisfaction is an important issue, yet we know less about it than should. This narrative review updates our knowledge U.S. physician and proposes new foci for understanding studying the topic that align better with evolving healthcare delivery system, physicians' everyday work situations, medicine's internal demographic changes. Using PubMed database of empirical studies published between 2008 2013 examine job, career, or satisfaction, compare findings a covering 1970 2007. We...

The Covid-19 global pandemic changes how we study professional workers and their everyday lives. We normally think of professionals as leading stable, secure, independent work has made life more challenging for them. Increased workloads economic uncertainties; the stresses demands caused by an abrupt juxta positioning with non-work life; greater risks safety concerns at work; new ways performing complex fewer resources disposal; additional public scrutiny decisions made; increased reliance...

This study examines identity and solidarity among 22 physician-managers working in a changing health maintenance organization. It describes two distinct identities these professionals the social relations associated with them. The are labeled organization-compatible profession-compatible. Social between characterized by conflict, distrust, game-playing rather than collegiality. findings support existence of fragmented within group as whole. Understanding organization physicians under managed...

To describe and analyze the types of data-related policies practices that currently exist among state newborn screening (NBS) programs in relation to long-term follow-up (LTFU) oversight for newborns with confirmed disorders.A 19-question online survey.Thirty-five NBS programs.Whether LTFU is performed, collection use data, variety data collected.Survey findings reveal challenges faced by their ability perform ongoing oversight, evaluation, quality assurance respect disorders. Of surveyed,...

In 2008, the Centers for Medicare & Medicaid Services introduced a new policy to adjust payment hospitals health care-associated infections (HAIs) not present on admission. Interviews with 36 hospital infection preventionists across United States explored perspectives of these key stakeholders potential unintended consequences current policy. Responses were analyzed using an iterative coding process where themes developed from data. Participants’ descriptions impacts centered around...