Are the Organisational Management Characteristics of Healthcare Organisations Distinguishable from Other Professional Organisations?

Organisational management characteristics occur with varying rates across industries and organisations within industries. While professional organisations tend to have fewer undesirable management characteristics than non-professional organisations, little work has been done to assess whether healthcare, with its unique legal structure that can put hospital administration at odds with physician autonomy, is an exception among professional organisations. In this study, rates of positive as well as undesirable management practices were estimated from publicly available ethnography data and compared to data from non-healthcare professional settings. A structured literature review was conducted to validate the ethnography data and further explore possible mechanisms. The main finding is that healthcare professionals do have greater group conflict with administration than other professionals and that healthcare settings exhibit greater instances of unwritten rules than other professional organisations. Overall, our results suggest that common management practices in other professional settings may not fully apply to healthcare. The potential for group conflict between physicians and administration is higher than other autonomous professional fields. Healthcare administration may benefit from examining practices in non-professional settings for beneficial ideas in management innovation.

Awareness about medical ethics among undergraduates after introduction of humanities in curriculum

<p class="abstract"><strong>Background:</strong> Modern day medicine is full of ethical challenges. A structured training in ethics can help doctors in choosing the best course of action during an ethical dilemma. It will be interesting to explore the knowledge and aptitude regarding bioethics in medical students who are already undergoing structured modules on humanities.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional study was done involving final year part I, final year part II medical students and interns using a validated semi-structured self-administered questionnaire. Questions were predominantly about doctor patient relationship which could be assessed using Likert scale.<strong></strong></p><p class="abstract"><strong>Results:</strong> Acceptable response of over 70% was seen only in response to two questions, both on respect for person. Majority of students did not have a clear concept about consent, privacy and confidentiality. However, most of them gave acceptable response to respecting patient and his wishes. There were many fence sitters in response to the questions regarding paternalistic attitude of doctors and physician autonomy. Majority of students did not give acceptable response in questions pertaining to beneficence and justice. No significant difference was seen between the various phases of medical education.</p><p class="abstract"><strong>Conclusions:</strong> The students were not clear about most aspects of doctor patient relationship like physician autonomy, confidentiality and consent. We need to revamp our teaching to increase understanding of ethics among our medical students.</p>

Physician autonomy and the pharmaceutical industry

The physician–industry relationship is a topic that generates keen interest among physicians globally. This chapter reviews the potential risks and benefits of such relationships in patient care. Physicians must adhere to strict professional standards and strong ethical principles, with the prime interest of offering the best possible care for the patient while using the resources available through pharmaceutical industry partnerships. One must never cross the boundaries in this complex interaction; physicians should continue to be the best advocates for patients, and not the pharmaceutical industry. Other aspects of relationships between the pharmaceutical industry and doctors’, trainees’, and residents’ perspectives in the industry, essential drug policy solutions in Sri Lanka, and several key points from the Australian Medical Association’s position statement on medical practitioner’s relationships with industries, are also discussed.