International medical travel is a rapidly developing phenomenon that promises patients cheap and affordable medical care abroad. However, the logistics of making travel arrangements, selecting a medical provider, and evaluating quality can be a daunting task for even the most experienced traveler. At the nexus, connecting patients and providers are medical travel facilitators (MTFs), who are individuals and companies that market foreign medical care to patients. While the services that MTFs offer vary, they primarily focus on making foreign medical care more accessible to patients through commodifying the medical experience and providing logistical support. Although they are an important part of international medical travel they are often overlooked, especially along the US/Mexico border. This paper contributes to the discussion on medical travel by focusing on MTFs and the methods they employ through (1) discussing the characteristics and logistical challenges of medical travel; (2) identifying the different types of medical travel facilitators; and (3) addressing how MTFs remake patients into consumers. Findings suggest that while MTFs operate on a variety of different scales, and market their services differently, they all emphasize the consumer experience through advertising quality assurances and logistical support.
Unresolved work stress contributes to burnout, compassion fatigue, disengagement, and other work-contextualized factors. The impact of occupational stressors extends to the organization in a negative fashion as well. In 2017, advanced practice providers (APPs) from four health systems, including nurse practitioners, clinical nurse specialists, nurse midwives, nurse anesthetists, and physician assistants, participated in a quantitative online cross-sectional survey; 754 participants responded to a free-text question related to work stress and work–family balance. Suggested organizational strategies were ordered into 29 codes, 10 subthemes, and four main themes: “reduce job stressors,” “improve leadership and operations,” “promote APP well-being,” and “maintain the status quo.” Findings are consistent with other research related to occupational stress with many of the reported strategies considered as evidence-based. Targeted interventions for reducing job stress will need to include improved autonomy for APPs, role delineation, support for work–family balance, and better communication as part of management practices.
Rising medical costs and decreasing health insurance coverage are fueling the health care crisis in the United States. Often, patients have to make tough decisions about whether to forgo care or risk bankruptcy. This conundrum has encouraged some patients to use Mexican health care as an alternative to the high costs in the United States. While medical travel enables some patients to access affordable care, others perceive it as risky and thus not a viable option. This article explores how those concerns are mitigated and Mexican health care usage is increased by (1) outlining how Mexican health care information is disseminated and used within a community of winter Texans living along the US/Mexico border; and (2) discussing how Mexican pharmacies and dental clinics have broadened their appeal through association with US health care standards and practices. Research for this article was conducted during 11 months of fieldwork in the Lower Rio Grande Valley.
Background: High levels of stress and burnout, documented among healthcare professionals, result in high levels of job turnover. However, little is known about personal strategies employed by advanced practice providers (APPs) to mitigate stress. Methods: 3,939 APPs were invited to complete an online, anonymous, cross-sectional survey to examine work stress and burnout among APPs using quantitative and qualitative analyses. The Maslach Burnout Inventory (MBI) served as the measure for burnout. Work-stress reduction strategies were identified by an open-ended question. Findings: 854 APPs (70% of 1,218 respondents) (nurse practitioners, physician assistants, nurse midwives, anesthetists, and clinical nurse specialists) from four different United States health systems completed the free text portion of the survey. Qualitative analyses revealed that almost all of the APPs (94%) reported at least one stress reduction strategy. Four main themes were derived from the free-text responses: “Self-focused” (67.5%), “relational-focused”(16.1%), “job-focused” (11.5%) and “nothing” (4.9%). Quantitative results from the MBI revealed high levels of burnout among APPs with insignificant differences between those who provided a response to the qualitative question and those who did not: emotional exhaustion ( p = .188); depersonalization ( p = .265); personal accomplishment ( p = .213). Conclusion/Application to Practice: Qualitative results highlighted strategies, many evidence-based, that APPs use to mitigate stress. Further research is needed to determine the frequency and consistency of APPs’ enactment of personal strategies. These initial findings provide insights for occupational health practitioners and researchers planning primary prevention and secondary interventions for improving workplace health, enhancing personal wellness, and reducing job-related stressors.
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