Paradoxes of professional autonomy: a qualitative study of U.S. neonatologists from 1978‐2017

Rozier, Michael; Willison, Charley E.; Anspach, Renée R.; Howell, Joel D.; Greer, Ann; Greer, Scott L.

doi:10.1111/1467-9566.13169

Cited by 4 publications

(2 citation statements)

References 37 publications

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“…Due to the concentration of disciplines, the organizational culture construction of specialized hospitals is more unified than that of general hospitals. Rozier points out that it is more urgent for specialized hospital doctors to integrate into the organizational culture, and doctors have more autonomy in their work [ 24 ]. On the other hand, there were differences in perceived organizational commitment factors between the two hospitals.…”

Section: Discussionmentioning

confidence: 99%

Is there any difference in organizational commitment between general hospitals and specialized hospitals? Empirical evidence from public hospitals in Beijing, China

Gao,

Zhu,

et al. 2023

BMC Health Serv Res

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Objective The purpose of the study on the one hand is to see different hospital organization commitment have difference, including the overall score and various dimensions, on the other hand, due to the different hospital type, its function orientation is different, the factors of the doctor organization commitment may also exist differences, so the study of another purpose is to determine for different types of hospital doctor organization commitment the focus and key groups, provide reference for the doctor incentive strategy. Methods A total of 292 doctors in four large public hospitals in Beijing were investigated. Physicians’ perceived organizational commitment was investigated using self-made electronic questionnaires. Data were analyzed by factor analysis, descriptive statistics, t-test, ANOVA, and multiple linear regression. Results In the large public hospital doctor perception of the hospital commitment status, Specialized hospitals had higher overall commitment behavior scores, it is 3.47 ± 0.86; General hospital commitment behavior scored low at 3.39 ± 0.91. In the regression results, department category, working years, administrative position, and entry mode are the influencing factors of the organizational commitment of doctors in general hospitals, while in specialized hospitals, in addition to whether to hold an administrative position, entry mode, and working hours, the influencing factors also include gender, professional title and overseas learning background. Conclusion There are differences in the perceived organizational commitment by doctors in different types of public hospitals, and different factors influencing their organizational commitment.Hospital type directly influences physicians’ organizational commitment and plays a moderating role in influencing other factors. A possible solution is general hospital specialization, encouraging general hospitals to develop the dominant discipline. These findings can help healthcare service hospital executives or government policymakers understand the impact of hospital specialization strategies and develop more efficient medical staff incentive systems.

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Section: Discussionmentioning

confidence: 99%

Is there any difference in organizational commitment between general hospitals and specialized hospitals? Empirical evidence from public hospitals in Beijing, China

Gao,

Zhu,

et al. 2023

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Some parents claimed that HCP ought to protect parents against this immediate instinct, based on HCP's knowledge about the hardship for both the child and the family. The influence of social media can also fortify the primary instinct of saving, offering easy access to "miracle" stories, and the many narratives of heroic parents fighting for their baby might further reinforce the primary instinct of saving (Rozier et al 2020).…”

Section: Making Decisions In the Gray Zonementioning

confidence: 99%

Postponed Withholding: Balanced Decision-Making at the Margins of Viability

Syltern

Ursin

Solberg

et al. 2021

The American Journal of Bioethics

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Advances in neonatology have led to improved survival for periviable infants. Immaturity still carries a high risk of short-and long-term harms, and uncertainty turns provision of life support into an ethical dilemma. Shared decision-making with parents has gained ground. However, the need to start immediate life support and the ensuing difficulty of withdrawing treatment stands in tension with the possibility of a fair decision-making process. Both the parental "instinct of saving" and "withdrawal resistance" involved can preclude shared decision-making. To help health care personnel and empower parents, we propose a novel approach labeled "postponed withholding." In the absence of a prenatal advance directive, life support is started at birth, followed by planned redirection to palliative care after one week, unless parents, after a thorough counseling process, actively ask for continued life support. Despite the emotional challenges, this approach can facilitate ethically balanced decision-making processes in the gray zone.

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Professions, Data, and Political Will: From the Pandemic Toward a Political Science with Public Health

Greer

2022

Integrating Science and Politics for Public Health

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The COVID-19 pandemic promised to teach us many things. One of the things it can help to teach us is about ways to do political science with public health. A political science with public health can work best if informed by a broad social-scientific understanding of both fields. This chapter, therefore, takes its inspiration from not just political science but also sociology and Science and Technology Studies, a field which focuses on the social construction of facts and their flow through society. The chapter focuses on three issues that seem to be particular causes of disciplinary misunderstanding and potentially fruitful research. The first is the professional authority of public health as a profession, including the extent to which it has a clear domain of expertise that others in government and academia respect. The second is the politics of data. Data are endogenous to the political process because the collection and coding of data of any kind are political decisions. The experience showed the potential value of viewing statistics as a dependent variable. The third is of the most contested concepts that can be found at the border of public health and political science: political will.

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Paradoxes of professional autonomy: a qualitative study of U.S. neonatologists from 1978‐2017

Cited by 4 publications

References 37 publications

Is there any difference in organizational commitment between general hospitals and specialized hospitals? Empirical evidence from public hospitals in Beijing, China

Is there any difference in organizational commitment between general hospitals and specialized hospitals? Empirical evidence from public hospitals in Beijing, China

Postponed Withholding: Balanced Decision-Making at the Margins of Viability

Professions, Data, and Political Will: From the Pandemic Toward a Political Science with Public Health

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