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Biomedical subjects

S S Mick

Publications and source records attributed to S S Mick.

54 records · Page 3Linked to original sources
PubMed1983

Physician turnover in eight New England prepaid group practices: an analysis.

The objectives of this questionnaire study of all primary care physicians (N = 154) who had ever worked in eight New England prepaid group practices (PGPs) include 1) calculation of turnover rates, 2) comparison of those who stayed in (stayers) versus those who left (leavers) the PGPs, and 3) description of reasons given for leaving. An annual turnover rate of 3.9 to 6.3 per cent, depending upon the measure, was within the range reported by others. Factors associated with stayer-leaver status were experiences before and during the physician's PGP tenure. Leavers reported pre-PGP experience in fee-for-service, hospital-based, and academic positions, and while in the PGPs, they reported constraints on autonomy, independence, and professional development. Leavers reported higher incomes and longer working hours in their new practices. They cited the potential for greater autonomy as the reason for leaving. The findings and study limitations are discussed.

Attitude of Health Personnel↗
PubMed1978

Understanding the persistence of human resource problems in health.

Four current and central problems in health manpower--total numbers, geographic distribution, field of practice, and productivity--are analyzed in the light of the recommendations of the Committee on the Costs of Medical Care. The persistence of these problems since 1932 is due to limited mobility within health occupations, and other differential controls of human resources. Efforts to correct manpower imbalances through educational solutions ignore the role of educational institutions in perpetuating social inequality. Traditional patterns are challenged in an exploration of new sources of change.

Allied Health Personnel↗
PubMed1976

United States foreign medical graduates in Connecticut: how they compare with foreign medical graduates.

This study contrasts the graduate training and subsequent careers of a cohort of United States-born foreign medical graduates (USFMGs) and foreign medical graduates (FMGs) who were in training positions in Connecticut in 1964 and who were located in 1971. The data suggest that although USFMGs were foreign-educated, they had certain advantages--both cultural and administrative--in hospital training positions which helped them to pursue different career alternatives than FMGs. However, the data further suggest that they retained characteristics of their foreign training which continued to differentiate them from United States medical graduates (USMGs).

Age Factors↗
PubMed1975

Licensure, competence, and manpower distribution. A follow-up study of foreign medical graduates.

Medical statistics report United States medical graduates licensed at higher rates than foreign medical graduates. This difference is often interpreted to show greater medical competence of United States graduates. This study questions this interpretation by analyzing 1971 licensure rates for both groups who had been interns and residents in 1963. We found that factors unrelated to competence--namely, visa-citizenship status and state of examination--are associated with holding a license. Moreover, quality of medical education is not an accurate predictor of licensure. It follows that the use of licensure rates as measures of medical competence distorts understanding of the quality of medical care in the United States. More probably, the difficulties in obtaining medical licensure experienced by foreign graduates result from the use of such graduates to relieve specific medical-manpower shortages.

Clinical Competence↗
PubMedDate not supplied

[The dream of the Far West: French physicians in the United States].

At the end of 1996, there were 115,484 foreign medical graduates in the US. More than one quarter of the US physician workforce were FMGs, among them 973 came from a French medical school (nearly 0.6% of the French physician workforce). French-trained doctors in the US are mainly located in New York, New Jersey, California and Florida, i.e. in the urban areas. However, their membership to the medical learned societies is less frequent than their American colleagues. In general, their ways of practice evidence a lower level of professional status. Based on training costs, the loss for France, due to migration to the US of these 973 doctors could be estimated between 1.2 billion and 8.5 billion French Francs. One has to remind that, at the same time, France "imports" doctors trained in other countries for fulfilling medical posts in hospitals in remote areas. The process occurs in a context of oversupply of physicians in France. A large-scale study of international migration of physicians and nurses was undertaken under the aegis of the World Health Organization in the early 70's. It seems now of interest to re-examine again the issue.

Adult↗
PubMedDate not supplied

Knowledge and attitudes toward Tay-Sachs disease among a college student population.

To assess the feasibility of screening the single Jewish population for Tay-Sachs disease (TSD), a questionnaire examining the knowledge of and attitudes toward TSD and genetic screening was sent to 348 Yale University Jewish undergraduates. Of those students responding (63 percent), 78 percent were able to answer general genetic questions correctly while only 1.9 percent could answer specific Tay-Sachs questions correctly. A majority of the students (93.9 percent) indicated some concern about being a carrier for TSD, believed that carrier status would affect future social and reproductive behavior, and expressed an interest in having TS carrier status determined while still single (77.4 percent). Strong correlations were found between knowledge and attitudes, but no significant differences appeared between male and female respondents. In addition to leading to improvements in Tay-Sachs screening programs, the observations have led to suggestions that may be generalized to other genetic screening programs.

Adult↗
PubMedDate not supplied

Graduate medical education as a policy instrument: promise and problems.

Increasingly, graduate medical education (residency training) is being proposed as a policy instrument to reform the traditional manpower problems of distribution of physicians. This article suggests why graduate medical education has become the latest policy device in the decades-old effort to rectify physician imbalances, and it discusses the potential for reform contained in this approach. It then presents a number of problems that will probably hinder the effective implementation of such policy and concludes that future federal policy directives are uncertain.

Health Policy↗
PubMedDate not supplied

[An American in Clamency: closing of small hospitals in France].

This article chronicles events in 1993-1994 in the small rural town of Clamecy, located in the Burgundy region of France, stemming from proposals of regional planning authorities to close the maternity and emergency services of the local hospital. This possibility engendered a series of protests and maneuvers by town notables, hospital personnel, and local physicians to halt such plans. The situation provided an opportunity for a sociological examination of the role of the hospital in the social and economic life of a rural community. This included a series of unstructured interviews with various townspeople and health professionals conducted within a sociological framework and with the benefit of the author's status as a foreign observer, beholden to no particular French political affiliation or health policy position. The results of the study reveal profoundly held perceptions that the hospital was a key element in the social, cultural, and economic life of the community, far surpassing its "mere" role as a health delivery organization. These findings are placed in the French context of rural development on the one hand, and rationalization of the health delivery system on the other.

France↗