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Financial managers are playing an increasingly important role in the negotiation of hospital service contracts with vendors. However, many legal issues and provisions should be considered when negotiating these contracts. Financial managers will find that they will be able to negotiate much more effectively when they have a better understanding of the legal framework in which these contracts are drafted.
The appropriate planning, negotiation and drafting of a hospital-based physician agreement is important to its success. Not only does Mr. Gravely discuss important issues to be covered in the negotiating process, but his experience in this field enables him to share effective negotiating strategies. A reprint from In Touch, this article serves to broaden the radiology manager's understanding of hospital-based physician contracts.
In recent years, it has become possible for the end of life to be a negotiated event, particularly in the intensive care unit. A multitude of often unidentified and poorly understood factors affect such negotiations. These include, family dynamics, ever-changing health care teams, inconsistent opinions about prognosis, and cultural differences between physicians, and patients and their families. When these factors converge, conflict may erupt. This article explores the nature, antecedents, and cost of such conflict. Arguments for the importance of balanced communication, negotiation, and mediation in end-of-life care are put forward.
"Though the concept of negotiated settlements gained its momentum in southern Africa--Angola, Mozambique, Namibia and South Africa--the full success of negotiations is yet to be seen in most of these countries.... Demographic consequences of conflicts are explained through a systemic model. The importance of demographic variables on negotiated settlement has also been explained the same way. There is no easy way out to overcome conflicts...but it is suggested that mutual consultation with opposition parties or minorities, or the suppressed people, would help ease many situations in Africa or elsewhere."
This research seeks to determine the social competence of children between 18 and 24 months of age. It took place in two consultation centers (PMI) (50 children of North African origin) and two nurseries (20 native children). Each child is observed in a "natural" setting: in a waiting room and during free activity. The sequences in its behavior allow us to pinpoint the conflicts arising between the child and its peers as to who gets what and how an object is used: it also allows us to analyze the negotiating tactics it brings into play: resolution or avoidance tactics. Three conclusions can be drawn: 1. The ways of negotiating depend on the context; 2. The young child's negotiating shows processes of becoming less self-centered that go from mere anticipation to coordinating viewpoints; 3. Each child shows an interactive style. This research could contribute to creating a preventive policy: the pedagogy of conflict and a program for learning to interrelate socially.
Somewhere between the image of psychoanalysis as suggestion and psychoanalysis as unearthing is that of analysis as negotiation. This is a picture of a mutual construction of reality by analyst and patient. Such an interaction allows for reciprocal input of the participants and a possible change in both. This paper sketches the role of negotiation throughout the entire process of treatment--from the initial rules, to the theory of the analyst, to the emergence of the transference, to the goal of the cure. The technique of psychoanalysis is said to lie in the process of negotiation.
The low level of patient compliance with physician management regimens is widely recognized. Although numerous studies either have measured levels of noncompliance or have attempted to fathom the essential elements of patient-physician interaction, they do not indicate how complicance may be increased. Negotiation is a process by which two active and equal participants negotiate to obtain their respective goals (which are often at odds). Without appropriate negotiation, which requires the patient's active participation, the physician cannot hope to motivate the patient. Patients will continue to be noncompliant as long as they are treated as inferiors in the process.
There are numerous other useful negotiating tools, including Escalation, the Limit, the Krunch, Call for Higher Authority, CIA, Intimidation, Churning, Phoney Offers-unfortunately, too many to detail in this short chapter. But all of these tools are based on the fundamentals of human action, reaction, and interaction. Negotiating works because it recognizes the mutual desire for satisfying needs, and it recognizes others as persons as human and fragile as ourselves. Believe this, and believe that all of us share a longing to bring greater happiness and satisfaction to our lives. Raise your goals and awareness, and conduct yourself as a skilled and ethical negotiator in your daily life. It will bring you increased satisfaction and the same time help others to achieve theirs. An "I Win-You Win" philosophy will contribute to the building of a better world for all of us.
The authors conducted a study to examine nurse and patient perceptions of self-care and the performance of self-care in rehabilitation settings. The grounded-theory method was used to conduct and analyze in-depth interviews of 12 nurses and 12 rehabilitation patients. Every nurse and every patient had expectations regarding who would control each aspect of the patient's self-care. When these expectations were noncongruent, negotiation usually occurred. Successful negotiation resulted in a balance of self-care, the optimal balance between nurse and patient control.
In several instances, third-party payers negotiate prices of health care services with providers. We show that a third-party payer may prefer to deal with a professional association than with the sub-set constituted by the more efficient providers, and then apply the same price to all providers. The reason for this is the increase in the bargaining position of providers. The more efficient providers are also the ones with higher profits in the event of negotiation failure. This allows them to extract a higher surplus from the third-party payer.
Environmental management decisions typically lie at the interface of science and public policy. Consequently, these decisions involve a number of stakeholders with competing agendas and vested interests in the ultimate decision. In such cases, it is appropriate to adopt formal methods for consensus building to ensure transparent and repeatable decisions. In this paper, we use an environmental management case study to demonstrate the utility of a mathematical consensus convergence model in aggregating values (or weights) across groups. Consensus models are applicable when all parties agree to negotiate in order to resolve conflict. The advantage of this method is that it does not require that all members of the group reach agreement, often an impossible task in group decision making. Instead, it uses philosophical foundations in consensus building to aggregate group members' values in a way that guarantees convergence towards a single consensual value that summarizes the group position. We highlight current problems with ad hoc consensus and negotiation methods, provide justification for the adoption of formal consensus convergence models and compare the consensus convergence model with currently used methods for aggregating values across a group in a decision making context. The model provides a simple and transparent decision support tool for group decision making that is straightforward to implement.
Are happy people more likely to be cooperative and successful negotiators? On the basis of the Affect Infusion Model (AIM; Forgas, 1995a). Experiment 1 predicted and found that both good and bad moods had a significant mood-congruent effect on people's thoughts and plans, and on their negotiation strategies and outcomes in both interpersonal and intergroup bargaining. Experiment 2 replicated these results and also showed that mood effects were reduced for persons more likely to adopt motivated processing strategies (scoring high on machiavellianism and need for approval). Experiment 3 confirmed these effects and demonstrated that the mood of the opposition also produced more mood-congruent bargaining strategies and outcomes. The results are discussed in terms of affect priming influences on interpersonal behaviors, and the implications of these findings for real-life cognitive tasks and bargaining encounters are considered.
In this article, the authors advanced a cultural view of judgment biases in conflict and negotiation. The authors predicted that disputants' self-serving biases of fairness would be more prevalent in individualistic cultures, such as the United States, in which the self is served by focusing on one's positive attributes to "stand out" and be better than others, yet would be attenuated in collectivistic cultures, such as Japan, where the self is served by focusing on one's negative characteristics to "blend in" (S. J. Heine, D. R. Lehman, H. R. Markus, & S. Kitayama, 1999). Four studies that used different methodologies (free recall, scenarios, and a laboratory experiment) supported this notion. Implications for the science and practice of negotiation are discussed.
There has been little research examining customer reactions to brokered ultimatum game (BUG) contexts (i.e. exchanges in which 1 party offers an ultimatum price for a resource through an intermediary, and the ultimatum offer is accepted or rejected by the other party). In this study, the authors incorporated rational decision-making theory and justice theory to examine how customers' bids, recommendations, and repatronage behavior are affected by characteristics of BUG contexts (changing from an ultimatum to negotiation transaction, response timeliness, and offer acceptance or rejection). Results indicated that customers attempt to be economically efficient with their bidding behavior. However, negotiation structures, long waits for a response, and rejected bids create injustice perceptions (particularly informational and distributive injustice), negatively influencing customers' recommendations to others and their repatronage. The authors then discuss the practical and theoretical implications of their results.
In organizational groups, often a majority has aligned preferences that oppose those of a minority. Although such situations may give rise to majority coalitions that exclude the minority or to minorities blocking unfavorable agreements, structural and motivational factors may stimulate groups to engage in integrative negotiation, leading to collectively beneficial agreements. An experiment with 97 3-person groups was designed to test hypotheses about the interactions among decision rule, the majority's social motivation, and the minority's social motivation. Results showed that under unanimity rule, minority members block decisions, thus harming the group, but only when the minority has proself motivation. Under majority rule, majority members coalesce at the minority's expense, but only when the majority has a proself motivation. Implications for negotiation research and group decision making are discussed.
AIMS: This article presents the results of an ethnographic study exploring how teenagers negotiated motherhood. The main aims of the study were to explore how the young women negotiated motherhood and how they constructed their own identities and relationships through teenage parenting. BACKGROUND: Approximately 10% of all births occur to teenage mothers worldwide. This phenomenon is of concern because teenage mothers are reported to be disadvantaged financially, educationally, and cognitively in both the short and long term. Many teenage mothers find strength and fulfillment in their motherhood role but this does not come without cost to themselves or their children, as many teenagers are considered unsuitable to be parents and do not have adequate support. DESIGN: This interpretive study incorporated ethnographic practices and was guided by feminist principles. After ethical approval from the university, data was collected over a 12-month period from five homeless Australian sole-supporting teenage mothers. Methods used included observation, interviews, field notes, journalling, and discussions with key informants. FINDINGS: The five participants described stories of disrupted lives, unhappiness in childhood, turmoil during adolescence and a need to find love and connection in their lives. Analysis of the data revealed four major themes; transforming lives and opportunities for change, accommodating the challenges, tolerating the abandonment of supports and living publicly examined lives. CONCLUSIONS: It was concluded that becoming a sole-supporting mother during the teenage years was a difficult struggle for the young women, because of their youth, their lack of preparation for motherhood and their reliance on welfare supports. In addition, they experienced negative public attitudes directed towards them wherever they went, and this included their visits to community child health centres. Recommendations are made for nurses to take a different approach when working with teenage mothers to help ameliorate the negative impact of poor parenting.
The prevailing view in bioethics is that the relationship between doctors and their patients was largely a silent one before the landmark court decisions of the twentieth century. Some have proposed that this was not always the case. This paper provides historical evidence of consent and negotiation in one nineteenth century gynecological practice. The Clinical Records and writings of Dr. Alexander J.C. Skene, who practiced in Brooklyn, New York from 1863 to 1900, have been examined for evidence of discussion, consent and even negotiation with patients. Although this evidence comes from only one practice, it is especially significant because it was largely a gynecological practice with women who were varied in socioeconomic status and ethnic origin. The importance of documenting physician-patient relationships which included patients in decision-making before Schloendorff (1914) established the legal doctrine of informed consent cannot be underestimated.
The chaplain experience in modern-day hospital medicine is largely one of marginalization. It is not, however, an experience without agency. Working within the constraints of difference, chaplains learn how to negotiate on the margins of medicine. This starts with learning the language of hospital medicine, learning to skillfully see, speak, and move in ways that minimize difference. Successes in socialization and acclimation do not, however, guarantee the chaplain a place in the hospital, where chaplains encounter both structural marginalization (resulting from inequalities in power and hierarchy) and ideological marginalization (resulting from inequalities in accepted forms of knowledge and practice). Using the theories of Michel Foucault (1973) and Byron Good (1994), I examine how chaplains negotiate structural and ideological marginality, at times embracing their connection to medicine (downplaying their connection to the institution of religion) and at other times embracing their connection to religion and religious practices. The result is an ambivalent chaplain who strategically embraces one or the other paradigm in order to survive. Using data gathered during a 12-month ethnography of chaplain interns at a university teaching hospital, this article examines the structural and ideological differences between science and religion through the modern-day practice of hospital chaplains. It both introduces readers to the modern-day chaplain, a healer largely absent in ethnography, and adds a renewed perspective to a long-standing body of literature on the relationship between structure and agency, and science and religion.