Dissertations / Theses on the topic 'Doctors'
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1
Сулим, Людмила Григорівна, Людмила Григорьевна Сулим, Liudmyla Hryhorivna Sulym, and G. A. Sulym. "Ibn Sina (Avicenna) - Doctor of Doctors." Thesis, Видавництво СумДУ, 2008. http://essuir.sumdu.edu.ua/handle/123456789/5312.
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Ibn Sina was born in 980 C.E. in the village of Afshana near Bukhara wich today is located in Uzbekistan. He turned his attention to Medicine at the age of 17 years and found it, in his own words, “not digfficult”. By the age of 18 he had built up a reputation as a physician.
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2
Burke, Sarah Elizabeth. "The doctor-patient relationship : an exploration of trainee doctors’ views." Thesis, University of Birmingham, 2008. http://etheses.bham.ac.uk//id/eprint/125/.
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Greater understanding of the ways in which medical trainees perceive the doctor-patient relationship could inform future developments in educational provision. A qualitative study was conducted, using a case study approach to explore the perceptions of postgraduate trainees in two medical specialties, general practice (GP) and otolaryngology (ear, nose and throat surgery, ENT), in the West Midlands region of the United Kingdom. Following a scoping exercise in 2002, interviews with 20 trainees (10 GP and 10 ENT) in 2004 and questionnaires from 16 ENT and 89 GP trainees in 2007 explored trainees’ views of the doctor-patient relationship, including perceptions of the nature of that relationship and how they had learnt to develop relationships with patients. Five conceptual frameworks that participants drew upon when talking about the doctor-patient relationship were identified: paternalism; guided decision-making; partnership; clinical and consumerism. Trainees described a fluid doctor-patient relationship which adapts to differing contexts, taking different forms in different situations and influenced by factors outside the doctor’s control, including time and the patient’s personality. Personal experience and observing senior colleagues were considered to have had the greatest impact on learning. Higher Specialist Training which acknowledges the complexity of the doctor-patient relationship and encourages reflective practice is recommended.
3
Dent, Mike. "Doctors and computers." Thesis, University of Warwick, 1988. http://wrap.warwick.ac.uk/71206/.
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The twin concerns of the thesis are (a) to develop a labour process analysis that is able to account for professional work and (b) in so doing to explain the reasons for hospital doctors various responses to the introduction of computer systems into medical work. This thesis constitutes a study of hospital doctors (clinicians) use of information technology in their clinic work. The first part reviews the literature and general developments in medical computing in relation to a theoretical analysis of the organisation and control of the clinic/medical labour process. The second part consists of an ethnographic study of the introduction of computer-based medical information systems into three hospitals; two being case studies of renal units and associated clinics and the third a study of an outpatients' department at a small acute hospital. The computer systems involved either replaced or supplemented the traditional form of the medical records and for this reason it was possible to focus on the role of these organisational records in the maintenance and reproduction of dominance and subordination within the labour process of clinic/medical work.
4
Gill, Deborah. "Becoming doctors : the formation of professional identity in newly qualified doctors." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/10020735/.
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This enquiry concerns the professional identities of newly qualified doctors, exploring how early years practitioners form their sense of self-as-doctor and the structural, educational, social and personal influences on this formation. With identity formation and professional development framed as situated, socio-cultural and developed within and through practice as an iterative process of becoming, this qualitative study, conducted in the interpretivist tradition, uses life-history interviews and brief periods of observation with recently qualified doctors. It reveals that new doctors begin to establish their professional identities through the interlinked processes of learning, belonging and becoming. Developing professional competencies, learning 'medicine' and a re-contextualisation of existing knowledge allows them to 'figure' who they are and what is expected of them. Belonging, although always partial, affects not only what can be made of experiences but also what can be carried forward. Becoming orientated to being a 'good doctor' has both outward-facing and personal aspects and is stimulated by responsibility, influenced by the personal history and planned trajectory of the doctor and the affordances of workplaces and delayed by the fragmented nature of the early years of work. Much of this learning, attempting to belong and to become a good doctor is not directed at their eventual doctor role but at the here and now. This work provides telling insights into the socio-cultural dimension of becoming a doctor and the potential effects of recent workplace and education reform on identity, professional formation and ultimately, practice. It provides ways of theorising how medical professional identities develop, questioning notions of a simple novice to expert trajectory and suggesting novice doctors maintain a legitimately peripheral period of participation in their communities during the early years of work. Both pedagogical approaches in medical education and the conceptualisation of the medical workplace as a site of learning and formation would benefit from review in light of these findings.
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Tregoning, Catherine Louise. "Doctors' career & retirement choices." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.504696.
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This research investigates the influences on doctors' career and retirement choices. It looks at what influences the career choices of 1993-1996 medical graduates from The University of Manchester (in the North West of England) and also explores what makes-them leave the North West region during this training stage. Doctors in the late stage of their career are also studied to investigate what makes hospital consultants in the North West over the age of 55 retire from the UK's National Health Service (NHS). THE UNIVERSITY OF MANCHESTER ABSTBACJOFTHESI~submittedby Catherine Tregoning for the Degree of PhD and entitled Doctors' Career and Retirement Choices March 2008 . '. ~ .. - ....... ~. ,'., ....;- The research shows that trainees who make career choices based upon an interest in the specialty and/or opportunities as they arise at the time, are more likely to remain in the medical profession. If they have children, they are less likely to remain in medicine. Those who grew-up in the North West or have a partner who originates from the region, can more often be expected to remain in the North West. Furthermore, relocation during training is less likely if an individual has a preference for working with a mixture of deprived and affluent populations. Over 55 hospital consultan'ts are more likely to retire if they obtained their primary medical qualification before 1970, or have a disability or significant health problem. There is also a greater likelihood that they will retire if they consider issues with management to be an important factor in their decision to leave their NHS career. Conversely, they are more likely to remain working in the NHS if achieving their maximum NHS pension entitlement is important to them. The research was conducted in two stages. In stage 1, 47 doctors were interviewed from the two sample groups. The qualitative data gathered, informed the development of a questionnaire distributed to 1, 483 doctors in stage 2. Of these 534 (36%) responded. 32.1% responded from the trainee group and 55.5% from the over 55 consultant group. Pilot studies were conducted at both stages. The research draws upon several different theoretical perspectives to develop the concepts of individual, social and job influences on careers, as well as explore the process of change. The results of the research inform academic work by considering doctors' choices in the context of literature from the fields of careers, medicine and psychology, which has rarely been done. '~lt~aH:f6-U:jKes twOSamples~at different career stages and compares the influences on careers at these different stages. Recommendations for further research include more in-depth investigation of the difficulties for female doctors of combining their career with motherhood, and work into consultants' retirement intentions versus retirement behaviour.
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Mansfield, Caroline. "Factors infuencing hospital doctors' use of clinical guidelines : towards a specific model of doctors' behaviour." Thesis, Oxford Brookes University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.363449.
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Passi, Vimmi. "How does positive doctor role modelling influence the development of medical professionalism in future doctors?" Thesis, University of Warwick, 2013. http://wrap.warwick.ac.uk/62713/.
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Background There has been an explosion of interest in medical professionalism over the past decade but at present there are no evidence based guidelines on how to effectively develop medical professionalism in future doctors (Passi et al. 2010). Role modelling has been highlighted as an important method to help develop professionalism but there is no current theory regarding the process of role modelling (Passi et al. 2013). Therefore, the aim of this PhD was to investigate how positive doctor role modelling influences the development of professionalism in future doctors. Methods A qualitative methodology using the grounded theory inquiry approach of Strauss and Corbin (2008) was used to generate a general explanation (a theory) of the process of role modelling shaped by the views of the participants. The study involved focus groups with final year medical students, semi structured interviews with consultants and semi structured interviews with consultants and final year medical students immediately after outpatient clinics. This systematic approach used involved open coding, axial coding and selective coding to reveal the processes involved in role modelling, which is illustrated in a coding paradigm diagram. Results The results revealed a new theory of doctor role modelling which is described as follows – Doctor role modelling is an important process in medical education that involves conscious and subconscious elements. It consists of an Exposure Phase followed by an Evolution Phase. The exposure phase involves demonstration of professional attributes by the doctor role models (clinical expertise; relationships with patients, students and colleagues; personality and inspirational characteristics). The evolution phase begins with observation of the role model by the modellee, following which the modellee makes a judgement whether or not to trial the observed behaviours of the role model. When the decision to trial is reached, this then leads to the Model Trialling Cycle which involves 5 stages of assembly, emulation, experimentation, adaptation and assimilation. The outcome is the evolution of a professional doctor who has developed their unique professional identity and career aspirations. Conclusion This detailed qualitative study has provided a new theory of doctor role modelling in medical education. The impact of role modelling is in the development of medical professionalism professional identity and the influence of career choice. The theory can now be incorporated in medical curriculums worldwide to enhance the development of medical professionalism. Detailed recommendations for clinical practice and future research are described.
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Crossley, James Graham Macnamara. "Assessing the clinical performance of doctors." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.398398.
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Wardman, David Tobias. "Doctors' moral beliefs and public policy." Thesis, University of Hull, 2017. http://hydra.hull.ac.uk/resources/hull:16452.
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In this thesis, I address three related questions: • First, suppose we legalise some controversial medical practice tomorrow. Should we respect the moral objections of those doctors who object to the practice? I argue that we should indeed respect those objections, and I provide two complementary reasons for doing so. • Second, when the objections of doctors conflict with the interests of patients, how do we balance these two demands, and is there scope for compromise? I propose some criteria for resolving this conflict. I also suggest that the conventional compromise — compulsory referral — is morally problematic, and propose that the solution to this problem is to regard referral as ‘just another’ controversial medical practice. • Third, in circumstances where prioritising patients’ interests means that we will eventually decide to overrule doctors’ moral objections, how might we expect doctors to respond to this, and is there anything we can do to reduce the harm to them? In my final chapter, I sketch some possible answers to this question.
10
Slukhenska, R. V. "Creative self-development of future doctors." Thesis, БДМУ, 2022. http://dspace.bsmu.edu.ua:8080/xmlui/handle/123456789/19630.
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Lim, Chee Kiat (David). "Prescribing practices of Australian dispensing doctors." Thesis, Curtin University, 2010. http://hdl.handle.net/20.500.11937/176.
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Background: In response to health workforce shortages policymakers have considered expanding the roles that a health professional may perform. A more traditional combination of health professional roles is that of a dispensing doctor (DD) who routinely prescribes and dispenses pharmaceuticals. A systematic review conducted on mainly overseas DDs’ practices found that DDs tended to prescribe more items per patients, less often generically, and showed poorer adherence to best practice. Convenience for patients was cited by both patients and DDs as the main reason for dispensing. In Australia, rural doctors are allowed to dispense Pharmaceutical Benefit Scheme (PBS) subsidised pharmaceutical benefits if there is no reasonable pharmacy coverage. Little was known about the practices of these Australian DDs.Objectives: To examine the PBS prescribing patterns of dispensing with matched non-dispensing doctors and identify factors that influence prescribing behaviour.Method: A sequential explanatory (QUAN-->qual) mixed methodology was utilised. Firstly, rurality-matched DDs’ and non-DDs’ PBS data for fiscal years 2005-7 were analysed against criteria distilled from a systematic review and stakeholder consultations. Secondly, structured interviews were conducted with a purposive sample of DDs to examine the quantitative findings.Key findings: DDs prescribed significantly fewer PBS prescriptions per patients but used Regulation 24 significantly more than non-DDs. Regulation 24 biased the prescribing data. DDs prescribed proportionally more penicillin type antibiotics, adrenergic inhalants and non-steroidal anti-inflammatories as compared to non-DDs. Reasons offered by DD-respondents highlighted that prescribing was influenced by an awareness of cost to the patients, peer pressure and confidential prescriber feedback provided on a regular basis.Implications: This innovative census study does not support international data that DDs are less judicious in their prescribing. There is some evidence that DDs might reduce health inequity between rural and urban Australian, and that the DD health model is valuable to patients in isolated communities.
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Lim, David Chee Kiat. "Prescribing practices of Australian dispensing doctors." Thesis, Curtin University of Technology, 2010. https://espace.curtin.edu.au/bitstream/handle/20.500.11937/176/150097_Lim2010.pdf?sequence=2&isAllowed=y.
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Background
In response to health workforce shortages policymakers have considered expanding the roles that a health professional may perform. A more traditional combination of health professional roles is that of a dispensing doctor (DD) who routinely prescribes and dispenses pharmaceuticals. A systematic review conducted on mainly overseas DDs’ practices found that DDs tended to prescribe more items per patients, less often generically, and showed poorer adherence to best practice. Convenience for patients was cited by both patients and DDs as the main reason for dispensing. In Australia, rural doctors are allowed to dispense Pharmaceutical Benefit Scheme (PBS) subsidised pharmaceutical benefits if there is no reasonable pharmacy coverage. Little was known about the practices of these Australian DDs.
Objectives
To examine the PBS prescribing patterns of dispensing with matched non-dispensing doctors and identify factors that influence prescribing behaviour.
Method
A sequential explanatory (QUAN-->qual) mixed methodology was utilised. Firstly, rurality-matched DDs’ and non-DDs’ PBS data for fiscal years 2005-7 were analysed against criteria distilled from a systematic review and stakeholder consultations. Secondly, structured interviews were conducted with a purposive sample of DDs to examine the quantitative findings.
Key findings
DDs prescribed significantly fewer PBS prescriptions per patients but used Regulation 24 significantly more than non-DDs. Regulation 24 biased the prescribing data. DDs prescribed proportionally more penicillin type antibiotics, adrenergic inhalants and non-steroidal anti-inflammatories as compared to non-DDs. Reasons offered by DD-respondents highlighted that prescribing was influenced by an awareness of cost to the patients, peer pressure and confidential prescriber feedback provided on a regular basis.
Implications
This innovative census study does not support international data that DDs are less judicious in their prescribing. There is some evidence that DDs might reduce health inequity between rural and urban Australian, and that the DD health model is valuable to patients in isolated communities.
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Berleen, Musoke Solange. "Foreign Doctors and the Road to a Swedish Medical License : Experienced barriers of doctors from non-EU countries." Thesis, Södertörns högskola, Institutionen för livsvetenskaper, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-16842.
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This thesis in Global Development has looked at the personal experiences of non-European medical doctors that have migrated to Sweden to find out what they have encountered during the process of trying to obtain a Swedish medical license and if there are signs of discrimination. Sweden has a shortage of doctors, but has not resorted to brain drain. Contrary, it is difficult for non-European doctors to work as doctors in Sweden. This thesis has used a qualitative research strategy and five non-European unemployed doctors that were trying to get Swedish medical licenses as well as one non-European doctor that was working, were interviewed. Empirical data from a seminar with Swedish doctors about the pro-cess that foreign doctors have to go through to be able to work in Sweden has also been used in this thesis. The results showed that doctors from non-European countries have stricter requirements to fulfill in order to be able to practice medicine in Sweden than doctors coming from European countries. The system for accepting foreign doctors and validating their competence was flawed. The pro-cess was confusing, frustrating and unnecessarily long. Although there was no direct discrimina-tion or prejudice, European doctors were favored by the system.Denna C-uppsats i Global Utveckling har tittat på personliga erfarenheter av icke-europeiska läkare som har migrerat till Sverige för att ta reda på vad de har stött på under processen av att skaffa svensk läkarlegitimation och om det finns tecken på diskriminering. Sverige har brist på läkare, men har inte tillgripit ”brain drain”. Tvärtemot är det svårt för icke-europeiska läkare att arbeta som läkare i Sverige. En kvalitativ forskningsstrategi har använts och fem icke-europeiska arbetslösa läkare som försökte få svenska läkarlegitimationer samt en icke-europeisk läkare som arbetade intervjuades. Empiriska data från ett seminarium med svenska läkare som handlade om processen som utländska läkare måste gå igenom för att kunna arbeta i Sverige har också använts i denna C-uppsats. Resultaten visade att läkare från icke-europeiska länder har strängare krav att uppfylla för att kunna arbeta som läkare i Sverige än läkare som kommer från europeiska länder. Systemet för att ta emot icke-europeiska läkare och validera deras kompetens var bristfällig. Processen var förvirrande, frustrerande och onödigt lång. Även om det inte fanns någon direkt diskriminering, så var europeiska läkare gynnade av systemet.
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Cavenagh, Penelope Elaine. "Doctors and management : the factors that determine whether or not doctors take on management roles in NHS trusts." Thesis, Birkbeck (University of London), 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.397239.
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Stanley, Joachim. "Drugs, doctors and the mid-Victorian novel." Thesis, University of Oxford, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.432218.
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Raduma-Tomás, Michelle Amondi. "Doctors' shift handovers in acute medical units." Thesis, University of Aberdeen, 2012. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=186875.
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Aim and objectives: To describe the ideal doctors' shift handover process in a systematic fashion, and to identify tasks that should be performed, but are not consistently done. To understand the types of communication problems that may occur during the handover process, their causes, their likelihood of occurrence and their effect on patient safety. Method: Three studies were conducted in two, Scottish Acute Medical Units. A Hierarchical Task Analysis was performed and data was collected by means of interviews and focus groups. Observations of doctors' actual shift handover process were compared against the description of doctors' ideal handover process. To examine potential failures modes, a Healthcare Failure Modes and Effects Analysis was performed using focus group interviews. Results: The handover process entailed the pre-handover, the handover, and the post- handover phases. Multiple critical steps in the process were omitted by outgoing shift doctors. The pre-handover was particularly vulnerable to information omission, with over 50% of its critical tasks not being performed across a total of 62 observations. Nonetheless, most of these omissions were typically caught during the handover meeting, especially if incoming doctors participated in pre-handover activities. Post-handover activities involved prioritizing and delegating clinical tasks. However these were observed not to happen consistently due to multiple interruptions. Thirty-four failure modes were identified, with eight of them posing a significant risk to patient safety. The studies found that interruptions, patient workload, and a lack of standardised procedures were the biggest causes for information loss during the handover process. Conclusions: There are key critical tasks necessary for an ideal doctors' shift handover process. A simple, handover process checklist may ensure critical handover tasks have been achieved prior to any shift change. Interruptions, patient workload, peer trust, and a lack of standard operating procedures are areas that future handover research should examine.
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ROQUETE, VITORIA DE ANDRADE. "INTERNET USE PROFILE OF BRAZILIAN MEDICAL DOCTORS." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2001. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=2621@1.
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Para a indústria farmacêutica, novas práticas de marketing
via internet têm implicações muito relevantes, pois
permitem não apenas criar vínculos diretos com seus
consumidores finais(antes quase inexistentes), mas também,
criar novas formas de interação com a classe médica,
antes restritas basicamente às visitas de seus
representantes de vendas aos consultórios e a eventos
promocionais (e.g. divulgação de produtos via congressos,
seminários e publicações especializadas).
Esta dissertação pretende avaliar o padrão de utilização da
internet por um grupo de médicos brasileiros, bem como suas
reais necessidades no que diz respeito aos serviços
disponíveis através da internet. Esta avaliação de seus
usos e demandas é realizada de modo a pensar suas
possíveis implicações sobre o marketing de relacionamento
praticado pela indústria farmacêutica e demais provedores
de serviços (baseados na internet) direcionados para a
classe médica.For the pharmaceutical industry, the new marketing practice via internet has much relevant implications since it allows the establishment of direct bonds not only with their final customers (almost non existent before, in the Brazilian marketplace), but also with the medical community, which has been historically approached through restricted ways such as sales representatives and promotional events, such as congresses, seminars and specialized publishing on medical research. This dissertation evaluates the standards of internet use by a group of doctors, as well as their needs with respect to internet services. This evaluation of habits and demands allows us to think about some possible implications to the relationship marketing practiced by pharmaceutical industry and others internet based service providers whose main focus is thr medical community.
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Jefferson, Laura. "Exploring gender differences in doctors' working lives." Thesis, University of York, 2013. http://etheses.whiterose.ac.uk/4010/.
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Background: As the proportion of women in medicine draws towards parity, long-standing questions about gender differences in the way that doctors work become more pertinent. Gender differences in medical working patterns and career choices are well documented; but there is a lack of understanding of everyday differences in the working lives of male and female doctors, particularly in UK hospital medicine. In this thesis, potential sources of gender variations in activity rates, previously reported in the literature, are identified. Methods: Multiple methods were employed to explore potential gender differences in doctors’ working lives. Systematic review methods synthesised existing literature on gender differences in the communication style, content and length of medical consultations. Qualitative methods were used to develop in-depth and contextualised understanding of potential gender differences in UK hospital consultants’ working lives, using observation and interviews. Potential variations in clinic length data were analysed quantitatively and synthesised with the existing literature using meta-analysis. Finally, a pilot questionnaire was designed and tested to build on qualitative findings and investigate variations in a wider sample. Results: Doctors’ gender appears to influence their working lives, and the interface between home and work, and these influences may partly explain variations in activity rates. Specifically, female doctors appear to spend longer on consultations; adopt different styles of communication such as lowered dominance and greater use of psychosocial communication; experience greater barriers in their careers such as gender discrimination and problems with work-family conflict; and may experience lower levels of cooperation from colleagues. Conclusions: This research provides important and timely understanding about the sources of gender differences in the working lives of hospital consultants, which may affect both the quality and quantity of care provided by male and female doctors.
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Sungay, Aneesa Mugjenkar. "Stress amongst medical doctors in the Western Cape." Thesis, University of the Western Cape, 2011. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_8505_1361367465.
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Numerous theories were established as to why doctors are leaving the country. A collection of stressors have presented itself and are seen as the contributing factors that lead to the outflow of doctors to other countries. Masia et al (2010) suggest that heavy workloads, afterhour calls, conflicts between work and personal lives, and dealing with life and death situations are stressors that form part of the daily routine of medical practitioners as well as financial pressures, insufficient budgets, a challenging working environment, information overload and threats of litigation can threaten the health and well-being of the medical practitioner. Various reasons contributed to doctor&rsquo
s leaving the country and can be explained and addressed by the push-pull theory of migration. Investigations were conducted to identify the reasons for doctors leaving the country. The significant push factors that were identified as most frequently noted in investigations were poor remuneration and wages, lack of job satisfaction, lack of future prospects (further education and career development), poor working conditions, HIV/AIDS, lack of quality of life, high levels of crime and violence, civil conflict and political instability, and a decline in the quality of the school education system. Relevant non-financial incentives shown to be significant in retaining medical practitioners include support, teamwork and feedback from supervisors. Training and recognition was also noted by medical practitioners as deciding factors on whether to stay in a rural area. South Africa has witnessed a major outflow of doctors that have left the country to seek employment elsewhere and has been seen as a potential problem for the near future. However, not enough research has been conducted to study the various sources of stress and determine ways in which to combat these stressors. This study aims to present an understanding of the various sources of stress that doctors face on a daily basis and also distinguish between various coping mechanisms. A sample of 150 doctors was used for the purpose of this study and was selected primarily from 3 Western provincial hospitals. Informed consent was obtained from the relevant authorities before participating in the study. A 36-item Stressor Checklist and a Ways of coping checklist, which were adapted from previous research, were administered. No significant differences in sources of stress were found, although males evaluated their experiences as being more stressful. Significant differences were, however, obtained in terms of coping mechanisms utilised. Female doctors had a greater propensity to utilise problem and appraisal-focused coping. However, males were more apt to utilise avoidance-coping. The research findings indicate a need for further research to be done, and can be highly beneficial for the purpose of therapeutic intervention.
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Ngxukumeshe, Tandiswa. "The importance of managerial skills for medical doctors." Thesis, Nelson Mandela Metropolitan University, 2008. http://hdl.handle.net/10948/977.
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The role played by medical doctors and the employment positions they hold in South Africa and in the world today has shifted from being clinical only to include management. They were once only responsible for patient care, now are responsible for their organization's management. Physician managers have difficult tasks for which medical school provides no preparation. Doctors in an assortment of roles take on management responsibilities to varying degrees: these may be a single-handed private practitioner or lead a small clinical team; or a clinical or medical director or a chief executive; or hold senior management positions in National or Regional Legislature. Some are also managing and supervising colleagues in public or private hospitals and are responsible for managing budgets, allocation of resources; developing policies and making other management decisions. These roles require knowledge and competence of managerial skills in order to facilitate and lead in an effective and efficient manner. This study revealed that medical doctors, as business owners, in Mercantile Hospital are running their businesses, the medical private practices, without any managerial skills’ training. There was a general consensus that there is a need for managerial skills in any business and the respondents confirmed that managerial skills are important and necessary for the successful achievement of goals in a medical private practice.
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Drake, Julie E. "Doctors in management : a study of fundholding GPs." Thesis, University of Huddersfield, 2013. http://eprints.hud.ac.uk/id/eprint/19320/.
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Fundholding enabled General Practitioners (GPs) to have financial responsibility for practice budgets to purchase health services for their patients. This thesis examines that significant episode in the history of the UK‟s NHS (Chapter 2) when independent contractors chose to be accountable as part of the creation of the internal market within the ethos of New Public Management (NPM). The reasons for practices electing to go fundholding are investigated, followed by examination of the implications of, and potential for, accounting in the management of fundholding at practice level through an empirical study of twelve fundholding practices in one region in England (Chapter 4). Accounting per se did not loom large, but in addition to significant findings on why practices went fundholding, the role of the lead partner for fundholding and why they took on that role emerged as a significant issue. Several years after the completion of the fundholding episode in the NHS, the GPs concerned were asked to reflect on its implications for their careers, in particular the relationship between their work as doctors and managers (Chapter 7). This brings a longitudinal element to the research. This thesis is based on two major and one minor previously published refereed journal articles, together with further interpretation and more empirical work. The thesis structure reflects the emergent character of the overall research project (Chapter 3). After presenting the already published research on why practices volunteered to go fundholding and how those practices selected their „lead‟ partner (Chapter 4) and attitudes of GPs who took the management role(Chapter 6), a second analysis of the first phase of data is presented for the first time, finding different levels of engagement in management once fundholding was „live‟ and evidence of doctors in primary care taking hybrid manager roles (Chapter 6). GPs are found to adopt different levels of engagement in management. The factors that contribute to doctors‟ engagement in management are identified. Accounting is found to enable doctors in management and assist them in securing notions of professionalism. The study contributes to knowledge on a number of levels: it presents the case of an application of a NPM „experiment‟ in an institutional setting recognising the context of general practice and financial responsibility as important in engaging doctors in management; it contributes to an emerging „doctors in management literature‟, complementing the majority of that literature by focusing on primary care rather than secondary care. The study recommends that as doctors are increasingly being asked to get involved in the management of the finite NHS resource that fundholding was a significant episode to guide the design of policy and structures that will engage doctors in management. Future studies should investigate doctors in management, using case studies to examine the schemes in order to capture the „lived experience‟, identifying the different levels of engagement, what they do and how they do it.
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Ledingham, Georgina May. "Chekhov's doctors : a prescription for a better life." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26864.
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Anton Chekhov pursued two careers simultaneously throughout his life—that of a doctor as well as a writer of prose and drama. It is not surprising, therefore, to discover many physicians amongst his characters but it is puzzling that the portrayal of doctors is frequently unflattering despite his admitted indebtedness to the profession. The thesis herein proposed is that the poor image Chekhov presents points to the necessity of self-determination in matters of emotional and spiritual health; if the doctors are incapable of healing themselves and those in their care, the patients might well take the biblical directive, "Arise! Take up thy bed and walk." In his stated desire to show people how bad and dreary their lives are, thereby assisting them in fashioning better lives, Chekhov's prescription is one of self-help. The short stories—Late-Blooming Flowers, Anyuta, Ward No. 6, The Head Gardener's Tale and The Doctor's Visit—and the plays— Platonov, Ivanov, The Seagull, The Wood-Demon, Uncle Vanya and Three Sisters—have been examined; beneath the incompetence and villainy of the doctors an affirming statement is discovered in the otherwise melancholy canon of Chekhov.Arts, Faculty of
Theatre and Film, Department of
Graduate
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Farkas, Carol-Ann. "Aesculapia victrix, fictions about women doctors, 1870-1900." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp02/NQ59585.pdf.
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Davies, Karen. "Clinical information needs of doctors in the UK." Thesis, Loughborough University, 2008. https://dspace.lboro.ac.uk/2134/8089.
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The aim of this study was to determine the information-seeking behaviour, needs and preferences of doctors, specifically with reference to Evidence Based Medicine (EBM) in the UK. This is particularly relevant during the current IT and resource development currently being undertaken in the NHS. Mixed methods research techniques were utilised to gather and analyse the data collected to meet the aims and objectives of this study. Three data collection methods have been utilised. The first utilised Clinical Librarians to count the information needs (questions) of doctors (Clinical Librarians Logs). The second data collection method gathered clinical questions from clinical librarians (specialists), medical librarians (generalists) and from websites hosting clinical questions (such as http://www.attract.wales.nhs.uk). These were analysed using the taxonomy developed by Ely et al. 2000. Finally an online questionnaire was used to gather data on doctors' awareness and use of electronic EBM resources. The major finding is that research undertaken on the information needs in the healthcare sector in the USA cannot be readily utilised in the NHS. This research utilised a unique data collection technique, the Clinical Librarian as a data collector. This enabled the quantification of doctors unperceived information needs. This research identified that doctors in the UK asked roughly one question for every four patients seen. Despite the advances and ease of use of electronic resources, the preferred information source was colleagues. Time continues to be the major barrier for accessinge lectronici nformation to aid clinical decision making.
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Fröjd, Camilla. "Cancer Patients’ Satisfaction with Doctors’ Care : Consequences and Contributing Conditions." Doctoral thesis, Uppsala universitet, Vårdvetenskap, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8267.
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The main aims were to: explore whether there is a relation between doctors’ ability to identify patients’ worry and wish for information and self-efficacy with regard to communicating with patients about difficult matters; describe which cues doctors consider when estimating patients’ worry and wish for information, and investigate whether there is a relation between patients’ satisfaction with doctors’ care and patients’ psychosocial function. Eleven doctors and 69 patients (of which 36 patients participated in the longitudinal study) with carcinoid tumours participated. Doctors’ self-efficacy, and ability to identify patients’ worry/wish for information were investigated at patients’ first admission. Doctors were interviewed about which cues they considered when estimating patients worry/wish for information. Patients’ satisfaction with care (CASC SF 4.0) and psychosocial function (EORTC QLQ-C30, HADS) were measured longitudinally, during the first year after diagnosis. Doctors reported higher self-efficacy when showing good ability to identify patients’ wish for information, than when showing less good ability, overestimated patients’ worry and underestimated patients’ wish for information. Doctors considered patients’ verbal behaviour and body language together with knowledge and experience when estimating patients worry and wish for information. Patients who met doctors showing good ability to identify their wish for information, reported a higher cognitive function than patients who met doctors showing less good ability. At all assessments patients expressed high satisfaction with doctor’ care and patients’ satisfaction did not change over time. Patients’ satisfaction with doctors’ care were related to their psychosocial function shortly after the first three admissions to specialist care. Patients with carcinoid tumours in some respects reported a worse HRQoL than the general Swedish population. Fatigue, diarrhoea, limited possibilities to work/pursue daily activities, and worry that the illness will get worse were among the most prevalent, and worst, aspects of disease- and treatment related distress.
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Katko, Nicholas John. "Hard-Hearted Doctors: Hard-Hearted Doctors: The Incremental Validity of Explicit and Implicit-Based Methods in Predicting Cardiovascular Disease in Physicians." University of Toledo / OhioLINK, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1290084946.
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Cao, Fang. "Control of doctors in the NHS : a critical appraisal." Thesis, University of Liverpool, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.539473.
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Grainger, Caron. "Junior doctors : morale, job satisfaction, stress and their interrelationships." Thesis, University of Leeds, 1997. http://etheses.whiterose.ac.uk/656/.
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Research and anecdote suggest that . the morale of doctors is low. Consequences of this in medicine include poor communication, faulty decision making, and poor interpersonal relationships. This works assesses the morale of pre-registration house officers (PRHOs), using the proxy measures of job satisfaction and mental and physical ill-health manifestations of stress, and follows one group over a period of eighteen months to determine whether morale improves over this time. Data collections was by modified postal questionnaire and consisted of self reported job satisfaction and mental and physical ill-health, life style data and career information. Data was obtained in three separate studies, comprising : 234 eligible PRHOs working within the West Midlands in 1993 (response rate of 83.6%) : A follow up study of the respondents to the original west Midlands survey (response rate 80.4%) : 828 eligible PRHOs working in the West Midlands, Bristol, Nottingham, Oxford and Sheffield (response rate of 58.9%) PRHOs and SHOs had significantly lower scores for job satisfaction and significantly higher scores for mental and physical ill-health than comparative groups. Female PRHOs and SHOs had significantly higher scores for ill-health than male PRHOs. Some improvement in job satisfaction was seen in the 18 month period from PRHO to SHO, but there was no significant change in well being during this time. As a result of this work, a stress counselling and management service has been made available in the West Midlands, an "Introduction to being a House Officer" course begun in the final year at Birmingham Medical School, and a "Stress Survival Guide" book published.
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Swanson, Vivien. "Occupational stress, job satisfaction and role conflict in doctors." Thesis, University of Stirling, 1997. http://hdl.handle.net/1893/2201.
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Based on a transactional model of stressors, mediators/moderators and strains, this large scale study investigated occupational stress, job satisfaction and role conflict in doctors in Scotland using a self-report questionnaire methodology. The sample of 986 doctors included male and female general practitioners (GPs) and specialist consultants. The relationship between sources and levels of occupational stress and job satisfaction was investigated using scales from the Occupational Stress Indicator (OSI) (Cooper et al 1988), considering the role of intervening variables mcludmg age, gender, marital/parental status, medical speciality, coping and attitudes. The relationship between occupational and domestic stressors and satisfactions was examined using theoretically denved models of additivity and asymmetric permeability of roles. A range of analytic procedures mcluding multivanate analysis of variance, hierarchical regression, factor analysis and qualitative content analysis methods were employed. Results mdicated that GPs recorded greater stress and lower job satisfaction than consultants on the OSI scales Managenal or structural occupational factors, and factors intrinsic to medical work were major stressors. Patient care was both a main source of stress and job satisfaction. The rather small magnitude of differences in stress and satisfaction between subject groups, and between subject groups and norms for the OSI scales was offset by clear evidence of stress related to doctors occupational roles, domestic roles, and gender roles elucidated using more qualitative methodologies. Subjects' age, gender and medical speciality were shown to affect the relationship between occupational stress and job satisfaction. Younger doctors, male GPs and female consultants experienced greater stress and less job satisfaction. Coping efficacy was negatively related to occupational stress and positively related to job satisfaction for GPs, and male and female GPs employed different styles of coping with stressors. Comparison of consultant specialities revealed differences in sources and levels of occupational stress and job satisfaction with Public Health Consultants recording most stress. Both male and female doctors with multiple occupational and domestic role demands reported higher levels of stress. Stress from work to home was found to be greater than stress from home to work for both male and female doctors. Recommendations and implications of the research for doctors, patients, and the National Health Service are discussed.
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Archer, Julian Charles. "Multisource feedback to assess doctors' performance in the workplace." Thesis, University of Sheffield, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.440899.
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Nunez, Elvira Alberto. "Doctors' labour supply and incentives : a collection of essays." Thesis, Lancaster University, 2018. http://eprints.lancs.ac.uk/127357/.
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This thesis examines UK doctors’ labour supply from the intensive margin. Initially, it explores trends in average weekly hours of work using data from the Labour Force Survey (LFS). Next, it compares how average weekly hours of work vary over the lifecycle for doctors and compare to with other professionals’ hours (lawyers and accountants). Finally, as doctors continuously report being stressed and unhappy, this thesis explores data from the Annual Population Survey (APS) to assess whether hours of work could alter self-reported wellbeing levels for doctors and other workers. This thesis is made up of five chapters with three main essays on the topic of interest. Chapter 1 conveys an extensive background on what we know about doctors’ labour supply in the UK and other countries. Chapter 2 exploits the LFS to examine main trends in doctors’ weekly hours of work (GPs and hospital doctors) over 21 years (1994-2014). It proposes a definition of total hours worked that encompasses total usual hours in main job (basic hours and overtime hours, paid or unpaid) plus total hours in second job. The chapter is mostly descriptive and focuses on changes in average weekly hours of work of the headcount of doctors over the period and on variation across different characteristics. It also portrays irregular working patterns, second job hours and desired hours of work (both more and fewer hours). The main finding conveys that despite training more doctors every year and the increasing female participation in the medical profession, hours of work have fallen over time and the sharpest fall occurs between 1994 and 2004. From 2004, this trend attenuates but continues falling though at a reduced rate. Chapter 3 estimates labour supply models over the lifecycle for a representative agent using a pooled cross-section dataset from the LFS for ‘partner’ GPs (Selfemployed), ‘salaried’ GPs, hospital doctors, lawyers and accountants. The main finding posits that the reduction in female doctors’ average weekly hours of work – especially ‘salaried’ GPs – has been larger than those of lawyers and accountants. This is attributed to lifecycle effects and, particularly, children. Chapter 4 examines self-reported well-being outcomes (anxiety, happiness, life satisfaction and worthwhile levels) and variables relating health problems (depression, hypertension or whether having a health problem limits activity to work). We examine the relationship between hours of work and well-being levels. Although there is considerable literature on doctors’ job satisfaction, especially GPs, and, also, there are numerous studies on the issue of burnout, this is not the case for well-being of physicians which is underexplored. The few existing studies come from small snapshots and unrepresentative samples. This chapter explores a large well-established dataset using conventional screens to examine the distribution of well-being and their proximate determinants. The information is available in the Annual Population Survey (APS) from 2011 quarter 2 to 2015 quarter 1, covering four fiscal years (2011/12 to 2014/15). Our main finding conveys that, contrary to popular belief, and the assertions of the professional bodies for physicians, doctors appear to be more satisfied, happier, feel that their life is more worthwhile, and they are less anxious than other professionals. The chapter also makes an economic contribution on labour supply: hours of work, at the margin, have virtually no significant effect on the measures of well-being. This means that individuals are on their labour supply curve but those reporting to work more hours may have lower values of the well-being measures. This is true for lawyers and accountants but not for doctors, which is viewed as evidence of intrinsic motivation driven by mission orientation among doctors. So, there is scope for expanding supply along the intensive margin, which may be both an inexpensive and quick solution to the alleged supply shortfall, relative to the current policy of expanding supply along the extensive margin. Chapter 5 sums up the main findings and contributions.
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Edwards, Julie. "Doctors' perspective on obstetric ultrasound : concept, knowledge and practice." Thesis, Sheffield Hallam University, 2012. http://shura.shu.ac.uk/17101/.
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Problems arise when women attend for obstetric ultrasound scans, not always fully aware of the purpose of the examinations they have chosen to opt for and sometimes experience anxiety, as their expectations are not met. This study has explored, through in-depth interviews and ‘framework’ analysis, whether doctors are actively engaged in unbiased information sharing with pregnant women during their consultations. Through exploration of the literature on women’s and health professionals’ perspective on the use of obstetric ultrasound, a gap is seen in the knowledge regarding the medical perspective on ultrasound use in pregnancy. Results of this study revealed three themes relating to the doctor’s experiences of offering obstetric ultrasound: doctors’ knowledge and understanding, their views on the practice of obstetric ultrasound use and their ideas on the concept of ultrasound. These themes been considered alongside the writings on power/knowledge, govemmentality and self-surveillance through risk theory, by the philosopher Michel Foucault (1926-84), as his ideas have been central to this research question. The conclusion reached is that, although making changes to doctors’ in house training may increase their knowledge of obstetric ultrasound, it may still be the case that their professional position within society will still create a barrier to women making informed decisions when requiring to consider opting for ultrasound scans during their pregnancy.
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Machaczek, Katarzyna Karolina. "Barriers to effective communication between doctors at shift handover." Thesis, Sheffield Hallam University, 2014. http://shura.shu.ac.uk/20750/.
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Shift handover is a process during which doctors can exchange information, authority and primary responsibility for patient care. The level of handover standardisation may vary across departments and hospitals, and handover may be affected by the context in which it occurs. If during handover communication doctors do not transfer information pertinent to a patient's care delivery, it may lead to unintended negative consequences. An explanatory, mixed-methods study, using the principles of critical realism was conducted to investigate whether or not similar barriers to effective shift handover communication between doctors identified in hospitals around the world are identified by doctors working in hospitals in the Czech Republic and to develop hypotheses regarding how various individual performance-, work environment- and system-related factors may collectively contribute to ineffective shift handover communication between doctors. In accordance with the principles of critical realism the study included theory-testing phases: (i) a critical review of literature; (ii) a cross-sectional questionnaire survey; and (iii) semi-structured interviews with doctors. The results of the study show that doctors working in hospitals in the Czech Republic identify similar barriers to effective shift handover communication between doctors identified in hospitals around the world. However, handover between the Czech Republic doctors has its own specific characteristics. The inadequacies of the social, systemic and environmental features that make up different contexts in which handover is conducted collectively contribute to ineffective shift handover communication. For example, a systemic feature (e.g. the absence of training), may lead to specific doctors' beliefs (e.g. handover is meaningless), which in turn trigger certainbehaviours (e.g. doctors go home without communicating either verbally or in writing the work carried out during the previous shift), that tend towards a particular kind of outcome (e.g. the absence of handover). Consequently, the division of barriers to handover into one-dimensional categories such as 'the individual performance', 'the system' or 'the social environment', has emerged as superficial as it does not adequately reflect the reality of the context and process of handover communication. Any interventions and programmes, which aim to enhance communication between doctors at shift handover, may need therefore to address the multidimensional nature of handover communication.
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Alaofin, Babatunde Ayodele. "The Value of Diagnostic Software and Doctors' Decision Making." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/344.
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The prevalence of medical misdiagnosis has remained high despite the adoption of diagnostic software. This ongoing controversy about the role of technology in mitigating the problem of misdiagnosis centers on the question of whether diagnostic software does reduce the incidence of misdiagnosis if properly relied upon by physicians. The purpose of this quantitative, cross-sectional study based on planned behavior theory was to measure doctors' opinions of diagnostic technology's medical utility. Recruitment e-mails were sent to 3,100 AMA-accredited physicians through their database that yielded a sample of 99 physicians for the study. One-sample t tests and, where appropriate because of non-normal data, one-sample Wilcoxon signed-rank tests were conducted on the data to address the following key research questions on whether diagnostic software decreases misdiagnosis in healthcare versus unassisted human diagnostic method, if physicians use diagnostic software frequently enough to decrease misdiagnosis in healthcare, and if liability concerns prevent physicians from using diagnostic software. It was found that in the opinion of those surveyed (a) diagnostic software was likely to result in fewer misdiagnoses in healthcare than unassisted human diagnostic methods, (b) when speaking for themselves, physicians thought they used diagnostic software frequently enough to decrease misdiagnoses, and (c) physicians agreed they were not prevented from using diagnostic software because of liability concerns. The study's social significance is the affirmation of diagnostic software's usefulness: Policy and technology stakeholders can use this finding to speed the adoption of diagnostic software, leading to a reduction in the socially costly problem of misdiagnosis.
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Nash, Louise (Louise Mary). "Medico-legal matters and Australian doctors : an investigation of doctors' experience of medico-legal matters, their mental health and their practice of medicine." Phd thesis, Faculty of Medicine, 2010. http://hdl.handle.net/2123/8385.
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Sharif, Hana. "Chekov, Ibsen and Flaubert’s doctors : An ideo-historical literature essay on how the medical revolution of the 19th century changed the role of doctors." Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-73521.
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Background: Today we are very likely to encounter exceedingly competent, courageous, charismatic and often times good-looking doctors as TV-show protagonists whilst flipping through the television channels. Just over a hundred years ago it would have been unimaginable for a doctor to lead a storyline, to be a well-liked hero, to even be described as competent. Aim: The purpose of this paper is to study how the medical revolution of the 19th century changed the role of doctors in society and consequently the portrayal of them in literary works and theatrical performances throughout time. Method: This essay is an ideo-historical literary analysis, with a hermeneutic approach of interpretation. The selection of landmark literary work and theatrical plays range from mid-17th century to contemporary times and are chosen on the basis of their popularity and influence. Results: The portrayal of doctors transforms from being figures used as laughingstocks, painted with colors of incompetence and deceptiveness to become highly respectable heroes of society whose steps should be followed and words should be listened to. Conclusion: An increased awareness of the different positions of doctors in society may bring the clinicians of today a better understanding about the conditions of their status. This insight might make it easier for them to navigating in a professional life with the new and ever-challenging well-read patient of today.
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Jelley, Diana Mary. "Peer appraisal in general practice." Thesis, University of Newcastle Upon Tyne, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.366581.
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Васильєв, Костянтин Костянтинович, Константин Константинович Васильев, and Kostiantyn Kostiantynovych Vasyliev. "Отечественные врачи за рубежом: беженцы и высланные." Thesis, Издательство СумГУ, 1997. http://essuir.sumdu.edu.ua/handle/123456789/25071.
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Ong, Lucille Mei Lin. "Communication between doctors and cancer patients taping the initial consultation /." [S.l. : Amsterdam : s.n.] ; Universiteit van Amsterdam [Host], 2000. http://dare.uva.nl/document/81188.
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Fröjd, Camilla. "Cancer patients' satisfaction with doctors' care : consequences and contributing conditions /." Uppsala : Acta Universitatis Upsaliensis : Universitetsbiblioteket [ditributör], 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8267.
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Rajapakse, Harshini Iyanthimala. "Functional problems : prevalence in secondary care and perceptions of doctors." Thesis, Durham University, 2012. http://etheses.dur.ac.uk/3413/.
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1 Abstract 1.1 Title Functional problems: prevalence in secondary care and perceptions of doctors 1.2 Aims (a) To evaluate the prevalence of functional problems in general medicine, gastroenterology, gynaecology and psychiatry outpatient specialist clinics in a hospital setting in Sri Lanka and (b) To assess the perceptions of doctors in these specialties around functional problems in the UK and in Sri Lanka. 1.3 Methodology (a) Prevalence study: Functional problems were defined as those for which a cause could not be ascertained after clinical evaluation and investigations. The prevalence of functional problems was assessed over a three month period in each specialty clinic. The patients‘ records were reviewed at three and six months to confirm the diagnosis of a functional problem. (b) Perceptions of clinicians: Qualitative methodology was used to ascertain the perceptions of doctors in the two settings covering the three specialties. A grounded theory approach was used and sixty interviews were carried out. Emphasis was placed on identifying socio-cultural implications around perceived causations and the management of these functional problems. 1.4 Results (a) Prevalence study: The prevalence study ascertained that functional problems were the commonest diagnoses in the general medicine/gastroenterology and gynaecology clinics accounting for almost a fifth of patients. In psychiatry, functional problems were the fourth common diagnosis and accounted for nearly ten percent. Patients of all consultations with functional symptoms tended to be younger; there were long delays in iv making the diagnosis and a substantial proportion of patients were subjected to iatrogenic harm from invasive investigations and inappropriate therapeutic measures. (b) Perceptions study: The perceptions study revealed divergent views by doctors about what functional problems were, how they could be categorized and how best to manage them. Socio cultural factors were thought to be intricately linked to causation and outcomes. Nonetheless, most doctors tended to isolate the clinical presentation and management from the cultural context in the way they dealt with their patients. 1.5 Conclusions Functional problems were commonly seen and diagnosed in hospital outpatient clinics. The Sri Lankan prevalence was similar to that reported from the UK. In both cultural settings the doctors who were sensitive to socio-cultural factors used tools beyond pharmacotherapy and those who held improved quality of life as the goal of treatment as opposed to cure, reported greater success in managing people with these problems. v 1.6 Acknowledgements The School of Medicine and Health, Durham University, for granting a scholarship through Project Sri Lanka for the PhD, for fulfilling research training needs and providing accommodation during my stay in the UK The Faculty of Medicine, University of Ruhuna, for granting me study leave for three years Professor Pali Hungin, my supervisor in the School of Medicine and Health, Durham University, for helping convert the research idea to a PhD thesis Professor Martyn Evans, my second supervisor in the School of Medicine and Health, Durham University, for guidance and support Professor David Petley, Deputy Head (Research), Faculty of Social Sciences and Health, Durham University, for research support To Professor Susirith Mendis, Vice Chancellor and Professor Ranjith Senaratne, former Vice Chancellor of the University of Ruhuna, Professor Thilak Weerasooriya, Dean and Professor P.L. Ariyananda, former Dean, Faculty of Medicine, University of Ruhuna, for support in obtaining study leave and a travel grant Dr Chandanie Hewage, Head, Department of Psychiatry at the Faculty of Medicine, University of Ruhuna, for constant support and encouragement over the study leave period My colleagues in the Department of Psychiatry, Faculty of Medicine, for covering the additional work during my study leave period Mrs Alex Motley, for help with correspondence and formatting Dr Simon Stockley, General Practitioner, for assistance with the pilot study Dr Amanda Gash, Consultant Psychiatrist and Dr Suresh Babu, Consultant Psychiatrist at the Tees Esk and Wear Valleys NHS Trust, Dr Deepak Dwarakanath, Consultant Gastroenterologist and Dr Anne Ryall, Consultant Gynaecologist at North Tees and Hartlepool NHS Trust, who were the co investigators for the UK arm of the qualitative study My co-investigators from Sri Lanka for the prevalence study, Dr Gamini Jayawardene, Dr Gayani Punchihewa and Dr Ajith Jayasekera, Consultant Psychiatrists, from Teaching Hospital Karapitiya Galle, Professor Thilak Weerarathna and Dr Arosha Dissanayake, Consultant Physicians from Teaching Hospital Karapitiya Galle, Professor Malik Goonawardene and Dr Dammika Jayasooriya, Consultant Obstetricians from Teaching Hospital Mahamodera, Galle vi Dr Rachel Casiday, Dr Helen Hancock, Dr Helen Close, Dr Sharyn Maxwell, Dr Eileen Scott, Durham University, for helping with the methodological aspects of the research Professor James Mason, Director of Research, School of Medicine and Health, Durham University, for advice on statistical matters Dr J. Howse, Doctoral Researcher, Durham University, for second coding of transcripts Mrs Judith Walsh, Mrs Susan Williams, Durham University, for assistance with administrative matters Members of the NHS National Research Ethics Committee, Durham and Tees Valley Research Ethics Committee 2, and Research Ethics Committee, Faculty of Medicine, University of Ruhuna, for helping conduct an ethically sound research study Staff at the North Tees and Hartlepool NHS Trust, Research and Development Office for guidance on methodological and ethical aspects of the research Directors of Teaching Hospital Karapitiya, Galle and Teaching Hospital, Mahamodera, Galle, for permitting the analysis of patient records for the prevalence study All the participants in the research Mrs Barbara Hungin for encouragement and support Sri Lankan expatriate community for assistance with logistical aspects Staff at the Keenan House, where I was accommodated during my stay in the UK My family members for their constant encouragement and support during three long years of researching
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Hanlon, Timothy R. G. "British army doctors' views on medicines management (prescribing and dispensing)." Thesis, University of Portsmouth, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.500339.
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Medicines management involves the safe and cost-effective use of medicines across the health economy in order to produce informed and desired outcomes of patient care. Anecdotal evidence suggested that various aspects of medicines management in the British Anny, both in peacetime and on operational deployments, were not as robust as in mainstream NHS care. This study aimed to explore British Army doctors' views on medicines management (prescribing and dispensing) on matters such as ethical a professional concerns with the role of dispensing doctor and cost-effective prescribing.
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Moss, Philip John. "The migration and racialisation of doctors from the Indian subcontinent." Thesis, University of Warwick, 1991. http://wrap.warwick.ac.uk/71953/.
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This research identifies and examines the circumstances and processes surrounding the migration and racialisation of doctors from the Indian subcontinent to Britain. Theoretically the research will critically evaluate several current debates within sociology and reconstructs a different set of criteria to that which has until recently governed investigations into racism. The research argues that the concept of 'race' is an ideological construction with no analytical role to play in the investigation of racism and discrimination. The real object of analysis is the development and reproduction of racism as an ideology within specific historical and material conjunctures determined by the uneven development of capitalism. Within this context a full explanation of the migration and racialisation of doctors from the Indian subcontinent requires not only an examination of the post-war era, but also an investigation of the origins of that migration and racialisation during the pre-1945 period when India was the subject of British rule. A great deal of contemporary research on migration and racism, has tended to concentrate on unskilled and semi-skilled migrant labour. This study will focus on the neglected area of the 'professions', through an investigation of doctors from the Indian subcontinent and their relationship with the British 'professional' occupation of medicine. Through the exegesis and critique of the 'sociology of professions', the research will demonstrate that doctors from the Indian subcontinent represent a racialised fraction of the new middle class. The main question surrounding the analysis of the relationship between Indian doctors and the British 'professional' occupation of medicine as 'gatekeepers' of the occupation, will focus on the relationship between professionalism and racism. The research will contend that the content of professionalism does not merely define certain occupations as 'professions', but more importantly, professionalism like racism is an ideology. Professionalism not only operates to justify and legitimate the supposed special status of medicine, but it also reinforces racist exclusionary practices in a 'sanitised' form within the occupation. This provides the research with the rare opportunity of analysing the nature and content of two ideologies operating within the same arena: the relationship between racism and professionalism. This will illustrate that the racism which black migrant 'professional' labour is subject to, does not only operate in a functional way for capitalism in providing labour for the less desirable specialisms of medicine, but also operates through the mediation of the occupation of medicine to help reproduce the 'professional status' of the occupation.
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McKee, Clifford Martin. "The appropriateness of out-of-hours work by junior doctors." Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335316.
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Merrette, Edwin James. "Company 'doctors' : do higher academic qualifications make for 'better' managers?" Thesis, University of Birmingham, 2004. http://etheses.bham.ac.uk//id/eprint/85/.
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This thesis addresses two main questions. Firstly “Are there significant differences between the level of academic achievement (qualification) of German senior managers and their British counterparts?” Secondly if so, “why should this be so?” These two questions lead to a third, “what impact, if any, do these differences have”? This third question, whilst it is not the focal point of this research, is discussed in outline in so far as it impinges upon our topic, it would however probably be more properly addressed as the subject of a further separate thesis. This thesis, supports the proposition that German senior managers are usually academically better qualified than their British counterparts and in particular that many more, by a factor of between 10 and 50 to one, have Doctorates. It identifies long standing and deep-seated cultural differences as being one of the principal reasons why this should be so. As to the third question the differing levels of productivity in the two countries, particularly in the manufacturing industry, have been the subject of much debate. This thesis supports the argument that lack of qualification both academic and vocational of British managers may contribute to this difference. However, it also indicates that the British less focussed more generalist approach may prove advantageous where the ability to innovate or to be entrepreneurial is concerned, an area where German managers it seems do less well.
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Lake, Jonathan. "Teaching doctors : the relationship between physicians' clinical and educational practice." Thesis, University of Exeter, 2013. http://hdl.handle.net/10871/8002.
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This thesis explores the relationship between physicians’ clinical and educational roles in the context of UK General Practice (GP) education by investigating the experiences of seven GP trainers through an ethnographic approach employing Activity Theory (AT). The Introduction considers the philosophy and structures of GP education and outlines the author’s professional biography to provide context. The Literature Review focusses on the development of medical education as a discrete field and identity formation in medical educators, concluding that: specialist medical educators are a relatively new group; and there is a paucity of knowledge regarding the impact on physicians of occupying dual clinical and educational roles. The thesis then focusses on three Research Questions (RQs), namely: 1. What is the impact of GP trainers’ clinical practice upon their educational work? 2. How does GP trainers’ educational practice influence their clinical work? 3. What are the social contexts for GP trainers’ clinical and educational practice? These questions are addressed within a pragmatic theoretical framework to build up an ethnographic description of the participants’ experiences. Data collection is through semi-structured interviews and observation of video-recorded teaching. Ethical issues associated with the study are discussed in detail, in particular the challenges of “insider” research. Four approaches are used for data analysis: global impressions; word cloud analysis; thematic analysis; and analysis shaped by AT. In answer to RQs 1 and 2, the study finds that GP trainers experience their dual roles as intimately linked, intuitively transferring their skills between their clinical and educational practice. The study also finds that GP trainers reconstruct their professional identities through teaching. With regard to RQ 3, engaging in teaching can lead to internal conflict for GP trainers and tensions with their colleagues, trainees and regulators. These findings are discussed in relation to medical education research methodology and the impact the study on the researcher is explored. The thesis closes by considering the conflicted position the participants occupy, concluding that teaching offers physicians the opportunity to reconstruct their professional identities so they can approach tensions in their practice with a sense of agency and optimism.
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Euclides, Maria Simone. "Black women, doctors, theorists and university teachers: challenges and achievements." Universidade Federal do CearÃ, 2017. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=20054.
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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgicoThe objective of this research was to analyze the professional trajectory of black teachers and doctors, who work in public universities in CearÃ. Objectively, has been sought to understand if institutional racism and gender interfere in their professional trajectories, and what challenges were found to legitimize themselves in academic and scientific space. The methodology adopted is a qualitative research through semi-structured interviews with black female teachers who work in federal and state public institutions located in the interior and capital of the state of CearÃ. The interviews were fulfilled into 3 parts: identity profile (general information of interviewed), socioeconomic data and life history. Parallel to the interviews, the Curriculum Lattes of each teacher was analyzed in order to identify the academic course carried out by the teachers. From the narratives of nine black female teachers located at the State University of CearÃ, Federal University of CearÃ, Cariri Regional University and University of International Integration of Afro-Brazilian Lusophony, we present her trajectories, achievements and challenges. In this research, in spite of showing the advances and the achievements made by black teachers in higher education institutions, what represents the constant effective work through the construction of new methodological and epistemological proposals, it also presents and denounces the multiple facet of racism, prejudice and racial discrimination, through the career trajectories in the institutional sphere or in interpersonal relationships. These findings call attention to the urgency of constructing new concrete attitudes in the institutional sphere, in this way, some actions could be more prominent to confront racism and segregationism practices and the power relations imbued in academic culture. In spite of everything, we could reaffirm that the presence of black teachers in this white academy, rework the scientific canons, and it is also a space of affirmation and recognition. Once they are there (in the universities), they carry out a work where the individual is collective, within a perspective of schooling and antiracist education.
O objetivo desta pesquisa foi analisar a trajetÃria profissional de docentes negras e doutoras, que atuam em universidades pÃblicas do CearÃ. Objetivamente, buscou-se compreender se racismo institucional e gÃnero interferem em suas trajetÃrias profissionais, e quais os desafios encontrados para se legitimarem no espaÃo acadÃmico e cientÃfico. A metodologia adotada parte de uma pesquisa qualitativa mediante a realizaÃÃo de entrevistas semiestruturadas junto Ãs professoras que se autodeclararam negras e que atuam nas instituiÃÃes pÃblicas federais e estaduais, localizadas no interior e na capital do estado do CearÃ. As entrevistas foram divididas em 3 partes: perfil identitÃrio (informaÃÃes gerais da entrevistada), dados sÃcios econÃmicos e histÃria de vida. Paralelo as entrevistas, realizou-se anÃlise do CurrÃculo Lattes de cada professora de modo a identificar o percurso acadÃmico realizado pelas mesmas. A partir de narrativas de nove professoras negras situadas na Universidade Estadual do CearÃ, Universidade Federal do CearÃ, Universidade Regional do Cariri e Universidade da IntegraÃÃo Internacional da Lusofonia Afro brasileira, apresentamos aqui suas trajetÃrias, conquistas e desafios. Nesta pesquisa, apesar de mostrar os avanÃos e as conquistas realizadas pelas professoras negras nas instituiÃÃes de ensino superior, no que se refere ao constante trabalho efetivo mediante a construÃÃo de novas propostas metodolÃgicas e epistemolÃgicas, tambÃm apresenta e denuncia as mÃltiplas facetas nas quais o racismo, preconceito e a discriminaÃÃo racial transversalizam as trajetÃrias profissionais, quer seja no Ãmbito institucional, quer seja nas relaÃÃes interpessoais. Tais achados, nos chamam a atenÃÃo para a urgÃncia de construÃÃo de novas atitudes concretas em Ãmbito institucional, no enfrentamento das prÃticas racistas, segregacionistas e das prÃprias relaÃÃes de poder impregnadas na cultura acadÃmica. Apesar de tudo, podemos reafirmar que a presenÃa de docentes negras nesta academia branca, reelaboram os cÃnones cientÃficos, e à tambÃm um espaÃo de afirmaÃÃo e reconhecimento. Uma vez que là estÃo (nas universidades), realizam um trabalho onde o individual à o coletivo, dentro de uma perspectiva de escolarizaÃÃo e educaÃÃo antirracista.
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Yahya, Nabila Qaseem Ali. "Knowledge and practice of emergency doctors regarding traumatic dental injuries." University of the Western Cape, 2017. http://hdl.handle.net/11394/6233.
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Magister Chirurgiae Dentium - MChD (Oral Medicine and Periodontics)Traumatic dental injuries (TDI's) are an important public health problem in children and adolescents worldwide. The emergency center (EC) serves as the spearhead to the hospital as it has to deal with a broad spectrum of patients with different ailments and injuries. The level of knowledge and doctors' practice at emergency centers (EC's) regarding TDI's has a direct impact on patient outcomes. The current literature reports that EC doctors have insufficient knowledge of the management of TDI's.
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Westbury, J. "An exploration of consultant doctors' hand hygiene : practice and perspectives." Thesis, University of Southampton, 2012. https://eprints.soton.ac.uk/340447/.
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Hand hygiene is considered the cornerstone of infection prevention practice, but previous studies demonstrate one group of healthcare professionals, doctors, have not achieved good levels of compliance in comparison to other staff groups. The aim of the research was to examine consultant doctors‟ practice and perspectives of hand hygiene, exploring their perceptions as leaders and role models, so as to identify strategies to improve compliance. The study design was based on naturalistic inquiry, focussing on the social constructions of participants. Nineteen consultant doctors were observed during hospital ward rounds using both a national audit tool to assess hand hygiene compliance and recording of field notes. These same consultants, plus a further two, were interviewed individually to elicit their views. Data from the 21 interviews and field notes were analysed qualitatively using thematic content analysis. Observations demonstrated high levels of hand hygiene compliance for high risk and medium risk activities, with low levels of compliance for low risk activities. Thematic content analysis revealed a strong belief by consultant doctors in the value of hand hygiene. However, a perceived conflict between political and scientific drivers of hand hygiene promotion gave rise to confusion, frustration and a lack of engagement that created barriers to leadership and acting as a role model. Differing guidelines and audit tools that did not address levels of risk compounded the matter. However, consultant doctors offered various recommendations to resolve the issues. Compliance with hand hygiene by consultant doctors is dependant on perceived levels of risk. To promote leadership and role modelling it is critical to engage consultant doctors, understand their views, employ their recommendations and recognise they are motivated by evidence-based rationales for practice rather than political mandates. The findings, conclusion and recommendations of the research study have significant implications for addressing the shortfalls of the hand hygiene agenda in clinical practice and for the engagement of consultant doctors.
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Fisher, Evan. "Humanitarian presence. Locating the global choices of Doctors Without Borders." Thesis, Université Paris sciences et lettres, 2020. http://www.theses.fr/2020UPSLM024.
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Cette thèse constitue une monographie de l’organisation non gouvernementale Médecins Sans Frontières. Son matériel de base est une enquête ethnographique menée sur les opérations de cette ONG médicale humanitaire au moment même où elles se déroulent. En observant les membres de MSF en train de proposer des soins médicaux aux migrants dormant dans les rues à Paris ou aux habitants d’un bidonville à Nairobi, ou en train d’évaluer et de planifier leurs projets depuis le siège, nous les voyons bricoler pour faire tenir ensemble les objectifs parfois incompatibles d’une mission humanitaire en apparence simple : l’assistance médicale à des personnes vulnérables à travers le monde. Notre approche pragmatiste nous invite à prendre au sérieux dans l’analyse le fait que c’est l’aide humanitaire elle-même qui doit faire tenir ensemble en situation les ambiguïtés, les ambivalences ou même les contradictions d’une telle mission, tant dans ses projets et ses actions que dans ses effets ambivalents. Pour ce faire, nous nous sommes demandé comment procède MSF pour sélectionner celles et ceux qu’elle cherche à aider autour du monde. Pour répondre, nous avons produit une description fine de l’instrumentation du triage : les processus d’élaboration et l’usage des outils qui soutiennent le choix réflexif des bénéficiaires autour du globe. Nous proposons pour cela trois gestes analytiques, qui nous permettent de contribuer aux discussions actuelles sur la globalité en anthropologie : assemblages globaux, espaces globaux, santé globale. D’abord, nous montrons comment le tracé de frontières, de territoires, d’échelles que ces instruments de triage ne cessent de produire participe à la distribution de lieux humanitaires : l’espace humanitaire, le terrain, les plateformes médicales, le siège de MSF. Ensuite, en faisant porter l’analyse sur la façon dont les instruments de triage débouchent sur une mise en « scripts » ou en scénarios de ceux que les humanitaires prétendent aider, nous montrons comment MSF acquiert la capacité d’agir spécifiquement dans ses relations avec les bénéficiaires humanitaires : tact et tactiques du care, reconnaissance réciproque des bénéficiaires dans leur besoin d’aide et des humanitaires dans leur besoin d’aider, acceptabilité d’une responsabilité envers cette vulnérabilité associée dans le même temps à la tentative de transférer cette responsabilité vers des systèmes des santé publics. Enfin, en rendant compte de ces instruments en termes de technologies humanitaires d’intervention, nous mettons en évidence la façon dont MSF opère des interventions ponctuelles tant dans les organes de gouvernement que dans les corps des gouvernés. Notre description de l’aide en train de se faire et notre analyse des problèmes associés aux lieux, aux bénéficiaires et aux technologies d’intervention humanitaires constituent ce que nous appelons l’aide humanitaire au présent. Par aide humanitaire au présent, nous désignons les manières d’exister de MSF, son extension physique globale, les soins de santé qu’elle accomplit, sa politique non gouvernementale et son éthique de l’attention. Sur ce concept peut se soutenir une approche critique positive de l’aide humanitaire, considérant à la fois la pluralité et l’incompatibilité des bénéfices qu’elle est censée apporter, mais aussi les cas et les instances précis où MSF a échoué à les faire tenir ensembleThis dissertation is a monograph of the nongovernmental organisation (NGO) Doctors Without Borders (MSF). It is based on an ethnographic inquiry into the operations of this medical humanitarian NGO as they take place. Observing members of MSF providing healthcare to migrants in Paris and to inhabitants of a slum in Nairobi, evaluating and planning projects in their headquarters, we see them tinker together the sometimes-incompatible goals of a seemingly simple humanitarian mission: medical assistance to the vulnerable around the world. Our pragmatist approach consists in arguing that analysis of international aid must account for how humanitarians find a way to hold together the ambiguities, and even the contradictions, of this claimed mission in the ambivalent effects humanitarian aid in practice. To this end, we ask how MSF selects those it seeks to assist around the world. Our response entails close description of the instrumentation of triage: the problematic processes of elaborating and using tools that support the reflexive choice of beneficiaries around the globe. We then make three analytical gestures, allowing us to contribute to ongoing discussions in anthropology on global assemblages, global spaces, and global health. First, we show how the processes of bordering, territorializing, and scaling that triage instruments support, participate in producing humanitarian locations: humanitarian space, the field, medical platforms, and headquarters. Second, analysing the ways triage instruments script for those humanitarians claim to assist, we argue that MSF gains humanitarian agency in the ways it relates to humanitarian beneficiaries: the tact and tactics of care, the reciprocal recognition of beneficiaries in their need and of MSF’s need to help, the acceptance of responsibility for this vulnerability coupled with an attempt to transfer responsibility to public health care systems. Third, accounting for these instruments in terms of humanitarian technologies of intervention, we demonstrate how MSF makes timely interventions into governing bodies and the bodies of the governed. Together, our description of aid as it takes place and our analysis of the problems associated with humanitarian locations, beneficiaries, and technologies of intervention constitute what we call MSF’s humanitarian presence. This humanitarian presence indicates the ways MSF exists, in their global physical extension, in the health care they practice, in their nongovernmental politics and their ethics of attention. This concept supports critique by indicating, first, the multiple and incompatible goods that are to inhere in humanitarian aid, and second, those specific instances when MSF has failed to do so