The effect of COVID-19 on oncology practice in Turkey

PURPOSE

The novel coronavirus (COVID-19) was defined in China, leading an outbreak, impacted the organization, and maintained cancer care. Although the alterations of cancer treatment maintenance were evaluated, the difference in physicians' side was not determined. In this survey study, we tried to assess the alteration of Turkish oncologists' daily practice.

METHODS

An online survey was prepared via Google forms and sent to oncologists registered to the Turkish Society of Medical Oncology. One hundred twenty-eight oncologists answered the online survey.

RESULTS

Twenty-three percent of the oncologists moved their facilities to another place in the hospital after the pandemic, which was resulted in nearly 90% of worse patient services. Seventy percent of the oncologists did not receive any duties on COVID-19 services after Turkey's first case. Thirty-one percent of the oncologists stated their oncology practice was disturbed by working in the COVID-19 services. Three oncologists accepted they were responsible for cross-infection to oncology patients. Eighty-five percent of the oncologists declared oncology practice was disturbed by the other specialists' assignment in COVID-19 services. The leading areas were general surgery, pulmonary diseases, and ENT, according to oncologists. Twenty-two percent of the oncologists needed to send their patients to other oncology clinics due to the COVID-19 pandemic.

CONCLUSION

Although oncologists tolerated oncological patient management alterations, the prolonged pandemic situation may harm oncology practice via the loss of oncologists' motivation and incomplete multi-disciplinary patient management. There is a need for follow-up studies to evaluate the situation for the alternation in the COVID-19 pandemic.​.

Private Equity Acquisitions of Physician Medical Groups Across Specialties, 2013-2016

This study characterizes practice characteristics and specialties of physicians and medical groups acquired by private equity firms between 2013 and 2016.

Growing a Robust Academic Practice Partnership in an Academic Health System

Schools of nursing located within academic health centers have embraced expanded opportunities to lead in this era of rapid change and considerable uncertainty in US health care. These schools bear a unique responsibility to work with their clinical nursing partners to advance the care of patients, improve the health of communities and populations, and help steward the nation's health care resources. This article describes how the Emory University Nell Hodgson Woodruff School of Nursing has formed and sustained academic-practice partnerships in response to these imperatives. The structures and processes that have supported the partnerships are shared, as are the keys to success in a true partnership. The authors describe the work required to achieve mutually agreed-upon goals, along with the challenges that faculty and health care leaders have faced in their journey to system partnerships.

Dynamics between doctors and managers in the Italian National Health Care System

This article focuses on the changes in the Italian NHS by concentrating on patterns in the managerialisation of doctors. It addresses a series of shortcomings in studies on the response by doctors to managerialisation. The first is a shortcoming of theoretical and analytical nature. It is necessary to adopt a broader perspective whereby analysis considers not only the interaction between doctors and managers, but also the public control and regulation agencies that operate in that field. The second shortcoming is a methodological one. The literature on managerialisation is more theoretical than applied. It is necessary to adopt a strategy based on a plurality of methodologies and sources in order to focus attention on a national case (Italy in the present study), discussing the changes over time (from the beginning of managerialisation until today) and considering different groups within the medical profession. The outcome is a complex picture of the dynamics between doctors and managers which foregrounds the managerial co-optation processes of a small group of national health service doctors, the transition from strategic adaptation to forms of resistance against managerialisation by the majority of Italian NHS doctors, and the emergence of restratification processes among self-employed doctors working with the NHS.

New directions for veterinary technology

Veterinary technology has generally established itself well in companion-animal and mixed-animal veterinary medical practice, but the career's growth trajectory is uncertain. Michigan State University (MSU) convened a national conference, "Creating the Future of Veterinary Technology-A National Dialogue," in November 2011 to explore ways to elevate the veterinary technician/technologist's role in the veterinary medical profession and to identify new directions in which the career could expand. Veterinary technicians/technologists might advance their place in private practice by not only improving their clinical skills, but by also focusing on areas such as practice management, leadership training, business training, conflict resolution, information technology, and marketing/communications. Some new employment settings for veterinary technicians/technologists include more participation within laboratory animal medicine and research, the rural farm industry, regulatory medicine, and shelter medicine. Achieving these ends would call for new training options beyond the current 2-year and 4-year degree programs. Participants suggested specialty training programs, hybrid programs of various types, online programs, veterinary technician residency programs of 12-18 months, and more integration of veterinary technician/technology students and veterinary medicine students at colleges of veterinary medicine.

[Management in stomatology: the theory and practice]

The article is devoted to a scientific-theoretical substantiation of management as the theory and practice of management of stomatologic activity.

Exotic animal corporate practice

I have attempted to give insight into many of the aspects of a corporate veterinary job in the retail pet industry. Understand that these are my experiences, and corporate jobs are as diverse as the number of corporations in this field. My experiences have been positive because I have been fortunate enough to become an integral part of a company with an outstanding company ethic regarding animal care and business as a whole. This is a dream position for a veterinarian who wishes to make a far-reaching difference for animals. At PETCO I am the Animal Advocate and I do have the responsibility to look at every situation through the eyes of the animals. I take this responsibility very seriously and understand that every decision I make has a lasting impact on not only the animals we sell but also the associates who daily give their heart and soul as they care for the animals in our stores. This is the way I have chosen to make a difference in the world: by using my veterinary education as well as my life experiences in ways that are very different from the James Herriot of old-different from the advanced veterinary practices in this new millennium but steadfastly following the same principles we promised to uphold when we took the veterinary oath... Being admitted to the profession of veterinary medicine, I solemnly swear to use my scientific knowledge and skills for the benefit of society through the protection of animal health, the relief of animal suffering,the conservation of livestock resources, the promotion of public health, and the advancement of medical knowledge. I will practice my profession conscientiously, with dignity, and in keeping with the principles of veterinary medical ethics. I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.

[A call for organizational and managerial changes in primary and hospital care services]

The changing epidemiological situation and socio-economic conditions in Italy have led to a situation where the Italian health care system no longer adequately satisfies the actual needs of society. Organizational and managerial changes in both primary and hospital care are needed and are proposed in this article. As regards general practice and primary healthcare it is crucial that a stable and exclusive relationship between GPs and their patients be regained through continuous and qualified care by the GP. This can be achieved through the establishment of primary care structures where a team of general practitioners work in association with nursing personnel for the delivery of key services including continuous at-home assistance. As for the organization of hospital care it would be useful to set up, in addition to existing general hospitals, "zonal inpatient facilities", resembling the old "infirmaries", directed by a specialized nurse and with a small full-time medical staff. In these facilities, designed for brief hospitalizations of patients with chronic conditions, GPs could take part in the management of their patients. Two important results could be achieved by establishing such facilities: a substantial reduction of healthcare costs related to frequent hospitalizations of patients with chronic medical conditions, and a structural reorganization of existing hospitals. Presently hospitals are often too large especially considering the continuous progresses made in diagnostic and therapeutic techniques which allow consistently shorter lengths of hospital stay and consequently, a more rapid turnover of patients.

Performance management in small practices

Performance management, variably referred to as corporate, business, or enterprise performance management, has traditionally been viewed as a strategy to achieve an optimum mix of solvency, quality, safety, and patient satisfaction in large healthcare organizations. Now, however, with the readily available data from government and nonprofit organizations promoting quality health care and affordable business intelligence tools, small practices can adopt management strategies, tools, and techniques once limited to corporate executives. With a modest investment in self-assessment and affordable analysis tools, a small practice can benefit from a scaled-down version of the performance management initiatives in place at the leading health-care organizations.

Advances in equine practice management

As equine practices move forward in the 21st century, we feel increasing pressure to manage our businesses like business people. This requires outside expertise, in-house business-trained managers, and continuing education on various aspects of practice life. Aside from the AAEP, several other organizations are providing continuing education in management, including the Association of Veterinary Practice Managers, the Veterinary Management Institute offered at Purdue University Krannert Graduate School of Management, the American Animal Hospital Association through (The Virginia-Maryland Regional College of Veterinary Medicine's) on-line practice management course, and the University of Illinois Equine Practice Management modules.

Advances in information technology

Advances in digital technology have vastly increased the speed and content of information transfer. Equine practitioners of the future should be in contact with their office and other information resources at all times through an array of digital networks. Patients and practitioners alike should benefit from better information access.

Psychotropic PRN: a model for best practice management of acute psychotic behavioural disturbance in inpatient psychiatric settings

PRN, or 'as needed', medications are administered frequently by mental health nurses in psychiatric inpatient settings to manage difficult and disturbed behaviour when other strategies fail. Research indicates that approximately 50% of psychiatric inpatients receive a PRN medication at some stage of their treatment. Although evidence indicates that traditional antipsychotics and benzodiazepines are equally effective in managing acute agitation and other psychotic symptoms, it has been recommended that benzodiazepines should be the first-line of action because they do not cause the serious side-effects that are common with the traditional antipsychotics. Unfortunately, research indicates that doctors and nurses are not taking advantage of the latest evidence to guide their practice. This paper reviews the limited research available in the area and makes recommendations for evidence-based practice.

Three perspectives on physical therapist managerial work

BACKGROUND AND PURPOSE

The nature of managerial work in the commercial sector has not been studied since the 1970s, and little is known about the work of managers in the health care sector. In this study, the perceived importance of managerial role and skill categories among 3 groups of physical therapists were studied to better understand the work priorities of physical therapist managers.

SUBJECTS

Two groups of subjects were physical therapist managers in hospitals or private practices. A third group consisted of faculty members in professional physical therapist education programs.

METHODS

Respondents (n=343) rated the importance of 75 managerial activities. Responses related to 16 predetermined work categories were placed in rank order by group. A multivariate analysis of variance (MANOVA) was used to identify differences among groups.

RESULTS

All groups identified communication, financial control, entrepreneur, resource allocator, and leader as the 5 most important categories and rated technical expert and figurehead as least important. The MANOVA showed differences between faculty members and private practice managers in 15 work categories, between hospital-based managers and private practice managers in 9 categories, and between faculty members and hospital-based managers in 8 categories.

DISCUSSION AND CONCLUSION

Work setting appears to have an impact on level of importance placed on managerial work categories. The strongest candidates for "universal" physical therapist managerial work categories were communication, financial control, and resource allocator.

Pragmatism and structuralism in occupational therapy: the long conversation

The history of occupational therapy may be understood as a continual transaction between two cultural discourses: pragmatism and structuralism. Pragmatism is a way of thinking that presupposes humans are agentic by nature and knowledge is tentative and created within particular contexts. Structuralism is a way of thinking that assumes humans are composites of recurring general frameworks and that knowledge is objective and can be generalized to multiple contexts. Early in the field's history, both pragmatist and structuralist assumptions about the human and knowledge produced different readings, or interpretations, of what constituted the appropriate tools, methods, and outcomes for occupational therapy. Consequently, occupational therapy adopted an interesting mix of pragmatist language regarding the human and structuralist approaches to knowledge, resulting in professional identity problems still experienced today. However, recent developments offer an opportunity for occupational therapists to correct old identity problems through critically evaluating incompatible assumptions and carefully reading the prevailing cultural ethos.

Practice unwinds and disengagements

Many employed physicians are being forced to consider entering the private practice arena as physicians networks and groups are contemplating total or partial divestitures. Still other physicians are evaluating the possibility of leaving their current practice or hospital based network and opening their own practice. This article is designed to better prepare a physician for this situation ad proactively plan for their future.