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Professional Autonomy (professional + autonomy)
Selected AbstractsDental hygiene regulation: a global perspectiveINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 3 2008PM Johnson Abstract:, Occupational regulation of health personnel is important to professional associations and their members, the public that relies on their services and the regulatory agencies responsible for their conduct. There is increasing interest in ensuring that dental hygiene regulation fosters the continuing evolution of the profession and its contribution to oral health. The keynote address for the 2007 Regulatory Forum on Dental Hygiene, this paper discusses the rationale for and issues pertaining to occupational regulation, outlines the evolvement of dental hygiene and identifies regulatory options for the profession. Professional regulation exists to ensure public safety, health and welfare. However, negative political-economic side effects coupled with environmental pressures have resulted in increased scrutiny for health professionals. One such profession is dental hygiene. Its evolution has been dramatic, in particular over the past few decades, as illustrated by its rapidly increasing numbers and broader distribution globally, gradual shift to the baccalaureate as the entry-level educational requirement and increase in postgraduate programs and expanding scope of practice and increased professional autonomy. Regulatory changes have been more gradual. Regulation is mandatory for the vast majority of dental hygienists. Of the options available, the practice act , the most rigorous type, is predominant. Globally, regulation tends to be administered directly by the government (n = 9 countries) more so than indirectly through a dental board (n = 4) or self-regulation (n = 3). Whether regulated directly or indirectly, dental hygienists increasingly are seeking a greater role in shaping their professional future. Self-regulation, its responsibilities, misperceptions and challenges, is examined as an option. [source] The professionalisation of social work: a cross-national explorationINTERNATIONAL JOURNAL OF SOCIAL WELFARE, Issue 4 2008Idit Weiss-Gal This article compares the professional features of social work in ten countries. It is based on detailed descriptions of the professional features of social work in Chile, Germany, Hungary, India, Mexico, South Africa, Spain, Sweden, the UK and the USA. Social work in these countries is discussed in terms of eight features, chosen as marks of a profession on the basis of the ,attributes' and ,power' approaches to professionalisation: public recognition, monopoly over types of work, professional autonomy, the knowledge base, the professional education, the professional organisations, the existence of codified ethical standards and, lastly, the prestige and remuneration of social work. [source] Impact of cost containment measures on medical liabilityJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 6 2006S. Callens PhD Abstract Rationale, Owing to the growing health care expenditure and the need to improve efficiency, public authorities have since the 1980s changed their policy with respect to health care. Financial pressures encouraged them to investigate methods to control health care costs. One recent method is the enactment of cost containment measures based on clinical practice guidelines (CPGs) that provide financial or administrative sanctions. Aims and objectives, This article describes the legal value of CPGs, the evolution towards cost containment measures based on CPGs, and finally the legal value of these new cost containment measures. It questions whether these measures may have an impact on the medical liability rules and it wants to open the debate on the legal value of these measures based vis-à-vis the professional autonomy of the physician and patients' rights on quality care. Methods, The research for this article is based on a comparative analysis of the legal literature and jurisprudence of a number of legal systems. Results and Conclusions, The article concludes that, as a result of the rising costs, it becomes increasingly difficult for a physician to balance his duty to take care on the one hand and his duty to control costs on the other. Maintaining a high standard of care towards patients becomes difficult. Consequently, one wonders whether the law should then allow the standard of care to be adjusted according to the available means. Until now, courts in a fault based system have not been willing to accept such an adjustment of the standard of care, but it might well be possible that this attitude will change in case of no-fault compensation systems. [source] Client Influence and the Contingency of Professionalism: The Work of Elite Corporate Lawyers in ChinaLAW & SOCIETY REVIEW, Issue 4 2006Sida Liu This study examines how the professional work of elite corporate lawyers is constructed by influence from different types of clients. The data presented include interviews with 24 lawyers from six elite corporate law firms in China and the author's participant-observation in one of the firms. For these elite Chinese corporate law firms, foreign corporations, state-owned enterprises, and private enterprises constitute their extremely diversified client types. Accordingly, lawyers' work becomes flexible and adaptive to accommodate the different demands of the clients. Meanwhile, client influence on lawyers' professional work is mediated by the division of labor within the corporate law firm: whereas partners have solid control over the process of diagnosis, inference, and treatment and thus enjoy a high degree of professional autonomy, associates are largely stripped of this cultural machinery in the workplace, and their work becomes vulnerable to client influence. As a result, client influence on professional work appears to decrease with a lawyer's seniority. [source] Swedish mental health nurses' responsibility in supervised community care of persons with long-term mental illnessNURSING & HEALTH SCIENCES, Issue 1 2004Annabella Magnusson rpn Abstract The aim of the present study was to describe psychiatric nurses' experience of how the changing focus of mental health care in Sweden, from in-patient treatment to community-based care, has influenced their professional autonomy. Eleven psychiatric nurses were interviewed and a qualitative content analysis was used to identify major themes in the data. Three main themes were found: pattern of responsibility, pattern of clinical judgement, and pattern of control through support and supervision. All themes were related to the nurse's identity, moral responsibility and the feelings of loneliness and independence in his/her daily work. Together, the three themes were found to constitute a process. This study shows the complexity involved in nursing care provided in the patient's home. Achieving control over the patient's everyday life through support and supervision does not imply taking over the patient's autonomy, but rather reducing the stigma attached to mental illness and facilitating the process of rehabilitation. [source] Education not training: the challenge of developing professional autonomyOCCUPATIONAL THERAPY INTERNATIONAL, Issue 3 2000SROT, Susan A. Esdaile PhD Abstract The aims of this paper are first, to differentiate between education and training, emphasizing the importance of the former in the professional education of occupational therapists; and second, to outline some of the possible threats to professional autonomy. A focus on training may result in a level of education that cannot sustain professional autonomy. However, the establishment of proscribed and detailed, nationally controlled educational standards may also limit a profession. The latter may occur when cost-containment is a major societal concern, focusing educational standards on training and measurable outcomes of professional practice. Copyright © 2000 Whurr Publishers Ltd. [source] ,Psy' research beyond late modernity: towards praxis-congruent researchPSYCHOTHERAPY AND POLITICS INTERNATIONAL, Issue 1 2010Richard House Abstract Lees and Freshwater's Practitioner-based Research is a significant intervention into the struggle for the ,research soul' of the psychological therapies. Positivistic notions beloved of the managerialist ,audit culture', centred on the totem of ,evidence-based practice', are increasingly colonizing psy research, creating a new ,regime of truth' that privileges ,standards', ,competencies' and ,quality assurance', and presages a shift in the locus of power away from practitioners' professional autonomy and towards managerialist bureaucracy. In arguing that no one (,scientific') paradigm should necessarily be assumed to be more ,valid' than a multiplicity of possible others, they advocate the practitioner's voice having at least equal validity to that of academics and bureaucrats, aiming to establish an ,epistemology of practice' that redresses a balance that has become too skewed towards uncritical, and in many ways anti-human, ,technical rationality'. This review article explores the rationale for this shift, and finds it compelling and convincing. It is also argued here that great benefit can be gained for the future flourishing of psy research from building bridges to other radical-critical research traditions and innovations in late-modern culture. Copyright © 2010 John Wiley & Sons, Ltd. [source] Soft Governance, Hard Consequences: The Ambiguous Status of Unofficial GuidelinesPUBLIC ADMINISTRATION REVIEW, Issue 4 2006Taco Brandsen Soft governance is an approach to policy implementation in which the central government relies less on hierarchy than on information to steer local organizations. This allows for a combination of formal accountability and professional autonomy that improves the quality of public services in both the short and the long term. Guidelines of an advisory, unofficial status are one tool that central government can use for this purpose. However, an inherent problem with this approach is that even though guidelines have no official legal status, in practice, they can take on the character of formal regulation when local organizations suspect that they cannot choose alternative courses of action, however well reasoned, without being sanctioned. It is a situation that encourages conformist behavior and diminishes the long-term potential for innovation. This phenomenon is illustrated with an analysis of disaster management in the Netherlands. [source] Health-care reform and the dimensions of professional autonomyCANADIAN PUBLIC ADMINISTRATION/ADMINISTRATION PUBLIQUE DU CANADA, Issue 1 2009Glen E. Randall With this model, it was assumed that competitive forces would encourage quality while driving down costs. While such reforms often achieve cost controls by constraining the incomes and practices of health-care workers, there has been relatively little analysis of the extent to which self-governing health-care professionals, particularly those outside of medicine and nursing, may experience a decline in their ability to control the content and context of their professional work. In this article, the authors analyse the results of thirty-six in-depth interviews with representatives of Community Care Access Centres (CCACs), the organizations that purchase and coordinate the delivery of home-care services, and rehabilitation provider agencies to examine the impact of Ontario's managed competition reform on rehabilitation professionals. Findings suggest that the impact of the reform varied across the economic, political, and clinical dimensions of professional autonomy and that, despite a general loss of autonomy under the managed competition model, market forces also served to mitigate the loss of autonomy, thus contributing to a remarkable resilience of professional autonomy. Sommaire: Un modèle de « concurrence dirigée » a été introduit récemment dans la province canadienne de l'Ontario dans le cadre de la réforme gouvernementale des soins à domicile. Avec ce modèle, il était présumé que les forces de la concurrence encourageraient la qualité tout en faisant baisser les coûts. Alors que de telles réformes parviennent souvent à maîtriser les coûts en réduisant les revenus et les pratiques des travailleurs de la santé, il y a eu relativement peu d'analyses de faites sur la mesure dans laquelle les professionnels de la santé autonomes, particulièrement ceux qui exercent en dehors de la médecine et de la profession infirmière, connaissent une perte de contrôle sur le contenu et le contexte de leur travail professionnel. Dans le présent article, les auteurs analysent les résultats de trente-six entrevues en profondeur menées auprès de représentants des Centres d'accès aux soins communautaires (CASC), organismes qui achètent et coordonnent la prestation des services de soins à domicile, et organismes de prestation de soins de réadaptation, afin d'examiner les conséquences de la réforme de la concurrence dirigée de l'Ontario sur les professionnels de la réadaptation. Les résultats laissent entendre que l'effet de la réforme a varié en fonction des dimensions économiques, politiques et cliniques de l'autonomie professionnelle et que, malgré une perte d'autonomie générale liée au modèle de concurrence dirigée, les forces du marché ont également permis d'atténuer la perte d'autonomie, contribuant ainsi à la remarquable résilience dont font preuve ces professionnels en la matiére. [source] | |||||||||||||