The Health Care Industry and Staffing Policies

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Please see response attached, including one relevant article as well. I hope this helps and take care.

RESPONSE:

1. Most people have some familiarity with hospitals and the health care industry. Based on your knowledge, in which quadrant of the staffing policies matrix (fortress, baseball team, club, and academy; the four distinct strategic staffing types four distinct strategic staffing types) do you think hospitals are located? Are the staffing policies of hospitals more like baseball teams, academies, clubs or fortresses? Explain our reasoning.

The Promotions or External Recruitment The Promotion Decision Scenario is based on the career system framework of Sonnenfeld and Peiperl (1988). These are the Club (internal labor market group loyalty), Academy (internal labor, performance-based), Fortress (external labor market group loyalty), and Baseball Team (external labor market performance based) profiles. The most important criteria are the source of the promotion candidate (e.g. internal vs external), the performance criterion used to evaluate candidates for promotion (e.g. group service/loyalty vs individual performance), and age. The problem setting is the creation of a new post to help an overloaded manager handle increasing business (Table 2). The German sample stands nearly alone in its concern for promoting managers based on objective performance criteria. French managers are at the other extreme in basing promotion criteria on seniority or group loyalty (http://66.102.7.104/search?q=cache:oyfqc43DsR8J:studies.hec.fr/object/SEC/file/A/STPNAAHHBCRKVXKKJLZYBNDAQTRGAGCQ/Making%2520cross-cultural%2520research%2520relevant%2520to%2520European%2520corporate%2520integration%2520-%2520old%2520problem%2520new%2520approach.pdf+staffing+policy+fortress,+baseball+team,+club,+and+academy&hl=en).

Hospitals are probably located as Academy with staff being promoted by seniority and performance based criteria.

2. Examine the projections for the various health care occupational specialties. Are there substantial differences in the rates at which employment is expected to grow in the different occupations? How have the strategic actions by health care organizations, such as mergers, shifts to preventative approaches, and the focus on cost control, affected the expected growth of the different specialties?

I examined the projections and to determine whether there was a substantial difference in the rates at which employment is expected to grow, I calculated the percentages in the above chart (divide 1998 figure/2008figure ? highest growth rates highlighted in red). Obviously, there are differences in the observed growth rates across occupational specialties. For example, notice that the top two are optometrists and dentists, followed by clinical lab technicians, licensed practical nurses and physicians. The two with the least growth are dental hygienists and physicians Assistants.

The strategic actions obviously are expected to affect the expected growth of different specialties as predicted above i.e., lower expected rate for dental hygienists and physicians assistance could be due to mergers and cost cuts.

How is the market demand for medical care expected to affect employment in the different specialties?

This is reflected in the chart above. For example, as market demand changes (i.e., aging population, etc.) along with the cost drivers (i.e., next generation of technology promises to reduce cost), employment will be affected (i.e., move care to ambulatory settings will increase employment in this specialty) and improve outcomes.

EXAMPLE: Trained Physicians

The characteristics of today's workforce of fully trained physicians represent the cumulative decisions of many previous cohorts of medical residents. The future composition of the workforce depends on the makeup of the pool of physicians who are already trained and on the decisions made by current medical residents and future cohorts of residents about the specialties they will pursue. The workforce is also shaped by the characteristics of immigrating physicians.
The Mix of Physicians in Primary Care Versus Non-Primary Care Specialties

The relative balance of physicians in primary care specialties versus non-primary care fields continues to be an area of concern among health policymakers. Although no clear-cut definition of "primary care" exists, characteristics that tend to be associated with the concept of a primary care physician include being a point of first contact for a patient with the medical care system and providing routine examinations and vaccinations. Another distinction that people sometimes make is that primary care physicians are less oriented toward procedures (such as surgical interventions) than are non-primary care physicians. Yet another characteristic that is sometimes associated with primary care specialties is the breadth of patient problems that such physicians handle. Some people might argue that a primary care physician is one who engages in a broad range of activities, whereas a non-primary care doctor is one who treats only a narrow range of illnesses.

The above set of plausible characteristics for defining primary care is somewhat unsatisfactory because certain physicians will fit some of the attributes but not others. Nonetheless, a widely accepted view is that general practice, family practice, general internal medicine, and general pediatrics are primary care specialties; obstetrics and gynecology might also belong in the primary care category. (http://www.cbo.gov/showdoc.cfm?index=17&sequence=2&from=0).

EXAMPLE 2: Resident Physicians and Trained Physicians

For example, besides the fact that resident physicians become the trained physicians of the future, another important link exists between the market for hospital residents and the market for the services of fully trained doctors. Namely, the incomes of trained physicians provide incentives to young doctors that affect the number of new physicians who choose to ...