Physician-management relationships at HCA: a case study

The questions of whether Hospital Corporation of America (HCA), a for-profit hospital company, fostered an environment detrimental to the physician-patient relationship during the period of implementation of the Medicare Prospective Payment System (PPS) was explored. The transition to PPS provided an opportunity to evaluate whether hospital ownership differences affected responses to a payment system which encouraged institutional intervention in the practice of medicine. A case study approach was used to observe the influence of the then largest for-profit hospital corporation upon physicians' medical practice in four owned hospitals. Findings indicated that HCA hospital managers were most directly influenced by the local competitive environment and their own personal agendas in responding to PPS incentives. Corporate influence actually softened payment system incentives to intervene in medical practice by providing a generous supply of capital, and by fostering a corporate culture conducive to cooperative relationships with physicians. Better public understanding of the determinants of hospital behavior is needed to preserve or enhance important social goals such as the physician-patient relationship; easily measurable characteristics such as ownership or bed size explain little about hospital behavior or motivation.     

The electoral consequences of issue ambiguity: An examination of the presidential candidates' issue positions from 1968 to 1980

This study investigates the consequences of ambiguity in the issue positions of presidential candidates from 1968 to 1980. Two potential consequences are examined: a direct impact and a conditional impact on the vote. The findings indicate no significant direct effect on the vote. However, significant conditional effects were found. Compared to losing candidates, winning candidates were somewhat less likely to hold clear positions when issues were salient to the public and were somewhat more likely to hold ambiguous positions when public opinion was dispersed. They were especially more likely to be ambiguous when their positions substantially differed from the median public position on the issue.     

Deoxyribonucleic acid (DNA) analysis by restriction fragment length polymorphisms of blood and other body fluid stains subjected to contamination and environmental insults.

Deoxyribonucleic acid (DNA) restriction fragment length polymorphism (RFLP) profile results were obtained from bloodstains and other body fluid stains subjected to mixture with other body fluids, environmental insults (sunlight and temperature), different substrates (cotton, nylon, blue denim, glass, aluminum, and wood), and contaminants (gasoline, bleach, sodium hydroxide, soil, motor oil, detergent, phosphate salt, glacial acetic acid, and microorganisms). Of the samples that produced profile results, all had profiles that were consistent with those of untreated control samples.     

The Perceptions of Academic Lawyers Concerning the Effects of the United Kingdom's Research Assessment Exercise

In this article, the authors analyse quantitative and qualitative data compiled from a large-scale postal survey of legal academics concerning the United Kingdom's Research Assessment Exercise. The purpose of the study was to measure the attitudes of academic lawyers affected by the RAE rating process and institutional responses to that process. The study reveals that a substantial number of respondents lack faith in the objectivity of the rating process, believe institutional responses to the RAE have caused damage to academic working environments, and perceive that the RAE has failed to improve the quality of legal research.