Pharmaceuticals, Money, and the Health Care Organizational Field

2016 ◽  
Author(s):  
Wendy Lipworth
Keyword(s):  
Health Care ◽  
Pharmaceutical Industry ◽  
Institutional Theory ◽  
Institutional Logics ◽  
The Other ◽  
Organizational Field ◽  
Stakeholder Groups ◽  
Theory Framework

Using an institutional theory framework, this chapter discusses the place of the pharmaceutical industry within the health care organizational field, and the wide-ranging effects the industry has on the other organizations in the field. It then provides a snapshot of the discourse that has emerged about the pharmaceutical industry, and about commercialization and marketization of the health care more generally. This paints a picture of deep ambivalence toward the pharmaceutical industry, both within and between stakeholder groups. The chapter ends with an effort to explain this ambivalence as the effect of competing institutional logics. This, in turn, points to some suggestions as to how the pharmaceutical industry might be better accommodated within the health care organizational field, without losing sight of the need for ongoing critique of industry behavior.

Bridging competing demands through co-leadership? Potential and limitations

2019 ◽  
Vol 73 (4) ◽  
pp. 464-489 ◽  
Author(s):  
Émilie Gibeau ◽  
Ann Langley ◽  
Jean-Louis Denis ◽  
Nicolas van Schendel
Keyword(s):  
Health Care ◽  
Shared Leadership ◽  
Health Care Organizations ◽  
Institutional Logics ◽  
Leadership Role ◽  
The Other ◽  
Collective Leadership ◽  
Leadership Potential ◽  
Competing Demands ◽  
Multiple Leaders

Collective leadership arrangements in which two people jointly occupy a shared leadership role space are often thought to enable the bridging of competing demands and sources of expertise and legitimacy in pluralistic settings where multiple institutional logics coexist. This research investigates 20 co-leadership dyads in health care organizations to examine whether, when, and how co-leadership arrangements can enable the bridging of institutional logics. Empirical findings suggest that the potential for bridging through co-leadership arrangements is present, but that it may often be achieved through the assimilation of one side by the other rather than balanced integration of competing demands. We conclude that the challenge of collective leadership (and of co-leadership, in particular) may lie not only in developing smooth relations among multiple leaders and their followers, but also in maintaining and mobilizing the tensions that can make their collaboration most fruitful. We suggest that the collective leadership literature has often missed the significance of this central paradox: that collective leadership may be most needed where it is most difficult to achieve. When it seems to operate most smoothly, it is possible that it may not always be fulfilling its mission.

RECONCILING COMPETING INSTITUTIONAL LOGICS IN CORPORATE VENTURE CAPITAL UNITS

2020 ◽  
pp. 2040004
Author(s):  
MARCEL AHLFÄNGER ◽  
MAGDALENA KOHUT ◽  
JENS LEKER
Keyword(s):  
Venture Capital ◽  
Institutional Theory ◽  
Institutional Logics ◽  
The Other ◽  
Corporate Venture Capital ◽  
Organisational Structure ◽  
Strategic Objectives ◽  
Prior Literature ◽  
Corporate Venture

Prior literature highlights the competing institutional logics corporate venture capital (CVC) units have to face due to their intermediary position between the two environments in which they operate — the VC industry and the corporate firm. By conducting an inductive case study of 20 CVC units, we unravel how novel organisational subunits reconcile the conflicting logics in terms of their organisational structure. We show that, instead of fully aligning with one or the other environment, most units form hybrid organisations incorporating elements of both logics. Our data suggest that CVC units tend to follow the hybridisation strategy of selective coupling rather than apply strategies of compromising or decoupling. The type of structure depends on factors on the intra-, inter-organisational and industry level. We further suggest a specific hybridisation pattern that is especially beneficial in the achievement of a unit’s strategic objectives. Our findings contribute to both institutional theory and CVC literature.

Surveillance of pediatric adverse drug reactions: A neglected health care program

PEDIATRICS ◽  
1975 ◽  
Vol 55 (3) ◽  
pp. 308-310
Author(s):  
W. Archie Bleyer
Keyword(s):  
Health Care ◽  
Pharmaceutical Industry ◽  
Adverse Reactions ◽  
Care Program ◽  
The Other ◽  
Preclinical Studies ◽  
Drug Reactions ◽  
Health Care Program ◽  
Pediatric Pharmacology ◽  
The Many

Dr. Alan K. Done, Director of Pediatric Pharmacology for the Food and Drug Administration, has recently secured a commitment from the pharmaceutical industry to complete preclinical studies of the many drugs which have not as yet been tested in young animals and are therefore not currently available for use in children. Once accomplished, this action and others already taken by the agency should help solve the problem of "therapeutic orphans."1 On the other hand, young children continue to be exposed to a large number of drugs which are already on the market and which are being given without adequate medical supervision or monitoring for adverse reactions.

scholarly journals Contracting with General Dental Services: a mixed-methods study on factors influencing responses to contracts in English general dental practice

2015 ◽  
Vol 3 (28) ◽  
pp. 1-194 ◽  
Author(s):  
Rebecca Harris ◽  
Elizabeth Perkins ◽  
Robin Holt ◽  
Steve Brown ◽  
Jayne Garner ◽  
...  
Keyword(s):  
Health Care ◽  
Population Health ◽  
Medical Practice ◽  
Institutional Logics ◽  
The Other ◽  
Dental Practice ◽  
Dental Services ◽  
General Dental Practice ◽  
Self Interest ◽  
Institutional Forces

BackgroundIndependent contractor status of NHS general dental practitioners (GDPs) and general medical practitioners (GMPs) has meant that both groups have commercial as well as professional identities. Their relationship with the state is governed by a NHS contract, the terms of which have been the focus of much negotiation and struggle in recent years. Previous study of dental contracting has taken a classical economics perspective, viewing practitioners’ behaviour as a fully rational search for contract loopholes. We apply institutional theory to this context for the first time, where individuals’ behaviour is understood as being influenced by wider institutional forces such as growing consumer demands, commercial pressures and challenges to medical professionalism. Practitioners hold values and beliefs, and carry out routines and practices which are consistent with the field’s institutional logics. By identifying institutional logics in the dental practice organisational field, we expose where tensions exist, helping to explain why contracting appears as a continual cycle of reform and resistance.AimsTo identify the factors which facilitate and hinder the use of contractual processes to manage and strategically develop General Dental Services, using a comparison with medical practice to highlight factors which are particular to NHS dental practice.MethodsFollowing a systematic review of health-care contracting theory and interviews with stakeholders, we undertook case studies of 16 dental and six medical practices. Case study data collection involved interviews, observation and documentary evidence; 120 interviews were undertaken in all. We tested and refined our findings using a questionnaire to GDPs and further interviews with commissioners.ResultsWe found that, for all three sets of actors (GDPs, GMPs, commissioners), multiple logics exist. These were interacting and sometimes in competition. We found an emergent logic of population health managerialism in dental practice, which is less compatible than the other dental practice logics of ownership responsibility, professional clinical values and entrepreneurialism. This was in contrast to medical practice, where we found a more ready acceptance of external accountability and notions of the delivery of ‘cost-effective’ care. Our quantitative work enabled us to refine and test our conceptualisations of dental practice logics. We identified that population health managerialism comprised both a logic of managerialism and a public goods logic, and that practitioners might be resistant to one and not the other. We also linked individual practitioners’ behaviour to wider institutional forces by showing that logics were predictive of responses to NHS dental contracts at the dental chair-side (the micro level), as well as predictive of approaches to wider contractual relationships with commissioners (the macro level).ConclusionsResponses to contracts can be shaped by environmental forces and not just determined at the level of the individual. In NHS medical practice, goals are more closely aligned with commissioning goals than in general dental practice. The optimal contractual agreement between GDPs and commissioners, therefore, will be one which aims at the ‘satisfactory’ rather than the ‘ideal’; and a ‘successful’ NHS dental contract is likely to be one where neither party promotes its self-interest above the other. Future work on opportunism in health care should widen its focus beyond the self-interest of providers and look at the contribution of contextual factors such as the relationship between the government and professional bodies, the role of the media, and providers’ social and professional networks.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

The other Drug Lords

1993 ◽  
Vol 23 (2) ◽  
pp. 263-273 ◽  
Author(s):  
Viveca Novak
Keyword(s):  
United States ◽  
Health Care ◽  
Pharmaceutical Industry ◽  
Patent Protection ◽  
The United States ◽  
Government Support ◽  
The Other ◽  
Pharmaceutical Firms ◽  
Drug Companies ◽  
Care Costs

To gain an understanding of how hard it will be to control skyrocketing health care costs in the United States, consider one small part of the health care system: the pharmaceutical industry. Every time Congress threatens to crack down on drug costs or reduce government support for the industry, the pharmaceutical firms crank out PAC contributions and deploy their lobbyists. The upshot: drug companies get to charge what they want while holding onto millions of dollars' worth of government giveaways, including tax breaks and generous patent protection.

An Institutional Perspective on Accountable Care Organizations

2016 ◽  
Vol 73 (6) ◽  
pp. 685-693 ◽  
Author(s):  
Elizabeth Goodrick ◽  
Trish Reay
Keyword(s):  
Health Care ◽  
Institutional Theory ◽  
Institutional Logics ◽  
Accountable Care Organizations ◽  
Accountable Care ◽  
Institutional Complexity ◽  
Institutional Perspective ◽  
Health Care Settings ◽  
Strategic Approach

We employ aspects of institutional theory to explore how Accountable Care Organizations (ACOs) can effectively manage the multiplicity of ideas and pressures within which they are embedded and consequently better serve patients and their communities. More specifically, we draw on the concept of institutional logics to highlight the importance of understanding the conflicting principles upon which ACOs were founded. Based on previous research conducted both inside and outside health care settings, we argue that ACOs can combine attention to these principles (or institutional logics) in different ways; the options fall on a continuum from (a) segregating the effects of multiple logics from each other by compartmentalizing responses to multiple logics to (b) fully hybridizing the different logics. We suggest that the most productive path for ACOs is to situate their approach between the two extremes of “segregating” and “fully hybridizing.” This strategic approach allows ACOs to develop effective responses that combine logics without fully integrating them. We identify three ways that ACOs can embrace institutional complexity short of fully hybridizing disparate logics: (1) reinterpreting practices to make them compatible with other logics; (2) engaging in strategies that take advantage of existing synergy between conflicting logics; (3) creating opportunities for people at frontline to develop innovative ways of working that combine multiple logics.

Health Informatics: Handle with Caution

1997 ◽  
Vol 36 (02) ◽  
pp. 79-81
Author(s):  
V. Leroy ◽  
S. Maurice-Tison ◽  
B. Le Blanc ◽  
R. Salamon
Keyword(s):  
Health Care ◽  
Data Management ◽  
Medical Informatics ◽  
Health Care Professionals ◽  
Data Security ◽  
Health Informatics ◽  
The Other ◽  
Inappropriate Use

Abstract:The increased use of computers is a response to the considerable growth in information in all fields of activities. Related to this, in the field of medicine a new component appeared about 40 years ago: Medical Informatics. Its goals are to assist health care professionals in the choice of data to manage and in the choice of applications of such data. These possibilities for data management must be well understood and, related to this, two major dangers must be emphasized. One concerns data security, and the other concerns the processing of these data. This paper discusses these items and warns of the inappropriate use of medical informatics.

Pesquisas sobre Currículos e Culturas: tensões, movimentos e criações

2020 ◽  
Author(s):  
Maria Patrícia Silva
Keyword(s):  
Health Care ◽  
Research Group ◽  
Training Programs ◽  
Academic Research ◽  
Art Music ◽  
The Other ◽  
Educational Policies ◽  
Cultural Spaces ◽  
Teacher Training Programs ◽  
Do It Yourself

The book Research on Curricula and Cultures: tensions, movements and creations, organized by Marlucy Alves Paraíso and Maria Patrícia Silva, it consists of 17 chapters, one of which is an interesting work by a Canadian scholar who investigates state anti-feminism. The other chapters bring results from 16 researches developed by researchers from the Study and Research Group on Curricula and Cultures (GECC), created and coordinated by Marlucy Alves Paraíso, which has researchers from several Brazilian universities and states. The articles in the book combine the post-critical perspectives used to investigate curricula and cultures in their different nuances, addressing silences, power relations, modes of subjectivation and the movements that prevent their fixity. The book brings research results that discuss the possibilities of creating possibilities at school and in other cultural spaces that also have curricula and develop pedagogies, such as: cyberspace, city, health care programs, teacher training programs, educational policies, etc. In addition, curricula are investigated with emphasis on different practices and aspects: childhood, art, music, dance, gender, sexuality, ethnicity, corporality, politics, with research that also innovates methodologically when operating with openings, experiments, do-it-yourself and compositions in different ways. to research curricula without rigidity, although with the necessary rigor in academic research. O livro reconhece de diferentes modos as possibilidades de conexões entre currículos e culturas, e mostra movimentos capazes de operar transgressões apostando em uma cultura porvir.

Sign in / Sign up

Export Citation Format

Share Document