Internationally educated health professionals.

Even as recently as a decade ago, it was not uncommon for many Canadian decision- and policy makers in healthcare and government to ignore the matter of internationally educated healthcare professional (IEHP) integration and retention. With all the talk in the past few years, however, of employee shortages in nearly every healthcare profession and a rapidly aging population that requires more and more care, nobody can afford to neglect this potentially large and highly skilled talent pool.

Editorial.

In much of the industrialized world, the worst recession since the 1930s seems determined to plague us for a while longer. In that grim context, many of us are particularly interested in healthcare delivery and administrative solutions involving innovations that do not cost the earth - and that might even save some money. In this issue of Healthcare Quarterly, you'll find many examples of both.

Part-time physicians...prevalent, connected, and satisfied.

OBJECTIVE: The health care workforce is evolving and part-time practice is increasing. The objective of this work is to determine the relationship between part-time status, workplace conditions, and physician outcomes. DESIGN: Minimizing error, maximizing outcome (MEMO) study surveyed generalist physicians and their patients in the upper Midwest and New York City. MEASUREMENTS AND MAIN RESULTS: Physician survey of stress, burnout, job satisfaction, work control, intent to leave, and organizational climate. Patient survey of satisfaction and trust. Responses compared by part-time and full-time physician status; 2-part regression analyses assessed outcomes associated with part-time status. Of 751 physicians contacted, 422 (56%) participated. Eighteen percent reported part-time status (n = 77, 31% of women, 8% of men, p < .001). Part-time physicians reported less burnout (p < .01), higher satisfaction (p < .001), and greater work control (p < .001) than full-time physicians. Intent to leave and assessments of organizational climate were similar between physician groups. A survey of 1,795 patients revealed no significant differences in satisfaction and trust between part-time and full-time physicians. CONCLUSIONS: Part-time is a successful practice style for physicians and their patients. If favorable outcomes influence career choice, an increased demand for part-time practice is likely to occur.

Healthcare papers.

It is clear that the obesity epidemic is here. It is complex and pervasive in most developed countries. The stark contrast between the millions of people who are morbidly overweight and the undernourished is frightening; but as you will read in this issue, there is no simple way to rectify the equation.

Pay-for-performance in publicly financed healthcare: some international experience and considerations for Canada.

Recent reports in the United States and Canada provide evidence that healthcare systems routinely fail to deliver safe and high-quality healthcare services. Governments and other healthcare payers have begun to experiment with pay-for-performance programs that offer healthcare providers and organizations financial incentives for quality. The purpose of this paper is (1) to provide an overview of the design of major pay-for-performance programs in the United States, the United Kingdom, and Australia, with specific focus on government-sponsored programs, and (2) to articulate some considerations for potential implementation of pay-for-performance in Canada.