Testing Drugs and Attesting Cures: Pharmaceutical Monopolies and Military Contracts in Eighteenth-Century France.

This article explores the role of testing in the allocation of royal monopoly privileges for drugs in eighteenth-century France by following the multi-generational fortunes of a single "secret remedy" from 1713 to 1776: the poudre fébrifuge of the Chevalier de Guiller. On at least five occasions, this drug was tested on patients in order to decide whether it should be protected by a privilege and whether or not its vendors should be awarded lucrative contracts to supply it in bulk to the French military. Although efforts were made early in the century to test the drug through large-scale hospital trials and to relegate privilege granting to a bureaucratic commission, the case of the poudre fébrifuge instead suggests that military expediency and relatively small-scale trials administered personally by royal practitioners remained decisive in determining whether or not a drug received a monopoly privilege or a military contract.

[Continuing Medical Education in Germany - mandatory and voluntary obligations]. / Ärztliche Fortbildung in Deutschland -Pflicht und Freiwilligkeit.

After 1945 the common medical training infrastructure was broken up into two different political systems. While in the Federal Republic of Germany the structure was based on physicians' self-governance, in the German Democratic Republic medical professional structures were organised by the government. After the unification of the two German states, which took place on October 3, 1990, the centralistic structure was replaced by the system of physician self-governance. Before January 1, 2004, continuing medical education (CME) in West Germany relied on a system of voluntary obligations. In East Germany, though, professional CMEs were compulsory; they were called "obligatorische periphere Fortbildung." Based on 15 expert interviews on the topic of "CME in Germany", the different circumstances and conditions were analysed taking account of the historical background. Only selected professionals with experience in both German states (one with a federal, the other with a centralistic system), were chosen for the survey.

Analysing contractual environments: lessons from Indigenous health in Canada, Australia and New Zealand.

Contracting in health care is a mechanism used by the governments of Canada, Australia and New Zealand to improve the participation of marginalized populations in primary health care and improve responsiveness to local needs. As a result, complex contractual environments have emerged. The literature on contracting in health has tended to focus on the pros and cons of classical versus relational contracts from the funder's perspective. This article proposes an analytical framework to explore the strengths and weaknesses of contractual environments that depend on a number of classical contracts, a single relational contract or a mix of the two. Examples from indigenous contracting environments are used to inform the elaboration of the framework. Results show that contractual environments that rely on a multiplicity of specific contracts are administratively onerous, while constraining opportunities for local responsiveness. Contractual environments dominated by a single relational contract produce a more flexible and administratively streamlined system.

Supplier behaviour and public contracting in the English agency nursing market.

The worldwide expansion in the use of private firms to deliver public services and infrastructure has promoted a substantial literature on public sector contract and relationship management. This literature is currently dominated by the notion that supplier relationships should be based upon trust. Less prominent are more sceptical approaches that emphasize the need to assiduously manage potential supplier exploitation and opportunism. This article addresses this imbalance by focusing upon the recent experience of the English National Health Service (NHS) in its dealings with its nursing agencies. Between 1997 and 2001, the NHS was subjected to considerable exploitation and opportunism. This forced managers to adopt a supply strategy based upon an assiduous use of e-auctions, framework agreements and quality audits. The article assesses the effectiveness of this strategy and reflects upon whether a more defensive approach to contract and relationship management offers a viable alternative to one based upon trust.

Doctors five: African-American contract surgeons in the Spanish-American War.

The role played by African-American contract surgeons during the Spanish-American War has been a neglected aspect of the war's medical history. These men left their civilian practices, as did their white colleagues, to serve in the U.S. Army for relatively (even for the time) little compensation. After the war, as "civilian employees," they were not even eligible for a pension. Patriotism motivated their call to arms.

Master Samuel Ebrej ophthalmic surgeon of Dubrovnik and contracts relating to medical services dating from 1414.

Throughout the Middle Ages, Dubrovnik maintained active and regular commercial and maritime contacts with various cities and states of the Mediterranean. These activities led to the organisation of a health care system and the development of medicine. With respect to the economic, commercial and maritime aspects of the culture of this city state, Dubrovnik became open to the civilising progress of the region and period. The brief visit of the Mediaeval ophthalmologist, Master Samuel Ebrej supports this fact.