Squeezing blood from a stone: how income inequality affects the health of the American workforce.

Income inequality is very topical-in both political and economic circles-but although income and socioeconomic status are known determinants of health status, income inequality has garnered scant attention with respect to the health of US workers. By several measures, income inequality in the United States has risen since 1960. In addition to pressures from an increasingly competitive labor market, with cash wages losing out to benefits, workers face pressures from changes in work organization. We explored these factors and the mounting evidence of income inequality as a contributing factor to poorer health for the workforce. Although political differences may divide the policy approaches undertaken, addressing income inequality is likely to improve the overall social and health conditions for those affected.

Becoming a resident in Germany: an experience-based practical guideline.

INTRODUCTION: Many young doctors in Europe and beyond are considering different career alternatives. Germany is one of the most sought after countries for medical specialization. Since there is no centralized structured application process, course, or nationwide rotating program, it may seem a little bit easier to find job opportunities in Germany than in other European countries. However, the process of changing country of residence, looking for and finding new employment, and obtaining all the required paperwork is far from easy. It is therefore essential to gather as much information about the application and its process when considering a career move in order to be well prepared about what may come before and after applying for a resident position. METHOD: The essential information about the application possibilities and process were reviewed and summarized. RESULT: This article provides a practical guide on how to proceed when considering job opportunities as a resident in Germany, the application process, and what to expect once a job has been found.

Deciding when physicians are unfit to practise: an analysis of responsibilities, policy and practice in 11 European Union member states.

In 1974, the European Economic Community established mutual recognition of medical qualifications obtained in any of its member states. Subsequently, a series of directives has elaborated on the initial provisions, with the most recent enacted in 2013. However, greater movement of physicians across borders and some high-profile scandals have raised questions about how to prevent a physician sanctioned in one country from simply moving to another, without undermining the principle of free movement. A survey of key informants in 11 European Union (EU) member states was supplemented by a review of peer-reviewed and grey literature, with the results validated by independent reviewers. It examined processes, adjudicative and disciplinary measures that are in place to evaluate physicians about whom concerns arise, and related sanctions, along with other aspects of professional standards and regulation. Overall, responses varied greatly between participating countries, with respect to the institutions responsible for the regulation of medical professions, the investigation processes in place, and the terminology used in each member state. While the types of sanction (removal from the register of medical professionals and/or licence revocation, suspension, dismissal, reprimand, warnings, fines, as well as additional education and training) applied are similar, both the roles of the individuals involved and the level of public disclosure of information vary considerably. However, some key features, such as the involvement of professional peers in disciplinary panels and the involvement of courts in criminal cases, are similar in most member states studied. Given the variation in the regulatory context, individuals and processes involved that is illustrated by our findings, a common understanding of definitions of what constitutes competence to practise, its impairment and its potential impact on patient safety becomes particularly important. Public disclosure of disciplinary outcomes is already applied by some member states, but additional measures should be considered to protect medical professionals from undue consequences.

Complementarities or contradictions? Scoping the health dimensions of "flexicurity" labor market policies.

Flexicurity, or the integration of labor market flexibility with social security and active labor market policies, has figured prominently in economic and social policy discussions in Europe since the mid-1990s. Such policies are designed to transcend traditional labor-capital conflicts and to form a mutually supportive nexus of flexibility and security within a climate of intensified competition and rapid technological change. International bodies have marketed flexicurity as an innovative win-win strategy for employers and workers alike, commonly citing Denmark and The Netherlands as exemplars of best practice. In this article, we apply a social determinants of health framework to conduct a scoping review of the academic and gray literature to: (a) better understand the empirical associations between flexicurity practices and population health in Denmark and (b) assess the relevance and feasibility of implementing such policies to improve health and reduce health inequalities in Ontario, Canada. Based on 39 studies meeting our full inclusion criteria, preliminary findings suggest that flexicurity is limited as a potential health promotion strategy in Ontario, offers more risks to workers' health than benefits, and requires the strengthening of other social protections before it could be realistically implemented within a Canadian context.

Retaining the older workforce: social policy considerations for the universally designed workplace.

Even in the midst of massive layoffs that come with an economic downturn, employers must remain aware of the pending impact of their aging workforce. Losing older employees to retirement drains knowledge and expertise. In response, employers are looking at new ways to retain older workers at the same time that older workers are reevaluating the traditional approach to retirement. This article presents findings from case study research consisting of interviews with key employees at 18 companies in 13 states. Five of those companies subsequently participated in in-person site visits. Interviews were held with a wide range of informants, including company leadership, supervisors, and older workers. Findings include a description of the cultural context within which the development of formal and informal older worker retention strategies occurred, as well as the retention strategies themselves. The discussion section explores the universal nature of these retention initiatives and how consideration of universality benefits not only older workers but a range of diverse groups as well.

Improving workplace productivity--it isn't just about reducing absence.

Employers must get more aggressive in their health and productivity strategies. A comprehensive strategy includes data analytics across health and lost-time programs, absence policies that meet today's needs for both employer and employee, health and wellness programs targeting modifiable health behaviors, and absence program administration that is aligned to operational goals. This article targets key aspects of a comprehensive long-term health and productivity strategic vision. An organization can use these aspects independently to address immediate tactical issues while it develops its broader strategy. The target areas include a view from the perspective of data management, absence program design and management, employee health and wellness, and behavioral health.

The Business of Plastic Surgery: Employment Contracts.

SUMMARY: Plastic surgeons are increasingly choosing to practice as employed physicians: either in an academic position, a single-specialty or multispecialty group, or within a franchise-type business. Employment offers advantages with regard to immediate income, minimal investment in practice start-up costs, and easier access to prospective patients. Surgeons considering such employment must perform due diligence to determine whether the position offered is a good fit. Once the decision is made to offer the plastic surgeon a position, an employment contract is negotiated. It is imperative that all parties understand the provisions of the contract, so that there are no misunderstandings between the employer and employee for the duration of the term. This article introduces physician recruitment offers and employment contracting. The key components of a contract are described, and compensation options are explained. Negotiation of the contract is critical so that all aspects are understood and agreed on, and the responsibilities of all parties are delineated.

The role of human-at-work systems in business sustainability: perspectives based on expert and qualified production workers in a manufacturing enterprise.

A community of highly qualified employees is desirable for the workforce to become a competitive business advantage, improving and sustaining corporate health. Currently, the scientific literature is limited on information comparing the assessment of expert and qualified workers for the employee-work environment interface. Such information would be valuable for industrial managers to obtain and act on the different perspectives of its workers for business improvement and survivability. A primary objective of this study is to explore the perspectives of expert and qualified workers on the quality of the employee-work environment interface in a manufacturing enterprise. This investigation was performed in a production department in a small manufacturing enterprise. Two expert workers participated in the study, with each being in the company for 30 years and having performed all jobs in the production department as well as supervisory and line management responsibilities. A total of 13 qualified workers from day and night shifts were used in the study, with the great majority of workers possessing 10 or more years of on-the-job experience but not acquiring the same specialised knowledge required for operating the technological resources in the department. The work compatibility methodology was used to assess the quality of employee-work environment interface for both expert and qualified workers. Both expert and qualified workers provided similar trends in terms of their compatibility assessment of experienced and acting work domains. In general, the compatibility levels for the day shift were poorer than those obtained for the night shift for acting work domains. The similarities in assessment between the expert and qualified workers were much closer for factors impacting job performance at the task and immediate surrounding levels (i.e. physical and mental task content, physical environment). There were greater differences at the macro level, that is, at the process and enterprise levels, in terms of organisational/social/technological environment. This is particularly noted for the organisational environment. The compatibility values obtained for the experienced domains mirror those obtained for acting domains. The overall workload was assessed as requiring major redesign during the day shift and needing added responsibilities for the night shift according to both expert and qualified workers. The assessment of qualified workers is comparable with that of expert workers for the job content and immediate surroundings. Differences are more observed for process- and enterprise-based factors; thereby, providing company management different perspectives in order to devise organisational strategies conducive for optimum human and corporate health and pointing to the probable interactions of the different systems impacting individual and enterprise performance. STATEMENT OF RELEVANCE: This research examines similarities and differences between qualified and expert workers in their assessment of the worker-work environment interface. The contribution to improved understanding of the complex interactions of human-at-work and enterprise systems should be beneficial to organisations in their quest to remain competitive in a global economy.

New NP job search experience: Opportunities and obstacles.

ABSTRACT: This descriptive study investigated new NPs' job search experience including the job search process, employment negotiation, and compensation. The majority of new graduates found a job through networking within 3 months in a specialty practice or family medicine. Lack of experience and few available positions were employment obstacles.

Safety and security update.

Despite resolution of the initial dispute that occurred in early 2008 regarding safety and security issues for nurses employed on the Torres Strait Outer Islands, concerns continue about the ongoing sustainability of health services in this remote location as well as for Queensland Health-run accommodation across the state.

Labor flexibilization and deregulation for nursing workers in Brazil: the PROFAE case.

This study analyzed the flexibilization process of labor relations in the PROFAE Professionalization Project of Nursing Workers (Projeto de Profissionalização dos Trabalhadores da Area de Enfermagem - PROFAE) in Brazil. This qualitative study used dialectical and historical materialism as the theoretical-methodological framework. Data were collected through directed interviews with open-ended questions, and answers were submitted to discourse analysis. The obtained results evidence the flexibilization and deregulation process of labor relations in the health area in Brazil, characterized by the following elements: payment by production; fragmented labor division; criteria for variable wage payment; qualified and versatile professionals; perceived professional freedom; reduced governability and power to make decisions; multiple jobs; activity planning as a substitute for planning models, and the massive systematic operationalization of actions.

[Is it acceptable to carry out preventive screening in any given place?]. / Czy badania profilaktyczne mozna wykonac w dowolnym miejscu?

BACKGROUND: Employers are, among their numerous responsibilities, obliged to refer their employees or the person applying for the job to prophylactic examinations. Initial, seasonal and check-up examinations should be carried out in the primary occupational health care institution the employer is obliged to sign the contract for this kind of services, according to the binding regulations. However, due to the fact that these regulations do not contain an imperative that prophylactic examinations must be performed in the institution with which the employer is under contract, it is theoretically possible that the examinations are carried out in an outpatient department chosen by an individual who is to be examined. MATERIAL AND METHODS: The critical analysis of existing rules, judgments and writs was performed. RESULTS: In practice, such a possibility exists only in case of those who apply for the job. This results from the fact that job candidates unlike employees, are not obliged to follow the employer's official order concerning initial examinations. Employees and those employed on the basis of the civil-law contract have to obey the employer's official orders concerning the type and place of performing prophylactic examinations. The employee's disobedience in this matter may have serious consequences arising from the contravention of order and work organization rules. CONCLUSIONS: Employees employed on the basis of the civil-law contract are obliged to undergo prophylactic examinations. However, the time and the type of institution in which the examination is performed depends on the legal basis of employment. Persons applying for the job do not have to obey the employer's official orders and thus cannot be forced to perform the examination in a given time or institution. If the conditional contract is signed, the employee can start his or her work without presenting the certificate of working ability at a given post.

Protections Preserved for University-Employed Physicians.

The Texas Supreme Court blocked a challenge to liability protections for physicians employed by state medical schools, a legal victory for TMA. Thanks to the court's decision, physicians employed by a government institution, like a publicly funded medical school, still can perform clinical duties at a non-government facility, like a private hospital, without giving up immunity from lawsuits.