Do health-care institutions perform better under leaders with medical or non-medical backgrounds? A scoping review.

PURPOSE: This study aims to summarize studies that compared the performance of health-care institutions led by leaders with medical background versus those with no medical background. DESIGN/METHODOLOGY/APPROACH: A systematic search was conducted on three databases: PubMed, Ovid Medline and Google Scholar to identify relevant peer-reviewed studies using the keywords "performance," "impact," "physician," "medical," "doctor," "leader," "healthcare institutions" and "hospital." Only quantitative studies that compared the performance of health-care institutions led by leaders with medical background versus non-medical background were included. Articles were screened and assessed for eligibility before the relevant data were extracted to summarize, appraise and make a narrative account of the findings. FINDINGS: A total of eight studies were included, four were based in the USA, two in the UK and one from Germany and one from the Arab World. Half of the studies (n = 4) reported overall better health-care institutional performance in terms of hospital quality ranking such as clinical effectiveness and patient safety under leaders with medical background, whereas one study showed poorer performance. The remaining studies reported mixed results among the different performance indicators, especially financial performance. PRACTICAL IMPLICATIONS: While medical background leaders may have an edge in clinical competence to manage health-care institutions, it will be beneficial to equip them with essential management skills to optimize leadership competence and enhance organizational performance. ORIGINALITY/VALUE: The exclusive inclusion of quantitative empirical studies that compared health-care institutional performance medical and non-medical leaders provides a clearer link between the relationship between health-care institutional performance and the leaders' background.

Contract doctors' strike in Malaysia: A content analysis of the perception of medical fraternity and stakeholders on Facebook.

Contract appointment policy for newly graduated medical officers was implemented by the Ministry of Health Malaysia in 2016 to overcome the lack of permanent posts. Contract officers faced disadvantages in terms of salary, leave provision, and career prospects. A nationwide strike, Hartal Doktor Kontrak (HDK) was organised on 26th July 2021. Besides generating widespread public attention, HDK was also closely scrutinised by the medical fraternity and stakeholders. This content analysis aimed to explore how the medical fraternity and stakeholders viewed the strike as their perception would offer vital insights into the fundamental causes and viable solutions to the contract appointment policy. A qualitative content analysis of Facebook (FB) posts on the HDK strike was conducted from 1st June 2021 until 28th February 2022. A total of 182 FB posts were retrieved from stakeholders, medical fraternity groups, and medical key opinion personnel. Inductive coding was used in the thematic analysis to identify pertinent themes. Three main themes emerged: triggering factors, reactions to the strike, and outcomes of the strike. Factors that led to the strike included unequal treatment faced by contract officers, frustration with the government's lack of long-term solutions, and aggravation by the COVID-19 pandemic. In terms of reactions, there was a mixture of supportive and opposing voices. No substantial negative impact on the healthcare service resulted from the strike. Instead, it generated widespread attention that propelled the government into implementing solutions to prevent adverse short and long-term consequences. Various suggestions were proposed, including the reform of human resource planning and undergraduate medical education. The results highlight the importance of proactive systemic measures by the government to prevent further strikes that may jeopardise healthcare provision. In summary, social media was found to influence the progress and outcome of HDK, thus demonstrating the impact of media influence on similar issues.

Comparison and determination of factors associated with smoking status, smoking knowledge, attitude and practice (S-KAP) between smoke-free and non-smoke-free campuses in public universities in Malaysia: a cross-sectional study.

OBJECTIVES: We compared the smoking prevalence, smoking knowledge, attitudes and practices (S-KAP) between smoke-free campuses (SFCs) and non-SFCs (NSFCs) and determined the associated factors of smoking status and S-KAP. DESIGN: Cross-sectional study. SETTINGS: The research was conducted in four public universities in Malaysia; two SFCs and two NSFCs. PARTICIPANTS: Students and staff from SFCs (n=1063) and NSFCs (n=1040). MAIN OUTCOME MEASURES: Compared the smoking prevalence, S-KAP between SFCs and NSFCs and determined the associated factors. RESULTS: The prevalence of smokers among the SFC and NSFC respondents was 5.2% and 6.7%, respectively. University type and smoking attitude were significantly related (p=0.02). At the SFCs, the factors associated with becoming a smoker were male gender (p<0.001), monthly income ≥RM3000 (p=0.02), positive smoking attitude (p=0.003) and positive smoking practice (p<0.001); at NSFCs, the associated factors were male gender (p<0.001), low smoking knowledge (p=0.004), positive smoking attitude (p=0.001) and practice (p<0.001). The factors associated with good smoking knowledge were female gender (SFCs: p=0.001; NSFCs: p=0.004), and monthly income ≥RM3000 (NSFCs: p=0.02). Male respondents were likely to have positive smoking attitudes (SFCs: p<0.001; NSFCs: p<0.001) and negative smoking practices (SFCs: p<0.001; NSFCs: p<0.001). CONCLUSION: Overall, smoking prevalence, knowledge and practice were not much different between SFCs and NSFCs. However, there was a significant relationship between university type and smoking attitude due to the existence of the SFC policy likely rendering smoking a less acceptable social norm. Continual education programmes on smoking harms and smoking cessation strategies are highly recommended to aid the SFC policy in preventing secondhand smoke in universities.