Managing Boundaries in the Health Professions

Managing Boundaries in the Health Professions



Product Details

ISBN-13: 9780398058630
Publisher: Charles C. Thomas Publisher, Limited
Publication date: 06/01/1993
Pages: 270
Product dimensions: 6.50(w) x 1.50(h) x 9.50(d)

About the Author

John G. Bruhn, New Mexico State University, Las Cruces, New Mexico Harold Grumet Levine, University of Texas Medical Branch at Galveston, Galveston, Texas Paula L. Levine, University of Texas Medical Branch at Galveston, Galveston, Texas

Table of Contents

Chapter 1About Boundaries3
B.Sources of Boundaries4
2.Personal Space9
C.Perceptions of Reality13
D.Development of Boundaries16
2.Ethnic Differences16
3.Class and Hierarchy17
5.History and Tradition20
E.Purposes and Functions of Boundaries20
F.Types of Boundaries21
G.Developing Personal Boundaries21
H.Boundaries and Social Norms23
I.Testing Boundaries with Labels25
J.Health Boundaries28
K.Boundaries are Changeable29
Chapter 2Boundaries in Organizations39
A.Types of Boundaries in Organizations40
3.Prevention vs. Rehabilitation45
4.Mental vs. Physical Health48
5.Political Boundaries50
7.Hierarchy in Organizations53
B.Boundary Personnel and Boundary Roles55
C.Boundaries, Work Roles, and Work Satisfaction58
D.Boundaries and Professional Autonomy63
E.Technological Innovation and Boundaries65
Chapter 3Boundary Issues in the Health Professions73
A.Learning Professional Boundaries in Medicine73
B.Allied Health Professionals75
C.Health Personnel Shortages78
D.The Cost of Health Care82
E.Boundary Conflicts84
1.Conflicts Within Professional Groups85
2.Conflicts Between Professional Groups86
F.The Need for Collaboration94
G.Conflicts in Defining New Areas of Knowledge96
H.Clarifying the Boundaries of Practice98
I.Boundary Problems of Generalists99
J.Patients and Professional Boundaries100
Chapter 4Interactions Between Boundaries and Personality105
A.Leadership: Styles and Tasks106
B.Values and Boundaries108
C.The Issue of Control110
D.Control, Trust, and Creativity110
E.The Dynamics of Management Style111
1.Managerial Personalities111
2.Victims of Management Style113
F.Team Managers and Creative Gamesmen113
G.Compromises to Control115
H.Boundaries of Self-Control120
I.Territoriality and Stress122
J.Stress and Personality in Organizations123
K.Boundary Spanning and Personality125
L.The Role of the Leader in Boundary Management128
Chapter 5Boundary Conflicts in Organizations and Groups133
A.Types of Boundaries134
B.Boundaries Between Organizations137
C.Conflict-Prone and Conflict-Resistant Organizations141
D.Boundary Change and Boundary Fighting142
1.Situations Conducive to Boundary Fighting143
2.Symptoms of Boundary Fighting146
E.Boundary Conflicts Among Health Disciplines147
F.Boundary Conflicts in Academic Health Centers149
G.Non-traditional Jobs and Boundary Crossing153
H.Motivations for Boundary Conflict154
Chapter 6Effects of Organizational Change on Boundary Management159
A.Reshaping Organizational Mission and Structure160
1.Urban Public Hospitals160
2.For-Profit Hospitals161
3.Academic Medical Centers161
4.Residency Education163
5.Clinical Specialties165
6.Problem-Oriented Learning in Medical Schools166
B.Management by Committees168
1.Affirmative Action/Equal Opportunity168
2.Admission to Professional Schools171
3.Interdisciplinary Groups/Programs/Care172
4.Total Quality Management174
5.Quality Circles and Self-Directed Work Groups177
C.Developing Health Care Teams--Constraints179
D.How Change Reshapes Boundaries180
1.Sources of Change180
2.Management Style and Change181
3.Employee Empowerment and Change182
4.The Role of the Boundary Manager and Change183
Chapter 7Managing Boundary Diversity and Change189
A.Boundaries and Perceptions191
B.Types of Boundary Structures192
C.Boundary Structures and Management Styles196
D.Managing Multi-Level Boundaries in Complex Organizations203
E.Managing Boundaries is Managing People209
F.The Value Factor209
G.The Reflective Manager212
H.Intuition and Creativity in Boundary Management213
I.Directed Autonomy214
J.Managing Boundaries: From Win/Lose to Win/Win216
K.Healthy Organizations and Healthy Managers220
Appendix AGuidelines for Managing Boundaries229
Appendix BVignettes for Discussion233

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