In March of 2010, the 44th President of the United States, Barack Obama, signed into law a health care reform bill that will change the medical and business approach to healthcare that has been witnessed for quite some time. The Patient Protection and Affordable Care Act, aims to eliminate several inefficiencies encountered in our current health care system, as well as extend coverage by providing affordable care for the roughly forty six million Americans currently uninsured. Many of the changes will be implemented over the next several years, but hospitals, businesses, physicians, and insurance companies are no doubt planning ahead for the effects these changes will have on their particular industry. Although there will be many facets of change affecting all of the previously mentioned occupancies, the goal of this paper is to investigate the effect healthcare reform will have on private medical practices in the United States. The following sections will cover ways in which medicine has been practiced in the pre-reform era, historical attempts made to pass health reform legislation, several of the issues our current system faces along with the reform changes implemented to fix them. Then I will investigate the effect these changes will have, if any, and conclude by relating everything back to independent medical practices.

No description available.

Hand therapy (HT) is a specialty area of occupational therapy (OT) practice that focuses on rehabilitation for individuals with hand and upper extremity related conditions with aim to return to performance of daily activities required for life. As with other health professionals, occupational therapy practitioners (OTPs) have a duty to the public to ensure that services rendered are safe and use evidence-based best practices to improve patient health-outcomes. In HT clinics, OTPs face numerous challenges implementing evidence-based practice (EBP) including a lack of time, skills, and misperceptions of EBP (Scurlock-Evans et al., 2014), as well as reimbursement and funding models which incentivize high productivity over time to evaluate the evidence and integrate into clinical practice. The cost of OTPs not implementing EBP into their clinical decisions negatively impacts health outcomes of the patients under their care. The Hand Therapy with Evidence Based Practice (HT-EBP) program aims to enhance patient care through enhancing private HT clinics adoption of up-to-date research evidence into clinical practice. The HT-EBP program is designed for use in community-based private HT clinics that typically have less than 10 OTPs employed. A commitment of two OTPs, preferably one seasoned and one entry level, coming together in a mentor-mentee relationship is needed to implement the program. This program requires the participating clinics and OTPs to actively engage in the development of clinical care plans through review of research evidence on selected clinical diagnoses. Resulting from the HT-EBP program, the HT clinic will be able to provide evidence-based quality care while the OTP participants will develop professionally in the field of HT, gaining firm knowledge in clinical topics and building clinical confidence at the same time. This program will be further enhanced through 1) access to high quality research databases from clinic affiliated universities, 2) professional organization’s focus on continuing education courses that develop research knowledge and analytic skills for OTPs, and 3) collaborating with clinic managers to facilitate more time for clinicians to engage in acquiring and creating knowledge in chosen clinical topics of interests. The HP-EBP will first be piloted at the author’s private HT clinic prior to recruiting other private HT clinics to adopt the program. The HT-EBP program will aim to address the challenges that OTPs face when implementing EBP by working with universities, professional organizations. With time, it is anticipated that a significant volume of evidence-based clinical care plans would be compiled and shared among OTPs in HT, thus enhancing care for patients with hand conditions. Successful implementation of the HT-EBP program may have the potential to serve as a template for other healthcare specialties to deploy EBP.

Purpose: To assess the impact of dental Medicaid reform in Virginia on dental practice settings (private practice, corporate practice and safety net clinics). Methods: This retrospective cohort study of 16.2 million dental claims is from the Virginia Department of Medical Assistance Services, which included claims for providers participating in Virginia’s Medicaid program during a 10-year period (2002-2012). The dividing date for the reform was July 1, 2005. The outcome measure was mean claims per participating provider. A Poisson regression model was used to predict the mean number of claims per provider with the following predictors: reform period, practice setting, provider specialty, practice location. Results: The mean number of claims after program reform was significantly higher depending on practice setting and provider specialty, but not practice location. Conclusion: Medicaid reform has resulted in a significant increase in the number of dental claims, providers, and practice settings in Virginia.

The United States economy depends on small businesses, which represent 99% of all businesses in the United States, yet approximately 50% of small businesses cease operations in the first 5 years. The purpose of this multiple case study was to explore the marketing strategies used by owners of small businesses to develop and maintain their organization through the initial 5 years of business operation. The population included 5 physical therapy business owners in northeastern Florida who had sustained their business for a minimum of 5 years. The conceptual framework for this study was the brand equity model, and data were collected through semistructured interviews, online company marketing materials, and archival company documents. Yin's 5-step analysis guided the data analysis process: (a) collecting data, (b) grouping data into codes (c) grouping data into themes (d) assessing the themes, and (e) developing conclusions. Member checking, transcript review, and triangulation were used to validate the study data. The 5 study themes were brand awareness, relationship marketing, perceived quality, social media and online marketing, and word-of-mouth marketing. The implications of this study for positive social change include the potential for economic growth in the physical therapy practice market, as well as improved patient access to physical therapy services through a greater number of physical therapy practices.

<p>Syftet med studien var att jämföra den upplevda arbetssituationen hos tandhygienister inom folktandvården med tandhygienister inom den privata tandvården. Tandhygienister i södra Sverige som var registrerade hos SRAT (n=313) tillfrågades att delta i studien. Enkäten skickades ut elektroniskt, vilket gav en svarsfrekvens på 48% (n=151). Inom folktandvården svarade 59% (n=101) och inom den privata tandvården svarade 35% (n=50). Enkätfrågorna omfattade arbete, arbetsklimat, arbetssituation, profession, hälsa, inflytande och stöd i yrkesrollen samt bakgrundsfrågor om ålder, kön, anställningsform och arbetstid. Resultaten visade statistiskt signifikanta skillnader (p<0,05) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården gällande i vilken utsträckning de styrde över sina tidsbokningar, upplevde trötthet, orolighet, besvär från rygg, nacke eller axlar samt besvär från andra delar av kroppen. En statistisk signifikant skillnad (p<0,01) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården syntes även i vilken utsträckning respondenterna styrde över sin arbetstakt. Slutsatsen av studiens begränsade material är att tandhygienisterna inom den privata tandvården tycktes ha en mer positiv syn på deras arbetssituation än tandhygienisterna inom folktandvården.</p> / <p>The aim of this study was to compare the perceived work situation among dental hygienists in the public dental health service with dental hygienists in private practice. Dental hygienists in southern Sweden who were registered at SRAT (n= 313) were asked to participate in the study. The questionnaire was sent out electronically, which gave a response rate of 48% (n= 151). The response rate in the public dental health sevice was 59% (n= 101) and in private practice 35% (n=50). The survey questions covered work, work atmosphere, work situation, profession, health, influence and collegial support together with background questions about age, gender, employment status and working hours. The result showed a statistically significant difference (p<0.05) between the dental hygienists in the public dental health service and dental hygienists in private practice as regards to what extent the dental hygienists decided over their own scheduled time, experienced tiredness, worry, disorders from the back, neck or shoulders and disorders from other parts of the body. A statistically significant difference (p<0.01) between the dental hygienists in the public dental health service and the dental hygienists in private practice was also shown as regards to what extent the dental hygienists could control their own work pace. The conclusion from the limited material of this study is that the dental hygienists in private practice seemed to have a more positive view of their work situation compared to the dental hygienists in the public dental health service.</p>

Syftet med studien var att jämföra den upplevda arbetssituationen hos tandhygienister inom folktandvården med tandhygienister inom den privata tandvården. Tandhygienister i södra Sverige som var registrerade hos SRAT (n=313) tillfrågades att delta i studien. Enkäten skickades ut elektroniskt, vilket gav en svarsfrekvens på 48% (n=151). Inom folktandvården svarade 59% (n=101) och inom den privata tandvården svarade 35% (n=50). Enkätfrågorna omfattade arbete, arbetsklimat, arbetssituation, profession, hälsa, inflytande och stöd i yrkesrollen samt bakgrundsfrågor om ålder, kön, anställningsform och arbetstid. Resultaten visade statistiskt signifikanta skillnader (p&lt;0,05) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården gällande i vilken utsträckning de styrde över sina tidsbokningar, upplevde trötthet, orolighet, besvär från rygg, nacke eller axlar samt besvär från andra delar av kroppen. En statistisk signifikant skillnad (p&lt;0,01) mellan tandhygienister inom folktandvården och tandhygienister inom den privata tandvården syntes även i vilken utsträckning respondenterna styrde över sin arbetstakt. Slutsatsen av studiens begränsade material är att tandhygienisterna inom den privata tandvården tycktes ha en mer positiv syn på deras arbetssituation än tandhygienisterna inom folktandvården. / The aim of this study was to compare the perceived work situation among dental hygienists in the public dental health service with dental hygienists in private practice. Dental hygienists in southern Sweden who were registered at SRAT (n= 313) were asked to participate in the study. The questionnaire was sent out electronically, which gave a response rate of 48% (n= 151). The response rate in the public dental health sevice was 59% (n= 101) and in private practice 35% (n=50). The survey questions covered work, work atmosphere, work situation, profession, health, influence and collegial support together with background questions about age, gender, employment status and working hours. The result showed a statistically significant difference (p&lt;0.05) between the dental hygienists in the public dental health service and dental hygienists in private practice as regards to what extent the dental hygienists decided over their own scheduled time, experienced tiredness, worry, disorders from the back, neck or shoulders and disorders from other parts of the body. A statistically significant difference (p&lt;0.01) between the dental hygienists in the public dental health service and the dental hygienists in private practice was also shown as regards to what extent the dental hygienists could control their own work pace. The conclusion from the limited material of this study is that the dental hygienists in private practice seemed to have a more positive view of their work situation compared to the dental hygienists in the public dental health service.

The main aim of the study was the description of the experiences of opportunities, rewards and challenges faced by social workers in private practice in the Durban Metropolitan Area, Kwa Zulu Natal. This study used an exploratory design, which was qualitative in nature. The researcher administered interview schedules that contained both open–ended and close–ended questions. The findings of the study indicated that some of the challenges experienced are professional isolation, stress and burnout, difficulties of managing a business and role confusion and conflict between a social worker in private practice and a psychologist. Respondents indicated that some of the benefits of private practice were working with motivated clients, control over professional growth and work environment, financial rewards, escape from bureaucracy, flexibility and quality casework services. The opportunities offered to private practitioners were employee wellness programmes, legal work, training, work in schools and quality casework services that made private practice a lucrative business. In terms of support systems it was found that the South African Association of Social Workers in Private practice was supportive. Respondents regarded The South African Council for Social Services Professions and the Department of Social Development as unsupportive. Emanating from the findings, recommendations have been made with regards to making private practice a more viable option. The findings can also be used to inform future research on a national level as well as comparative studies on the experiences between social workers in private practice and those at an agency level. Some of the recommendations in relation to private practice are that the South African Council of Social Services Profession and the Government should acknowledge social workers in private practice, the community should become more responsive to private practitioners and tertiary institutions should offer training courses to prepare social workers for private practice. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2008.

No description available.

<p>The purpose of this qualitative study was to learn more about the experiences of social work practitioners who are employed in the for-profit sector. Data were collected through individual interviews with four registered social workers. Findings showed that social worker’s experiences of practice within for-profit or private practice settings falls into six main categories. ‘Social work identity’, which includes a comparison of social work and other professions, professional values and ethics, and professional practice issues. ‘Valued characteristics’, which includes past and current work experience, goals for practice, service provision, and job flexibility. The category of ‘fee for service’ examines charging fees in exchange for social work services, salary and compensation, funding, and advertising. ‘Challenges’ of social work practice in the for-profit sector includes experiencing financial pressure, client no-shows, and navigating the “balancing act” of providing services while earning an income. ‘Supervision’, which addresses issues of debriefing. The final category, ‘social work education’, explores the current post-secondary social work program and includes recommendations from participants on improving the curriculum and preparing graduates for working within the field. A central issue for social workers within the for-profit sector is the misconceptions that exist regarding their work. The conclusion is that unlike private practice, social work practice within non-profit and for-profit agencies has a number of similarities. The social work profession offers a multitude of career options for practitioners; different social workers fill different roles, according to their proficiencies, experience, and expertise.</p> / Master of Social Work (MSW)