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Explores careers in the medical field, discusses a typical work environment, and describes the educational requirements for each.

Grounded in intimate moments of family life in and out of hospitals, this book explores the hope that inspires us to try to create lives worth living, even when no cure is in sight. The Paradox of Hope focuses on a group of African American families in a multicultural urban environment, many of them poor and all of them with children who have been diagnosed with serious chronic medical conditions. Cheryl Mattingly proposes a narrative phenomenology of practice as she explores case stories in this highly readable study. Depicting the multicultural urban hospital as a border zone where race, class, and chronic disease intersect, this theoretically innovative study illuminates communities of care that span both clinic and family and shows how hope is created as an everyday reality amid trying circumstances.

How we recruit future healthcare professionals is critically important, as the demand for high quality healthcare increases across the globe. This book questions what the evidence tells us about how best to select those most suited to a career in healthcare, ensuring that the approaches used are relevant and fair to all who apply.

Physicians recognize the importance of patients' emotions in healing yet believe their own emotional responses represent lapses in objectivity. Patients complain that physicians are too detached. The book argues that by empathizing with patients, rather than detaching, physicians can best help them. Yet there is no consistent view of what, precisely, clinical empathy involves. This book challenges the traditional assumption that empathy is either purely intellectual or an expression of sympathy. Sympathy, according to many physicians, involves over-identifying with patients, threatening objectivity and respect for patient autonomy. How can doctors use empathy in diagnosing and treating patients without jeopardizing objectivity or projecting their values onto patients? The book develops an account of emotional reasoning as the core of clinical empathy. It argues that empathy cannot be based on detached reasoning because it involves emotional skills, including associating with another person's images and spontaneously following another's mood shifts. Yet it argues that these emotional links need not lead to over-identifying with patients or other lapses in rationality but rather can inform medical judgement in ways that detached reasoning cannot. For reflective physicians and discerning patients, this book provides a road map for cultivating empathy in medical practice. For a more general audience, it addresses a basic human question: how can one person's emotions lead to an understanding of how another person is feeling?

Empathy and compassion are vital components of health care quality; however, physicians frequently miss opportunities for empathy and compassion in patient care. Despite evidence that empathy and compassion training can be effective, the specific behaviors that should be taught remain unclear. We synthesized the biomedical literature on empathy and compassion training in medical education to find the specific curricula components (skills and behaviors) demonstrated to be effective. We searched CENTRAL, MEDLINE, EMBASE, and CINAHL using a previously published comprehensive search strategy. We screened reference lists of the articles meeting inclusion criteria to identify additional studies for potential inclusion. Study inclusion criteria were: (1) intervention arm in which subjects underwent an educational curriculum aimed at enhancing empathy and/or compassion; (2) clearly defined control arm in which subjects did not receive the curriculum; (3) curriculum was tested on physicians (or physicians-in-training); and (4) outcome measure assessing the effect of the curriculum on physician empathy and/or compassion. We performed a qualitative analysis to collate and tabulate effects of tested curricula according to recommended methodology from the Cochrane Handbook. We used the Cochrane Collaboration's tool for assessing risk of bias. Fifty-two studies (total n = 5,316) met inclusion criteria. Most (75%) studies found that the tested curricula improved physician empathy and/or compassion on at least one outcome measure. We identified the following key behaviors to be effective: (1) sitting (versus standing) during the interview; (2) detecting patients' non-verbal cues of emotion; (3) recognizing and responding to opportunities for compassion; (4) non-verbal communication of caring (e.g. eye contact); and (5) verbal statements of acknowledgement, validation, and support. These behaviors were found to improve patient perception of physician empathy and/or compassion. Evidence suggests that training can enhance physician empathy and compassion. Training curricula should incorporate the specific behaviors identified in this report.

Kaiser Permanente is the largest managed care organization in the country. It also happens to have the largest and most complex labor-management partnership ever created in the United States. This book tells the story of that partnership-how it started, how it grew, who made it happen, and the lessons to be learned from its successes and complications. With twenty-seven unions and an organization as complex as 8.6-million-member Kaiser Permanente, establishing the partnership was not a simple task and maintaining it has proven to be extraordinarily challenging. Thomas A. Kochan, Adrienne E. Eaton, Robert B. McKersie, and Paul S. Adler are among a team of researchers who have been tracking the evolution of the partnership between Kaiser Permanente and the Coalition of Kaiser Permanente Unions ever since 2001. They review the history of health care labor relations and present a profile of Kaiser Permanente as it has developed over the years. They then delve into the partnership, discussing its achievements and struggles, including the negotiation of the most innovative collective bargaining agreements in the history of American labor relations.Healing Togetherconcludes with an assessment of the Kaiser partnership's effect on the larger health care system and its implications for labor-management relations in other industries.

Life is unpredictable. Control over one's time is a crucial resource for managing that unpredictability, keeping a job, and raising a family. But the ability to control one's time, much like one's income, is determined to a significant degree by both gender and class. InUnequal Time, sociologists Dan Clawson and Naomi Gerstel explore the ways in which social inequalities permeate the workplace, shaping employees' capacities to determine both their work schedules and home lives, and exacerbating differences between men and women, and the economically privileged and disadvantaged. Unequal Timeinvestigates the interconnected schedules of four occupations in the health sector-professional-class doctors and nurses, and working-class EMTs and nursing assistants. While doctors and EMTs are predominantly men, nurses and nursing assistants are overwhelmingly women. In all four occupations, workers routinely confront schedule uncertainty, or unexpected events that interrupt, reduce, or extend work hours. Yet, Clawson and Gerstel show that members of these four occupations experience the effects of schedule uncertainty in very distinct ways, depending on both gender and class. But doctors, who are professional-class and largely male, have significant control over their schedules and tend to work long hours because they earn respect from their peers for doing so. By contrast, nursing assistants, who are primarily female and working-class, work demanding hours because they are most likely to be penalized for taking time off, no matter how valid the reasons. Unequal Timealso shows that the degree of control that workers hold over their schedules can either reinforce or challenge conventional gender roles. Male doctors frequently work overtime and rely heavily on their wives and domestic workers to care for their families. Female nurses are more likely to handle the bulk of their family responsibilities, and use the control they have over their work schedules in order to dedicate more time to home life. Surprisingly, Clawson and Gerstel find that in the working class occupations, workers frequently undermine traditional gender roles, with male EMTs taking significant time from work for child care and women nursing assistants working extra hours to financially support their children and other relatives. Employers often underscore these disparities by allowing their upper-tier workers (doctors and nurses) the flexibility that enables their gender roles at home, including, for example, reshaping their workplaces in order to accommodate female nurses' family obligations. Low-wage workers, on the other hand, are pressured to put their jobs before the unpredictable events they might face outside of work. Though we tend to consider personal and work scheduling an individual affair, Clawson and Gerstel present a provocative new case that time in the workplace also collective. A valuable resource for workers' advocates and policymakers alike,Unequal Timeexposes how social inequalities reverberate through a web of interconnected professional relationships and schedules, significantly shaping the lives of workers and their families.