Increasing the Supply of Providers for the Medically Underserved: Marketing and Public Policy Issues

Scammon, Debra L.; Li, Lawrence B.; Williams, S. D.

doi:10.1177/074391569501400104

Cited by 19 publications

(11 citation statements)

References 28 publications

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“…The term “underserved” is used to define vulnerable and at-risk populations, especially individuals who are uninsured, poor, from racial and ethnic minorities, homeless, newly immigrated, socially isolated, or poorly educated [ 1 ]. Many studies have demonstrated that underserved populations experience health disparities, including increased premature mortality [ 2 ], poorer physical [ 3 ] and mental health status [ 4 ], and diminished access to the healthcare system and health prevention programs [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Medical students attitudes toward and intention to work with the underserved: a systematic review and meta-analysis

et al. 2021

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Background Experts in the field of medical education emphasized the need for curricula that improve students’ attitudes toward the underserved. However, some studies have shown that medical education tends to worsen these attitudes in students. We aimed at systematically reviewing the literature assessing the change in medical students’ attitudes toward the underserved and intention to work with the underserved throughout medical education, the sociodemographic and educational factors associated with favorable medical student attitudes toward and/or intention to work with the underserved and the effectiveness of educational interventions to improve medical student attitudes toward and/or intention to work with the underserved. Method We conducted a systematic review on MEDLINE, Scopus, and Web of Science databases. Three investigators independently conducted the electronic search. We assessed the change in medical students attitudes toward the underserved by computing a weighted mean effect size of studies reporting scores from validated scales. The research team performed a meta-analysis for the sociodemographic and educational factors associated with medical students attitudes toward and/or intention to work with the underserved. Results Fifty-five articles met the inclusion criteria, including a total of 109,647 medical students. The average response rate was 73.2%. Most of the studies were performed in the USA (n = 45). We observed a significant decline of medical students attitudes toward the underserved throughout medical education, in both US and non-US studies. A moderate effect size was observed between the first and fourth years (d = 0.51). Higher favorable medical students attitudes toward or intention to work with the underserved were significantly associated with female gender, being from an underserved community or ethnic minority, exposure to the underserved during medical education and intent to practice in primary care. Regarding educational interventions, the effectiveness of experiential community-based learning and curricula dedicated to social accountability showed the most positive outcome. Conclusions Medical students attitudes toward the underserved decline throughout medical education. Educational interventions dedicated to improving the attitudes or intentions of medical students show encouraging but mixed results. The generalizability of our results is impeded by the high number of studies from the global-North included in the review.

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Section: Introductionmentioning

confidence: 99%

Medical students attitudes toward and intention to work with the underserved: a systematic review and meta-analysis

et al. 2021

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“…The authors thank the informants for providing many valuable insights and Mary Galligan for facilitating the project. The first author acknowledges the feedback and support of Jim Gentry. panics (Bristor, Lee, and Hunt 1995;Pefialoza 1995), and residents of rural communities (Franzak, Smith, and Desch 1995;Scammon, Li, and Williams 1995). In addition, states of mind, such as grieving the loss of a loved one (Gentry et al 1995), and states of the body, such as addiction (Hirschman and McGriff 1995), also are included.…”

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confidence: 99%

Marketplace Experiences of Consumers with Visual Impairments: Beyond the Americans with Disabilities Act

Baker¹,

Stephens²,

Hill

2001

Journal of Public Policy & Marketing

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The authors explore how consumers with a variety of visual impairments liandle day-to-day interactions with service providers, products, and services. Interviews with 21 people with visual impainnerits reveal that there are considerable individual differences in adaptation strategies, including the degree of independence desired and achieved. Interview themes are explicated by means of a conceptual model of the contexts and interplay of dependence and independence in the lives of people with visual impairments. The model suggests that independence and dependence are not mere opposites on a single dimension: rather, they are domain-specific and complex and are determined by both environmental factors and personal characteristics. It further suggests that some forms of dependency may be as adaptive for many people as is the striving for independence by others. The authors conclude with a discussion of implications for the Americans with Disabilities Act and marketing practice as well as the larger area of consumer vulnerability.

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“…Because of the judgment nature of the sample and the sensitivity of the subject, our research should be considered exploratory, 85 We are taking the first look at how and what physicians are doing to comply with legislation that has in effect removed a captive patient base resulting in a need to market heretofore locked in ancillary medical services. Our findings highlight issues that should be investigated fbrther with more comprehensive and structured research (Scammon, Li and Williams 1994).…”

Section: Introductionmentioning

confidence: 85%

The Role of Healthcare Marketing

Trombetta¹,

Woodard-Bourke²

1998

Health Marketing Quarterly

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INTRODUCTIONPhysician-owned self-referral networks have come under scrutiny. The so-called Stark-legislation (Rep. Pete Stark D-California) has severely limited the ability of doctors to own and invest in referral networks thereby capturing self-referrals. Doctors and hospitals have diversified into these referral devices in order to enhance income generation and to try to circumvent constraints on traditional forms of healthcare reimbursement (Winston 1993).Traditionally, the notion of marketing has been viewed with suspicion and disdain by the medical profession. This paper explores the effects of the Stark legislation on physician practices and whether marketing has (or has not) played a role in the survival of the traditional medical practice. Our research goal is exploratory and therefore we are relying on qualitative research methods. We chose participants because of their likelihood to cooperate in a study that has legal and criminal implications for those healthcare providers that violate the anti-kickback provisions of the federal fraud and abuse laws. Because of the judgment nature of the sample and the sensitivity of the subject, our research should be considered exploratory, 86 HEALTH MARKETING QUARTERLYWe are taking the first look at how and what physicians are doing to comply with legislation that has in effect removed a captive patient base resulting in a need to market heretofore locked in ancillary medical services. Our findings highlight issues that should be investigated fbrther with more comprehensive and structured research (Scammon, Li and Williams 1994).An informal survey was conducted among thirty physician practices (including family practice, various specialty and surgical practices) throughout the central portion of a mid-Atlantic state in which doctors andtor their practice managers were questioned regarding the effects of the Stark legislation on their own investment patterns as well as any marketing as a consequence of the legislation.Our survey results were not surprising with regard to the impact of the law. The legislation has succeeded in eliminating most physician investment in downstream health related services. Many doctors who invested in various imaging centers or clinical labs have divested themselves of any financial interests. Some took huge losses in order to avoid liability.What was surprising were the results of the second part of our survey which dealt with marketing. The practices were surveyed as to the extent of marketing used to obtain or maintain patient base, including such things as measurement of patient satisfaction and the use of outside consulting services. While it would seem apparent that marketing can be helpfhl to doctors facing a new competitive environment, doctors have been slow to acquire a taste for marketing. BACKGROUND OF ANTI-REFERRAL LEGISLATION

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Increasing the Supply of Providers for the Medically Underserved: Marketing and Public Policy Issues

Cited by 19 publications

References 28 publications

Medical students attitudes toward and intention to work with the underserved: a systematic review and meta-analysis

Medical students attitudes toward and intention to work with the underserved: a systematic review and meta-analysis

Marketplace Experiences of Consumers with Visual Impairments: Beyond the Americans with Disabilities Act

The Role of Healthcare Marketing

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