A longitudinal study of the attitudes of the medical profession towards competition and advertising.

AIMS: To measure changes in the attitudes of medical practitioners toward the move from a collegial to a more competitive orientation of the medical profession and, in particular, toward the role of advertising. METHOD: In the years 1985, 1988 and 1994, self-completion questionnaires were mailed to samples of medical practitioners. The questionnaires for each year were identical, containing forty Likert scales with questions relating to advertising, competition and commercial behaviour. Similar data were also gathered from members of the dental, veterinary, legal and accounting professions. RESULTS: Over the three studies there has been an undramatic but steady movement towards acceptance of a competitive orientation in general and towards acceptance of informative advertising in particular. There remains substantial reservation towards the use of persuasive advertising. Although patients are viewed as being more demanding than in past times, practitioners still expect their relationships with patients to be long lasting. CONCLUSION: The results suggest that acceptance of the move towards a more competitively oriented profession will continue. The results also suggest that in view of the kinds of advertising that are now used by medical practices, and of the change in attitudes that has occurred, control of advertising might cease to be a concern to the profession.

Veterinary practice, competition and advertising: 1985-1994.

In 1985, members of the veterinary profession and four other professional groups in New Zealand were surveyed to establish their attitudes towards the developing commercialisation of their professions, and particularly towards advertising. This survey was repeated in 1988, and again in 1994. The results of the three surveys are presented in this paper. There was a sharp movement towards acceptance of advertising, and toward a competitive orientation in general, between 1985 and 1988, with a consolidation of these changes during the following 6 years. The acceptance of the idea of an openly competitive profession now has widespread support among veterinarians. Similarly, there is general support for the use of most kinds of informative advertising, with many practitioners viewing advertising as a business building tool, but with the advertising of fees remaining an area over which there is still considerable caution. Although clients are seen as more demanding than in the past, the client-practitioner relationship is still expected to be an enduring one. We suggest that, in view of the relaxed attitudes towards advertising that now exists among members of the veterinary profession, control of advertising should cease to be a concern to the profession.

The medical profession and changing attitudes towards advertising and competition.

This paper examines the attitudes of general medical practitioners towards competition and advertising and the changes that have occurred between 1985 and 1988. The data was derived from a self completion questionnaire, 1500 of which were evenly distributed among the members of five professions; doctors, dentists, lawyers, accountants and veterinarians. General practitioners are now favourably disposed towards advertising by the profession as a whole in an effort to increase awareness of medical services (70% in favour in 1988 compared to only 53% in 1985), but the perceived need for increased business efficiency has lessened (70% in 1988 compared to 78% in 1985). Collegiality continues to be the dominant ideology but this position has weakened slightly. In 1988 only 65% of general practitioners regarded other members of the profession as colleagues rather than competitors, compared to 73% in 1985.

Attitudes of dental practitioners towards advertising and competition.

This paper examines the attitudes of dental practitioners towards competition and advertising and the changes that have occurred there between 1985 and 1988. It provides an insight into the views of members of the profession as they dealt with the issue of commercialisation. The study came at a time when proposed legislative changes would profoundly impact upon the profession's stance on business ethics and upon the business practice of its members. The data were derived from a self-completion questionnaire, 1,500 of which were evenly distributed among the members of five professions, doctors, dentists, lawyers, accountants, and veterinarians. The main findings were that the dental profession had moved along the collegiality-competition continuum only slightly, preferring to shun the use of overtly competitive behaviour while seeking to improve the efficiency of practice management.

Veterinarians, advertising and competition--three years on.

The views of veterinarians towards the changes that are occurring in professional practice with respect to competition and advertising are examined and compared with the views expressed in a similar study carried out 3 years previously. Data was derived from self completion questionnaires containing 40 Likert scales which were mailed to 300 members of the profession, first in 1985 and then in 1988. The moves made by the New Zealand Veterinary Association since 1985 in relaxing the rules on promotion appear to have largely alleviated any frustrations that were building up amongst the membership at that time. However, the study suggests that the profession will still find the boundaries of acceptable behaviour being tested by entrepreneurial practitioners.

Turbulence and change--the veterinary profession in a competitive environment.

This paper examines the views of members of the veterinary profession towards the change in orientation of professional practice that is occurring. It contrasts the values of veterinarians with those of doctors, dentists, lawyers and accountants. Particular attention is given to the areas of business efficiency, competition and advertising. Data was derived from self-completion questionnaires containing 40 Likert scales which were mailed to 300 members of each of the five professions.

Atypical retinitis in patients with the acquired immunodeficiency syndrome.

We examined three patients with AIDS who had large, sharply demarcated areas of thinned retina consistent with inactive cytomegalovirus retinitis and who were not treated with ganciclovir. These lesions appeared identical to clinically inactive areas of cytomegalovirus retinitis after effective antiviral treatment. All patients were receiving azidothymidine or ribavirin, or both, which have activity against the human immunodeficiency virus and which may improve immune function. All patients also received oral acyclovir at doses ineffective against cytomegalovirus retinitis.

Confirmatory evidence for a direct parasympathetic pathway to internal eye structures.

The hypothesis that a direct neural pathway exists between the midbrain and the intrinsic musculature was investigated. Wheat germ agglutinin labeled with HRP and WG-HRP were injected intraocularly into the ciliary muscle of rabbits and cynomolgus monkeys, and their retrograde movement was monitored. Sparse, but definite labeling was found in the AM nuclei, the EW nuclei, and Perlia's nucleus of the monkey, confirming the existence of a nonsynapsing pathway between intraocular structures and the midbrain in the primate.