Managing diversity: the differing perceptions of managers, line workers, and patients.

This study assesses how hospital managers, line workers, and patients understand the impact of patient and workforce diversity on the delivery of hospital care. Data come from managerial interviews and staff and patient focus groups at five voluntary hospitals in New York City. Three findings emerge from the research. Cultural competence is critical to the provision of quality care, but the perceived significance of cultural competence depends on one's role in the organization. Language remains a problem for patients and staff, although all of the hospitals have extensive translation services. Compared with management, staff and patients identify diversity to be more of a problem. Differing perceptions about the meaning of diversity must ultimately be reconciled to effectively provide care.

The American College of Obstetricians and Gynecologists and the evolution of abortion policy, 1951-1973: the politics of science.

The autonomy granted to physicians is based on the claim that their decisions are grounded in scientific principles. But a case study of the evolution of the American College of Obstetricians and Gynecologists' abortion policy between 1951 and 1973 shows that decisions were only secondarily determined by science. The principal determinant was the need to preserve physician autonomy over the organization and delivery of services. As a result, the organization representing physicians who specialized in women's reproductive health was marginal to the struggle for legalized abortion. But, the profession was central to decisions about whether physicians would perform abortions and how they would be done. This case study finding has implications for understanding the role that organized medicine might take in the ongoing debates about national health policy.