John G. Bruhn

The wellness process.

Wellness is viewed as a continually evolving and changing process related to the developmental stages of man and the individuals completion of certain developmental tasks. Wellness differs from good health; it is a measurable process in which individuals actively participate to become more healthy. The index proposed here for assessing or measuring wellness is based upon the individuals completion of the minimal wellness tasks appropriate to his developmental stage.

Outcomes of Problem-Based Learning in Health Care Professional Education: A Critique

&NA; Problem‐based learning is one of many types of active, participatory learning strategies. It has become popular in health care professions education, especially medical education. Assessments of the effectiveness of PBL are generally favorable, yet its cost in money and time, as well as its effect on the future behavior of practitioners, has not been established. Factors affecting the evaluation and comparison of PBL experiences are discussed, along with the outcomes expected from PBL. While the health care professions are attempting to mold practitioners for the future who will be holistic, reflective, critical thinkers and who will acknowledge the necessity for teamwork in solving complex problems, educators should guard against the edification of any one type of learning strategy.

Health and organizational issues in managing a multicultural work force

As American society becomes more multicultural and the work force more diverse, it is becoming increasingly important for organizations and institutions to address the many needs of employees. This article discusses major health and organizational issues facing organizations that are successfully developing a multicultural work force. Several health programs initiated in a university are used to illustrate what can be done to accommodate the health needs of a culturally diverse work force.

Ethical issues in intervention outcomes.

This article discusses selected ethical issues involved with the outcomes of interventions. An intervention is a process of intrusion into value systems based on a relationship of mutual trust and shared expectations between the intervener and the participant. Too often, interveners focus on the outcome without considering the mediating variables that can influence the outcome; therefore, intervention outcomes may fail or be short-lived. Many ethical issues with respect to how interventions are designed and implemented can affect their success or failure.

Managed Care: What It Is and How It Works

The overarching purpose of the second edition of Managed Care: What It Is and How It Works is to imbue the reader with a solid understanding of how managed care works. And, indeed, it cannot be gainsaid that this core goal has been substantially achieved by physician-author Kongstvedt. In quite capable fashion, Kongstvedt traces the principal lineaments comprising the body of managed care. At the least, this easy-to-read, managed care primer should inculcate the reasonably discerning reader with generalized knowledge of the broad contours of managed care, and impart respect for the ever-shifting dynamics of this vibrant, contentious realm. Kongstvedt’s relatively terse volume is a member of the family of the Managed Health Care Handbook series. Writing in a style that is neither pedantic nor overly didactic, Kongstvedt illumines the timely subject of managed care in a pellucid, if somewhat unanimated, manner. The pages of the volume are saturated with clear exposition, which adds flesh to the bones of some of the intricacies of managed care. The textual material ramifies into seven chapters. Particular appendages of the body of managed care dissected and examined assiduously by Kongstvedt include: the historic evolution of managed care; managed care variants, and their respective structures; the insinuation of managed care into primary-care medicine, specialty medicine, and the hospital industry; management of medical utilization and quality management, in the wider context of managed care; managed care in the particular contexts of the Medicare and Medicaid programs; and state and federal regulatory requirements affecting managed care. A prolix, salutary glossary adjoins the text. The multitude of “figures” that suffuse the text further contribute to the practical value of the book. In sooth, Kongstvedt’s vade mecum for persons interested in learning about managed care proffers a good, solid introduction to this vital, and vexing, subject. Prospective readers should understand, though, that Kongstvedt, figuratively speaking, shows a snapshot of managed care, taken at a particular moment in time; and that managed care is undergoing quite rapid metamorphosis. Moreover, the epitome of managed care, although described ably by Kongstvedt, does not constitute a valid surrogate for counsel with qualified experts to resolve nettlesome issues of specific, real-life cases. The potential beneficiaries of this very good book are actually wide-ranging, extending to: health care professionals, health care administrators, and interested lay persons. Kongstvedt’swell-crafted book is surely a laudable contribution to the literature of managed care.

Managing crazy behavior in organizations.

Crazy behavior is an aspect of organizational life. This article examines the two sides of crazy behavior, positive and negative, and suggests guidelines for its management so that it does not become pathological or destructive to the competence of the organization. Crazy behavior is related to professional and ethical behavior, but the boundaries of craziness are often less clear than those for professional and ethical behavior. Therefore, crazy behavior is often tolerated, if not supported and encouraged, by the reactions of administrators.