Kathleen Montgomery

Hip And Knee Implants: Current Trends And Policy Considerations

This paper constitutes an analysis of the issues, relationships, emerging hospital strategies, and policy needs surrounding hip and knee implants. Demand for hip and knee replacements is rising annually, and growth is expected to be substantial. Costs are high, reaching

Accounting for Differences in Norms of Respect A Study of Assessments of Incivility through the Lenses of Race and Gender

11 billion for hospitals in 2004 and

A framework for understanding dysempowerment in organizations

5 billion for Medicare in 2006. Relationships among stakeholders add complexity. Case studies reveal emerging strategies by hospitals for management of implants. Policy considerations include development of a national council for data and technology assessment, a national joint registry, price transparency, and incentives.

Responses by Professional Organizations to Multiple and Ambiguous Institutional Environments: The Case of AIDS

Incivility, an often ignored but potentially destructive workplace behavior, represents violations in norms of respect. The authors propose that norms of respect may not be shared within a work place and that variations in norms are reflected in the way individuals assess uncivil behavior toward others. Tests are carried out for variations in personal norms of respect with data from observers of the behavior by professional men toward a professional woman. Results from this study suggest that males and females may have different thresholds at which they perceive a vio lation of their norms of respect. Furthermore, perceptions may be affected by observers’ social identification (by race and sex) with either the perpetrators or the targets of incivility. The authors discuss implications from the study for perpetuating workplace inequalities.

A System Cybernetic Approach to the Dynamics of Individual- and Organizational-Level Trust

The concept of dysempowerment is introduced as a process whereby an individual perceives certain work events as affronts to ones dignity. This perception results in affective responses that generate attitudes and behaviors having the potential to disrupt or impair the individuals task motivation. We specify propositions to predict the impact of factors on potential dysempowerment, and we present a typology to characterize organizational climates that result from the coexistence of dysempowerment and empowerment.

Toward the construction of a profession’s boundaries: Creating a networking agenda

In this paper we examine responses to multiple and ambiguous pressures gener ated by the environmental threat of AIDS. Using an institutional theory frame work and insights from professional dominance theory, we develop a two- dimensional typology, incorporating the belief systems of important constituents and the degree of institutional rules, to explain the patterns of organizational adoption of AIDS-related policies and related professional prac tices. Hypotheses are tested with data from a national survey of hospitals (n= 506), with interviews from administrators and chiefs of medicine. Results sup port the usefulness of the explanatory schema for patterns of organizational policy adoption; the schema also provides a stronger explanation of pro fessional behaviour patterns than does the existence of policies requiring such behaviour. Theoretical and practical implications of the findings for professional organizations in the context of environmental threats are discussed.

How Vulnerability and Trust Interact During Extreme Events Insights for Human Service Agencies and Organizations

In this article, we argue that trust is a system-related concept and that it is a continuously evolving state of information gathering, processing, and feedback. Based on this argument, we demonstrate the usefulness of the conceptual framework of cybernetics to an understanding of the dynamics of developing and sustaining trust. We begin with some background information about the science of cybernetics and the basic principles relevant to this framework that enable a system to function effectively. We then use the principles of cybernetics to illustrate the dynamic nature of trust within the social system of a complex organization and externally between organizations in an environment. We summarize by relating our model to recent theoretical developments in the trust literature and by providing suggestions for future research using a cybernetic framework.

Beliefs About Social Responsibility at Work: Comparisons between Managers and Non‐Managers Over Time and Cross‐Nationally

Attention to the boundaries of an organization or profession is an essential precursor to facilitating boundary-spanning activities. We follow a four-stage process model of constructing boundaries to delimit a profession’s membership and domain prior to its recognition as an institutionalized entity. A set of networking activities forms the basis of boundary construction, yet identifying and prioritizing which activities to pursue is a challenge that can jeopardize the success of an aspiring group. We use a case study of the emerging Jewish legal profession in pre-state Israel to analyze how an agenda for creating membership and domain boundaries implicitly surfaces through interactions among members of the new group. We employ content analysis of a key meeting transcript and network analytical methods to reveal a shared cognitive map of priorities. The study adds to the literature on professional boundaries and demonstrates the utility of an innovative qualitative-quantitative research approach.

How Pharmaceutical Industry Employees Manage Competing Commitments in the Face of Public Criticism

The article discusses a theoretical model developed to predict the motivational dynamics of individuals facing extreme events. The model demonstrates how the imposed vulnerability of unexpected harmful events (e.g., natural disasters, accidents, serious illness) creates a second form of vulnerability for needy individuals when they rely on and cooperate with little-known others offering rescue and care. Trust in the relationship between a care provider and a care receiver is used as the link between two types of vulnerability to articulate the process through which individuals assess their care providers trustworthiness. This article outlines an approach for future tests of the models hypotheses and discusses practical implications of the model for improving public services that depend on cooperation from individuals in extreme need as well as its theoretical contributions.

Trouble in the Gap: A Bioethical and Sociological Analysis of Informed Consent for High-Risk Medical Procedures

We examine the link between the growing emphasis on corporate social responsibility at the organizational level and beliefs about social responsibility at work (SRW) expressed by individuals. Drawing from theories of professionalism and diffusion of innovations (including practices and beliefs), we advance hypotheses about beliefs of managers and non‐managers in 11 countries at two time periods, and use a unique international data set to test our hypotheses. Our general prediction that managers would score higher than non‐managers on a measure of SRW was not supported. However, further analysis revealed a more complex relationship moderated by the contextual factors of time frame and country inequality level. We discuss implications and extensions for future research.