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In April 2004 a new 'pay for performance' contract was introduced for general practice (family medicine) in the UK. The contract can be interpreted as part of the process of promoting 'enterprise' in public services. This paper examines the impact of this change on practice organisation and professional identity. Based on an ethnographic case study, we found that doctors engaged in a 'no change' narrative, suggesting that the new contract had made little impact on their work. This allowed them to maintain their claims to provide patient-centred care, whilst supporting the use of pay-for-performance targets, which threaten to override patients' agendas and concerns. Our data suggest that despite traditional professional identity narratives which emphasise 'holism' or 'biopsychosocial' approaches in primary care, there has been a shift towards the delivery of biomedical care by nurses and doctors. At the same time, both groups are becoming enrolled, to varying degrees, in regimes of self-surveillance. Furthermore, far from eradicating or reducing bureaucracy as proponents suggest, the expansion of 'enterprise' in our case study site was facilitated by the creation of new forms of bureaucracy and top-down surveillance. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]

This article presents a study on the application of service-dominant logic (SDL) to social marketing. It presents an overview of the primary critiques of social marketing and discusses the main principles of SDL, the difference between social change contexts and commercial marketing contexts, and the challenges associated with applying SDL in social marketing.

The article presents studies focusing on the extent to which health care reforms had accomplished in bringing medical personnel to work together in a productive way to improve efficiency. One of the studies interviewed patients who attend with medically unexplained symptoms (MUS) as well as those who represent up to 25% of practice consultations. The studies highlight the significance of investigating organizational activities to understand impacts of changes in accountability structures.

The use of formal standards developed by one (knowledge) elite and enforced by another (administrative elite) as part of a proliferation of formal mechanisms to judge and where necessary, correct and control the technical and ethical standards of physicians' work were seen by Eliot Freidson as threatening collegiality and professional unity. Drawing on interviews with primary care doctors in England and California this paper reports the emergence of new strata or elites, with groups of doctors involved in both surveillance of others and action to improve compliance in deficient individuals and organizations. This paper compares responses of primary care doctors in England and California to these developments and explores the implications in the context of Freidson's predictions. [ABSTRACT FROM AUTHOR]

Come hear how the Lincoln County School District, Oregon Sea Grant/ Oregon State University Hatfield Marine Science Center and the Oregon Coast Aquarium forged a partnership to support local students in becoming the most "ocean literate" students in the country. ..PAT.-Unpublished Manuscript [ABSTRACT FROM AUTHOR]