Overtreatment is when medical or dental services are provided with a higher volume or cost than is appropriate. This study aimed to investigate how a group of dentists in Switzerland, a wealthy country known to have high standards of healthcare including dentistry, evaluated the meaning of unnecessary treatments from an ethical perspective and, assessed the expected frequency of different possible behaviors among their peers.

Dental tourism is patients travelling across international borders with the intention of receiving dental care. It is a growing phenomenon that raises many ethical issues, particularly regarding the dentist–patient relationship. We discuss various issues related to this phenomenon, including patient autonomy over practitioner choice, patient safety, continuity of care, informed consent and doctor–patient communication, among other factors. In particular, patients partaking in medical tourism should be informed of its potential problems and the importance of proper planning and post-treatment care to (...) guarantee high-quality treatment outcomes. (shrink)

In A Dentist and a Gentleman the sociologist Tracey Adams retells a familiar professionalization story, this time about elite dental practitioners in nineteenth‐century Ontario who launched a status‐enhancement project to reshape their self‐ and public image into “professional gentlemen” and establish monopoly control over dental practice. Dentists secured legislation in 1868 giving them authority to set entrance requirements, test and license practitioners, and establish a college. In subsequent decades they campaigned against those they called “quacks” who practiced without a (...) license, advertised, charged low fees, maintained dirty offices, misled patients about pain, or brought the gentlemanly status of dentistry into disrepute.Despite early resistance, the project had mostly succeeded by 1918, as dentists skillfully linked their expertise to emerging public health concerns and a professional image subtly reoriented toward an ideal of public service. By 1900 dental rhetoric was warning Canadians of an impending crisis of tooth decay and dental disease that would bring physical deterioration and mass feeblemindedness in its wake. Racial degeneracy, dentists warned, began in the mouth; the advance of civilization produced too much soft food and sugar, too little chewing, and too many high‐strung and overindulgent mothers. Only dentists, as “sentinels at the portal of the alimentary tract” , could stand against this threat to Anglo‐Saxon civilization. Rhetoric like this, combined with doses of guilt heaped on mothers, teachers, school boards, and public health agencies, resulted by 1915 in regular dental inspections of schoolchildren, free dental clinics, and the creation of the army dental corps.Dentistry brought unique twists to this familiar professionalization story. Prior to 1860 dentistry was an especially low‐status craft, associated with uneducated, itinerant tooth‐drawers or craftsmen like blacksmiths and gunsmiths . Professionalizing dentists therefore felt a special imperative to recast themselves as “gentlemen”; this image also reassured the upper‐middle‐class women who were dentists' main clientele. Unexpectedly, as Adams shows in an intriguing analysis, dentists benefited from an invaluable social alliance with physicians, who offered no opposition of the sort they raised against other rival groups of healers to dentists' professional aspirations.The study deals extensively with how gender shapes professions. Dentistry's professionalization, Adams insists, involved the adoption of a new ideal of personal masculinity, as seen in admonitions to dentists to establish firm, courteous, expert authority over their clients and in dentists' efforts to shape the imagined persona of the ideal dental assistant as uniquely female and wifelike. This masculine crafting of the profession notwithstanding, Ontario dentists evinced less overt opposition to women aspirants than did doctors or lawyers. Nevertheless, the proportion of female practitioners was much lower in dentistry than in medicine or law and remains substantially lower today. Adams brings considerable insight to her discussion of these facts and their causes, and she presents useful comparisons among the professions.This study has a few limitations. Perhaps because the author's sources are mainly professional journals, her account mostly mirrors the outlook of the professionalizing elite and her prose occasionally adopts their moralizing and improving tone. Regrettably, the book deals scarcely at all with what dentists actually did. One learns little about how changing scientific and medical ideas affected dentists' work, how dentists utilized anaesthesia and coped with the problem of pain, and what controversies over diagnostics and treatment animated the profession or about dentists' training and income. This is a history of dentistry's professionalization, not of dental medicine per se. But Isis readers impressed by this solid and modest study will hope that a history of dental practice will be Tracey Adams's next project. (shrink)

Background Decision making when patients ask a dentist for fee reduction is a real ethical dilemma at dental settings. The aim of this study was to evaluate how dental students and tutors think about their position for, or against fee reduction at dental offices. Method It was a questionnaire-based survey, which examined the ethical attitudes of students and tutors of an Iranian Dental School. The questionnaire included a vignette about an ethical dilemma at a dental office. Different ethical approaches, i.e. (...) duty-based, virtue-oriented and consequentialist arguments, for or against fee reduction at dental office were suggested. Respondents were asked to rank those ethical options. Data was entered and analyzed in SPSS 16.0. Result 121 dental students and thirty-six faculty members participated in this study. It revealed that a majority of dental students and tutors are in favor of charging patients less, when facing an imagined request at dental office, using either virtue-oriented or consequentialist argument for fee reduction. The difference between rankings of four options was statistically significant, while no statistically significant difference exists neither between male and female respondents, nor students and tutors. Conclusion This case study provides a basis for fruitful discussions in ethics courses for dental students. Our study suggests that financial issues should be considered as a part of ethical training within the dental student's curriculum. (shrink)

Several publications with healthcare professionals, such as psychotherapists, have shown a significant difference in personality styles in practitioners using hypnosis compared to those not using hypnosis. To investigate differences in personality styles, dentists were contacted to participate in a personality-inventory [Personality Style and Disorder Inventory ] online survey. Dentists using hypnosis were compared to dentists not using hypnosis. Results show that hypnosis-practicing dentists score significantly higher in the intuitive/schizotypal ST personality style compared to non-hypnosis-practicing dentists. (...) Female dentists scored significantly higher in intuitive/schizotypal ST and unselfish/self-sacrificing SL in the HYP DGZH sample but only in unselfish/self-sacrificing SL in the NONHYP DENT sample. The percentage of women was similar in both samples. Intuitive/schizotypal ST was found to be the predominant personality style of men who are interested in or use hypnosis, metaphorically so-called “homo hypnoticus.” Within the limitations of this cross-sectional non-interventional observational online-questionnaire study, results expand this notion to the so-called “homo hypnoticus dentalis.” However, further research on the subject is needed to investigate and confirm this personality type in other than the German-speaking DACH countries. (shrink)

This early work on dentistry is both expensive and hard to find in its first edition. It contains details on professional ethics and jurisprudence for the dentist. This is a fascinating work and thoroughly recommended for dentists and dental students. Many of the earliest books, particularly those dating back to the 1900s and before, are now extremely scarce. We are republishing these classic works in affordable, high quality, modern editions, using the original text and artwork.

Negative properties, like not flying, are controversial. I oppose Chateaubriand’s view on these properties and offer semantic arguments against their inclusion in ontology. I distinguish predicate negation and sentential negation, and examine the syntactic and semantic behaviour of predicate negation. I contend that predicate negation is identical with sentential negation. If it is not, then we lose a lot of intuitive inferences found in natural languages and make no clear metaphysical gain. Other arguments based on Ockham’s razor are offered.

Like other health care practices, the increasing complexity in dentistry signals the need for a reconceptualisation of dentist professional learning. Professional dental bodies, at large, still privilege formal continuing professional development (CPD) provisions focusing on off-the-job activities despite growing evidence that much invaluable learning occurs through and at work. In exploring the two common dentist CPD approaches, this article critiques the narrow conceptions of learning inscribed in these frameworks, which are individualistic and acquisition oriented. Drawing on a vignette of (...) class='Hi'>dentists’ professional practice at work, this paper argues for a shift in discussion from an emphasis on which CPD models work best to what counts as professional learning for dentists. To flesh out these arguments, the paper proposes using an innovative conceptual approach through the lens of ‘complexity thinking’ and the concept of ‘co-present group’. Through this lens, the reframing of thinking brings out two key features of learning: Emergent learning cannot be specified in advance and much significant learning is typically beyond an individual’s learning. Given the learning potentials of group practice and group learning, the paper concludes with suggestions to support dentists’ lifelong learning at work. (shrink)

Veronica had crashed Shelly Pomeroy's 09‐er party even though she was neither invited nor welcome. During the party, she took a drink which was mixed with gammahydroxybutyric acid (GHB). Consequently, she was taken advantage of. Does that make Veronica partially responsible for the horrible things done to her that night? Can we blame her, even in part, for what she suffered? This chapter discusses these issues and comes to the conclusion that it doesn't make sense to assign moral blame to (...) a victim for harms that result from prudential mistakes. If someone like Veronica makes a bad prudential choice that causes her harm, then maybe she should blame herself, but we can't blame her for any moral wrong done to her as a result. (shrink)

This essay consists of an examination of the work of three thinkers who conceive of liberal education primarily in teleological terms, and, implicitly if not explicitly, attempt to offer some answer to the question: what does it mean to be fully human? John Henry Newman, T. S. Eliot, and Josef Pieper developed their understanding of liberal education from their own intellectual and religious experience, which was informed by a specifically Christian conception of the place of education in a fully developed (...) human life. I suggest that the strength of their understanding of liberal education derives from its connection to the various small cohesive religious communities to which they were connected. Nonetheless, this insularity was also the primary weakness because each writer ended universalising what was in fact a particular and unique cultural and religious experience instead of providing convincing proof of a single human nature with a single telos. I will contrast this teleological conception of liberal education with that of Michael Oakeshott and his student Kenneth Minogue, both of whom wrote about education in a post-religious era in which the earlier consensus had completely broken down. They both celebrated the variety of practices which human beings have invented for themselves over the past several centuries (and past several millennia), and did not appear to suffer from the lack of any unifying single human telos. I will suggest that their understanding of practice insulated them from the need for a single unifying telos. (shrink)

This essay consists of an examination of the work of three thinkers who conceive of liberal education primarily in teleological terms, and, implicitly if not explicitly, attempt to offer some answer to the question: what does it mean to be fully human? John Henry Newman, T. S. Eliot, and Josef Pieper developed their understanding of liberal education from their own intellectual and religious experience, which was informed by a specifically Christian conception of the place of education in a fully developed (...) human life. I suggest that the strength of their understanding of liberal education derives from its connection to the various small cohesive religious communities to which they were connected. Nonetheless, this insularity was also the primary weakness because each writer ended universalising what was in fact a particular and unique cultural and religious experience instead of providing convincing proof of a single human nature with a single telos. I will contrast this teleological conception of liberal education with that of Michael Oakeshott and his student Kenneth Minogue, both of whom wrote about education in a post-religious era in which the earlier consensus had completely broken down. They both celebrated the variety of practices which human beings have invented for themselves over the past several centuries (and past several millennia), and did not appear to suffer from the lack of any unifying single human telos. I will suggest that their understanding of practice insulated them from the need for a single unifying telos. (shrink)

When we go to the doctor, he or she will not begin to treat us without taking our history – and not just our history but that of our parents and grandparents before us. The doctor will not see us u...

Pediatric dentists rely on access to hospital operating rooms for safe, effective, and humane delivery of dental care. The children who benefit most from dental treatment in a hospital operating room are those who are very young, have dental anxieties or phobias, are precommunicative or noncommunicative, need extensive or invasive dental treatments, or have special healthcare needs. Diminishing access to hospital operating rooms for pediatric dental treatment has become an escalating problem in contemporary times. Financial barriers, hospital costs, reimbursement (...) rates, health insurance policies and deductibles, out-of-network hospitals, socioeconomic factors, and the COVID-19 pandemic are prominent contributing factors. This problem in access to care has resulted in long waiting times for hospital operating rooms, deferral of medically necessary dental care, and pain and infection among this vulnerable patient population. Pediatric dentists have responded to the problem by utilizing alternative methods of care delivery, such as in-office deep sedation or in-office general anesthesia, and by implementing aggressive medical management of dental caries. However, the youngest of pediatric patients and children with special healthcare needs still remain at a disadvantage in receiving definitive dental treatment. This article aims to highlight the ethical challenges faced by pediatric dentists in contemporary practice in the face of limitations in hospital operating room access through four case scenarios. (shrink)

Every year in this country, some 10,000 college and university courses are taught in applied ethics. And many professional organizations now have their own codes of ethics. Yet social science has had little impact upon applied ethics. This book promises to change that trend by illustrating how social science can make a contribution to applied ethics. The text reports psychological studies relevant to applied ethics for many professionals, including accountants, college students and teachers, counselors, dentists, doctors, journalists, nurses, school (...) teachers, athletes, and veterinarians. Each chapter begins with the research base of the cognitive-developmental approach--especially linked to Kohlberg and Rest's Defining Issues Test. Finally, the book summarizes recent research on the following issues: * moral judgment scores within and between professions, * pre- and post-test evaluations of ethics education programs, * moral judgment and moral behavior, * models of professional ethicseducation, and * models for developing new assessment tools. Researchers in different professional fields investigate different questions, develop different research strategies, and report different findings. Typically researchers of one professional field are not aware of research in other fields. An important aim of the present book is to bring this diverse research together so that cross-fertilization can occur and ideas from one field can transfer to another. (shrink)

Time is woven into the fabric of our lives. Everything we do, we do in and across time. It is not just that our lives are stretched out in time, from the moment of birth to the moment of our death. It is that our lives are stories. We make sense of ourselves, today, by understanding who we were yesterday, and the day before, and the day before that; by understanding what we did and why we did it. Our memories (...) shape our present selves, since we are the product of who we were, and who we remember being. Yet who we are lasts for but a moment. It is who we will be that demands attention. We are forever projecting ourselves into the future. We painstakingly plan for the needs of our future selves, all the while knowing that while what we do will make those future selves who they are, still, our future selves are elusive. So it is not simply that we happen to live our lives in time, the way, say, one might happen to live in Australia, or Singapore. It is hard to fathom how things could be otherwise. What would it be to live a life without time? Yet time itself is intangible. Though we are keenly aware of what has been ‒ of pain and loss, regret and pride ‒ and of what might be ‒ of anticipation, and dread, and longing ‒ time itself seems unaffected by anything we do. Though we can anticipate a future birthday cake, time itself cannot be tasted. Though we can dread a future dentist’s appointment, time itself cannot be touched. Though we remember the crunching of leaves this past autumn, time itself cannot be heard. How can it be that something so central to each of us, to who we are, and what we care about, can be so spectral? What, in the end, is time? Is time real, like a substance in which each of us, like insects in amber, finds ourselves trapped? Is time a dimension through which we can move? Is time not a thing at all, but some connection between events? If time is real, what is it like? Does it flow like a river, taking each of us prisoner in its current, washing us ever closer to the end of our lives? Is time like a cresting wave, coming ever closer to each of us from the future, engulfing us, and then receding into the past? Or is time static? Like a one-way road that each of us might wander, with no chance to turn back? Or perhaps time is like none of these things. Perhaps time is more like space; something we can navigate freely, so that we can visit different times just like we visit different places. Perhaps we can we travel in time the way we can travel in space. These questions, and many more, are the focus of this book. Now, you might wonder what philosophers are doing writing a book about time. Surely that’s a job for physicists! It is true: a great deal of what we know about time stems from our understanding of physics. However, even in physics we find that there are questions about time that go unanswered. Moreover, increasingly, physicists are turning to philosophers for help in understanding the role that time plays in current physical theories. Our goal is to get the reader up to speed on some of the central issues that influence our understanding of time so that they too may play a role in this ongoing discussion between science and philosophy. We hope that in doing so it will become clear what philosophy can bring to the study of time. There is a natural narrative in philosophy regarding the study of time, and we have chosen to organise this book according to that narrative. However, the book may also be approached in a ‘choose-your-own adventure’ spirit. While later chapters build on material introduced in earlier chapters, you can skip around, reading the book in any order you choose. For the instructor, this means that she can design her course around this book in any number of ways, depending on the particular topic she wishes to focus on. (shrink)

Doctors and dentists have traditionally used antibiotic prophylaxis in certain patient groups in order to prevent infective endocarditis (IE). New guidelines, however, suggest that the risk to patients from using antibiotics is higher than the risk from IE. This paper analyses the relative risks of prescribing and not prescribing antibiotic prophylaxis against the background of Pascal’s Wager, the infamous assertion that it is better to believe in God regardless of evidence, because of the prospective benefits should He exist. Many (...) doctors seem to believe the parallel proposition that it is better to prescribe antibiotics, regardless of evidence, because of the prospective benefit conferred upon the patient. This has been called the “no lose philosophy” in medicine: better safe than sorry, even if the evidence inconveniently suggests that following this mantra is potentially more likely to result in sorry than safe. It transpires that, just as Pascal’s Wager fails to convince because of a lack of evidence to support it and the costs incurred by trying to believe, so the “belts and braces” approach of prescribing antibiotic prophylaxis is unjustifiable given the actual evidence of potential risk and benefit to the patient. Ultimately, there is no no-lose if your clinical decisions, like Pascal’s Wager, are based on faith rather than evidence. (shrink)

Currently, any dentist in the UK who is HIV-seropositive must stop treating patients. This is despite the fact that hepatitis B-infected dentists with a low viral load can continue to practise, and the fact that HIV is 100 times less infectious than hepatitis B. Dentists are obliged to treat HIV-positive patients, but are obliged not to treat any patients if they themselves are HIV-positive. Furthermore, prospective dental students are now screened for hepatitis B and C and HIV, and (...) are not allowed to enrol on Bachelor of Dental Surgery degrees if they are infectious carriers of these diseases. -/- This paper will argue that: (i) the current restriction on HIV-positive dentists is unethical, and unfair; (ii) dentists are more likely to contract HIV from patients than vice versa, and this is not reflected by the current system; (iii) the screening of dental students for HIV is also unethical; (iv) the fact that dentists can continue to practise despite hepatitis B infection, but infected prospective students are denied matriculation, is unethical; and (v) that the current Department of Health protocols, as well as being intrinsically unfair, have further unethical effects, such as the waste of valuable resources on ‘lookback’ exercises and the even more damaging loss of present and future dentists. Regulation in this area seems to have been driven by institutional fear of public fear of infection, rather than any scientific evidence or ethical reasoning. (shrink)

A recent decision by several Australian State politicians to support a parliamentary review of artificial water fluoridation has an intensified debate on the public health intervention. While there is a majority agreement among Australian dentists and other health professionals that adequate enamel fluoride is essential for dental health, the ethics of artificial fluoridation of public water supplies as a contemporary vehicle for facilitating adequate supply of fluoride to teeth is highly contested. Opponents of artificial water fluoridation insist that there (...) are many alternative sources of fluoride, that mandatory water fluoridation violates the ethical principle of autonomy and that water fluoridation is not only expensive and unnecessary but also may endanger health by causing fluorosis and, potentially, hypothyroidism and pathological bone fractures. In contrast, proponents of water fluoridation posit that mandatory water fluoridation facilitates health equity and that the benefits accruing to society from prevention of dental caries (beneficence principle) outweighs impairment of individual autonomy. This article utilizes Childress’ ‘justificatory conditions’ to evaluate the ethical appropriateness of artificial water fluoridation in Australia. The author concludes that there is insufficient ethical justification for artificial water fluoridation in Australia. (shrink)

Ethics and professionalism -- Ethical theory and philosophy -- Ethical principles and values -- Social responsibility -- Codes of ethics -- Ethical decision making in dental hygiene and dentistry -- Society and the State Dental Practice Act -- Dental hygienist/patient relationship -- Dental hygienist/dentist-employer relationship -- Risk management -- Case studies, activities, and testlets -- Appendix A : American Dental Association Principles of Ethics and Code of Professional Conduct.

In 2021, there was a significant amendment to the legislation on medical experimentation. In particular, Chapter 4 of the Law of December 5, 1996 on the Profession of Physician and Dentist (Journal of Laws 2023, item 1516) was amended, in which the prerequisites of legally relevant consent given by the participant in the experiment or by other entities that express a position on their behalf were specified. In addition, procedures related to the opinion of the research project by the so-called (...) bioethics committee were described. Its members were obliged to maintain confidentiality with regard to information obtained in connection with the fulfilled function. These norms became protected by criminal sanctions, set forth in the amended Article 58 of the law. New generic types of criminal acts were introduced, primarily aimed at protecting the participant's right to self-determination, the voluntariness of participation in the experiment, and the confidentiality of data submitted by the experimenters in their proposals to bioethics committees. These norms fill in the gaps that have existed so far in the criminal law protection of these values. The article systematically discusses the generic types of criminal acts that have been penalized in Article 58 (4) to (6) of the referenced law. Their object of protection, object side, subject, subject side, punishability and potential confluence with other regulations are presented. The historical-dogmatic justification for the introduction of these regulations is also shown. (shrink)

This study examines the relationship between gender, class, and race through a case study of the Ontario, Canada dental profession in the first two decades of the twentieth century. During this time period dentists endeavored to solidify their claims to professional status by defining their relations with patients, the public, and with dental assistants. Dentists drew on gender, class, and racial-ethnic relations and ideology in defining these relations and fostering their professional identity. Dentists' use of these relations (...) enabled them to define and defend their claims to professional authority in the area of dental health. (shrink)

Hesyre was a high court official in ancient Egypt and lived about 2650 bc during the reign of King Djoser. He managed to combine religious as well as secular posts, and has the distinction of being the first recorded physician and firstknown dentist in history. Healthcare developed at an early period in ancient Egyptian history as is supported by the evidence from the skeletal and mummified remains, from the artistic record, as well as from inscriptional and textual sources. These textual (...) sources, the medical papyri, provide details of medical procedures undertaken, drugs employed and treatments provided - some of which have influenced modern medical practice. What we know about Hesyre comes from his impressive tomb at Saqqara, the walls of which are brightly decorated with items of daily life. Additionally, the tomb contained six fine wooden panels listing Hesyres titles, among them those relating to his practice of medicine and dentistry. (shrink)

In many clinical cases a dentist may feel certain when for example diagnosing, deciding on treatment, or assessing the prognosis - in other cases many dentists may feel a degree of doubt or uncertainty. This paper aims to explore the philosophical concept of uncertainty and its different dimensions, using the condition "persistent apical periodontitis associated with a previously root filled tooth" as an example. Acknowledging that uncertainty exists in any clinical situation can be perceived as uncomfortable, as some might (...) regard it as a weakness. While some types of uncertainty met in dental practice can be addressed and reduced, there are other types which are inevitable and must be accepted. To make sound decisions, it is pertinent that the dentist reflects on and values the consequences of uncertainty. In this paper, a conceptual model is presented by which the dentist can identify the type of uncertainty in a clinical case, making it possible to decide on a strategy on how to manage the uncertainty and its possible consequences, with the aim to support the dentist's care for their patients. The understanding that uncertainty exists and the ability to acknowledge and be comfortable with it when making decisions should be addressed throughout our professional career, and thus ought to be developed during undergraduate education. Some suggestions on how teachers could target this are given in the paper. (shrink)

The Polish equivalents of Research Ethics Committees are Bioethics Committees (BCs). A questionnaire study has been undertaken to determine their situation. The BC is usually comprised of 13 members. Nine of these are doctors and four are non-doctors. In 2006 BCs assessed an average of 27.3 ± 31.7 (range: 0–131) projects of clinical trials and 71.1 ± 139.8 (range: 0–638) projects of other types of medical research. During one BC meeting an average of 10.3 ± 14.7 (range: 0–71) projects of (...) medical research were assessed (2006). The amendment of Polish laws according with Directive 2001/20/EC caused a percentage increase in BCs which assessed less than 20 projects per year (16% vs. 33% or 42% in 2003 vs. 2005 or 2006 respectively, p < 0,05). The results confirm the usefulness of the current practice of creating BCs by medical universities, medical institutes and regional chambers of physicians and dentists but rationalization of the workload for individual BCs is necessary. (shrink)

The presented article is devoted to the question of whether extended access therapy can or should be accompanied by research activity. It consists of three parts. The first lists the tasks that can be used for medical information regarding extended access programs, which leads to the conclusion that even taking into account the specific limitations of their cognitive value, this type of data can be meaningfully used. The second part is devoted to the limited regulations in European law concerning the (...) discussed issue, and the Polish Act on the Professions of Physician and Dentist which grants physicians/researchers broader powers. In the last part of the article, two arguments are presented to ethically justify the granting of such broad powers to researchers, and thus limiting the autonomy of patients. (shrink)

This article examines whether cosmetic interventions by dentists and plastic surgeons are medically indicated and, hence, qualify as medical interventions proper. Cosmetic interventions (and the business strategies used to market them) are often frowned upon by dentists and physicians. However, if those interventions do not qualify as medical interventions proper, they should not be evaluated using medical-ethical norms. On the other hand, if they are to be considered medical practice proper, the medical-ethical principles of nonmaleficence, beneficence, justice and (...) others hold true for cosmetic interventions as much as they do for other medical and dental interventions. It is concluded that most cosmetic interventions do not qualify as medical interventions proper because they do not restore or maintain the patient's health (defined as the patient's integrity) by any objective standards. Rather, cosmetic interventions are intended to enhance a person's physical appearance; more specifically, they intend to fulfill the client's subjective perception of an enhanced appearance. (shrink)

Physician strikes in the United States have been relatively rare, although this has not been the case in other countries nor with other members of the healthcare community, such as nurses. This situation, however, could change. More physicians are either joining unions or seriously discussing doing so. The National Guild for Medical Providers, for example, is actively trying to expand its membership of 11,000 doctors in Michigan, Pennsylvania, and New Hampshire into Illinois, California, New Jersey, Colorado, Texas, and South Carolina. (...) The Federation of Physicians and Dentists, with 2,500 members in Florida and Connecticut, is trying to establish itself in Seattle, Las Vegas, Tucson, and Philadelphia. Although unions are neither necessary nor sufficient conditions for strikes, if physician unions do become more prevalent, the potential for collective work actions, including strikes, increases. (shrink)

Drawing on the transactional model of stress, we propose that organizational identification and positive affectivity moderate the relationship between abusive supervision and proactive behavior. In Study 1, we collected data from a sample of 165 dentists and 41 supervisors in two Chinese hospitals. In Study 2, we used a sample of 226 employee-supervisor dyads from a large Chinese transportation company. The results of two studies showed that the interaction between abusive supervision and organizational identification on proactive behavior occurred only (...) when positive affectivity was high. We discuss theoretical and managerial implications and indicate future research directions. (shrink)