This study constitutes an applied sociology project in that the research has been conducted in cooperation with a Southern California psychiatric and chemical dependency private hospital serving adolescents, and with a view to providing institutional top management with a better understanding of some personnel dynamics under the strictures of a major operational change. The researcher believes that such better understanding will lead to more appropriate personnel management strategies which, in turn, will be reflected in improved personnel morale and attitudes to, eventually, benefit the institution's clientele.
The major operational change in question - the conjuncture, is a fundamental modification in patients' care modalities as forced upon the hospital by a drastically reduced insurance coverage of treatment costs. Insurance companies claim skyrocketing costs of healthcare as demanding reduction in quantity if not in quality of therapeutic approaches. As a result, traditional long-term residential care is being replaced by short-term in-patient treatment followed by out-patient consultations.
As a member of Asylum's direct-delivery healthcare staff, the researcher's unsystematic and undocumented personal observations of the hospital's employees led him to formulate the following tentative propositions:
Asylum's direct-delivery healthcare employees by and large seek self-justifying definition of their professional status and functional effectiveness under the conjuncture; deplore what they perceive as a lowering of therapeutic standards; and hold negative and often prejudiced views of top management, insurance companies, and political representatives. These attitudes contrast rather sharply with those of administrative middle-managers, whose major concern appears to be operational cost-effectiveness - even at the price of lowered quality therapeutic standards, and who express understanding if not total acquiescence of t...