Lawton Robert Burns, Jeff C. Goldsmith and Aditi Sen
Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these…
Abstract
Purpose
Researchers recommend a reorganization of the medical profession into larger groups with a multispecialty mix. We analyze whether there is evidence for the superiority of these models and if this organizational transformation is underway.
Design/Methodology Approach
We summarize the evidence on scale and scope economies in physician group practice, and then review the trends in physician group size and specialty mix to conduct survivorship tests of the most efficient models.
Findings
The distribution of physician groups exhibits two interesting tails. In the lower tail, a large percentage of physicians continue to practice in small, physician-owned practices. In the upper tail, there is a small but rapidly growing percentage of large groups that have been organized primarily by non-physician owners.
Research Limitations
While our analysis includes no original data, it does collate all known surveys of physician practice characteristics and group practice formation to provide a consistent picture of physician organization.
Research Implications
Our review suggests that scale and scope economies in physician practice are limited. This may explain why most physicians have retained their small practices.
Practical Implications
Larger, multispecialty groups have been primarily organized by non-physician owners in vertically integrated arrangements. There is little evidence supporting the efficiencies of such models and some concern they may pose anticompetitive threats.
Originality/Value
This is the first comprehensive review of the scale and scope economies of physician practice in nearly two decades. The research results do not appear to have changed much; nor has much changed in physician practice organization.
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Ba-Thanh Vu, Hung Le-Quang and Qi-Chang He
The phase-field method of interfacial damage is used to simulate the damage in composite structures containing the brittle orthotropic materials and their interface.
Abstract
Purpose
The phase-field method of interfacial damage is used to simulate the damage in composite structures containing the brittle orthotropic materials and their interface.
Design/methodology/approach
In the brittle fracture modeling, the strain tensor is decomposed into positive and negative parts characterizing tension and compression behaviors. By requiring an elastic energy preserving transformation involving the elastic stiffness tensor, these two strain parts must satisfy the orthogonality condition in the sense that the elastic stiffness tensor responds as a metric. However, most of the recent phase-field methods for brittle fracture do not verify this orthogonality condition. Additionally, to describe the damage in structures with anisotropic phases, recent studies have used multiple phase-field variables, with each preferential orientation represented by a phase-field variable to describe the bulk damage of component materials. This approach increases the complexity of simulation procedure. These disadvantages motivate the present study aimed at enhancing the simulation method.
Findings
The present study improves the phase-field method of interfacial damage by (1) incorporating the strain orthogonality condition into the phase-field method; (2) using only one phase-field variable instead of multiple phase-field variables to simulate damage in component orthotropic phases; and (3) investigating the interaction between interfacial damage and bulk damage as well as the effect of orientation tensor of preferential orientation in each orthotropic phase and the interfacial parameters on crack branching in composite structures.
Originality/value
Through several simulation examples, the present simulation method is proven to be accurate, effective, and helps the simulation process simpler than previous relevant methods.
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Studies have identified low levels of social support as one of several risk factors for poor psychological outcome following bereavement. Despite this fact, little is known about…
Abstract
Studies have identified low levels of social support as one of several risk factors for poor psychological outcome following bereavement. Despite this fact, little is known about how bereaved individuals interpret and define social support or which behaviors they perceive as helpful (Cacciatore, Thieleman, Fretts, & Jackson, 2021). The present study seeks to understand the experiences of the support received by Danish families who have lost a parent to death. Individuals recruited from a mutual bereavement support group (N = 87, 25–59 years old) responded to an online survey, which yielded both quantitative and qualitative data, the latter from open-ended questions and comment boxes. The results demonstrated a variety of sources of support. However, some of the bereaved individuals also reported a decided lack of help for both adults and children post-loss. As most respondents were women (93%), future research might shed more light on possible gender differences in the expectations, needs, and experiences of social support in bereavement. The study participants provided elaborate suggestions for the improvement of bereavement support, such as, practical help, access to bereavement support groups, more knowledge on bereavement and grief in the Danish society, and easier access to peer support. The chapter revealed an apparent lack of coordination of the support for parentally bereaved families. Additionally, some groups of bereaved children seemed to be particularly vulnerable and overlooked, namely the very young children, children in late adolescence/young adulthood, and children with special needs.
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Yama Temouri, Ha-Phuong Luong, Vijay Pereira and Hussain Rammal
This paper examines the role played by business cluster ecosystems and intellectual capital (IC) in achieving high-growth firm (HGF) status.
Abstract
Purpose
This paper examines the role played by business cluster ecosystems and intellectual capital (IC) in achieving high-growth firm (HGF) status.
Design/methodology/approach
We draw our insights from the knowledge-based perspective and economic geography as a theoretical lens, which combined offer a more unifying understanding of how business cluster ecosystems and IC foster high growth entrepreneurship.
Findings
Drawing on a sample of 11,360 German incorporated firms across 80 clusters, we find that cluster ecosystems play a significant role in supporting firms to become HGFs. More specifically, being located in business clusters increases the likelihood of becoming HGFs by 2.2% to 4.49%. We also find that clusters with more productive firms in the ecosystems provide favorable conditions for member firms to achieve HGF status, while the impact of other cluster-specific conditions (high-tech cluster membership and multinational enterprise share in clusters) is less clear. Additional insights suggest that firm IC (investments in intangible assets) enables firms to achieve high growth status.
Research limitations/implications
The findings of this paper hold theoretical and managerial relevance and shed more light on the impact of cluster-specific factors in the ecosystems and firm IC in achieving high growth entrepreneurship.
Originality/value
This paper is among the first of its kind to bring together three distinct literatures (HGFs, business clusters and IC) and utilize insights from each to derive a conceptual framework that links them in explaining high-growth entrepreneurship.
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Ghahhar Zavosh and Marie-Ann Betschinger
In multi-business firms, mergers and acquisitions (M&As) serve as a primary growth strategy. Yet, within multi-business firms, the value of an M&A can vary substantially for the…
Abstract
In multi-business firms, mergers and acquisitions (M&As) serve as a primary growth strategy. Yet, within multi-business firms, the value of an M&A can vary substantially for the different business divisions. Despite this, divisional-level drivers of corporate acquisition decisions and the subsequent performance implications for the divisions remain insufficiently explored. This study, grounded in the internal capital market and resource redeployment theories, seeks to fill this gap by investigating a sample of 1,728 multi-business firms spanning from 1998 to 2017. The statistical findings suggest that firms engage in acquisitions to allocate resources to their more promising divisions, particularly those with higher growth prospects and greater potential for resource sharing among sister businesses. A post-hoc analysis reveals that acquisitions are associated with a rise in the performance of those divisions that are in the same business segment as the acquisition target.