Lehman E W, Lehman E
J Health Soc Behav. 1976 Dec;17(4):364-75.
The inability to attract adequate numbers of psychiatrists has been a concern of community mental health (CMH) planners for some time. This paper considers whether normative or utilitarian (i.e., economic) inducements have more of an impact on their participation. Data are drawn from a survey of 946 New York area psychiatrists. These data suggest the likelihood of incremental growth among community psychiatrists because organizational involvement, high quality residency training, and "younger generation" status all are linked to normative commitments to CMH values. Moreover, since political orientation is the strongest single determinant of these values, commitments also can be deliberately stimulated through normative appeals. Yet, our principal finding is that severe utilitarian disincentives tend to undercut the effects of normative inducements and commitments. The paper concludes by examining the social policy implications for community mental health staffing of the primacy of utilitarian considerations among psychiatrists.
一段时间以来，无法吸引足够数量的精神科医生一直是社区心理健康（CMH）规划者所关注的问题。本文探讨规范性诱因或功利性（即经济性）诱因对他们参与的影响哪个更大。数据取自对946名纽约地区精神科医生的调查。这些数据表明社区精神科医生人数有逐步增长的可能性，因为组织参与、高质量的住院医师培训以及“年轻一代”身份都与对CMH价值观的规范性承诺相关联。此外，由于政治倾向是这些价值观最有力的单一决定因素，通过规范性呼吁也可以有意激发承诺。然而，我们的主要发现是，严重的功利性抑制因素往往会削弱规范性诱因和承诺的效果。本文最后考察了精神科医生中功利性考虑占首要地位对社区心理健康人员配备的社会政策影响。
