Short answer questions free essay sample

Explain three differences between a working relationship and a personal relationship. -A working relationship is a relationship where the person spends time with a co-worker or client at work but has little to no contact with them out of working hours. Whereas in a personal relationship; personal life, extra curricular activities and social life are all involved. -Work relationships don’t usually involve arguing, discussing interests and personal life problems between co-workers. Whereas they a big part to personal relationships. -Sharing information with colleagues, clients and other professionals is limited whereas sharing in a personal relationship is unlimited. Give two exampled of different working relationships in an adult social care setting. The relationship between the social care worker and service user is a type of working relationship in the adult care setting. The social care worker must have a working relationship with service users. The relationship between the social care worker and line manager is another example of a working relationship. We will write a custom essay sample on Short answer questions or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page This relationship must stay professional within the adult care setting. Explain why it is important that social care workers work in partnership with individuals using the service and their family. It is important that social care workers work together with service users and their families as both have a common goal to protect the service users. It is important that all parties work together to support the best interest of the service user. Identify three ways of working that can help improve partnership working. †¢ It is important to work with other as we have a common goal to protect from harm. To ensure we are all involved in decision making to contribute to the growth and development of the whole team. †¢ Using your skills to the best of our ability, train new staff, attend training, you know your own role and responsibilities. †¢ Seek advice from your manager if you had issues in your working relationships. Seek advice if you were unable to resolve the conflict yourself also. When people with different views and expertise are working together, they may disagree about the best way forward. Identify five different skills or approaches that might help resolve conflict. †¢ Listen to the person with the most expertise in the area. †¢ Work as a team to resolve the situation. †¢ Compromising and resolving the situation in the best manner. †¢ Listening to everyone and let staff view their thoughts. †¢ Resolve the situation by problem solving. Explain two ways you could obtain support and advice about working in a partnership and resolving conflicts. You could obtain support and advice from your manager as they would have a neutral standpoint on the conflict and therefore would be able to help resolve it. If the management weren’t available going to the nurse in charge would also be a good step to take in resolving any work conflicts. 206 Task B Handout It is a legal requirement to follow agreed ways of working. Policies and procedures or agreed ways of working set out how we your employer require you to work. They incorporate various pieces of legislation as well as best practice. They are there to benefit and protect you, the individuals you support and us your employer. They enable you to provide a good quality service working within the legal framework and most importantly aim to keep you and the individuals you support, safe from danger or harm. To implement agreed ways of working you follow the Policies and Procedures and the service users care plan, where the management of the individuals daily care needs are agreed and documented. It is extremely important to have up to date agreed ways of working as there may be changes in policies within the law. Our company may have to implement them to help protect the vulnerable. You have a duty to keep service users safe by following policies, procedures and working within your job role. Each job title entails particular duties and responsibilities. Within each position there are routine tasks and activities and expectations. Individuals will be specifically trained to perform the responsibilities of their role. And each role involves limits. Every worker is expected to limit herself or himself to the usual and customary activities involvedin the fulfilment of their role. Think about what could happen if you did something that was outside your job role. E. G suppose you administered medication before you had been trained, what could happen, both to your service user and to you? Your contract will stipulate your responsibilities. It could lead to your dismissal if you exceed your role level of ability when this leads togross errors.

Tips On Writing A Sample Duke Essay

Tips On Writing A Sample Duke EssayThere are many reasons why a college student might be seeking to write a Duke Essay sample. In fact, more students each year are starting to feel a burning desire to develop their own personal writing style and establish their own author status. Since so many people are starting to apply their writing abilities in this fashion, it's only right that the process be made easier for them, too.When writing a sample Duke Essay, there are a number of things you should take into consideration. The first and most important is that you should always stay within the bounds of the format as dictated by the writer. It is not uncommon for a student to attempt to break the rules and publish their own edition of the essay, but only cause themselves so much trouble later on.Another thing to remember when writing a sample Duke Essay is to avoid asking for a lot of information. Since the essay will be open to the public, you will need to have a simple and direct forma t for providing your information. If your essay is very long, you will find it difficult to present any information and make sense at all.This means that even though a college students' final version of the essay will eventually be published, it might not do any good if they don't have the exact information right from the start. In addition, the guidelines for formatting a sample Duke Essay can be easily and simply written out in case you find yourself in this situation.However, the biggest benefit of submitting a sample Duke Essay is the easy and accurate way to write. With the help of a computer, you will not only be able to do it faster than the average person, but you'll also have the chance to include and discuss the student's preferred reading material. These can include magazines, eBooks, newspapers, and even the Internet.However, you should also realize that when you submit a sample Duke Essay, there is also an obligation that you make it clear that the essay is to be used f or research purposes only. Doing so will protect the student from any claims that they are engaging in plagiarism.So before submitting your sample Duke Essay, there are a few guidelines you should follow. These include: always staying within the boundaries of the form and format dictated by the student, making it clear that the essay is going to be used strictly for research, and emphasizing that the essay is to be used strictly for research only.

Employment Scenario in India Essay Example

Employment Scenario in India Essay Employment has emerged as an important subject in the development agenda of most national governments and several international organisations over the past two decades. In recent years, the processes of globalisation have also resulted in certain trends in labour markets in both the developed and developing countries. in the developing countries, fears have been expressed of displacement of workers in the hither to protected sectors as a result of international competition. Current scenario of India: As a belong to India, I would like to emphasize on the current education and employment scenario in India. In India, The educational system follows 12 years of schooling and then a 3-4 years of graduation course, and 2 years of post graduation course. India  has a total  of 253 universities and 12,732 colleges right now. Growth rate of employment is 3. 29% in 2009. Highest rate of Employment is observed in agriculture , fishing and forestry- 296. 62 million. The Lowest rate of employment is in Electricity, Gas and water supply – 1. 5 million. The country is having a population of 1. 2 billion while the total employment is 529. 87 million. It indicates that major portion of the youth remain unemployed. Major employment challenges in India: 1. Population: India  is the  second most populous  country in the world, with over 1. 18 billion people (estimate for April, 2010), more than a sixth of the worlds population. More than this every year about 5 million people become eligible for securing jobs. But the employment opportunities are much lower than the job seekers. 2. Poverty: In India, Poverty often forces households to withdraw children from schools for reasons of both direct and opportunity costs. We will write a custom essay sample on Employment Scenario in India specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Employment Scenario in India specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Employment Scenario in India specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In addition, schools and the style of instruction are not always attractive for the children. In the case of girls, the familial attitude towards educating them continues to be discriminatory. As a result, Drop-out rates are high: at 40 per cent in the primary, 50 per cent in the middle and 66 per cent in the secondary stages of schooling for boys and 42 per cent, 58 per cent and 72 per cent at the three levels, for girls In rural families. 42 per  cent of children said they wanted to be graduates and just 24 per  cent wished to go in for a post-graduate  degree. Even the choice of subject changed according to the occupation of parentschildren of the salaried class were more likely to study engineering or medicine. 3. Employability: A part of the problem of employment has always been the result of a mismatch between qualitative aspects of the supply and demand of labour: demand has remained unfulfilled due to non-availability of workers with requisite skills and workers have remained unemployed or underemployed as they have no skills or their skills have no demand. This mismatch seems to have grown in recent years due to fast changes in production technologies and structures to which the skill supply mechanisms and institutions have not been quick enough to respond. 4. Rate of Literacy: 39 per cent of the Indian workforce in the 15 years and above age group is illiterate; another 23 per cent have studied only up to the primary level. Only 22 per cent have secondary and higher level of education. 5. No of colleges: India  has a total  of 253 universities and 12,732 colleges right now. If we take the total  population in the relevant age group and divide this by the number of colleges/universities, then it shows that, at the all-India level, each university will have to cater for around 250,000-300,000 studentswhile thats about the size of Delhi University, there arent too many universities of this size in the country, nor are many being planned. 6. Educational Infrastructure: The infrastructure and curriculum of the school and colleges suffer from lack of adequate technologies, Shortage of funds. The curriculum of professional colleges are not updated to met the requirements of the industry. India is having Total engineering colleges more than 3000, when Total number of  Private MBA  colleges  in India is more than 1700. Almost 90% of these  colleges  are unable to provide quality education. Only top 10% college of Engineering and managements are able to provide job to students through Campus selection. 7. Economic depression : sick industries are often close down compelling their employees to become unemployed. 8. Technological advancement : Technological advancement contributes to economic development . But unplanned and uncontrolled growth of technology is causing havoc on job opportunities. The computerization and automation has led to technological unemployment. 9. Industry lockouts: Strikes and lockouts have become inseparable aspect of the industrial world today. Since workers do not get any salary or wages during the strike period they suffer from economic hardships. They become permanently or temporarily unemployed. How to improve the education system: Education system plays a crucial role in the employment scenario. Because it delivers the students who possess the skills and knowledge to participate in the global economy. Following measures should be taken to make the students employable in Public and Private sectors: 1. Increasing No of Schools: As discussed earlier, the existing No of schools are not adequate to provide quality education to the eligible students. So the No. of universities and colleges must be increased. 2. Providing Free education: In primary level, Education in the Govt. Schools should be made free for rural families. Also No of scholarships should be increased for higher education. . Developing Infrastructure: Increase spending substantially on primary and high school education (Both qualitative and quantitative). Increase the salaries of teachers at least at per with university lecturers and put stringent quality control while recruiting the teachers and introduce accountability among them. We must increase substantially the number of primary schools and quality of those a nd improve on physical infrastructures like school buildings, a minimum standard of school laboratory and library, a decent play ground, some internet connected computers in libraries etc. In technical institutions, technical equipments should be used in instructing. 4. Pattern of evaluation: Subsequently the exam patterns should change and put more emphasis on original thinking and problem solving rather than emphasizing database-quiz type format. 5. Improving curriculum: Basic education should be in mother tongue but English also should be compulsory from class 1. Technical education should be made available to students who have completed 8 years of schooling. To cover the lack of skills, a mechanism needs to be set up at different levels — national, regional and local — to continuously assess the emerging skill requirements of the rapidly changing economic and technological scene and reorient the training infrastructure to meet them. Second, it is necessary to develop training systems to meet the skill requirements of the unorganised sector, which is likely to be the main source of new employment opportunities, in highly diverse activities with many common as well as specific skills. 6. Training for competitive exams: In higher educational institutions, students should be prepared to clear the competitive exams. It will make a large No. Of students eligible for various public sector jobs. Conclusion: The first lead in improving the educational system should be taken by the Government. Because though Education in Private Colleges are expensive, they are having a good infrastructure and placement record compared to the Govt. Colleges. Govt. Should take initiative to increase no of schools and colleges with proper facilities, and also improve the curriculum and infrastructure of present education system.

History of Uganda Essay Essay Example

History of Uganda Essay Essay Example History of Uganda Essay Essay History of Uganda Essay Essay In the twelvemonth 1890 to 1926. the British authorities forged what is today the state called Uganda although they are non the initial integrity negotiants in the state. The derivation of the name Uganda was from the land of Buganda. This land encompasses the southern part which includes Kampala. its capital metropolis. Prior to the fusion of the state by the British. the state was under the control of the dynasty of the Bachwezi. These are the same people who had an influence upon Rwanda. the authorities of Tanzania every bit good as Congo in the period 1100 to 1600 AD ( Akallo A ; Alford 38-40 ) . Background Information about Uganda The state of Uganda is an East African landlocked state which takes its name from the land of the Buganda. This has the encompassing of the part in the southern portion of the state which incorporates Kampala. its capital metropolis. This East African state boundary lines Kenya. Sudan. DRC. Rwanda and Tanzania. It is land locked and its southern side is made up of Lake Victoria where the boundary lines to Kenya and Tanzania intersect ( White 1-6 ) . About the LRA The Lords Resistance Army is a guerilla ground forces of a sectarian type whose base is in the northern portion of Uganda. The LRA emerged out of the wreckage of the Uganda National Liberation Army in 1986. and settled down by Joseph Kony in early 1987. The activities of the group include armed rebellion directed to the Ugandan authorities doing it a major struggle in Africa as one of the longest-running struggles LRA was involved in perpetrating maltreatments every bit good as atrociousnesss of high magnitude runing from abduction. maiming. raping of the female. mass violent death of the civilians and largely the kids. The motion besides played a polar function in the destabilization of the northern part of Uganda runing from Sudan. which was their base. They besides congregated in an eastern part in Congo called Bunia. They made links with Army for Liberation of Rwanda. the ( ALIR ) among other Rebel groups ( White 1-6 ) . LRA came into being in 1987 for the intent of battle in the armed rebellion directed to the authorities of Uganda. This has been a major struggle in Africa. The leader of the group. Joseph Kony was in a place for self announcement as Gods spokesman every bit good as a Holy Spirit medium. Harmonizing to the belief of the Acholi. there is a possibility for diverse signifiers of manifestation by the Holy Spirit. This group holds to syncretic blend affecting the Christianity. the mysticism every bit good as Islam. the traditional faiths in Uganda every bit good as witchery. The claims of the group are the constitution of theocratic province whose footing is the Ten Commandments in line with the tradition of the Acholi. This group has been a focal point for accusals for the misdemeanor of human rights. This include actions of slaying. forcing of the kids to take portion in the violent belligerencies. their abduction and mutilation. sexual captivity of the kids every bit good as adult females The beginning and history of the LRA The ground forces is projected to incorporate two 1000 members working in northern parts of Uganda every bit good as southern portion of Sudan. The ground forces has been propped by the state of Sudan. Majority of its operations are based in the northern parts of Uganda although there is grounds of its operations in some parts in the DRC of Congo every bit good as Sudan ( Akallo A ; Alford 38-40 ) . Ideology of the LRA The LRA reportedly is responsible for the evocation of the patriotism of Acholi people on juncture. but bulk of the perceivers have a negative feeling with respect to the earnestness of their activities. The motivations behind the operations of the group are the overthrowing of the incumbent authorities of Uganda with the attendant replacing of the government that will follow with the execution of the Christianity trade name of the group. In frequent occasions. the group is involved in the snatch every bit good as the blackwash of the local civilians for the intent of the disheartenment of any foreign investing every bit good as the precipitation of the crisis in the authorities ( Akallo A ; Alford 38-40 ) . What the LRA have done The group terrorized the locals people. larceny from small towns. flaring huts. barbarous mutilation of the villagers. Slaughters and atrociousnesss took topographic point to people in many small towns. Majority of those people were displaced from their places and were forced by the fortunes to populate in the caps where life was suffering. The entree to nutrient every bit good as medical attention among other human necessities was hard to obtain. The group abducted vulnerable kids to do foot-soldiers this made them to give up their opportunities for schooling every bit good as the development of their societal lives. The kids were forced to kill people chiefly the villagers. their household members or even friends. LRA killed over 200 people and kidnapped at least 20 kids from small towns over a three-day period in the past 20yrs. So far. The LRA has abducted over 20. 000 kids. coercing male childs to contend as soldiers and misss to function as sex or labour slaves. ( United Nations ) How the LRA affected the people’s lives in Uganda Many people in Uganda lost their place and lives. Childs who were used to be child soldiers have been suffered in physical or emotional ways. LRA has been documented as holding abducted above 60 000 kids every bit good as young person in Uganda. In every three of the male stripling. one of them has been abducted. while in every 6 of the female stripling. one of them has been abducted. The immature adult females every bit good as the misss of the beginning of the Acholi every bit good as the Langi are used to execute some jobs while in imprisonment for the Rebels and their kidnappers. These include taking H2O. cookery. carrying of supplies. cleaning for the commanding officers of the ground forces. They besides played the functions of forced married womans to the group members and therefore the bulks were impregnated. Increasing HIV / AIDS rate The struggle of LRA has a great consequence on the kids due to intensifying incidences of premature sex. premature matrimonies. befoulments of great magnitudes. incidences of colza every bit good as sexual torment. In the extreme of these state of affairss the immature misss every bit good as adult females who are the victims of the abduction are made married womans to the Rebels. This has an deduction of exposure to HIV/AIDs. These immature adult females upon being rescued from the Rebels normally encounter hard life state of affairss taking to their engagement in harlotry. The same applies to those who have been displaced and fall back to populate in cantonments. This has besides contributed to intensifying instances of HIV/AIDs. This state of affairs is common ion the northern part of Uganda ( Gatwech 23-43 ) . Uganda has seen one of the most effectual national responses to the HIV/AIDS pandemic on the African continent. Harmonizing to the Uganda Aids Commission. so far. around 130. 000 Ugandans are infected with the HIV virus every twelvemonth. Over 1. 000. 000 ( one million ) citizens in the state of Uganda is the existent estimation existing with HIV. 520. 000 of them being adult females while 110. 000 of them are kids ( Gatwech 23-43 ) . The lives of the ex-child soldiers were distorted by the effects of the engagement in the activities of the group. It was hard for the kids to travel back to schools. Majority of the were in a state of affairs that they needed some more opportunities in order to restart to normal life. This is because to the bulk abduction took topographic point at a phase that was early in life. The immature soldiers greatly fear to take engagement in retaliation every bit good as a opportunity of credence. Majority of the citizens consider these childs to be slayers but the fact is that they are normally really good people ( Gatwech 23-43 ) . Decision and solutions In decision. to work out this internal struggle. the authorities is duty edge to carry on the development every bit good as the execution of the most comprehensive scheme turn toing issue of security. human-centered action every bit good as political action. The ground forces should be reformed every bit good as re-oriented which is merely accomplishable through the proviso of a way responsible for the dialogue and let for the passage of the state to greater democracy. The life of the immature kids who took portion in the struggle is at hazard and the duty of their rehabilitation falls on the authorities. Akallo. Grace. A ; Alford. Deann. â€Å"Survived Hell† Ignite Your Faith Vol. 65 Issue 8. p38-40 2007. Gatwech. Shame. â€Å"More victims of LRA Rebels revealed in South Sudan† Sudan Tribune p23-43. 2009. White. C. Todd. â€Å"Uganda† Country Report p1-6. 6p. 2007

Research Project Paper Example | Topics and Well Written Essays - 1000 words

Project - Research Paper Example Through the course of its contents this research project highlights areas in the hotel that need improvement and based on research, proposes solutions to said problem areas. Methodology This research project provides analysis of research material pertaining to the effective, strategic and efficient management of a hotel and includes a detailed stakeholder analysis by drawing on that research. Limits of Research The methodologies and strategies mentioned in this research project are generally applicable to any enterprise in the hospitality industry; however, some limitations may arise in very specific cases where a more customized approach may be necessary. Critical Analysis and Recommendations Hospitality and tourism are two of the world’s industries that are experiencing the most dynamic and rising growth levels. Combining the two industries are entrepreneurial ventures regarding hotels which become a bridge between the hospitality and tourism industries. Slattery (2002) talk s about how in this modern day and age the element of ‘hospitality’ has been lost from the hospitality industry due a more industrialized approach towards hospitality ventures. According to this paper, this element has been impaired by the industrialized commercial vision and to restore it we need to understand hospitality as a â€Å"social phenomenon involving relationships between people† and thus incorporate the â€Å"social factor† in the provision of services in any hospitality business. This research further goes on to say that to better understand hospitality we need to understand how it works in private settings, for example that of a nuclear family. Insight from this setting will make hospitality ventures better able to provide food, accommodation and other services. However, focus shouldn’t be limited to private settings for hospitality enterprises are after all business ventures and requires a very important commercial market interaction. The venture can be successful only if adequate attention is paid to all three domains. (Slattery, 1998). Further, the nature of hospitality is of crucial importance for hotels and their effective management. However, this aspect is mostly overlooked. To be more effective, management needs to factor in aspects of human behavior to better understand how to serve their clients in a more superior manner. (Brotherton and Wood, 2007). A feasibility study is also important and may take the developers months to collect the data that provides enough favorable economic argument to build a hotel. (Rutherford and O’Fallen, 2007). This is a very important step and must not be missed because future operational success builds on it. Another major concern in the modern world of globalization, expansion and technological progress is that businesses should be more concerned about ‘going green’ and not waste the earth’s resources that are available for their consumption, bu t devise ways through which these resources can be conserved. Hotels are a business in which the energy and resource consumption levels are high because they entertain a lot of people at one time. However due to their extensive consumption patterns they also have a higher responsibility to conserve resources and energy. Hotels, like other hospitality businesses are supposed to factor in sustainability and work to reduce their environmental footprint. Hotels that are conscious of this and appropriately address issues of

Zora Neale Hurston Article Example | Topics and Well Written Essays - 1750 words

Zora Neale Hurston - Article Example However, much of her work encountered criticism, as what endeavored to be ethnographic authenticity was construed as a perpetuation of black stereotypes made pliant for her white audiences. This combined with her controversial political affiliations in the 1940's led to a rejection of her work for some time. Rather than focus on a chronological review of her literary achievements, this paper will thematically consider portions of her corpus in terms of the various academic realms of analysis to which her work is now subject. Initially, some consideration will be given to the problematics of her presentation of "folk culture and folk language" and the degree those issues have traction in attempting to categorize the work of Hurston. Secondly, a de rigueur explication of how the issues of race and race relations were framed in her work will be given. Finally, the tropes of religion, religious imagery, and spirituality explicitly and implicitly play a significant role in her fiction and as such must be included in any literary analysis of her work. Though it is beyond the scope of this paper, one thematic element which operates consistently in her work is the role of women and her sensitivity to feminist concerns and issues of women's rights. Suffice it to say that many women in her novels and short stories play strong, consistent and even heroic roles and are often concern with other things than finding a husband or having children.

The implementation of electronic health record

The implementation of electronic health record Only 4 percent of U.S. doctors are using an electronic medical record system (EHR) because of a diverse range of barriers and perceptions involved with implementing an EHR system. The health care portion of the American Recovery and Reinvestment Act (ARRA) called Health Information Technology for Economic and Clinical Health or HITECH promotes the Meaningful Use of information technology in the form of EHR systems for every American by 2014 (Hoffman, 2009). Just having an EHR system is not enough; meaningful use means the system must improve the quality, efficiency, security, access, and communication in the delivery of health care among other functions. The United States government has provided $17 billion in available incentives to assist physicians and health care facilities implement certified EHR systems that meet Federal qualifications by the year 2014 (Blumenthal, 2009). This important health care issue affects everyone in this country because of the nature of private health i nformation. The U.S. government mandate for the implementation of electronic health records presents a wide variety of issues for and responses by physicians who want to retain their diversity relating to the way they practice medicine, while meeting the Meaningful Use requirements that will positively affect their investment and efficiency. Meaningful use depends on interoperability, which means that physicians systems will be able to communicate with each other for information exchange. Currently some physicians may have systems that are interoperable, but some may have invested in software that does not provide that function. Numerous vendors often market more than one type of system. Currently, estimates of physicians using a complete, fully functional EHR system are only at four percent (DesRoches, et al., 2008). This leaves the majority in need of researching software systems, purchasing, and implementing an EHR system to meet the Meaningful Use requirements. The practice of medicine is a highly individualized field where every physician has their own ways to provide for their patients. A general practitioner will have different software needs than a surgeon or obstetrician. An issue the physicians have to address is that they have to choose a certified EHR system that will provide the functions they need for their particular practice of medicine. Many physicians are starting with a basic system and customizing it to fit their practice needs (Baron, et al, 2005). HITECH will need to certify systems that provide functions that the physicians require with enough flexibility to meet the diverse needs of every type of practice. Some EHR systems are designed for primary care practices or large hospitals and may not meet the needs of a specialist. Physicians will have to choose a certified system that will have the required functions as well as those his practice will require. Whichever system a physician chooses will require training in order to benefit from the functions the software can provide. A basic knowledge of computer use is a skill many physicians do not even have. In fact, some physicians have technophobia when it comes to computers in their practice (Hayes, 2009). Statistics have shown that younger physicians are more apt to have a positive outlook on the EHR systems. Younger physicians also appear to have earlier adoption of an EHR system because of their prior exposure to computers. In-depth training to learn the functions and processes of the system are necessary to prevent severe disruptions in the workflow of the office. Many offices will train a few employees to be Super Users to be a resource for others in the office who have had less training. Super Users will be able to adjust the work processes when needed. Some physicians offices close for a period of days to bring the system online and prepare the office for going live. The diversi ty in computer abilities and comfort levels will affect the complexity, price, and amount of training required for each physician and his office staff for the chosen system. Cost is the biggest issue in the adoption of EHR systems. Cost estimates are between $12,000 and $24,000 to implement a fully functional EHR system (Baron, 2005). The equipment, software, training and one year of support can cost $140,000 or more (Baron, 2005). The HITECH incentives will cover some, but not all the cost of the conversion from paper to electronic records. Incentive payments can total $18,000 in the first year, for physicians implementing in 2011 and 2012 and will continue for 5 years at reducing amounts. The available incentive amounts will decline each year and end completely in 2016. In other words, physicians who adopt in 2011 could collect $44,000 over the five-year period while physicians who adopt in 2013 would receive $27,000 in incentive payments over 3 years (Blumenthal, 2009). The incentives will provide more funding for physicians that implement early. Surveys indicate that the incentives are a facilitator for approximately 55 percent of physicians who see the incentives as a reason to make the transition now, and receive maximum financial benefit (Blumenthal, 2009). The diversity in size of practices will affect how the physicians perceive capital costs. Due to the diversity in the types and ways physicians practice, issues that need to be considered and addressed, and the many solutions available, physicians attitudes and opinions on EHRs and Meaningful Use vary from very enthusiastic to resentful and wary. Studies have shown that physicians who have already adopted an EHR system are generally satisfied with their system and the benefits it provides. However, although the physicians will be the ones assuming approximately 89 percent of the cost of the system, they will not receive much of a return on their investment (Hoffman, 2009). The insurance companies will save money on reduced testing, streamlined billing, and overall efficiency. The government will save money on the same things as well as have a medium for monitoring fraud. Physicians will save some money on record storage, employee salaries previously paid for filing and transcribing records, and paper office supplies, but in comparison to the cost of the system, savings ar e minimal. Physician concern over return on investment is 50 percent for physicians who do not have an electronic system but only 33 percent for physicians who are already using an electronic system (DesRoches, 2008). The results may reflect Medicare and Medicaid patient numbers, size of the physician practice or perhaps the diverse perceptions physicians have over the dollar value versus the benefits to their actual income. Seemingly, the biggest numbers of implementers are the larger practices who are often better able to absorb the large investment than a small practice or single physician office. Statistics show that large primary care practices are more apt to implement EHR systems than other types of practices. These large group practices of fifty or more physicians were four times more likely to have a fully functional system than with physicians in practices of three or less physicians (DesRoches, 2008). The increased cash flow from a large practice makes the large capital expense less detrimental to the practice. This diversity in the size of physician practices is a significant basis for EHR implementation. EHR implementation itself will not provide for full Medicare and Medicaid reimbursement. In order for a physician to receive full reimbursement from Medicare and Medicaid, an EHR system must meet the Meaningful Use requirements. Physicians who do not have an EHR system that meets the meaningful use requirements will see penalties in the form of reduced Medicare payments. The reduction of payments will start at one percent in 2015, increase to two percent in 2016, and increase again to three percent in 2017 (Blumenthal, 2009). Physicians with large amounts of Medicare and Medicaid patients will have a significant reason to implement a system that meets the Meaningful Use guidelines. This issue will not affect all physician practices and some physicians do not feel it is a significant impediment to their practice income to warrant the large expense involved with implementing an EHR system. The diversity in the types of patients a physician or practice routinely cares for will have an e ffect on their financial return and willingness to implement an EHR system. For those who may not see a financial return there are many other benefits to adopting an EHR system for patients, insurance companies, and the government, and to some degree physicians. One benefit for physicians is a more efficient and streamlined insurance claims process, which will aid in cash flow. Physicians will also be better able to provide for their patients because the patient record will be able to go where the patient goes, including to hospitals and specialists, resulting in better coordination of the patients care. The EHR will provide a reduction in clinical errors because of the ability of the EHR to provide clinical decision support and monitor medication dosing and contraindications, and allergies. However, a group of physicians feel that this is questioning their judgment and do not want the interference in the way they practice medicine. Of physicians who are using a fully functional EHR system 86 percent appreciate the avoidance of medication error function that their system provides. The diversity in the physicians response to clinical decision support may be due to age of the physician, the number of years he or she has been in practice or any number of reasons including the personality of the physician. Along with those benefits, there is disruption of the office workflow. This is a significant cause for physician concern (DesRoches, 2009). The learning curve for an EHR system slows down all the processes in the office. Some physicians are better able to deal with the chaos that ensues while converting to an electronic system. Everyone within the practice has to relearn his or her job processes. All the office procedures of the practice have to be redesigned to work with the EHR system and the practice requirements. There is a period even after implementation of changes and adjustments that must be made to customize the system to the practice. Physician practices have reduced their patient load as much as fifty percent during implementation to try to reduce the waiting time for patients (Braon, et al., 2005). This essentially means a reduction in revenues until everyone can perform their jobs smoothly and handle the normal patient load again. Estimates are anywhere from four to six months before normal patient load is fully resumed. Physicians have reported losing patients because the wait time to see the physician was too long during the early stages of implementation (Baron, 2005). This is a major barrier for 41 percent of physicians in making the switch to electronic records (DesRoches, 2008). Physicians are very busy by nature and a slowdown in the office creates a diverse level of frustration that has caused some physicians to put off implementation or even to reverse the work already done in adopting an EHR system and return to their paper system. Those who do make the switch from paper to electronic records will have to consider HIPAA requirements for security of an EHR system. EHR systems require the secure storage of EHRs, which contain patients private health information and interoperability requires secure access to patient EHRs. Some physicians will choose to be on an encrypted network to share information with their local hospital, laboratories, and other health care providers. A verification process will be required to allow authorized physicians access to patients private health information and to deny access to unauthorized persons. Security of patient records is a concern for many physicians. Some physicians feel this is something that needs more regulation before they will expose their patients to the risk of a breach. The diversity in the EHR systems in operation now creates issues for secured patient PHI with system interoperability. With all the diversity involved in implementing an EHR system, physicians perceive the challenges of the U.S. government mandate for the implementation of electronic health records in different ways. Some feel there are too many barriers to address before implementation of an EHR and others feel the benefits outweigh the barriers. There are as many opinions on the issues of switching to an EHR system as there are physicians themselves. Addressing issues such as cost, security, training without a major loss in cash flow, which stems from disruption to the workflow of the office, will all stress the doctor patient relationship at least for a time. This is important because it will effect how and when the physicians adopt and use the nationwide system. The diversity in the way physicians practice medicine is individualized and the approved EHR systems will have to be flexible enough to allow for that individuality. The one thing all physicians want is to practice medicine they way they always have and meet the required mandate for Meaningful Use so they may recoup some of their investment. References Baron, R. J., Fabens, E. L., Schiffman, M., Wolf, E. (2005, August 2). Electronic health records: Just around the corner? Or over the cliff? Annals of Internal Medicine, 143(3), 222-226. Retrieved from http://search.ebscohost.com/.aspx?direct=truedb=a9hAN=17875478site= ehost-live This article is written by physicians in a 4-internist practice describing the processes involved with converting from traditional paper medical records to electronic medical records. Baron and colleagues address the problems and issues involved, and how they worked through them. Some topics of interest include both planned and unexpected finances, training, workflow and accommodations and the overall office environment. The article describes the realized benefits and lacking areas of standardization and interoperability. I chose this source for its overall description of actual process of implementing an electronic records system. This article also addresses computer skills and requirements. Blumenthal, D. (2009, April 9). Stimulating the adoption of health information technology. New England Journal of Medicine, 360(15), 1477-1479. doi:10.1056/ This article describes the portions of the American Recovery and Reinvestment Act of 2009 (ARRA) that pertains to health information technology. The article addresses barriers physicians have for implementing the mandated electronic medical record. Financial issues including incentives, costs and financial penalties are of adopting the mandate are covered. Other areas to promote and ease the transition, such as support systems, state and regional medical information exchanges, education initiatives, and extended HIPAA guidelines with regard to electronic records and transmissions are included in this article. This article explains the incentives for implementing the electronic records system. I chose this article to explain the diversity involved in the governments promotion for adopting an electronic health record system. DesRoches, C. M., Campbell, E. G., Rao, S. R., Karen, D., Timothy, F. G., Jha, A., . . . Blumenthal, D. (2008, July 3). Electronic records in ambulatory care: A national survey of physicians. New England Journal of Medicine, 359(1), 50-60. doi:10.1056/ This article is a summary of statistics and results compiled from a survey of physicians in the US regarding the adoption of electronic health records. Documented in the survey are physician statistics and opinions in areas of usage, implementation, and satisfaction with the electronic health record systems. Issues addressed are quality of care, age groups of physicians who have adopted an electronic system and size of practices more apt to adopt electronic health records. The positive effects on practice processes, barriers that hinder adoption of electronic health records, incentives for and reservations with switching to electronic health records are included in the survey. I chose this source because it provides actual statistics of the usage of electronic health record systems as well as the diversity in physicians perceptions of the process, the systems, the benefits, and problems associated with compliance. Hayes, F. (2009, February 2). No Rx for ROI. Computer World, 43(5), 40. Retrieved from http://search.ebscohost.com/.aspx?direct=truedb=a9hAN=36487540site=ehost-live In this article, the senior news columnist addresses the issue of return on investment (ROI) for the adoption of electronic health records. The definition of ROI is given and how it applies to aspects of electronic health record adoption for physicians and hospitals is examined. Risks to, benefits of, and improvements needed regarding electronic health records are noted. The author confirms that those assuming the expenses for electronic health records will not be the ones reaping the benefits. I chose this article because it covers reflects my opinion one of the most important reasons for physician resistance to implementing the government mandated electronic health record system. Hoffmann, L. (2009, November). Implementing electronic medical records. Communications of the ACM, 52(11), 18-20. Retrieved from http://search.ebscohost.com/.aspx?direct=truedb=a9hAN=45021143site=ehost-live In this article, a basic history of George W. Bushs goals for every American to have an electronic health record is presented along with the progress of the government in making those goals real. Usage of electronic records is briefly mentioned. The article focuses on some major barriers and concerns of physicians for implementation and usage. The article also addresses some of the positive aspects for electronic health records. I chose this article because it provides concise overall answers to who, what, when, where, and why answers to the implementation of the electronic health record and health information technology.