Applying I-O to Medicine: Making the Case That It Can Be Done and Should Be Done
Michele L. Ehler
The Dow Chemical Company
Debra A. Major and Thomas D. Fletcher
Old Dominion University
Enhancing the visibility of the I-O psychology profession is a major SIOP initiative. According to former SIOP President,
Ann Marie Ryan (2002), To make our field more visible and to continue its vitality, we need the involvement and perspective of individuals with different backgrounds and careers (p. 10). We also need to demonstrate our value in addressing issues of societal significance. One arena historically not entered into by I-O psychologists is the medical
field.1 Corporations hire I-O psychologists to do many things because we have proven the value of our skills. The same value can be brought to the medical field, yet there are very few I-O psychologists working in health care settings.
1The focuses of this paper are medicine, the medical field, and medical settings. Issues more broadly related to health and well-being (e.g., occupational health psychology) are not covered, since I-O psychology is relatively more visible within that arena.
Our interest in this topic is largely intrinsic. Each of us has a personal and/or professional interest in issues related to medicine. Moreover, weve each witnessed first hand the impact I-O can have in the medical field. To explore the links between I-O and medicine beyond our own experiences, we engaged in several activities. For instance, we reviewed the SIOP program for the last 5 years looking for sessions and papers related to medicine. We also searched the published literature, seeking out papers that have made such contributions to medicine in the areas traditionally covered by I-O psychologists. Then, we interviewed some of the conference contributors and authors identified as SIOP members, including
Arthur Bedeian, Dawn Riddle, Alan Saks, and Joann Speer Sorra. These interviews were useful in helping to emphasize the what and why of I-O contributions to medicine.
What Can I-O Contribute to the Medical Field?
- High quality social science research skills
- Expertise in workplace issues that are critical to the functioning of medical organizations
Hospitals have real human resource issues that need to be addressed through research. By and large, hospitals do not employ social science researchers or organizational scientists. There are some attempts by hospitals to do self-study in order to try and help themselves, but they frequently lack the right tools. Medical doctors do not have experience researching human resource and social science issues, rather their skills are in medical research. The methodologies may be similar, but in application, there are many differences.
For example, many hospitals engage in employee surveys, organizational development, and training without the aid of someone trained in these practices, such as an I-O psychologist. As health care professionals they are well versed in the scientific method but have no grounding in organizational theories and workplace intervention. In this respect, I-O psychologists are ideally equipped to contribute in much the same way that they are able to assist business organizations.
I-O psychologists are also experts in topics of substantial relevance to medical settings. Stress and burnout, for instance, are prevalent among medical personnel. The national nursing shortage has focused attention on the recruitment and retention of nursing professionals (U.S. Department of Health and Human Services, 2003). High-profile mishaps and more stringent government regulations have heightened interest in improving safety climate in medical settings (Agency for Healthcare Research and Quality, 2003). The medical community is eager to learn about strategies for confronting endemic problems, such as these. This creates the opportunity for I-O psychologists to develop research partnerships in medicine that have the potential to address significant applied problems and to contribute to organizational science. Alan Saks, for example, has helped hospitals address human resource issues in exchange for the opportunity to collect data to address research questions. He notes that hospitals are particularly open to such partnerships because budget constraints often prevent them from hiring external consultants to do such work. In Alans experience, the benefit has been mutual. The acquired data were ultimately publishable, and the hospital received an intervention that it would not have been able to afford otherwise.
The challenge is that much like the general public, the medical community is not necessarily aware of I-O psychology. Dawn Riddle, a visiting assistant professor at University of South Florida who has recently finished a 2-year stint as Project Director of a NIH/NCI funded
grant2 in the Department of Interdisciplinary Oncology (and Moffitt Cancer Center & Research Institute), told us that the medical industry recognizes the need for what we [I-O psychologists] have to offer, but unfortunately does not know we are out there with the expertise to do the job. However, in her experience and in the experience of the authors, medical professionals are particularly receptive to working with I-O psychologists because they can appreciate the science that underlies our field.
2Principal investigator, Teri Albrecht; The PI and grant has moved to Wayne State University (and Karmanos Cancer Institute) in Michigan.
Although not medical scientists, I-Os are clearly scientists, and health care professionals can relate to us on that level. Although I-Os lack of visibility can be a hurdle to making inroads into medicine, overcoming that barrier in the medical community may increase I-Os visibility more generally. Given the social significance of medicine and the general publics interest in it, an association with medicine is likely to enhance awareness of I-O.
Why Should I-O Psychologists Become More Involved
in the Medical Field?
- Opportunity to increase the visibility of the field in a meaningful way
- Medical settings are an ideal venue for studying particular phenomena of interest to I-O psychologists
- Stimulation of multidisciplinary research
- Access to resources otherwise not available (e.g., certain types of grant funding)
- Caveats: Not for everyone; there needs to be a sincere interest; may be unwise for junior faculty
There are a wide variety of entry points to working in the medical field as an I-O psychologist. Dawn Riddle took her position shortly after completing graduate school and is working in the medical field early in her career. Her work at Moffitt brought her into contact with physicians and patients. Although her position made more use of her basic research skills than her
I-O content knowledge initially, opportunities to apply I-O content began to emerge as she demonstrated her value as a research scientist.
Medical settings are ideal venues for studying important I-O topics, both classic (e.g., recruitment, selection, performance appraisal, stress, burnout) and more current topics (e.g., emotional labor, safety climate, and culture). While there are challenges, Dawn stated the medical field is ripe for our work as I-O psychologists.
Joann Speer Sorra is a senior study director at Westat, a consulting firm. Joann works with clients in the medical field and has direct contact with physicians and hospitals. Like Dawn, she too has found that medical professionals most readily appreciate I-O psychologists training in statistics and research methods. She has found that once she establishes credibility on that basis, her medical colleagues are more receptive to her I-O content expertise. Asked about her intentions about continuing to pursue work in the medical field as an I-O psychologist, Joann stated, I would be happy to spend the next 10 years doing research in medical settings. Theres enough to do!
On the whole, there is more research funding available in the medical field than in the social sciences. For example, just a cursory examination of the budgets for two federal funding agencies shows that the budget for the National Institutes of Health is about five times larger than the budget for the National Science Foundation. In addition, individual project grants are typically substantially larger in medicine than in the social sciences. Through collaborations with the medical field, I-O psychologists are able to tap into sources of research funding that might not otherwise be available to them (e.g., National Institute of Mental Health, National Institute of Health, World Health Organization).
Another benefit is the ability to publish research conducted in medical settings in I-O and organizational behavior journals. For instance, the interdisciplinary nature of Dawns work provides her with opportunities to publish in both medical journals and I-O journals; the material can be framed appropriately for both. Alan Saks has absolutely not had difficulty publishing research conducted in medical settings in I-O and OB journals. With regard to work he has conducted in medical settings, Arthur Bedeian told us that, To date, Ive encountered no barriers in presenting or publishing my research.
Caveats
While the reasons why I-O psychologists should work in medical settings are many, there are likewise a number of caveats. Namely, hospitals can be a difficult research setting, there exist multidisciplinary challenges, and publishing outlets may be restrictive for advancing early academic careers.
A hospital is not an easy place to do research, stated Alan Saks. You cannot randomly assign units or shifts to different conditions. Many health care professionals are overworked and underpaid with no time to participate in interventions or fill out surveys. Despite these organizational challenges, and sometimes because of them, hospitals are a good venue for researching many topics (e.g., shift work). In addition, issues that are straightforward and taken for granted in other organizational settings can be more complex in a medical setting. For instance, lets say you want to survey employees to better understand a hospitals culture. It turns out that how you define employee is of paramount importance. Namely because physicians, who have a tremendous impact on hospital culture, are not actually employed by the hospital and do not consider themselves employees.
Despite some of the inherent challenges, the medical field provides opportunities to do stimulating multidisciplinary work that has a high degree of task significance and societal impact. As Joann told us,
We can have a huge impact. We understand culture, communication, and interaction between policy, practice, and culture. I-O has a lot to say about the human side of affecting change. There is also a societal impact resulting in fewer adverse impacts on patient health.
That being said, any multidisciplinary collaboration can be difficult and time consuming. For instance, it requires extra work to learn the jargon of different disciplines and understand their priorities. The challenges can be exacerbated to the extent that the multidisciplinary team attempting to collaborate is geographically dispersed. Although the challenges may be great, there is the potential for the payoffs to be even greater.
As Dawn stated, There are opportunities for individual I-O psychologists and the field of I-O as a whole in medicine. There could be great visibility for I-O. The work is necessarily multidisciplinary and very complex. To be successful, there must be some intrinsic interest in both the medical field and in collaborating with another discipline outside I-O. Dawns new position in the Perceptual Robotics Laboratory in the College of Engineering at USF illustrates this to an even greater extent. Currently Dawn is funded by a DARPA
grant3 examining team issues surrounding emergency medical personnel, urban search and rescue robots, robot operators, and other search and rescue workers.
3 DARPA is the U.S. militarys Defense Advanced Research Projects Agency; Principal Investigator, Robin Murphy.
Any type of multidisciplinary work can be stimulating, but it also has the potential to lure I-O psychologists too far afield. (See Ann Marie Ryans Presidential Address, published in this issue of TIP, regarding the importance of professional identity.) For instance, doing work in the medical field often affords the opportunity to publish in medical journals. Yet, for a junior academician seeking tenure, such publications may not carry adequate weight. Unfortunately, the reward structure of academia does not necessarily encourage or support multidisciplinary work. For tenure and promotion purposes, a programmatic line of research within the I-O discipline is likely to be viewed more favorably than a program of research that demonstrates the value of I-O to the medical field.
Conclusion
Increasing the visibility of our profession is a major priority for SIOP. By working in the medical field we can meet this goal as well as impact the health of our communities. Further, health care settings are but another venue to ply our wares. For organizational researchers, hospitals offer a challenging environment to test and apply theory. Like many organizations, real problems such as recruitment, retention, and performance assessment are readily apparent in medical settings. What I-O topics might you be interested in researching in the medical setting? Talk to other I-O psychologists, hear about their experiences working in the medical field, and notice how many journal articles use a medical setting as a population. Some would see the challenges (e.g., multidisciplinary research and difficult research settings) of research in health care as stimulating, and that could be overcome with creativity and perseverance. The rewards far outweigh the limitations in the mutually beneficial relationship of I-O psychologist and medical community.
References
Ryan, A. M. (2002). A message from your President. The Industrial-Organizational Psychologist,
40(2), 710.
U.S. Department of Health and Human Services. Retrieved April 24, 2003 from
http://www.bhpr.hrsa.gov/nursing/.
Medical Errors: The Scope of the Problem. Fact sheet, Publication No. AHRQ 00-P037. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved April 24, 2003 from
http://www.ahrq.gov/qual/errback.htm.
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