American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Apr 2001
ReviewThe moral foundation of medical leadership: the professional virtues of the physician as fiduciary of the patient.
Leadership in medicine, as in other settings, should be based on values that provide appropriate direction for the use of institutional power and authority. Leadership also requires managerial competence. Managerial knowledge and skills can be used for worthy and unworthy goals and therefore require a moral foundation. ⋯ We then identify four vices--unwarranted bias, primacy of self-interest, hard-heartedness, and corruption--that undermine this moral culture of professionalism. Because health care organizations now play a central role in patient care, their moral culture and therefore physician-leaders have become vital elements in physicians being able to maintain their professionalism. Physician-leaders bear major responsibility to shape organizational cultures that support the fiduciary professionalism of physicians.
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Am. J. Obstet. Gynecol. · Apr 2001
Comparative StudyPostpartum sexual functioning and its relationship to perineal trauma: a retrospective cohort study of primiparous women.
Our goal was to evaluate the relationship between obstetric perineal trauma and postpartum sexual functioning. ⋯ Women whose infants were delivered over an intact perineum reported the best outcomes overall, whereas perineal trauma and the use of obstetric instrumentation were factors related to the frequency or severity of postpartum dyspareunia, indicating that it is important to minimize the extent of perineal damage incurred during childbirth.