Medical clinics are increasingly diversifying into various related services. We analyze the effects of different forms of diversification on profitability while controlling for other attributes that may have potential influence. Our findings from the two perspectives of operating profit ratio and loss avoidance reveal that diversification that involves the provision of concrete goods or services exerts a negative effect on clinic profitability compared to diversification that simply provides planning and support for the substance and method of the offering. In particular, four types of diversification (i.e. a combination of care-giving and residential services, three-way combination of care-giving and residential services and consultation support services, a combination of daycare services and residential services, and four-way combination) showed particularly poor performance in both operating profitability ratio and loss avoidance. However, we also find that the scale of the hospital, in terms of either assets or revenue, had a stronger influence on profitability than the types of diversification strategies mentioned above. Our results also suggest that there are numerous other variables with potential influence on profitability that were not incorporated into this study.

Despite the importance of the concept of patient orientation in healthcare organizations, there are very few empirical studies on the topic and no studies on the relationship between patient orientation and job satisfaction or organizational commitment. The present study is an empirical research that seeks to explore the relationship between patient orientation, job satisfaction, and organizational commitment in registered pharmacies. We administered an online survey to 400 pharmacists, measuring various composition concepts based on approaches employed in prior research, using structural equation modeling to assess structural effects. The results demonstrated that individual patient orientation affected organizational patient orientation, mainly through job satisfaction. In addition, in terms of organizational commitment, job satisfaction is found to exert an extremely strong effect in comparison with organization-wide customer orientation. Furthermore, minor deviations between individual and organizational patient orientations directly affect organizational commitment positively, whereas interpersonal relationships have an indirect and positive influence through the medium of job satisfaction.

The paper aims to reveal the reflections made by nurse managers after attending a second-level training program for nurse managers certified by the Prefectural Nursing Association in terms of how they would apply their learning in practice. Thirteen nurse managers were asked to compose reflection papers to reflect upon what they had learnt during the training program and their personal experiences in terms of applying their learnings practically. This reflection was conducted six times after the nurse managers completed their second-level training in each subject. A total of 61 papers were gathered and a qualitative narrative analysis was performed identifying 3 emergent categories: key learning points from the training and their applicability, difficulty in applying learnings to actual practice, and personal failures in the practice of nursing management. The nurse managers shared their thoughts and perceptions about the applicability of what they had learned in the courses to actual practice. However, there were some contents introduced in the training course that they were unable to fully grasp and found difficult to apply practically.