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C H A P T E R

1 An Overview of

Human Resources Chapter Objectives

After reading this chapter, readers will be able to:

• Understand the history of human resources in healthcare organiza- tions, as it originated from a few scattered tasks to a centralized activity, assuming additional necessary responsibilities as they arose.

• Appreciate the rationale for having a human resources department. • Describe or formulate the mission of a human resources department

or area in a healthcare organization.

■ CHAPTER SUMMARY

The human resources department provides vital services to any organiza- tion, including healthcare providers. The origin of most contemporary human resources departments was an overworked administrator who struggled to hire a sufficient number of employees to maintain normal operations. Organizational growth and expansion of the services that were being provided far exceeded the original administrator’s ability to hire employees. Delegating this task created a personnel office. Compensation issues were soon delegated to personnel. As legal requirements were im- posed, the size and complexity of the personnel office increased. The name of the department became Human Resources. Formal college-level training programs for people wanting to spend their careers working in human resources have been developed in recent decades. Contemporary human resource professionals continue to struggle for equal status within the ranks of an organization. The process of change is ongoing and is expected to continue in the future.

As previously mentioned, a human resources (HR) department provides essential services for any contemporary organization. Detractors claim that an HR department does not generate revenue. While this statement

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is true for direct monetary inputs, HR does make significant indirect con- tributions by ensuring that an organization does not violate reporting and other requirements imposed by the federal government. Here we open the dialogue on human resources and its operation.

Case Study: Mrs. Jackson’s Dilemma

In 1930, a hospital located in a prosperous town was growing along with its community. Mrs. Clara Jackson was effectively the administrator of the hos- pital, although it is doubtful that the title administrator was applied. Hospital administration had yet to emerge as a specialized field of study and a profes- sion in its own right. This hospital had started as many others had begun, as a private clinic owned by physicians who eventually turned their operation over to a community board that would convert it to a not-for-profit institution.

In 1930, few professions were represented in a typical hospital. There were physicians, most of whom were in private practice and admitted some of their patients to the hospital. A pharmacist might have been in attendance at least part of the time, as well as a few others working in oc- cupations that later developed into the health professions known today. The dominant occupation in a hospital of that time by far was nursing. Nurses originally provided nearly all of the services required by patients. Because nurses composed the majority of the staff and the persons who were in the hospital all the time, it was natural for a senior nurse, in this case Mrs. Clara Jackson, to oversee the operation of the facility.

Growth was accompanied by the emergence of people assigned to per- form specialized tasks and activities such as housekeeping and food service. Despite their presence, Mrs. Jackson remained the principal manager in the hospital. Her administrative responsibilities, however, cut into the time she could spend where she felt she belonged, which was involved in the nursing issues of patient care. The task that especially consumed much of her time was hiring employees. Even though she was able to delegate the hiring of non-nursing personnel to other group supervisors, Mrs. Jackson was often swamped with activities related to hiring nurses. She felt trapped. If she concentrated on nursing, where she believed she belonged, jobs went unfilled and conditions worsened. If she gave her full attention to hiring nurses, however, she had inadequate time available for her professional nursing responsibilities. Her dilemma intensified when the hospital’s sole bookkeeper and paymaster began to complain of having too much work to perform for a single person in keeping up with staff additions and departures. What options were open to Mrs. Jackson in 1930? What op- tions would be available to her today? What other issues or requirements did Mrs. Jackson have to think about in 1930? With what other issues, requirements, or regulations would a contemporary hospital have to cope?

2 CHAPTER 1 AN OVERVIEW OF HUMAN RESOURCES

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■ AN EVOLVING DEPARTMENT

Common Origins Many people refer to various activities when discussing the duties and responsibilities of a human resources department within a larger organiza- tion. Persons with specialized training in human resources often refer to the same activities but use the name function when referring to the duties and responsibilities. The word function is sometimes applied to an entire human resources group or organization. Using that nomenclature, a hu- man resources department becomes synonymous with a human resources function. In this text, we have tried to avoid using the term function. We raise the issue at this early stage so that readers will not be surprised when encountering a reference to a human resource function. Throughout this text we will use the interchangeable terms human resources and HR.

The human resources department, or office, of today originated and developed in the same manner as other areas of a health care or any other kind of organization. That is, beginning from what now are considered to be a set of fairly narrowly defined responsibilities, human resources originated and grew in the same manner as finance, purchasing, and other organizational areas. Bits and pieces of necessary work that have some characteristics in common tend to be bundled or gathered together. This occurs partly because they are related to each other and partly because their common tasks suggest the need for specialized skills and expertise. For example, the finance department evolved as activities that involve money, such as paying salaries, paying bills, receiving payments, maintain- ing bank accounts, and handling investments became collected and central- ized. Activities that might once have been known as accounting, keeping track of money and reporting on its movements, and payroll, dispensing compensation to workers, were bundled under this broader heading of finance, the name ultimately given to the overall managing of money.

Before the term human resources emerged, the bundled organizational activities related to people were called personnel. In what is likely a minor- ity of organizations, this activity still remains known as personnel today. In some organizations, as the activities related to people have evolved and expanded, the change in nomenclature from personnel to human resources has indicated real changes in overall scope and direction. However, in many organizations, the change from personnel to human resources occurred in name only, with the activities continuing unchanged in depth or breadth; the more preferred title is being used, but the scope of activities has not changed.

Development of the Employment Office Before personnel offices existed, there was an employment office. Before the emergence of a formal employment office, managers like Mrs. Jackson of the opening case study did their own hiring. In many instances, organizations

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were extremely small by contemporary standards, and the proprietor or most senior worker was often the sole manager. As businesses grew and the manager or managers became busier, however, they acquired help. The first assistance was clerical in nature: a person to assist with hiring.

The employment office came into being in such organizations because of the growth and accumulation of tasks related to hiring. When a sufficient number of these tasks emerged, it made sense to concentrate them into a single department. One of the reasons for bringing these tasks together in one place was to relieve proprietors and managers of the growing burden of work that did not generate revenue. Personnel work is essential but actually does little to produce an organization’s products or services. The two primary benefits of establishing an employment office included free- ing managers from the necessity of personally having to find workers and being able to establish consistency in hiring practices.

Initially, two significant activities pertained to employees and their needs. Workers had to be hired, and they had to be paid. Before these employee- related activities became centralized, they were ordinarily accomplished by proprietors or their designees. In some instances, the task of compensating employees became centralized before hiring. Many proprietors established the position of paymaster. In many organizations, the activities of the pay- master were merged into the newly established employment office. In this way, the new area became known as the employment office. The two pri- mary activities became known generally as “employment” and “payroll.”

The responsibilities of employment and payroll grew in scope and com- plexity as organizations were affected by legislation at all levels of their operations. With the introduction of wage-and-hour laws by state and federal governments and the advent of income tax and Social Security with their requirements for employers to withhold monies from employees, those who hired and paid employees acquired more and more tasks to perform within a business. These new tasks were in addition to complying with the requirements of other government agencies.

In a few organizations, payroll remains part of human resources to this day. In most organizations of appreciable size, payroll has long been a sub- function of finance. The qualification “of appreciable size” acknowledges the practice by many smaller organizations of having the payroll activities provided by an outside vendor; this is an example of outsourcing. In such cases, the human resources office often retains responsibility for transmit- ting necessary information to the payroll service.

Tasks were added to the employment office as needs arose. These addi- tions had one significant dimension in common: all were related to workers and the process of finding qualified people, hiring them, and maintaining them as employees. The employment office finally reached a point at which it encompassed much more than simply employment (and often payroll). Its name became less and less of an accurate descriptor of the department’s activities and responsibilities.

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Over time, the employment office began to be known as the personnel department. The title “Personnel Department” was considered to be a far more accurate description of the department’s activities. All in all, the word personnel essentially referred to people. All of the responsibilities of a personnel department revolved around an organization’s people.

The Expanding Personnel Department Other forces emerged and new external requirements were imposed. Employers began to offer forms of compensation in addition to wages. Some began to offer these on their own, while others were spurred by unions. However, most instituted them as a result of competitive forces. These added forms of compensation came to be called fringe benefits. They imposed additional responsibilities on an organization. People to support the new tasks had to be placed somewhere in the organization. Because they related to employees and their family members—that is, to people—the personnel department was a natural location for them.

In the economic boom that followed World War II, health insurance programs became part of many organizations’ benefit packages or ben- efits offerings. Government mandates such as Workmen’s Compensation (later changed to Workers’ Compensation in the 1960s) entered the pic- ture as statutory benefits. Statutory benefits are those that an employer is required by law to provide. These include the employer’s share of Social Security taxes per the Social Security Act of 1935, participation in Workers’ Compensation, and often state-mandated, short-term disability insurance programs. During this time, retirement programs also proliferated, provid- ing more work for personnel.

A major piece of government legislation that caused a great deal of work for some organizations was the National Labor Relations Act of 1935, also known as the Wagner Act. This act provided legal protection to labor unions and made the task of organizing workers considerably easier for unions than it had been. It created a great deal of people-related work for organizations that became subject to union organizing efforts. Once one or more unions were established, their interactions with the employer had to be organized so that business could continue. Some union-related activities, such as running an antiorganizing campaign, conducting negotiations, or administering a contract, were occasionally taken on by line managers. In many organizations, these new activities fell to those who were already in the people business. In contemporary organizations that have unionized employees, an organizational entity known as labor relations may exist on its own or as a subsidiary operation within human resources.

Prior to the early 1960s, a typical personnel department was respon- sible for most activities related to employment, record keeping related to employees, some degree of compensation and benefits administration, and possibly labor relations. Over the years leading up to the early 1960s, personnel departments developed an image of a staff or service group that

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ran an employment office, kept records, and generally pushed paper. In the early 1960s, however, the importance of the personnel department began to expand. In 1964, personnel departments were required to adopt significantly expanded and increasingly more important roles. The pivotal event in dramatically changing the activities of the personnel department was passage of the Civil Rights Act of 1964.

Beginning in 1964, the work of the personnel department became in- creasingly more complex, and the level of responsibility involved signifi- cantly increased. Practitioners working in the personnel office required more significant knowledge. Specialized education began to develop, and personnel began to grow as a specific professional field. The title of human resources came into being but did not immediately enjoy widespread usage.

Even as personnel work grew more complex, more requirements were im- posed on the operation. More and different kinds of problems emerged, and additional but different varieties of work had to be performed. The former image of the personnel department as a group of people who recruited em- ployees, kept files, and pushed paper continued to prevail. In many instances, this older image was reinforced by personnel practitioners who, after two or more decades in the field, were overwhelmed by the tide of change. Their knowledge fell well behind the times and quickly became obsolete.

In academia, personnel administration became a specialized educational field, joining labor relations in becoming a formal field of study. Several new subdisciplines such as compensation analysis, benefits administration, em- ployee testing, and selection began to emerge. In the mid-1970s, the person- nel department became responsible for interacting with a variety of external agencies and special-interest groups involved in issues such as Affirmative Action, Equal Employment Opportunity, worker safety, and social responsi- bility. Many new professionals came from the field of industrial psychology. Others came from programs in management or administration.

Problems with the Term Personnel : Real and Perceived Most of the personnel practitioners of the mid-1900s, from approximately 1945 to 1965, lacked education that specifically prepared them to enter the field of personnel in general or for their specific jobs in particular. When the great majority of these practitioners received their education, most formal training in personnel administration consisted of one or two courses included in other programs of study.

Healthcare organizations, especially hospitals, were once seen as funda- mentally low-pressure environments that offered an escape for individuals who had at times been described as industry dropouts. Many administra- tors, directors of finance, personnel managers, and others came to work in hospitals from businesses and industries in mid-career. Some person- nel managers, for example, left manufacturing and industrial positions for hospital jobs as an escape from union involvement. Their previous

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experiences in healthcare working environments were extremely limited. A strong attraction for making such a career change was to escape from unions, which, at the time, were not common in healthcare organizations.

Many of the problems associated with the image of personnel depart- ments and encountered by individual workers were surely due to the perfor- mance and behavior of senior personnel practitioners of the time. The lack of educational training contributed to the antipersonnel bias occasionally encountered. As the field became more complex and the pressures of the 1960s and 1970s from increasing union presence, mounting financial pres- sure, and the government’s entry into health care via Medicare, Medicaid, and state regulations continued to mount, many of these persons found themselves in situations that far exceeded their training or experience.

Many people who spend their entire working lives in one particular job or working environment do not readily adapt to change. Some of the practi- tioners who entered healthcare personnel work between 1945 and 1965 fell by the wayside as the field became more complex, tougher, and considerably more demanding. Some were unable to cope with unions and the demands of labor relations. Others became frustrated by the demands imposed by Affirmative Action and other newly introduced civil rights concerns and legislation. In the 1980s, some gave up when they perceived increasing gov- ernment regulation of benefits as creating a technical and legal nightmare.

Some undeniable image problems related to the personnel department still exist. A minority of senior managers continue to view personnel as a relatively unimportant staff activity that does little more than hire people and file papers. A considerable number of employees view the operations of personnel as a necessary bureaucratic activity that exists primarily for the benefit of a corporation and not for them.

■ WHAT’S IN A (NEW) NAME?

Although today human resources, or HR, is the prevailing name for the de- partment that handles personnel matters, the HR label is far from universally used. Many departments fulfilling the same overall responsibilities are still called personnel departments. Other names are occasionally encountered, among them employee affairs, employee services, personnel informatics, benefits processing, and others. Most of the uncommon titles reflect a limited portion of the activities that are performed by a contemporary, full-spectrum human resources department.

Is the term human resources more descriptive than personnel? Some experts contend that an organization’s ultimate resource is financial, and an organization uses financial resources to acquire both things (material resources) and people (human resources). Therefore, in an organizational context, human resources means people, as does the older, alternate title of personnel.

What’s in a (New) Name? 7

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Why the Change? Most scholars of the field agree that personnel became human resources in many organizations for one or more of the following reasons: the new name more appropriately reflected the workload of the department, the change in name improved the image and elevated the status of the work being performed, and the new name enhanced the professionalism of those who were accomplishing the work.

Did the personnel department become human resources to escape the existing and often negative image of personnel? For some practitioners and organizations, the change was made to overcome the outmoded and limited view of personnel and to gain both professional acknowledgment and a measure of respectability.

A parallel transformation of organizational image occurred in finance. Once there was only bookkeeping, which eventually became accounting as reporting and analytical tasks were added to the simple business of keeping track of money in and money out. As organizations grew, there developed the necessity to raise money, invest money, and generally manage money well beyond the needs of day-to-day operations, so the finance function developed. In most instances those narrower money-related activities such as payroll and accounting were brought under the umbrella of finance. This particular transformation is incomplete and far from being universally accepted; many contemporary accounting and finance practitioners are dismissed as number-crunchers or bean-counters. Marketing professionals incur a similar lack of professional respect or identity. Despite extensive efforts to modify their image, many marketing departments are stereotypi- cally referred to simply as sales, a term that has existed for decades and frequently carries derogatory connotations.

Practitioners in every field are required to learn and grow. The alterna- tive is to fall behind and eventually fail. Change occurs at various rates in different occupational fields. In the field of personnel or human resources, several bursts of change occurred within a sufficiently brief period to impact the career spans of many practitioners.

Bias, whether real or perceived, cannot be overcome by a simple change of name. Neither can respectability be acquired by a change of name. Respect, however, can be earned over time as a new image emerges, one that has nothing to do with the department’s title other than shedding the negativity that some associate with the name personnel. Human resources is taking its place among those activities now viewed as being essential to the success and survival of a modern organization. It required decades to form and solidify the image of personnel as being neither especially difficult nor demanding. The transformation of that image has been under way for years, yet it is far from complete.

Not everyone associated with the field has been enthusiastic about the name change to human resources. One personnel director described

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the trend to change the name of the company personnel office to the department of human resources as “an excellent example of corporate pomposity” (Hoey, 1987). The article argued that employees are hu- man and special, not just another resource similar to real estate or spare parts. As an interesting side note, not long after the article appeared in the professional journal Personnel, the publication changed its name to HR Magazine. Regardless of whether or not one approves of the name change, no title alone will confer respect. That is a commodity that must be earned through performance. When performance is forthcoming, re- spect will follow.

Here to Stay For a number of years, human resources has been the growing name of choice for this service activity of an organization. The HR name has been adopted by professional organizations, academic programs, and publica- tions formerly designated as serving personnel. This is a fairly good sign that the title of human resources will probably dominate for the next few decades.

The changeover of name was most evident during the 1980s. Surveys indicated that in 1986, some 40% of such departments used the HR des- ignation. Just 42 months later, the proportion using the HR designation was at 60% and still climbing. Also, the HR title was more prevalent in larger organizations, in use in 80% or more of organizations having 2,500 or more employees (Stier, 1989).

The title Human Resources is more prevalent in larger organizations. Professional organizations have also changed their names. The American Society for Personnel Administration has become the Society for Human Resource Management.

A number of additional surveys conducted by professional HR orga- nizations during the 1980s and 1990s seemed to focus primarily on the degree to which the name change from personnel to human resources had affected the status of the department within its organization. Historically, the position of the head of HR has carried the title of director or manager among supposed peers who enjoy the title of vice president. The head of HR frequently reports to a vice president rather than directly to the president or executive vice president.

The component duties and responsibilities of HR are not uniform across organizations. Changes are being made, but the relative status of HR within most organizations is improving only slowly. Many HR departments re- main in stages of transition, and some have made little progress. However, they are changing and continuing to evolve to be better able to address new and more complex responsibilities.

Experts disagree as to the present status of an HR department within the healthcare industry. Most do agree on several broad points, however. First

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and foremost, HR must continue to evolve so that it can remain current with the changing needs of healthcare organizations. Next, HR must strive to transcend its traditional reactionary role and adopt a more proactive outlook and approach. Human resources should be available to minimize undesirable occurrences to an organization through the systematic identi- fication of potential problems. The next step is working to avoid them or similar ones in the future.

In addition to performing all of the expected duties in support of an organization’s employees, an effective contemporary HR department serves as a full-fledged partner on an administrative team, participates in orga- nizational strategic planning as a full-fledged member, guides succession planning for an organization, and works as an agent for necessary and healthy change.

Throughout the remainder of this text, the term human resources (or simply HR) will be used as the prevailing name for the department or functional area. This use is not to be construed as claiming that any group that is called personnel or another name is any less legitimate than a human resources department. True differences do not reside in labels.

■ THE FOCUS BROADENS

For all practical purposes, in the first half of the 1900s, human resources in the healthcare industry essentially meant human resources in hospitals. Until the 1960s, acute care hospitals were perceived as being the cen- ter of the American healthcare system. Virtually all healthcare services provided to people were delivered in a hospital. Those that were not provided in hospitals were rendered in physicians’ personal offices. One has only to look briefly at the different healthcare provider organiza- tions in existence today to appreciate that human resources in health care is now practiced in a variety of settings and organizations that are both large and small.

Identifying only a small sample of organizations that deliver health- care services will help to make an important point. Contemporary com- ponents of the healthcare system include free-standing surgical centers; urgent care providers; community health centers; public health agencies; long-term care providers; groups specializing in imaging, physical therapy, laboratory testing, and other activities; and several forms of medical and surgical group practices of varying sizes. All of these organizations, from the smallest partnership or group practice to the largest acute care hos- pital, require the presence of human resources knowledge and expertise. In larger organizations, this expertise is provided by a human resources department. In a small organization, HR expertise may be provided by an in-house individual whose time and duties wholly or partly focus on personnel-related activities. Human resources needs may be outsourced

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or met by an external consultant who provides them on an hourly basis or whose services are shared among several small health provider offices. Regardless of size, however, human resources needs are essential to orga- nizational operating in today’s healthcare environment.

■ CONCLUSION

The typical human resources department has grown from a single-person operation into a multifaceted, complex organization. In some organi- zations, a single person continues to perform all of the needed tasks, although this has become an exception rather than the rule. The volume of government regulations has greatly increased in recent decades. The scope of duties performed has also increased. Changing the departmental name from personnel to human resources reflects these developments. People are now receiving specialized training in colleges and universities for subsegments of human resource activities. However, they continue to struggle for professional recognition and equal status with their orga- nizational counterparts.

Case Study Resolution

Returning to the dilemma posed in the initial case study, the first step that Mrs. Jackson took in lightening her load of non-nursing responsibilities was to hire a helper. The selected person was a combination secretary and gen- eral assistant who coordinated most of the hiring activities for the hospital. In effect, this helper was the hospital’s first personnel worker. It is likely that the first personnel records section was a drawer in this individual’s desk or file cabinet. At the time, employee hiring was the only element of a personnel worker’s position description or list of job duties. No govern- ment regulations had yet been introduced in 1930; the Social Security Act, with its automatic withholding of employees’ contributions, was not created until 1935. Affirmative Action and Equal Opportunity legislation was not enacted until the mid-1960s. The Americans with Disabilities Act added additional duties in 1990.

Mrs. Jackson’s helper was a staff of one that became the hospital’s employment office. Within a few years this office evolved into a personnel department. Mrs. Jackson was extremely relieved to be able to delegate the growing burdens of securing employees and looking after many of their needs. She continued to be involved in employee acquisition to the extent of interviewing potential employees for her own area, but she no longer as- sumed the responsibility to find and screen all job applicants. Furthermore, she did not have to process them into and out of the organization.

Conclusion 11

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References

Hoey, J. T. (1987). Human resources versus personnel. Personnel, 64(5), 72–75. Stier, D. (1989). More use of the human resource title. Resource, Society for

Human Resource Management (SHRM), 10, 2–4. (SHRM was formerly ASPA, the American Society for Personnel Administration.)

Townsend, R. (1970). Up the organization. New York: Alfred A. Knopf.

Discussion Points

1. Describe how you believe the business of locating, hiring, and main- taining employees was accomplished before the establishment of an employment office. List the activities that were probably performed and who was most likely to have performed them.

2. With specific reference to activities found within healthcare organiza- tions, describe how three departments or functional areas other than human resources might have evolved in a manner similar to the evolu- tion of HR. In each instance, describe the activities that might have initially existed and then accrued to form the basis of each activity as it is known today.

3. In your opinion, what did senior managers in the past believe were the primary benefits of gathering a variety of employee-related tasks together to form an employment office?

SPOTLIGHT ON CUSTOMER SERVICE

Customer Service: An Introduction

Customer service has become a buzzword in contemporary organizations. The good news is that organizations are waking up and beginning to recognize the importance of customer service. The bad news is that many of the same organizations treat customer service as little more than a passing fad.

Customer service is important. Critics may be correct when they say that customer service is only a single factor among many that contribute to an or- ganization’s success. However, poor customer service alone has the potential to cause organizational failure. Consider a restaurant that employs servers with poor attitudes. Conventional wisdom asserts that all dissatisfied custom- ers tell 20 additional actual or potential customers about their unsatisfactory experience. Satisfied customers typically share their experiences with only one or two other persons.

Quickly, the reputation for poor customer service spreads through a popu- lation and buries perceptions of good service. The main cost associated with customer service is remembering to provide it.

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4. In your opinion, what were the two or three earliest changes that in- fluenced the development of a centralized operation to address matters related to employees? Why?

5. Why might some people consider the term fringe benefits to be mislead- ing at best or completely erroneous at worst? Why is the value of these benefits most appropriately included as part of total compensation?

6. Comment concerning the industry dropout phenomenon as it con- cerned earlier full-time human resources managers in health care. Is the somewhat derogatory label of “industry dropout” reasonably or unreasonably applied? Why?

7. Do you personally agree with changing the name from personnel to human resources? Why or why not?

8. Do you support or oppose the abolition of a central personnel depart- ment in favor of having individual managers assume the responsibility for all such activities for their own departments? Why?

9. Do you believe that changing the name of personnel to human resources substantially improved the image of the department or service area? Why?

10. Comment on the following quotation from Up the Organization (Townsend, 1970): “Fire the whole personnel department. Unless your company is too large (in which case break it up into autonomous parts), have a one-girl people department (not personnel department).” Keep in mind that this passage was written in the late 1960s.

Resources

Books Bashford, A. (2004). Imperial hygiene: A critical history of colonialism, national-

ism, and public health. New York: Palgrave Macmillan. Flynn, W. J., Langan, P. J., Jackson, J. H., & Mathis, R. L. (2003). Healthcare

human resources and management. Mason, OH: Southwestern. Ljungberg, J., & Smits, J. P. (2005). Technology and human capital in historical

perspective. New York: Palgrave Macmillan. Martocchio, J. J. (2005.) Research in personnel and human resources management.

Burlington, MA: Elsevier. Mathis, R. L., & Jackson, J. H. (2005). Human Resource Management (11th ed.).

Mason, OH: Southwestern. Phillips, J. J., & Phillips, P. P. (2012). Proving the value of HR: How and why to measure

ROI (2nd ed.). Alexandria, VA: Society for Human Resource Management. Rakich, J. S., Longest, B. S., & Darr, K. (2003). Cases in health services manage-

ment (4th ed.). Baltimore, MD: Health Professions Press. Renckly, R. B. (2004). Human resources. Hauppauge, NY: Barrons. Stredwick, J. (2005). Introduction to human resource management (2nd ed.).

Burlington, MA: Butterworth-Heinemann. Walzer-Leavitt, J. W., & Numbers, R. L. (1993). Sickness and health in America:

Readings in the history of medicine and public health (3rd ed.). Madison: University of Wisconsin Press.

Conclusion 13

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14 CHAPTER 1 AN OVERVIEW OF HUMAN RESOURCES

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