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Physicians can have key role in helping to deal with substance abuse. Primary care physicians are well positioned to support patients recovering from drug and alcohol addiction. However, a lack of education about the causes and treatment of substance abuse can prevent helping these patients, says a School of Medicine research team led by Richard Saitz, assistant professor of medicine and public health. The study appears in the current issue of the Journal of the American Medical Association.

Because primary care physicians interact with their patients over a span of years or decades, they are ideally suited to monitor their patients' progress, says Saitz. They can facilitate involvement in 12-step recovery groups, encourage finding a job or going to school, and collaborate with addiction-specialty professionals. Physicians can also help patients cope with recovery through regularly scheduled visits. "Small amounts of counseling for a recovering addict, such as five to ten minutes during each visit, may be as effective as more intensive approaches," he says.

According to Saitz, more than 20 percent of adults in primary care settings have a past or current substance use problem. "Physicians should take a nonjudgmental but direct approach when asking their patients about substance abuse," he says. "When knowledgeable about dealing with substance abuse, physicians who convey concern and empathy can build a supportive relationship that may be crucial to recovery.

"Given the current knowledge about relapse prevention and the effectiveness of physician involvement with their patients' substance use problems, primary care physicians should begin the important work of educating themselves to support, monitor, and maintain patients in recovery from alcohol or other drug problems," he adds.

Uncovering why great technologies never were. "A computer on every desktop." Not only is that Microsoft's vision statement, it has quickly become a reality in the workplace. But how did consumers end up with MS-DOS and not rival operating system CP/M as the technological standard?

According to School of Management Assistant Professor Melissa Schilling, CP/M's technology was "locked out" of the market. Her recent study has uncovered the economic and strategic factors that drive technological success and failure, and has discovered a reliable way to determine which technologies will thrive. The theory portion of the study was recently published in the Academy of Management Review.

"There are forces which encourage the adoption of technology standards," she says. One force, pressure for compatibility, encourages the market to adopt a dominant design, which can be a single product, a family of products, or a process by which products and services are delivered. The problem, Schilling discovered, is that firms with equally good -- or even better -- products risk being locked out of a market for which there is an entrenched dominant standard.

"Sony's Betamax or Steve Jobs' Next personal computers were terrific technologies that were unable to compete with products that had more complementary goods -- namely videotapes and software -- available," she says. Other factors affecting technological lockout include the size of the installed base, government regulation, and wrong timing of a product's entry into the market.

While other economic research has focused on external market forces driving technology choice, Schilling found that factors such as a firm's internal strategic choices influence technology adoption as well. "A firm that has a greater understanding of the internal forces driving technology selection and that effectively manipulates them should have a competitive advantage in technology markets," she says. A firm's strategy regarding licensing arrangements, aggressive marketing, and bundling will have great impact on its likelihood of being locked out, she found.

"Everyone assumes that Gates' MS-DOS became the dominant standard not because of its technological superiority, but because rival operating system pioneer Gary Kildall chose not to meet with IBM the day they came out to speak with him regarding bundling CP/M with their PCs. This appears to be a pretty random event," she notes. In declining to license his operating system to IBM, however, Kildall forfeited a huge, ready-made market -- afterwards, he could never catch up with Gates' share of the installed base. So, Schilling points out, the apparently random nonmeeting actually affected technology selection in an ordered, predictable way.

"Research Briefs" is written by Joan Schwartz in the Office of the Provost. To read more about BU research, visit


15 May 2003
Boston University
Office of University Relations