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Medical Care Influenced by Civil War and Crimean Italian Unification Wars that Immediately Preceded the U.S. Civil War
The objective of this study is to examine how medical care influenced the Civil War and Crimean Italian Unification Wars that Immediately Preceded the U.S. Civil War. The work of Lieutenant Colonel Robert L. Pearce (2002) reports that the Napoleonic wars at the start of the19th century "introduced some important developments in the military medicine. Most significant was the work of the military surgeon Dominique Jean Larrey, who with courage, skill and determination, evolved a system to immediate treatment in the field." (Pearce, 2002, p.89)
Reports on Medicine During the Crimean War
Pearce states that Larrey wrote in his 'Memories de Dhirurgie Militaire et Campagnes as follows:
"…at Aboukir there were 1900 wounded, and many amputations were performed in the field of battle amid a shower of bullets." (2002, p.88)
Adams GW. Doctors in Blue. The Medical History of the Union Army in the Civil War. Louisiana State University Press, 1996.
Freemon, Frank R. Gangrene and Glory: Medical Care During the American Civil War. Madison [N.J.: Fairleigh Dickinson University Press, 1998.
Robert L. Pearce, Lt. Col. (2002) War and Medicine in the Nineteenth Century. ADF Health. Vol. 3 September 2002. Retrieved from: http://www.defence.gov.au/health/infocentre/journals/ADFHJ_sep02/ADFHealth_3_2_88-92.pdf
Rutkow, Ira M. Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine. New York: Random House, 2005.
Medical billing and coding can be described as the process of presenting and following up on claims to health insurance companies for the purpose of obtaining payment for services provided by the healthcare provider. egardless of whether an insurance company is government-owned or privately owned company, the process for medical billing and coding is similar for many companies. For an individual to become a specialist in medical billing and coding, he/she is usually encouraged to become certified through taking an exam. While such individuals are not compelled by the law to do so, certification schools have been established as avenues for theoretical foundation for students entering this field.
What is Medical Billing and Coding?
Generally, the medical billing and coding process is an interaction between the insurance company that caters for the health expenses and the health care provider. Medical coding involves the allocation of either a numeric or alphanumeric…
Becker, J.M. (2009). A guide to coding compliance. Clifton Park, NY: Cengage Learning.
"Career Guide -- Medical Coding." (2011, July). Medical Support Services Training. Retrieved February 25, 2012, from http://www.med-certification.com/wp-content/uploads/2011/07/All-About-Medical-Coding2.pdf
Morgan, H. (n.d.). The History of Medical Billing. Retrieved February 25, 2012, from http://www.ehow.com/about_6171600_history-medical-billing.html
Medical Office Management Software
Throughout the process of comparing medical office management software that serves medical professionals by streamlining the administrative, billing, transaction and service management processes of their businesses, the key features and core functions of physician vs. acute care hospitals were analyzed. The results of the analysis are provided in this report. Dominating both are rapid advances in support for tablet PCs, smartphones and all other forms of mobility devices, as these devise are showing significant potential to increase the accuracy and time savings of complex tasks in each type of business (Bellini, Bruno, Cenni, et.al., 2012).
Analysis of Medical Office Management Software
There are significant differences in how software companies design applications for physicians' practices vs. those used in acute care hospitals. The most significant differences exist in the core functional areas of the applications, in addition to the specific workflows supported across multi-departmental workflows. Medical office…
Bellini, P., Bruno, I., Cenni, D., Fuzier, A., Nesi, P., & Paolucci, M. (2012). Mobile medicine: Semantic computing management for health care applications on desktop and mobile devices. Multimedia Tools and Applications, 58(1), 41-79.
Castleman, P. (2006). Medical application of computers at BBN. IEEE Annals of the History of Computing, 28(1), 6-6.
Radjou, N., & Prabhu, J. (2012). Mobilizing for growth in emerging markets. MIT Sloan Management Review, 53(3), 81-88.
Medical Specialist eferral Process
The world is infested with numerous diseases that are caused due to several factors revolving around the change in the quality of lifestyle of humans. This change has led to people often visiting their doctors for recovering and restoring their healthy state of body and mind. In this regard, referral process plays a pivotal role, as it helps the doctors to keep a check and balance of the dietary and health patterns of individuals. This ensures that the patient receives correct and appropriate measures that keep them fit.
If the condition of the patient is such that it cannot be treated by the primary health care provider, then the patient is referred to a specialist that is proficient in treating that particular disease or illness. Therefore, the medical specialist referral process is usually based on a four-step course: common process, referral process, potential safety hazards and…
Black, C., Sharma, P., Scotland, G., McCullough, K., McGurn, D., Robertson, L., & #8230;..Smith, C. (2010). Early referral strategies for management of people with markers of renal disease: a systematic review of the evidence of clinical effectiveness, cost-effectiveness and economic analysis. Health Technology Assessment 2010; Vol. 14: No. 21. Retrieved from: http://www.hta.ac.uk/fullmono/mon1421.pdf
Jamison. (2006). Disease Control Priorities in Developing Countries. 2nd Edition. USA: World Bank Publications
National Kidney Foundation of Michigan, Chronic Kidney Disease Task Force & Michigan Department of Community Health (2010). REDUCING THE BURDEN OF CHRONIC KIDNEY DISEASE IN MICHIGAN. Retrieved from http://www.michigan.gov/documents/KidneyPlanComplete_124190_7.pdf
Wauters, J.P., Lameire, N., Davison, A. & Ritz, E. (2005). Why patients with progressing kidney disease are referred late to the nephrologist: on causes and proposals for improvement. Oxford Journals, Volume 20, Issue 3: pp. 490-496. Retrieved from http://ndt.oxfordjournals.org/content/20/3/490.full
Faulty Health Care System
[N a m e]
Medical or health professionals are considered to be the most respected and most valued persons. These professionals are source of hope for people suffering from different diseases. This puts additional responsibility on the doctors and health professionals and they are required to be more careful and cautious while performing their operations and duties.
Despite of all special care and caution on part of the health professionals, there are increasing number of medical errors. Medical errors are defined as the mistakes or faults done by the health or medical professionals resulting in harmful and dangerous implications for the patients. These include errors in the process of diagnosis known as diagnostic errors, mistakes in the management of drugs and prescribing medicines known as medication errors, faults or mistakes in the while performing procedures of the surgery, while using any other therapy, while…
Archibold, Randal. "Girl in Transplant Mix-Up Dies After Two Weeks." NewYork Times 23 Feb 2003, Print.
Channel3000. "State confirms medical error in hospital death of teen: St. Mary's releases statement." Channel3000. Network Solutions, LLC, 21 Jul 2006. Web. 21 Jun 2011. .
Institute of Medicine. To err is human: building a safer health system. National Academy of Sciences, 2000.
Rogers, Arvey. Medical Errors Prevention. Miami: University of Miami Health System, 2011.
In general, the meaning of the term abandonment means the forsaking of one's duty. Thus when a practitioner client relation gets established there is a 'duty of care' which includes the protection of the client, maintain records of the clients, and to always provide the client with due care with maximum application of the physicians skills. If one or all these have been breached, there is deficiency of service. However if the relationship is broken because of non-functioning from the part of the physician then there is abandonment. (Davis, 2008)
Medical abandonment is a concept that is broadly covered under the malpractice laws. Medical malpractice is found to have been taken cognizance of in the British and American laws for a century now. The Second World War and aftermath saw the expansions of the concept and the possibility of physician liability. It also was broadened by the reinterpretation…
Davis, Denise D. (2008) "Terminating Therapy: A Professional Guide to Ending on a Positive Note" John Wiley & Sons.
Donald, Shapiro, E. (1978-1979) "Medical Malpractice: History, Diagnosis and Prognosis"
22 St. Louis U.L.J, vol. 17, no. 2, pp: 469-475.
Hafter, Jacob L; Fedor, Victoria L. (2003) "Ems and the Law"
Medical Management of Adolescent Athletic Knee Fractures
is a 13-year-old middle school student who was admitted to Antelope Valley hospital complaining of severe pain in the right knee while playing football in his Physical Education class at school. As the patient turned to run for a pass, he twisted his right knee and fell to the ground. C.W. reports that he immediately felt a snapping and popping sensation at his right knee and experienced severe pain. The patient's knee began to swell and deform following his fall, and he was unable to bear weight. The coach for the Physical Education class called 911, and C.W. was transported by ambulance to Antelope Valley Hospital. X-rays taken in the Emergency oom revealed that the patient had sustained a right proximal tibia fracture. A basic metabolic panel, blood cell profile, PTIN, and PTT were all completed on the patient. C.W.'s labs were all…
Adirim, T.A. And Cheng, T.L. (2003). Overview of injuries in the young athlete. Sports Medicine, 33(1), 75-81.
Ackley, B. And Ladwig, G. (2003, 2011). Nursing diagnosis handbook: An evidence-based guide to planning care. St. Louis, MO: Mosby, Inc.
Black, J. And Hawks, J. (2009). Medical-surgical nursing. St. Louis, MO: Sanudners.
Bout-Tabuku, S. And Best, T.M. (2010). The adolescent knee and risk for osteoarthritis: An opportunity or responsibility for sport medicine physicians? Sports Medicine Reports. Columbus, OH: American College of Sports Medicine.
If a person is incapacitated, the family should be allowed to make whatever decision they feel will cause the least harm. All such decisions should be underlined with full consultation with legal and medical professionals.
I believe the best solution is therefore to firstly adhere to the four principles mentioned above. These principles should be underlined by legislation, and include ethically challenging issues such as euthanasia. To prevent indiscretionary approaches to the issue, professionals, family members, and friends of the persons involved should be included in the decision making process. I believe this will curb the problem of practices such as unconsented assisted suicide because one doctor feels that it is the best solution.
BBC News. 'Legalise euthanasia' says expert. 8 June 2006. http://news.bbc.co.uk/2/hi/health/5056326.stm
Boseley, arah. Call for No-Consent Euthanasia. The Guardian, 8 June 2006. http://www.guardian.co.uk/frontpage/story/0,1792711,00.html
Le Baron, Garn Jr. The Ethics of Euthanasia. 1993-2008. http://www.quantonics.com/The_Ethics_of_Euthanasia_By_Garn_LeBaron.html
Markkula Center for…
BBC News. 'Legalise euthanasia' says expert. 8 June 2006. http://news.bbc.co.uk/2/hi/health/5056326.stm
Boseley, Sarah. Call for No-Consent Euthanasia. The Guardian, 8 June 2006. http://www.guardian.co.uk/frontpage/story/0,1792711,00.html
Le Baron, Garn Jr. The Ethics of Euthanasia. 1993-2008. http://www.quantonics.com/The_Ethics_of_Euthanasia_By_Garn_LeBaron.html
Markkula Center for Applied Ethics. Legalizing Euthanasia: Medical Perspectives on Death and Dying. 2007. http://www.scu.edu/ethics/publications/iie/v4n2/euthanasia.html
Thus, confirming my original hypothesis that life is nothing but pain and suffering. And now, I suffer even more. So, thanks a lot. He walks away down the hall.
Woman Doctor: (Left standing in the hall looking perplexed and scratching her head. Shrugs and says sarcastically.) Who knows? Just another typical day at this hospital! (Shakes head, rolls eyes, yet smiles as she walks away in the opposite direction.)
Untitled image of two doctors conversing]. Retrieved 20 May, 2010, from: news.bbc.co.uk/2/hi/health/1764713.stm
Mimi, Homelessness and Ralph McTell British Music article]. 2010. Retrieved 20 May, 2010, from: http://britishmusic.crabbysbeach.com/blogs/2010/03/15/streets-of-london-ralph-mctell/
Healthline Networks, Inc. (Image creator). (1995). Retrieved June 1, 2010, from: http://www.healthline.com/sw/khs-what-is-dilated-cardiomyopathy
Marquette Electronics (Image creator). (1996). Retrieved June 1, 2010, from: http://library.med.utah.edu/kw/ecg/mml/ecg_arrhythmia.html
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[a barista at a coffee shop assisting a man]. Retrieved June 1, 2010, from: http://yhst-14463325294384.stores.yahoo.net/
Gutierrez, David. (Article author). 2008. Retrieved June 1, 2010, from: http://www.naturalnews.com/022502_MRSA_superbug_infections.html
Medical Ethics Interview
Healthcare providers include nurses, doctors, social workers and a number of other professions that seem to exist on the periphery of the helping field. One of those on the outside, that many do not consider when looking at the healthcare profession, are professional counselors. Since the term "counselor" has been diluted by everyone from friends to lawyers, it is unclear what one is talking about when employing such a generic term for an occupation, but professional counselors are vital members of the healthcare field. These individuals work in hospitals, nonprofits and private offices, working with couples, individuals and groups.
Among the many different specialties extant within the professional counselor fold is that of mental health counselor. Since the population of individuals who have a diagnosed mental illness has risen in recent years, the need for mental health counselors has risen with them. Alongside…
ACA. (2005). ACA code of ethics. Retrieved from www.counseling.org/files/fd.ashx?guid=ab7c1272-71c4-46cf-848c
MedTerms. (2011). Definition of Hippocratic Oath. Retrieved from http://www.medterms.com/script/main/art.asp?articlekey=2090 9
Ponton, R.F., & Duba, J.D. (2009). The ACA code of ethics: Articulating counseling's professional covenant. Journal of Counseling and Development, 87(1), 117-126.
Medical Uses of Electromagnetic Radiation
Electromagnetic radiation or EM radiation is "combination of oscillating electric and magnetic fields perpendicular to each other, moving through space as a wave, effectively transporting energy and momentum" (Electromagnetic pp).
EM radiation is quantized as particles called photons, and the physics of electromagnetic radiation is electrodynamics, a sub-field of electromagnetism (Electromagnetic pp). Generally, EM radiation is classified by wavelength into electrical energy, radio, microwave, infrared, the visible region, ultraviolet, X-rays and gamma rays (Electromagnetic pp).
Radiology is the branch of medicine that specializes in the use of X-rays, gamma rays, radioactive isotopes, and other forms of radiation used in the diagnosis and treatment of disease (Radiology pp). X-ray machines and fluoroscopes are an essential tool in diagnosing bone fractures, tumors, and other abnormalities of the internal organs (Radiology pp). The computerized axial tomography, or CAT, scan uses computer technology to focus X-rays on precise sections…
Electromagnetic radiation http://en.wikipedia.org/wiki/Electromagnetic_radiation
Gamma rays http://www.bartleby.com/65/ga/gammarad.html
It is feared that religious differences in decisions regarding when to withhold treatment are being ignored by the courts.
The social and legal issues are highlighted in cases that involve pre-term infants. In the elderly, the cultural consensus is that these persons have lived their life and are close to death anyway. However, in the case of a pre-term infant, the issue is raised of what measures should be taken to preserve life, particular when there is a lack of resources (Seri and Evans 2008). In the case of premature infants, significant cases exist to aid in the establishment of criteria to predict survival rates. If the survival probability is too low, resources are typically saved for those infants that have a greater chance for survival. For instance, it is the general rule that babies under 23-week and that weigh less than 500 grams are unlikely to survive. However, babies…
Bagheri, a., Asai, a., and Ida, R. 2006. Expert's attitudes towards medical futility: an empirical survey form Japan. BMC Medical Ethics. June 2006, pp. 7-8. Accessed February 28, 2009 http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1550716
Del Poze, R. And Fins, J. 2005. Death, dying and informatics: misrepresenting religion of Medline. BMC Medical Ethics. 6 (6). Accessed February 28, 2009 http://www.biomedcentral.com/1472-6939/6/6
Faunce, T. And Stewart, C. 2005. The Messiha and Schiavo cases: third-party ethical and legal interventions in futile care disputes. MJA. 183 (5). 261-263. Accessed February 28, 2009 http://www.mja.com.au/public/issues/183_05_050905/fau10214_fm.pdf
Gampel, E. 2006. Does Professional Autonomy Protect Medical Futility Judgments? Bioethics. 20 (2), 92-104.
Perhaps the single biggest blessing that any individual can thank his or her stars for is a sense of physiological and psychological well being that allows for the optimal utilization of one's lifetime. In the same vein, all humankind can perhaps also thank and bless the significant advances made by the medical sciences, which has resulted in the ability to cure many an illness and overall increase the average life span of humanity. Indeed, modern day humanity has only to look at its own history to truly understand the import of medical knowledge and aid. And it is precisely for this reason that it becomes hard to comprehend the fact that there still exists many lacunae in health care that is tantamount to the worst kind of social injustice. Take for instance, the shocking statistic that more deaths can be attributed to medical errors than car accidents or…
Chaiken, Barry P. "Patient Safety: Is It Really a Problem?" Nursing
Economics. 19.4 (2001). 176-177.
Huston, Carol Jorgensen. "Quality Health Care in of Era of Limited
Resources." Journal of Nursing Care Quality 18.4 (2003): 295-301.
The fourth step is to make a decision based on this best information available and the chosen technique.
The capital budgeting process is fairly straightforward in its structure, but making the determinations is potentially very difficult. There is often significant consideration of what constitutes an incremental cash flow, for example, and the firm must approach this issue with caution. Another tricky part of the process is determining an approach discount rate. The firm must consider its risk, market risk, the risk-free rate and the project's risk. Determining a cost of capital for privately-held firm often means finding a similar publicly-held firm in order to determine what the equity cost of capital might be. The cost of debt is easier to determine -- the bank can tell the firm that.
6. Project risk is incorporated into capital budgeting analysis in the discount rate. The discount rate reflects the rate of return…
Investopedia. (2011). Discounted cash flow. Investopedia. Retrieved May 22, 2011 from http://www.investopedia.com/terms/d/dcf.asp
The reason why, is due to the fact that you are addressing the needs of different demographics of the population. At the same time, you have numerous options in working with patients and a procedure for helping to collect all outstanding balances. (Lohr, 2010)
When you put these different elements together, they are showing how this strategy can be utilized to reduce the underlying costs and increase profitability. This is accomplished by: outsourcing those procedures that decrease productivity and costs (billing / collections). While, being able to offer patients flexible payment plans and certain times where they can receive discounted services. Once this occurs, it means that costs will remain under control and the profit margins of the clinic will increase. This is because of the flexibility that this policy is providing. As it is allowing health care professionals' to adapt to the underlying challenges facing many private practices. (Lohr,…
More Doctors Giving Up Private Practice. (2010). Facebook. Retrieved from: http://www.facebook.com/topic.php?uid=203408519096&topic=15199
Dunning, D. (2008). Dental Practice Transition. Ames, IA: Wiley.
Lohr, S. (2010). High Tech Alternatives. New York Times. Retrieved from: http://www.nytimes.com/2010/05/23/business/23unboxed.html
Quaddiami, T. (2002). The Role of Third Party Billing. Biz Journals. Retrieved from: http://www.bizjournals.com/houston/stories/2002/05/20/focus4.html
Texas law also adds the stipulation that a hospital may not destroy medical records that relate to any matter that is involved in litigation if the hospital knows the litigation has not been resolved (Practice brief - retention of health information).
Federal laws for record retention often are different from state laws. For instance, hospitals that participate in Medicare must keep medical records on each inpatient and outpatient, records of radiologic service, nuclear medicine including records for the receipt and disposition of radipaharmaceutics for five years. (42 CFR 482.24,.26, and.53) (Calloway). Further, psychiatric hospitals that participate in Medicare must maintain special records including development of assessment/diagnostic data, treatment plan, record progress, discharge planning, and discharge summary for 5 years (Calloway). Thus, Medicare record retention requirements are two years less than those in California and three years less than those in Texas in these instances, facilities would need to follow the…
Calloway S.D. Record retention periods. HIPAAdvisory. http://www.hipaadvisory.com/regs/recordretention.htm
Practice brief - retention of health information. American Health Information Management Association. http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_012547.pdf
The cases oif children are different from adults because they are still gowing through a growth phase so any surgical treatment may require extra care. Specialists make sure that the future growth of bones and joints does not get hindered reulting in problems and complications at a later stage in life.
Trauma and Congenital Deformities: Emergency rooms and trauma centers are the places where injured come and these are the places where orthopedics serve. Prompt treatments by these surgeons have helped many around the world from disabilities by losing their body parts. Due to developments in the field people are now not only consult orthopedic surgeons for complexities created because of diseases or trauma but also for congenital deformities.
Generally four years of medical school and one year of internship, residency or fellowship gives a person the title of MD but specialization requires extra training. After attaining the license…
Lewis, Carol. "Arthritis." FDA Consumer. 34.3. (May 2000): 27.
Orthopedic surgery." Wikipedia Encylopedia. 2007. 17 Jan 2007 http://en.wikipedia.org/wiki/Orthopedics .
Sherry, Eugene. "Electronic Textbook." World Ortho. 1997. 17 Jan 2007 http://www.worldortho.com/database/etext/index.html.
Huckstep, RL. "A Simple Guide to Orthopedics." World Ortho. 17 Jan 2007 http://www.worldortho.com/database/sgo/index.html.
Analyzing holistic programs that deploy a cross-sectional approach are even more difficult to ascertain, in terms of isolating the causal factors that cause an improved response to treatment.
ith another biological illness such depression, for example, "some types of depression run in families, suggesting that a biological vulnerability can be inherited...major depression also seems to occur generation after generation. However, it can also occur in people who have no family history of depression." ("Depression," 2000, NIH) (This is also true of substance abuse -- there is a genetic predisposition, but not all abusers share such a genetic legacy.) Responses to anti-depressants also vary depending on the patient. "Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications," and combine medication with psychotherapy. ("Depression," 2000, NIH) Also, while a combined approach seems to present the best clinical outcome, certain depressed populations such…
The Biological Model." (2004). The Science Museum: Making the Modern World.
Retrived 22 Jan 2006 at www.makingthemodernworld.org.uk/learning_modules/psychology/02.TU.04/?secti
Chapter 2: Understanding Addiction, Substance Abuse Treatment, and Recovery
Blending Perspectives and Building Common Ground." (1999) a Report to Congress on Substance Abuse and Child Protection. April 1999. Retrived 22 Jan 2006 at http://aspe.hhs.gov/HSP/subabuse99/chap2.htm
Medical Home Model and Health Disparity
Nursing esearch Proposal
The Impact of the Medical Home Model on Health Disparities
The Impact of the Medical Home Model on Healthcare Disparity
Medical homes are primary care practices where a physician or NP establishes a long-term care relationship with patients and provide patient/family-centered, coordinated, and culturally-sensitive care (AANP, n.d.; Strickland, Jones, Ghandour, Kogan, & Newacheck, 2011). The benefits include improved healthcare access, quality, and safety. A number of states have enacted statutes supporting the medical home model after research findings revealed health disparities for racial and ethnic minorities were reduced (NCSL, 2013).
As a nurse practitioner I am interested in how effective a medical home model would be in reducing healthcare disparities, especially for racial and ethnic minority children residing in underserved communities. Nurse practitioners have traditionally practiced in underserved communities and will continue to do so; therefore, any strategy that could improve…
AANP (American Association of Nurse Practitioners). (n.d.). Medicare legislation: Fact sheet: The medical home -- What is it? How do nurse practitioners fit in? Retrieved from: http://www.aanp.org/legislation-regulation/federal-legislation/medicare/68-articles/349-the-medical-home .
Abrams, M., Nuzum, R., Mika, S., & Lawlor, G. (2011). Realizing health reform's potential: How the Affordable Care Act will strengthen primary care and benefit patients, providers, and payers. The Commonwealth Fund. Retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Jan/1466_Abrams_how_ACA_will_strengthen_primary_care_reform_brief_v3.pdf .
NCSL. (2013). Health disparities: State laws. Retrieved from: http://www.ncsl.org/research/health/health-disparities-laws.aspx .
Strickland, B.B., Jones, J.R., Ghandour, R.M., Kogan, M.D., & Newacheck, P.W. (2011). The medical home: Health care access and impact for children and youth in the United States. Pediatrics, 127(4), 604-11.
Medical Coding Ethics
Ethical Concerns in Health Care Delivery: Focus on Medical Coding and Billing Practices
The objective of this study is to examine ethical concerns medical coding and billing in the physician office. Medical coding and billing has become very complex in light of health care reform. Recently, Christopher Gregory ayne, reported to be "dubbed the Rock Doc" was arrested on a dozen charges of Medicare fraud" when he was accused of fraudulently billing for "physical therapy procedures, such as massages and electrical stimulation, that were not necessary or in some instances had been provided at his prior medical practice in Miami." (eaver, 2013, p.1) It appears that where this doctor failed is billing for physical therapy when his staff was not properly accredited for providing these treatments.
Health Care Coding and Billing Changes
It was reported by Gunderman (2013) that October 1, 2014 is the deadline on implementing…
American Health Information Management Association Standards of Ethical Coding. (2008) AHIMA House of Delegates. "AHIMA Standards of Ethical Coding. Sept 2008. Retrieved from: http://library.ahima.org/xpedio/groups/public/documents/ahima/bok2_001166.hcsp?dDocName=bok2_001166
Know your ethical obligations regarding coding and documentation (2009) Association of Clinical Documentation Improvement Specialists, August 4, 2009 HCPro. Retrieved from: http://www.hcpro.com/HOM-236942-5728/know-your-ethical-obligations-regarding-coding-and-documentation
Weaver, J. (2013) Miami Beach's 'Rock Doc' busted on Medicare fraud charges. The Miami Herald. Retrieved from: http://www.miamiherald.com/2013/09/30/3660611/miami-beachs-rock-doc-busted-on.html#storylink=cpy
Sufficient documentation a major hurdle for ICD-10 (2013) APCs Insider. Retrieved from: http://www.hcpro.com/HIM-297687-859/Sufficient-documentation-a-major-hurdle-for-ICD10.html
Medical ID Theft and Securing EPHI
Medical Identity Theft
Medical information can be stolen by 1) the bad guys getting sick and using a victim's information to obtain services, 2) friends or relatives use another friend's or relative's information to obtain treatment, 3) when professionals, such as physicians, fabricate services that did not exist, 4) organized crime, and 5) innocent or not so innocent opportunists (Lafferty, 2007). ad guys that get sick can take a victim's insurance information to obtain services for treatment. Professionals can fabricate false claims to cover medical errors. Opportunists have access to patient data and the ability to steal, use, or sell that information.
Effective security requires clear direction from upper management (Whitman). Assigning security responsibilities and access controls with audit controls to organizational elements and individuals helps to place accountability on individuals. They must formulate or elaborate security policies and procedures based on the organizational…
HIPAA Security Series. (n.d.). Retrieved from HHS.gov: http://www.hhs.gov/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf
Hoffman, S. & . (2007). SECURING THE HIPAA SECURITY RULE. Journal of Internet Law, 10(8), 1-16.
Lafferty, L. (2007). Medical Identity Theft: The Future Threat of Health Care Fraud is Now. Journal of Healthcare Compliance, 9(1), 11-20.
Whitman, M. & . (n.d.). Case B: Accessing and Mitigating the Risks to a Hypothetical Computer System, pages B1-B24 .
Medical Use of Marijuana
Increasing use of medical marijuana
Having looked at the various areas that medical marijuana has been brought into use and the various forms in which marijuana is administered, it is also important to take note of the various challenges that come with it. There have been various researches that have been conducted that covers the medical as well as the ethical side of the medicinal marijuana, and there have been a dilemma in the balance of the two sides on whether to institutionalize the drug or to stop it, and even on whether the medicinal use can be made to work without the proneness to abuse as is the case at the moment.
Medicinal marijuana has neither medical nor ethical standing within the contemporary society where drug abuse is one of the biggest worries of governments across the world and the alternative medicines that medical research…
How do these companies provide care?
Aetna provides care by being a health insurance company that offers a range of services in the field of medical, pharmaceutical, dental, behavioral group, long-term care, and plans for those who are disabled. Humana is also a health insurance company that offers its services in numerous states. United Health Group operates two businesses, known as United Healthcare and Optum, and similar to the two aforementioned companies, it offers health insurance to individuals, which includes seniors.
What types of plans do they have?
Aetna offers various types of plans under its various insurance, which as mentioned before, include medical, dental, vision, medicare, disability, pharmacy, life, student, behavioral health, health expense funds, and wellness products and discounts. Under medical insurance, a person can get a quote via state, which may include individual HMO health benefits plan or QPOS individual advantage health benefits and health…
Aetna - Health Insurance, Dental, Pharmacy, Group Life and Disability Insurance. (n.d.). Aetna - Health Insurance, Dental, Pharmacy, Group Life and Disability Insurance. Retrieved December 19, 2011, from http://www.aetna.com
HUMANA - Guidance when you need it most. (n.d.). HUMANA - Guidance when you need it most. Retrieved December 19, 2011, from http://www.humana.com/
UnitedHealth Group - Featured News - Products & Services. (n.d.). UnitedHealth Group - Featured News - Products & Services. Retrieved December 19, 2011, from http://www.unitedhealthgroup.com
Medical Advances in Cancer Treatment Research
This paper discusses the medical advances in cancer treatment research. The writer explores several treatment options and compares them to treatment options of the past. There were two sources used to complete this paper.
There was a time when a diagnosis of cancer meant a death sentence. The word still strikes a chord of fear among the millions each year who are told they have it, but in recent years there have been many advances in medical science that allow many who would have died from the disease to live long and full lives. There are more cancer survivors now than ever before and treatment options continue to be made available.
In the past there were only two options for the treatment of cancer. One could have surgery and one could be given a course of radiation treatments. The surgery was for the purpose…
Medical Associates is a large for-profit group practice. Its dividends are expected to grow at a constant rate of 7% per year into the foreseeable future. The firm's last dividend (D0) was $2, and its current stock price is $23. The firm's beta coefficient is 1.6; the rate of return on 20-year T-bonds currently is 9%; the expected rate of return is 13%. The firm's target capital structure calls for 50% debt financing, the interest rate required on the business's new debt is 10%, and its tax rate is 40%.
You are to write a report that answers the following:
Calculate Medical Associates' cost of equity estimate using the DCF method.
Next years expected dividend = $2 * 1.07 = 2.14
Current Stock Price = $
E (Rc) = 2.14/23 + .07 = .1630 = 16.3%
Calculate the cost of equity estimate using CAPM.
R (Rc) = .09 + (1.6…
In this case, that power dynamic was only exacerbated by the fact that the entire MSICU nursing team had never received training in management of the type of clinical issues presented and by the fact that they were excluded from any consultation in connection with a post-operative management plan.
Therefore, it is recommended that the institution immediately implement a policy of "see something, say something" according to which all members of healthcare teams are encouraged to speak up irrespective of power differentials. Furthermore, that protocol must include a statement of policy insulating any member of a healthcare team who does voice a legitimate concern in good faith from any retaliation or other negative response that could conceivably deter such diligence. Finally, the record of this case also indicates the immediate need for protocols requiring all members of the healthcare team to identify themselves to other members of the team, especially…
Bosk, Charles L. (2003). Forgive and Remember: Managing Medical Failure.
Gawande, Atul. (2008). Better: A Surgeon's Notes on Performance.
Groopman, Jerome. (2008). How Doctors Think.
Timmermans, Stefan. (2003). The Gold Standard: The Challenge of Evidence-Based
How can eliminating abbreviations reduce errors?
In the medical profession, time is everything. To make documentation as expeditious as possible, a series of abbreviations have been accepted in records. This has been considered an acceptable practice as much as calling a registered nurse an "RN." The problems occur when people are unclear about the abbreviations mean or if a set of letters can have more than one meaning. For example, there is the abbreviation "CA" which means cancer and then "Ca" which is calcium. Another example is "a" which can mean both "artery" and "before" (Medical 2011-page 1). It is very easy to misread abbreviations when medical staff is in a hurry. Imagine the problem if a "q.w." which is take weekly was confused for a "q.v." which is take as one wishes. If the terms were written out rather than abbreviated, these potentially dangerous situations could be…
Berman, Jules. (2008). "Specified Life." Biomedical Informatics.
Greenall, Julie (2006). "Safe Medication Practices." Hospital News.
"Medical Abbreviations Glossary." (2011). JD-MD.
Medical l Nursing
The United States has the largest number of professional nurses in the world totalled 3 millions approximately. Despite the available large number of professional nurses, there is still imbalance between the supply and demand for nurses in the United States. Demand for the professional nurses has outnumbered the supply. Typically, critical nursing shortage has become a serious issue in the United States, and the production capacity is lagging based on the estimated future needs. The concept of nursing shortage refers to the situation where the demand for nurses outnumbers the supply. The worsening nursing shortage in the United States has created the demand for more nurses to fill the gap. Many private and public sectors healthcare leaders have advocated for the serious solution to boost the supply of nurses. One of the solutions advocated is that the U.S. should facilitate the migration of foreign graduate…
Aiken, L.H. (2007). U.S. Nurse Labor Market Dynamics Are Key to Global Nurse
Sufficiency. Health Service Research.42(3):1299-1320.
Brush, B.L. Sochalski, J. & Berger, A.M. (2004). Imported Care: Recruiting Foreign Nurses
to U.S. Health Care Facilities. Health Affairs. 23(3):78.87.
Medical Case Study
Florence (F) is a 43-year-old woman who is two days post-operative, following an appendectomy. She has a history of arthritis, and currently takes 10mg of prednisone daily. She is allergic to penicillin. She weighs 46 kg (101.5 lbs.) and is 168cm tall (5'6"). This puts her slightly underweight for her age and height, at least 18-25 pounds (Height and Weight Chart, 2010). While doing a route in dressing change, nurse notice a yellow discharge emanating from the wound.
Identify and discuss the importance of obtaining information during a nursing admission in relation to post- operative assessment. In modern healthcare, a nurse must first and foremost try to understand and utilize a systematic and synergistic model of data collection and assessment. Human beings are complex creatures, and the more data one has, the easier it will be to ensure that a proper diagnosis is made. A systematic assessment…
Height and Weight Chart. (2010). HealthCheck Systems. Retrieved from:
Prednisone and Other Corticosteroids: Balance the Risks and Benefits. (2011). The Mayo
Clinic. Retrieved from: http://www.mayoclinic.com/health/steroids/HQ01431
In spite of research gaps, medical robotics is a growing trend in the United States.
Advances in Medical Robotics (Diana, 2011)
Hybrid Assistive Limb 5 (HAL5) is an artificially powered ecoskeleton that helps double the amount of weight someone can carry unaided.
DaVinci Si HD Surgical System performs minimally invasive surgery through superior visualization and greater precision, with incisions of one to two centimeters causing less pain and speedier recovery. It reduces the hospital stay to one half and costs one third less.
Sofie incorporates force feedback allowing a surgeon to feel the pressure they apply making sutures and pushing tissue aside. Sofie is expected to develop in five years.
Cyberknife Robotic Radiosurgery System is a non-invasive alternative to surgery for treatment of cancerous and non-cancerous tumors.
Nursebot is designed to specifically help elderly deal with daily activities allowing them to live at home.
RIA is designed to…
Davies, B. (2006). Essay: Medical robotics -- a bright future. The Lancet, vol 368, doi:10.1016/S0140-6736(06)69929-7, S53-S54.
Diana, a. (2011, Jan 29). 12 Advances in Medical Robotics. Retrieved from InformationWeek Healthcare: http://www.informationweek.com/healthcare/patient/12-advances-in-medical-robotics/229100383
Huang, G.P. (2006). Robotics and clinical research: Collaborating to epand the evidence-based for rehabilitation. JRRD, 43(5), xiii-xvi.
Seaman, a. (2013, Jan 4). Racial gaps in access to robotic prostrate surgery. Retrieved from Yahoo Health: http://health.yahoo.net/news/s/nm/racial-gaps-in-access-to-robotic-prostrate-surgery
These examples highlight that technology is always a tool, a way of enhancing human judgment -- we must not mistake it as a replacement for good nursing practice.
After all, the use of a computer is no substitute for a medical education. Anyone who works in a hospital can see this -- the increased accessibility of information through the Internet also means that patients often come in, convinced that they are suffering from a serious illness, allergy, or condition, based more upon a diagnosis Googled on WebMD, rather than upon the fact that they saw a doctor! If a computer alone was required to diagnose, everyone would have a degree!
Don't get me wrong -- I use technology every day in my life, and thank my lucky stars, and my patient's lucky stars, that it is so ubiquitous. When health care providers wish to communicate, the use of cell phones…
Initial Patient Analysis
Discomfort in lower back.
Patient is a 78-year-old woman presented as disheveled, with bug bites throughout her body, and exuding a foul odor. Cognitively, she orients only to her name with a BMI of 30 and a minimal understanding of the English language. She is able to nod "yes" or "no" to questions, but calls the nurse "Mother." She is unsteady on her feet, and has a fine "pill-rolling "tremor in her left hand. He legs are quite cool to the touch, hairless, and toe capillary refill is greater than 2 seconds.
Past Medical History
Unknown, but patient appears to be in distress both physically and psychologically.
Poor, disheveled, may not be receiving adequate care or living in an environment with enough food or warmth. BMI of 30 is technically obese, which also may indicate the patient is not…
Hypoglycemia. (2012). Web MD. Retrieved from: http://symptoms.webmd.com/#./conditionView
Michael, K. And Shaughnessy, M. (2006). Stroke Prevention and Management in Older
Adults. Journal of Cardiovascular Nursing. 21 (55): 521-26.
Mohr, J., et al. (2004). Stroke: Pathopshyciology, Diagnosis and Management. New York: Churchill Livingstone.
Nurses are required to make many immediate decisions in their assigned duties. Unfortunately, in recent years, patient care has often been compromised as a nursing shortage crisis has escalated to epic proportions. Increased patient loads have resulted in often hasty nursing decisions as responsibilities and hours worked have increased. Although precious time must be spread thin to accommodate higher numbers of patients, nurses must exercise their morals through consistency in ethical behaviors. According to Peggy Chinn (1), "Many ethical issues, such as end-of-life decision making, have increased in complexity. Other issues, such as advocacy and choice, have changed in certain respects but are more clearly centrally situated within nursing's ethical domain."
As a result, nurses are held accountable for a variety of decisions in nursing practice and in many instances, a patient's life depends on such decisions to survive. Gastmans (496) states that "Generally, the goal of nursing…
Chinn, P. (2001). Nursing and ethics: the maturing of a discipline. Advances in Nursing Science
Erlen, J. (2001). Moral distress: a persuasive problem. Orthopaedic Nursing 20(2): 76-80.
Erlen, J. (2001). The nursing shortage, patient care, and ethics. Orthopaedic Nursing 20(6):
Gastmans, C. (2002). A fundamental ethical approach to nursing: some proposals for ethics education. Nursing Ethics 9(5): 494-507.
According to the work of Fulford (1994) in an Oxford Practice Skills Project eport "Three elements of practice (ethics, law and communication skills) are approached in an integrated teaching programme which aims to address everyday clinical practice. The role of a central value of patient-centered health care in guiding the teaching is described. Although the final aim of the teaching is to improve the actual practice, we have found three 'sub-aims' helpful in the development of the programme. These sub-aims are: increasing students' awareness of ethical issues; enhancing their analytical thinking skills, and teaching specific knowledge. (Hope, 1994)
In the work of Miles, et al. (1989) entitled "Medical Ethics Education: Coming of Age it is stated that "medical ethics education is instruction that endeavors to teach the examination of the role of values in the doctor's relationship with patients, colleagues and society. It is one form of a broad curricular…
Fryer-Edwards, PhD (2005) Tough Talk: Helping Doctors Approach Difficult Conversations - Resources for Teaching- Domains for Small Group Teaching Prelude 3 Department of Medical History and Ethics University of Washington School of Medicine.
Siegler, Mark MD (2001) Lessons from 30 Years of Teaching Clinical Ethics AMA Journal 2001 October.
St. Onge, Joye (1997) Medical Education Must Make Room for Student-Specific Ethical Dilemmas" Canadian Medical Association Journal 15 Apr 1987, 156(8).
Hicks, L. et al. (2001) Understanding the Clinical Dilemmas that Shape Medical Students' Ethical Development: Questionnaire Survey and Focus Group study. BMJ Journal 2001;322-709-71- 24 march 2001.
The facts that you have provided indicate extremely troubling circumstances that could seriously jeopardize the welfare of your organization. It is well-settled law that entities contracting for the services of subsidiaries are legally responsible for legal and ethical improprieties committed by those subsidiaries irrespective of whether or not the contracting organization had any specific involvement in or knowledge of those actions. Accordingly, we would strongly advise that you take immediate action to rectify the situations described in the manner outlined in our recommendations below.
To avoid the potentially serious criminal, civil, and financial consequences arising under MWHC's respondeat superior responsibility to prevent fraud and abuse in connection with its association with subsidiaries, it is hereby recommended that MWHC immediately:
1. Instruct the subsidiary to cease and desist from offering its contracted home health agency employees compensation of any kind in connection with client durable medical equipment (DME) orders from…
Reid, T. (2009). The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care. New York: Penguin Group.
USDHHS. (2004). U.S. Department of Health and Human Services-Office of Inspector
General-Statement of Organization, Functions -- and Delegations of Authority.
Federal Register. Vol. 69, No. 127; July 2, 2004. Retrieved November 14, 2010,
My predilection for working under stress prepares me psychologically for the unique and demanding profession. The college professor who advised that my disposition and talents lend themselves to a career in osteopathy told me that osteopaths need to be creative as well as analytical: to assess situations and make decisions that synthesize years of prior knowledge and experience. I believe I possess the qualities that would prepare me for a successful and rewarding career as an osteopathic physician.
As I seek entry into your esteemed medical school program with a focus in osteopathy, I can assure you of my capacity to meet challenges with poise and calm. My business experience has prepared me for the demands of medical school: owning a business while attending school full-time has not deterred nor tired me physically. I look forward to participating in your program; I assure you that I will represent your school…
As mentioned earlier, the desired outcome of nursing care is comfort and there are many articles in which the researchers have talked about the needs of the patients and the things that alter the comfort of the patients. Kolcaba suggested that the cancer patients who are terminally ill can benefit from comfort care as it pays attention to the perspective and needs of the patients. Through such kind of care, the patient is not only provided with pain relief, but the depression of the patient is also addressed adequately. As she said that patients who are not in pain but are depressed seek comfort in the transcendental sense as well as in the psycho-spiritual sense (Kolcaba, 1992 p 4). In some of her works, she has explained the use of the instruments and their application by the nurses. Kolcaba reckons that the instruments presented by her to evaluate the comfort…
Kolcaba K. (1994). A theory of holistic comfort for nursing. Journal of Advanced Nursing, 19(10): 1178-1184.
Kolkaba, K. (1992). Holistic comfort: Operationalizing the construct as a nurse-sensitive outcome..Advances in Nursing Science, 15 (1), pp. 1-10.
Kolkaba, K. (1997). The primary holisms in nursing..Journal of Advanced Nursing, 25 pp. 290-296.
Kolkaba, K. And Fisher, E. (1996). A holistic perspective on comfort care as an advance directive..Critical Care Nursing Quarterly, 18 pp. 66-76.
It is the dimension of knowing that connects with human experiences that are common but expressed and experienced uniquely in each instance. It is ultimately the processes of envisioning and rehearsing nurture artistic expression (Chinn, Kramer, & Chinn, 2008).
Empiric knowledge in nursing consists of knowledge development along with highlighting the role of conceptualizing and structuring ideas into knowledge expressions such as theories and formal descriptions. Theories and formal descriptions become shared as empiric knowledge in a discipline and serve to enable scientific competence in practice (Chinn, Kramer, & Chinn, 2008).
It is thought that if knowledge within any one pattern is not critically examined and integrated within the whole of knowing, that uncritical acceptance, narrow interpretation, distortions, and partial utilization of knowledge will occur. When the patterns are used in isolation from one another, the potential for synthesis of the whole is also lost. The formal expressions of knowledge…
Behm, Kathy, Comrie, Rhonda, Crane, Judy, Johnson, Charlotte, Popkess, Ann, Verbais, Chad,
Yancey, Val, Carstens, Belinda, Keene, Carol, Davis, Doris, and Durbin, Christine.(n.d.).
Knowledge Development: Patterns and Outcomes. Retrieved from Web site:
Bieber & Worley (2006) note that when students pay closer attention to their surroundings, and when teachers engage students in a more collaborative manner, students are more likely to set daily schedules that conform with their abilities and adapt to any limitations they may experience while juggling multiple responsibilities.
Anderson (1996) suggests that many Universities need to work with student's to accommodate their unique needs, as long as students are willing to engage in collaborative relationships with their peers (Austin, 2002) and families. One way to teach graduate students how to balance their education, career and any psychological or emotional blocks they may have to success is by teaching students to adopt self-efficient tools, such as creating daily task lists that limit the amount of time they spend on activities to ensure they fulfill all of their obligations (Bandura, 1982). Universities also have an obligation to effectively screen students (Brink,…
Anderson, M.S. (1996). Collaboration, the doctoral experience, and the departmental environment. The Review of Higher Education, 19, 305-326.
Austin, a. (2002). Preparing the next generation of faculty: Graduate school as socialization to the academic career. Journal of Higher Education, 73, 95-122.
Bandura, a. (1982). Self-efficacy mechanisms in human agency. American Psychologist, 37(2),
Bieber, J.P., & Worley, L.K. (2006). Conceptualizing the academic life: Graduate students perspectives. Journal of Higher Education 77, 1009.
medical examiners of years past to the current technological advancements of medical examiners today. The earliest medical examiners were called coroners, and they still exist in some areas of the United States, although they have largely been replaced by medical examiners. Medical examiners are licensed physicians trained in pathology and death investigation.
In the past, coroners had much more power than they do today. They were more involved in criminal justice, and could even arrest prisoners and set their bail. They were not paid a salary, but paid for each inquest they conducted. They were also open to bribes and embezzlement, since they did not receive a salary. Families would offer bribes to cover up suicides, and politicians would offer bribes to cover up embarrassing accidents or other deaths that might impact their political careers. One New York City coroner said, "A few of the coroners, and let me emphasize…
Timmermans, Stefan. "Postmortem: How Medical Examiners Explain Suspicious Deaths." University of Chicago Press. 2006. 2 Oct. 2009.
Medical marijuana has increasingly been in the news as a growing number of states throughout the U.S. have passed measures or at least put on the ballot an initiative to legalize either medicinal or recreational marijuana usage. The history of marijuana in the U.S. is one that goes back as far as the country itself: hemp (a type of marijuana plant) was used for rope, paper and a number of other purposes because of its strong fibrous tissue.1 It was not until the Prohibition Era of the 1920s that marijuana began to be prohibited by law in the U.S.—and within a decade, it was regulated among most states under the Uniform State Narcotic Act.2 Thus, from its very first days as a crop grown by the Virginia Company for exporting to England by decree of James I—and in fact from the days of the first President of the U.S.…
medical home concept and describe the principles (operational characteristics mentioned above) of the PC-MH as defined by these organizations. How does this concept differ from the gatekeeper concept of Managed Care Organizations?
According to the 'gatekeeper' philosophy of health management organizations (HMOs), physicians are intentionally given incentives to reduce access to care. This is based upon the assumption that patients will want to obtain as much care as they can receive and physicians will want to bestow that care to please patients and incur more revenue. HMOs encourage physicians to do the opposite and often financially reward physicians for cost reductions and limiting access of patients to specialists or heroic treatments. In the HMO model, physicians try to restrict access to specialists when they do not deem it necessary.
In contrast, the medical home concept is viewed as a partnership between "individual patients, and their personal physicians, and when appropriate,…
Case for change to the PC-MH Model (2011). American Dietetic Association.
Retrieved October 19, 2011 at http://www.eatright.org/HealthProfessionals/content.aspx?id=7059
Joint Principles of the Patient-Centered Medical Home. (2007). American Academy of Family
Physicians (AAFP). American Academy of Pediatrics (AAP). American College of Physicians (ACP). American Osteopathic Association (AOA)
medical and ethical dilemmas, even if the activities were deemed technically legal or not questioned at the time. The fact that the studies sought to gain information from human subjects under unfair and undesirable circumstances means their results cannot be condoned and the findings cannot be accepted or used as viable study data. Each study directly crosses the line into scientific unacceptability in different ways; and while their underlying approaches raise interesting historical and philosophical questions -- that did not need to be tested to be debated -- there is no way to weed out the biases that contaminate the data.
This being said, it is generally safe to say that all of the studies were improper (unethical and/or illegal) at the time that they were being undertaken. This can be seen in the fact that in every instance the medical professionals involved were either directly or indirectly punished for…
Consumer Reports (2007). "Off-Label" Drug Use, Shopper's Guide. Downloadable at http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/money-saving-guides/english/Off-Label-FINAL.pdf .
Pain Management of America (2011). Chronic Pain Treatment and Management with Medical Marijuana. Viewable at http://www.medicalmarijuana.net/uses-and-treatments/chronic-pain/.
SOURCES OF STUDIES
Jewish Chronic Disease: http://johnmueller.org/Problems/Cancer.html
Case Involving a Medical Dilemma
Nurses usually experience ethical dilemmas while carrying out their work of providing care to different patient populations. Ethical dilemmas arising during nursing practice are largely attributable to the complex processes involved in healthcare delivery. An example of a landmark case involving a medical dilemma is the case of a 17-year-old girl in Connecticut, Cassandra C, who refused to continue receiving chemotherapy. Cassandra was diagnosed with Hodgkin lymphoma at Connecticut Children’s Medical Center in September 2014. Following her diagnosis, doctors recommended chemotherapy as a suitable treatment approach that would help save her life. However, with her mother’s support, Cassandra refused this treatment approach for her potentially curable cancer resulting in a medical dilemma that ended up at the Connecticut Supreme Court. In a unanimous decision, the Connecticut Supreme Court ruled that the teenager cannot refuse chemotherapy on the premise that she is not mature (Viale, 2015).…
Hevia, M. & Schnidrig, D. (2016, December). Terminal Patients and the Right to Refuse Medical Treatment in Argentina. Health and Human Rights Journal, 18(2), 247-250.
Viale, P.H. (2015, March-April). Refusal of Therapy: When Is It Appropriate? Journal of the Advanced Practitioner in Oncology, 6(2), 96-97.
Internal rate of return is 72%.
Conversely, Proposal 2 operates at a $150,000 deficit for its first year of operation. Totals costs for the CT scan equipment are $1.1 million ($500,000 variable costs from $500 per patient and $600,000 fixed cost for insurance and equipment leases) while revenue for year one is only $950,000 (from per visit payments of $950 per patient). One thousand patients are expected in year one of operation. The initial cost of investment for Proposal 2 was $50,000 putting the total budget deficit for Proposal 2,-year 1 at $200,000. Total costs for year two are $1,350,000 while gross revenue reaches $1,425,000. This presents a positive cash flow of $75,000 however because of the loss of $200,000 in year one, net profits for year two are negative at $125,000 ($200,000 [year one net profit] - $75,000 [year two cash flow]).
Like Proposal 1, Proposal 2 becomes profitable…
Fridson, Martin S., and Fernando Alvarez. Financial Statement Analysis: a Practitioner's Guide. New York: John Wiley & Sons, 2002. Print.
Friedlob, G. Thomas., and Franklin James Plewa. Understanding Return on Investment. New York: Wiley, 1996. Print.
Hofstrand, Don. "Understanding Cash Flow Analysis - File C3-14 December 2009." Iowa State University Extension. Web. 15 Mar. 2011.
Lobotomy is a popular medical procedure introduced in curing mentally ill individuals, which requires the removal of the prefrontal lobes of the cortex of the brain, the part of the brain wherein aggressive and violent behavior is triggered. However, in the movie, lobotomy is shown to have disastrous results: McMurphy's violent behavior is indeed abated, but as illustrated in the movie, the lobotomy had turned him into a 'vegetable' neither responding to his ward mates' call for attention nor displaying his usual rowdy, obnoxious, McMurphy self.
This instance in the movie is considered as patterned after the medical model of abnormal psychology, wherein "mental disorders are described as medical diseases with a biological origin" (450). ecause this is the prevalent thinking in medical science during the time the movie (and novel) was made, Nurse Ratched decided, in order to "treat" McMurphy, to let him undergo lobotomy. Subsistence to the medical…
Santorck, J. (2001). Psychology. NY: McGraw-Hill Book Co.
Barnsteiner JH. Medication reconciliation: transfer of medication information across settings -- keeping it free from error. Am J Nurs. 2005;05(3 Suppl):3-6.
This article evaluates the need for proper medication reconciliation across various nursing settings. This article is important as emphasis is placed on error free reconciliation which is very important for proper client service and treatment.
Bullough, Vern L. and Bonnie Bullough. The Emergence of Modern Nursing (2nd ed. 972)
This reference emphasized modern nursing and many of the practices and advances of nursing over the years. This is important as it provides a historical perspective of medical reconciliation. A historical perspective is needed to better understand improvements that will need to be made in the future.
D'Antonio, Patricia. American Nursing: A History of Knowledge, Authority, and the Meaning of Work (200), 272pp
This reference provides further evidence into the history of medical reconciliation and recommendations on improvements that should…
13. Rogers G, Alper E, Brunelle D, et al. Reconciling medications at admission: safe practice recommendations and implementation strategies. Jt Comm J Qual Saf. 2006;32:37-50
14. Snodgrass, Mary Ellen. Historical Encyclopedia of Nursing (2004), 354pp; from ancient times to the present
15. Sullivan C, Gleason KM, Rooney D, et al. Medication reconciliation in the acute care setting: opportunity and challenge for nursing. J Nurs Care Qual. 2005;20(2):95-98
Describe briefly your topic of interest (15 possible points):
According to the United States Department of Health and Human Services (2013), medical reconciliation is "the process of comparing a patient's medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplications, dosing errors, or drug interactions." The process of medical reconciliation falls within the rubric of electronic medical records, which enable medical reconciliation. Medical reconciliation saves lives, improves the efficiency of hospital administration and of the healthcare team, and is simply necessary for providing quality of care.
#1 Database (or collection) (30 possible points):
Title of source:
"Electronic Health ecord (HE)"
Location of source (UL): http://www.ihs.gov/ehr/index.cfm?module=medication_reconciliation
Owner or publisher:
Indian Health Service
The Indian Health Service (2013) offers an overview of what medical reconciliation is, and how it applies to both individual and community health.…
"Electronic Health Record (EHR)," (2013). Indian Health Service. Retrieved online: http://www.ihs.gov/ehr/index.cfm?module=medication_reconciliation
"Medical Reconciliation," (2013). Greater Baltimore Medical Center. Retrieved online: http://www.gbmc.org/body.cfm?id=617
United States Department of Health and Human Services (2013). Electronic health record (EHR). Retrieved online:
Health are -- Medical Retention Laws
Medical records retention requirements, whether Federal or State, are apparently aimed at maintaining records for a significant length of time after a patient's discharge. HIPAA does not impose a specific requirement for retention of a patient's medical records and leaves that task to State legislatures. alifornia meets and far exceeds Federal requirements in multiple requirements from multiple laws. Meanwhile, Nevada takes a far simpler tack while still adhering to Federal requirements.
HIPAA does not impose a length of time for which patients' medical records must be retained (U.S. Department of Health and Human Services, 2009); rather, that requirement is left to the states. However 45 .F.R. §164.530(j) does require that an entity governed by HIPAA must retain its "privacy policies/procedures, privacy practices notices, disposition of complaints, and other actions, activities, and designations that the Privacy Rule requires to be documented" (U.S. Department of…
California's record retention laws are at least as strict as federal law, as required, and are often stricter. Beyond the HIPAA requirements binding covered entities, California has various strict retention requirements stemming from several laws. California's Code of Regulations §70751(c) (22 C.C.R. §70751(c) requires hospitals to keep patients' medical records for a minimum of 7 years after any patient's discharge and, if the patient is a minor, the records must also be retained for a minimum of 1 year after the minor has reached the age of 18 (California State Legislature, 2013). Also, the Welfare & Institutions Code §14124.1 states that the medical records of Medi-Cal patients must be kept by the provider for 3 years after the last date of service rendered under the Medi-Cal Program (California State Legislature, n.d.). In addition, the Health & Safety Code §1797.98e (b) states that providers reimbursed by the Emergency Medical Services Fund must keep patients' records for 3 years after the last reimbursed service was rendered (California State Legislature, n.d.). The Health & Safety Code under §11191 also requires that prescription books with issued prescription copies must be kept for 3 years after the last noted prescription was issued and that a provider who "prescribes, dispenses or administers a controlled substance classified in Schedule II" is required to make and keep a record of each such transaction for 3 years (California State Legislature, n.d.). Furthermore, under California's Code of Regulations §1300.67.8 (28 C.C.R. §1300.67.8), managed care plans governed by the Knox-Keene Act must also retain all "records, books, and papers of a plan" for 2 years, keeping the records available for inspection by the Commissioner of Corporations (California State Legislature, 2009, p. 54.5). California's Code of Regulations §39.5 also requires that in cases of Worker's Compensation, all qualified medical evaluators must retain patients' medical-legal reports for 5 years after the employees' evaluation (California State Legislature, 2013). Finally, regarding its state Occupational Safety and Health Administration (OSHA) program, California's Code of Regulations §3204(d) (8 C.C.R. §3204(d) requires that in cases of employees who were exposed to "toxic substances or harmful physical agents," providers must keep medical records for a minimum of the duration of employment plus thirty years (California State Legislature, 2013).
Nevada's laws regarding medical records retention
Ethical Dilemma: case study of clinical trial on a child
The field of medicine and research has been surrounded by issue of experiments in order to have the conclusive result of the effectiveness of a drug or otherwise. These results can only be obtained if the drugs are at times used on human beings with the real medical problem that the experiment seeks to find solution to. The problem of ethical dilemma often comes in at such stages on whether to go ahead to experiment on the effectiveness of the new drug or not.
Ethical dilemma refers to the situation that is deemed complex since it involves some element of mental conflict between moral imperatives that is one goes ahead and obeys one, it will mean the transgression of another (Braunack-Meyer A.J., 2001). The individual does not have a clear cut direction on which option to go for, despite there…
Braunack-Meyer A.J., (2001). What makes a problem an ethical problem? An empirical perspective on the nature of ethical problems in general practice. Retrieved November 29, 2014 from http://jme.bmj.com/content/27/2/98.full
Pier B.K., (2007). Children, Gillick Competency and Consent for Involvement in Research. Retrieved November 29, 2014 from http://jme.bmj.com/content/33/11/659.abstract
Spriggs M., (2010). Understanding Consent in Research Involving Children: The ethical Issues. Retrieved November 29, 2014 from http://www.mcri.edu.au/media/62539/handbook.pdf
against experimentation on animals, and some are more compelling than others. Some people suggest that the practice is immoral because choosing to experiment upon animals is directly analogous to racial or sexual discrimination; or more closely related to discrimination on the basis of mental capacity. Others contend that it is wrong because, by their estimations, no clear advances in medical research have been made through animal experimentation, and alternative modes of research are emerging. Doubtlessly, animal experimentation is a delicate moral issue, but asserting that animals should enjoy the same rights as humans within a society is a weak claim. Arguments have been formed differentiating animals from humans depending upon both their moral status and biological status. Yet, the most obvious line of reasoning is associated with the fact that granting animals the same rights as humans within society leads to many logical contradictions.
One question that needs to be…
1. Dunbar, Daniel. "The Confinement and Use of Non-Human Animals in Scientific and Medical Experiments is Morally Unacceptable." Ithaca University, 2005. Available: http://www.ithaca.edu/faculty/cduncan/250/ddunbar.doc .
2. Mitchell, Graham. "Guarding the Middle Ground: the Ethics of Experiments on Animals." African Journal of Science, Issue 85, May 1989. Available: http://www.garfield.library.upenn.edu/essays/v13p114y1990.pdf .
The differences between a medical diagnosis of Autism and an educational diagnosis of Autism often have implications for the individualized educational prospects of an autistic student in public schools. Often even when a child has a medical diagnosis of autism parents still go through the diagnostic process of the school to determine what, if any, educational adjustments can or should be made. Diagnosis is made more difficult by the fact Autistic symptoms vary widely in individuals and often tend to manifest themselves in many different combinations (Lenne, 2001, P. 71). Autistic impairment includes social, communicative, and behavioral development challenges. An autistic child may have trouble with nonverbal language, poor eye contact, and difficult making and retaining friends (Lenne, 2001, P. 71). n terms of communication, there may be delays in speaking difficulty using or imitating language and incorrect use of words (Lenne, 2001, P. 71). Repeated body movements and…
In 2000, a set of guidelines were formulated by the American Academy of Neurology. (Blackwell, 2001). The panel's guidelines are widely recommended and urge providers to carryout diagnosis in several stages. In the very first stage of investigation clinical practioners are urged to screen for any children who may display behavior or characteristics which may place the child at risk for any developmental delays (Blackwell, 2001). The second investigative step is to screen for those children who are specifically at risk for autism so that they can be differentiated from those children who have other developmental disorders (Blackwell, 2001). Blackwell, et. al argue that before the diagnosis of autism is attempted all primary care physicians should routinely, when necessary, use developmental screening tests on their patients. Unfortunately, less than 1/3 of "primary care providers have been shown to conduct a standardized developmental screening test in child office visits" (Blackwell, 2001, p. 534).
The AAN guidelines urge that when a child has delayed language development or motor skills, the primary care provider should immediately engage in audio logical assessment to rule out any ear or auditory issues, followed by using the CHAT, Autism Screening Questionnaire (Blackwell, 2001, p. 535). At this stage, one of two things must happen, either the child passes or fails the test; if the child passes, then the child still must undergo a formal diagnostic procedure including a neurological evaluation, if the child fails the doctors must communicate the need for early child-hood intervention with the school district in addition to the formal diagnostic evaluation (Blackwell, 2001, p. 535). Although Blackwell, et. al do not detail the specific diagnostic indicators of autism their overview of the AAN guidelines are important in order to demonstrate the relationship between the school and the medical provider.
Whereas the medical diagnosis focuses on the symptoms the educational diagnoses often focus on the relationship between the symptom and its impact on the child in the class room. An individualized education plan is dependent on significant impairment in the classroom which is more than just behavioral in nature. Often behavioral problems in school are seen as acting out rather than a symptom
Commercialization of a Medical Product
It is important to note, from the onset, that patents present the most effective approach to 'locking' the desired market after realizing the fruits of research. This is particularly the case given that the commercialization of medical research in itself brings about a high level of risk to the key stakeholders involved in the entire research process, particularly investors. In the case under consideration, we assume that investors will have a two-year period of market exclusivity, after which the medical research team will lose its patent protection. This effectively means that other companies will be free to manufacture and sell the drug. The relevance of formulating the right strategies to guarantee the profitability of the company after the two-year period cannot, therefore, be overstated.
The removal of patent holder's monopoly not only promotes, but also encourages competition (Joly and Knoppers, 2014). There are several approaches…
Gupta, H., Kumar, S., Roy, S.K. & Gaud, R.S. (2010). Patent Protection Strategies. J Pharm Bioallied Sci, 2(1), 2-7.
Joly, Y. & Knoppers, B.M. (Eds.). (2014). Routledge Handbook of Medical Law and Ethics. New York, NY: Routledge
Many people hate to go to the doctor's office -- especially when they know that they will be receiving an injection. However, I, along with millions of people the world over, consider ourselves very lucky to do just that, each and every month of our lives. You see, for people like me with a disorder known as "pernicious anemia," the doctor and her needle are the important link between a healthy life and a life of absolute misery. This is because, unlike classic anemia, the common form of the blood disorder that usually results in little more than fatigue, pernicious anemia can result in catastrophic changes in the body, chief among them severe neurological impairment that, in its severe form, can result in absolute madness. For those of us who suffer from this disease caused by an inherited deficiency, or caused from some disruption or disorder in the…
Intelihealth. "Pernicious Anemia." Web site. 2004. Retrieved from Web site on April 10, 2004 www.intelihealth.com/IH/ihtIH/WSIHW000/9339/20862.html
Medline Plus. "Pernicious Anemia." Medline Plus Medical Enclyclopedia. 2003 Retrieved from Web site on April 10, 2004 http://www.nlm.nih.gov/medlineplus/ency/article/000569.htm
health information technology occupation and conduct a search of the Internet, consult professional
Thorough Job Details: Although there are not an abundance of qualifications that an individual must have to earn a position as a professional medical coder, there are several different avenues to pursue them. Candidates typically must have graduated high school or earned the equivalency of a high school diploma. Once they have completed this step, they can satisfy the general education requirements in a couple of different ways: either by earning an associate's degree or a postsecondary certification in health information technology or in a related field. Certificate programs typically last less than a year, whereas associate's degree programs are generally two years of full time study. The completion of these courses usually qualifies individuals to begin working within the field of medical records and health information technology as a medical coder. It is also permissible for…
Bureau of Labor Statistics (2014). Medical records and health information technicians. www.bls.gov. Retrieved from http://www.bls.gov/ooh/Healthcare/Medical-records-and-health-information-technicians.htm
Bureau of Labor Statistics. (2014). Medical and health services manager. www.bls.gov. Retrieved from http://www.bls.gov/ooh/management/medical-and-health-services-managers.htm
Tiffan, B.; (2014) The art of team leadership, American Journal of Health -- System Pharmacy, Vol. 7, Issue 10
Credibility -- Author Analysis
Bill Tiffan is a Principal with T2 Management Consultants which he and his wife co-founded in 2000. According to the company website, Tiffan "provides management consulting, team development, executive coaching and facilitation services to organizations that want to improve the effectiveness of individual leaders and executive teams" (T2, 2009). Tiffan previously spent 12 years with and international transition consulting firm where he was Regional Vice President of Sales. Bill also writes a bi-monthly column for the ACPE's professional journal; the focus of his column is executive career development. Tiffan also serves on the Board of Global Partners for Development. Tiffan recently wrote an article for the Medical industry espousing his beliefs concerning medical professionals as they pertain to team leadership, an area in which he has displayed…
T2 (2009) Principals, accessed at http://www.t2-consultants.com/sitepages/principals.htm, on October 12, 2014
Tiffan, B.; (2014) The art of team leadership, American Journal of Health -- System Pharmacy, Vol. 7, Issue 10, pp. 799 -- 801
Cross Cultural elations
Cultural influences perceptions about gender roles in a number of ways. The first is through socialization. Being in a culture one sees how gender roles are typically manifested in that culture, and one thus will tend to adopt similar views. The structure of the culture is therefore highly influential simply because being in a culture leads one to adopt the gender roles in that culture (no author, 2015).
The second method is through enforcement. People in a culture will learn gender roles when those roles are enforced. People in positions of authority (parents, teachers, etc.) will specifically enforce gender roles on children in a society in the sense that when somebody steps out of the norms for that society, there will typically be negative consequences. Similarly, there are usually positive consequences for people who follow gender norms in a society most closely. Enforcement is not only through…
No author (2015). Gender and sociology. Boundless.com. Retrieved November 1, 2015 from https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/gender-and-sexuality-15/gender-414/gender-and-sociology-296-12831/
Chamberlain College of Nursing NR449 Evidence-Based Practice
Evidence Matrix Table
Size and Selection
(sample not a real article)
Smith, Lewis (2013),
What should I eat? A focus for those living with diabetes. Journal of Nursing Education, 1 (4) 111-112.
How do educational support groups effect dietary modifications in patients with diabetes?
Convenience sample-selected from local support group in Pittsburgh, PA
Support and education improved compliance with dietary modifications.
de Vries K, Green AJ (2012) Therapeutic use of cannabis. Nursing Times; 108: 9, 12-15.
Describe the potential uses of cannabis in palliative care, and to help nurses advocate for patients by providing information about cannabis use and legality. How should nurses react when patients ask about medical marijuana?
None; not an experimental research design.
Untold quantities of research studies in published journals.
Peer-reviewed and professional literature. Legal…
The author of this report has been asked to assess the medical condition and prognosis for John Smith. John is a sixty-eight years old and has a pretty good array of medical problems. He has had psoriasis for more than a generation and the ointments he has been using to treat it have become ineffective. Beyond that, the psoriasis is spreading to parts of his body that have not been trouble areas before. His son Patrick asserts that he believes that the psoriasis is to the point that it is contagious. While John is facing some challenges, there are things that can be done and this includes properly education both John and Patrick.
Straight off the top, the assertion by Patrick that the psoriasis is "contagious" is patently and absolutely false. Psoriasis is never contagious and there is not a chance that anyone around John will "catch" it.…
WebMD. (2015). Adult Vaccines TOC. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/vaccines/default.htm
WebMD. (2015). Causes of High Blood Pressure. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causes
WebMD. (2015). Heart Disease Health Center. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/heart-disease/default.htm
WebMD. (2015). Lung Disease & Respiratory Health Health Center - Symptoms, Causes, Treatments. WebMD. Retrieved 8 October 2015, from http://www.webmd.com/lung/default.htm
Medical and Billing Claims
I certainly do not agree with Tina's way of filling out an insurance claim. In fact, her method appears extremely suspect and potentially noxious to the company that both she and Tim are working for. The reason that I do not agree with Tina's way of filling out an insurance claim form is because she leaves far too much room for error. The fact that she would rather make an educated guess about the veracity of a claim based on unclear handwriting or terms she is ignorant about certainly does not bode well for her career -- or the degree of business that the company she is working for has. The billing and coding specialist position in the medical record field leaves little room for error.
There are a couple of rules or guidelines I would suggest Tina adhere to when attempting to fill out a…
Hobbes, T. (1651). Leviathan. www.Oregonstate.edu Retrieved from http://oregonstate.edu/instruct/phl302/texts/hobbes/leviathan-contents.html
Machiavelli, N. (2006). The Prince. Project Guttenberg. Retrieved from http://www.gutenberg.org/files/1232/1232-h/1232-h.htm