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physicians view the health care system of the United States in terms of cost, quality and access. The purpose of this research plan is to develop a survey that will present a conceptual model for measuring health plan quality from the perspective of physicians and nurses.
The survey will be conducted through telephone interviews and emailed surveys to a national random sample of 30 physicians and 20 nurses nationwide between February and March 2003.
Due to the fact that fewer Medicare beneficiaries are in managed health care plans, the survey asks doctors and nurses only about their experiences with patients under 65 years of age. The physician sample will be drawn from the American Medical Association's physician list and will target physicians who care for patients 20 or more hours per week.
This survey will gather quantitative information about physicians' and nurses' experiences with and attitudes towards health plans, particularly…
physicians agree that managed care is not doing the job it was originally created to do. Although reform efforts have not worked in the past, many doctors believe now is the time to revisit reform to combat the lack of health care access to a growing number of Americans, escalating costs, and deteriorating quality. This paper explores the evolution of managed care, and its problems and possible solutions from the viewpoint of two organizations representing the interests of physicians.
In 1993, President Clinton introduced a plan for regulated health care reform in response to escalating costs and the growing ranks of the uninsured. From 1970 until the time of the reform proposal, health care spending had increased from $74.4 billion to $752 billion annually. The Clinton proposal was met with huge opposition from the "medical industrial complex" comprised of insurance firms, pharmaceutical companies, hospital suppliers and medical device companies and…
Bibliography better-quality alterantive; single-payer national health system reform. Retrieved on February
3, 2003 Physicians For A National Health Program Web Site: http://www.pnhp.org/publications/archives/000015.php national health program for the United States: a physician's proposal. Retrieved on February 3, 2003 Physicians For A National Health Program Web Site: http://www.pnhp.org/publications/archives/000016.php
Caplan, A. (2000, December 21, 2000) In 2000, managed care our no. 1 health crisis, Retrieved on February 3, 2003 from MSNBC News Web Site: http://www.msnbc.com/news/671464.asp
Healthcare crisis: managed care. Retrieved February 3, 2002 from PBS Web site: http://www.pbs.org/healthcarecrisis/managedcare.html
Position paper on universal access to health care and health system reform. Retrieved on February 3, 2003 from American Medical Women's Association Web Site: http://www.amwa-doc.org/publications/Position_Papers/univesal_access.htm
The Dying Profession of Independent Physicians
In the past, it has always been the case that physicians were, for the most part, independent contractors who had working agreements with certain hospitals in their region. However, that is not the case anymore. Physicians are increasingly joining healthcare organizations because the costs of remaining autonomous are too strenuous. It does not matter that independent physicians, on average still make more than their group counterparts because there are too many advantages to joining a healthcare group. The primary advantage being the fact that the individual is no longer solely responsible for such tasks as billing and scheduling. Although joining a group may be advantageous in some ways, it is troubling in others. Patient care is sometimes lessened because, as with the government sponsored socialized medical practices that exist in other countries, the patient may have to wait longer for care and…
Berman, Micah. "The 'Quality Health Care Coalition Act': Can Antitrust Law Improve Patient Care?" Stanford Law Review 53.3 (2003): 695-717. Print.
Biz Times. "Independent Physicians are a Vanishing Breed." Biz Times: Milwaukee Business News, 8 August 2008. Web.
Chufo, Veronica. "Independent Docs Vanishing: As Healthcare Costs Rise, Many Physicians are Joining Healthcare Systems to Pool Resources, but is That Trend Best for Patients?" Daily Press, 15 June 2009. Web.
Figliuolo, Michael L., Paul D. Mango and David H. McCormick. "Hospital, Heal Thyself." The McKinsey Quarterly (2000): 91-95.
(Easterbrook, et al., 1999)
ourke goes on to discuss his recommendations for increasing the number of rural sourced students to medical training programs, the most important of which is changing the admissions one that more adequately recruits rural candidates:
Changes to admissions process
• to admit a fair and equitable number of students of rural original to medical school
• Include rural physicians and rural community members on admissions policy and process committees
• Include rural physicians and rural community members as interviewers
• Ensure that students of rural origin are not disadvantaged by the admissions process
• Apply a rural adjustment factor to grade point averages and MCAT scores
• Set targets for rural enrolment (ourke, 2005)
All of these strategies to increase enrollment of rural candidates in medical training programs seem logical as the need to recruit people that have ties to rural communities and…
Curran, V., & Rourke, J. (2004). The role of medical education in the recruitment and retention of rural physicians. Medical Teacher, 26 (3), 265-272.
Easterbrook, M., Godwin, M., Wilson, R., Hodgetts, G., Brown, G., Pong, R., et al. (1999). Rural background and clinical rural rotations during medical training: effect on practice location. Canadian Medical Association Journal, 160 (8), 1159-1163.
Grumbach, K., Vranizan, K., & Bindman, a.B. (1997). Physician Supply AndAccess to Care in Urban Communities. Health Affairs, 16 (1), 71-86.
Hutchison, B., Abelson, J., & Lavis, J. (2001). Primary Care in Canada: So Much Innovation, So Little Change. Primary Care, 20 (3), 116-131.
Introduction to Situation
This paper is based on a fictional case study in which a young woman is considering becoming a physician. Prior to fully committing to this decision, she desires to attain prudent financial information about its repercussions. Specifically, she is seeking to identify the return on investment that her decision could potentially generate. This involves both qualitative and quantitative factors, the former of which pertains to personal gain derived from aiding people in a much needed professional setting. The latter relates to the finances she can generate from practicing medicine.
This financial data is stratified into a number of different categories corresponding to the market for doctors in terms of supply and demand, elasticity, production costs, pricing, and normal profit. These factors will help her to decide in which state it is beneficial to practice. The focus of this paper, then, is to identify how these factors relate…
shortage of physicians overall, or only in key areas? If the latter, what policies might encourage more physicians to enter important fields like primary care and geriatrics?
The answer to both questions is 'yes.' While overall there is a shortage of physicians, there are clearly areas of greater need than others. In total, "at current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges" (Sataline & Wang 2010). However, there are critical areas that are suffering much more acute deficits, such as primary care. "The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007" (Sataline & Wang 2010). Only about half of…
Halsey, Ashley. (2009). Primary-care doctor shortage may undermine health reform efforts.
The Washington Post. Retrieved October 16, 2011 at http://www.washingtonpost.com/wp-dyn/content/article/2009/06/19/AR2009061903583.html
Kavilanz, P. (2010). Why the U.S. faces a shortage of rural physicians.CNN.
Retrieved October 16, 2011 at http://money.cnn.com/2010/03/26/news/economy/health_care_rural_care_country_doctors/index.htm
Medicare payments to physicians have come under some serious controversial debate lately due to erroneous calculations by CMS. This issue is raised in a recent article published in Ophthalmology Times where author, Neal Freeman, explains the variables used to calculate sustainable growth rate in Medicare payments systems which directly affects physicians' payout. The author first focuses on the estimates used to calculate sustainable growth rate in Medicare. These factors include "estimates in changes in physicians' fees, changes in the average number of Medicare beneficiaries, changes in expenditures due to regulatory changes, and growth in per capita gross domestic product." Once this has been determined, the government establishes an index of target and actual expenditure. A fee schedule for physicians is then determined with resource-based relative value system. There is a general resentment against this method for calculate of physicians' payments under Medicare. It is believed that this method of sustainable…
1. Freeman, L. Neal, Physician payments hinge on sustainable growth rate factor: system can be confusing, but does bear a crucial role in physician compensation.(Medicare reimbursement) Ophthalmology Times; 10/15/2004
specialization by physicians contributed to inefficiency in healthcare?
Research conducted by Dartmouth economics instructors Katherine Baicker and Amitabh Chandra indicates that areas of the United States that have "…relatively more medical specialists" tend to have "higher spending per Medicare beneficiary" and yet those areas do not produce "higher quality care," or more satisfaction, or even "lower mortality" (Baicker, et al., 2004).
The initial pertinent question raised by the researchers: a) is a higher density of doctor specialization in healthcare markets linked to "higher-quality healthcare?" The first part of the answer is that when there is increased specialization in a healthcare area it is linked to the fact that patients see more doctors (Baicker, 359). In areas where there are say, eight more medical specialists per 100,000 people -- and 8 fewer family practitioners -- those areas have "…50% more beneficiaries seeing more than 10 doctors in the last six months…
Baicker, K., and Chandra, A. (2004). The Productivity of Physician Specialization: Evidence
From the Medicare Program. Harvard University. Retrieved February 26, 2014, from http://www.hks.harvard.edu .
Feldman, D.S., Novack, DH, and Gracely, E. (1998). Effects of managed care on physician-patient relationships, quality of care, and the ethical practice of medicine: a physician survey. PubMed. Retrieved February 26, 2014, from http://www.ncbi.nlm.nih.gov .
Jecker, N.S. (1998). Managed Care. Ethics in Medicine. Retrieved February 26, 2014, from http://depts.washington.edu .
Euthanasia: "Should physicians be allowed to assist in patient suicide?" (No)
Euthanasia is, quite literally, a "life and death" issue. It is no surprise, therefore, that it evokes heated debate among doctors, lawyers, philosophers, academicians as well as the general public all over the world. Although, recent developments in modern medicine have given it a new dimension, euthanasia is by no means an exclusively modern-day concern. Even the ancient Greeks had pondered over the issue centuries ago, albeit without reaching a definite conclusion about its merits or otherwise. In more recent times, euthanasia has been the subject of discussion in various forums including the Supreme Court of the United States with similar inconclusive results. Despite considerable debate and weighty arguments by either side, several key euthanasia questions remain unresolved such as "Should physicians be allowed to assist in patient suicide?" which is the subject of this paper. In the following…
Angell, Marcia. "The Supreme Court and Physician-Assisted Suicide -- The Ultimate Right," Article reproduced in "Taking Sides: Clashing Views on Controversial Bioethical Issues," pp. 80-87
Evans, Hilary M.D. "Pitfalls of physician-assisted suicide" (September 1997) Physician News Digest. Retrieved on October 28, 2003 at http://www.physiciansnews.com/commentary/997wp.html
Foley, Kathleen M. "Competent care for the Dying Instead of Physician-Assisted Suicide." Article reproduced in Taking Sides: Clashing Views on Controversial Bioethical Issues," pp. 88-95
Hendin, Herbert "Physician-Assisted Suicide and Euthanasia in the Netherlands: Lessons from the Dutch," 277 Journal of the American Medical Association, (June 4, 1997), p. 1720-1722
Stark II rules, physicians are presumed to have "financial relationships" by virtue of any direct rather than indirect compensation arrangement with any clinic, hospital, or other entity furnishing or delivering healthcare services that are within the Stark designation. In principle, the applicability of Stark prohibitions to the entities detailed depend substantially on whether there is an intervening entity between the physician and the facility or entity in which he owns a financial interest. In that regard, the owning physician is deemed to "stand in the shoes" of the healthcare entity in that the payment or compensation format of one is presumptively and automatically, ipso facto, imputed to the other.
The Modern Evolution of Stark II and Applicability to Hospitals and Physicians
Previous version of Stark rules excepted various indirect compensation mechanisms, such as where the physician was technically employed by a clinic or other facility that was, in turn, owned…
ight to Die
The case of Mildred D: The right to die
The core dilemma of 'the right to die' of Mildred D. revolves around Mildred's alleged statement to her children that she wanted no heroic means to continue her life. There is also the question of whether intravenous feeding is 'heroic' means, since removing the NG will effectively 'starve' her and ending her life before it would naturally terminate were the NG tube not removed. Food is usually not considered 'additional' means of life support, although it is debatable whether food not administered by mouth constitutes heroic means. Mildred had no living will clarifying her wishes and is now not competent to make the decision herself.
Legally, in the U.S. Supreme Court case of Cruzan v. Director, Missouri Department of Health, "the Court considered whether Missouri could insist on proof by 'clear and convincing evidence' of a…
Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261 (1990). Retrieved:
The right to die. (2012). Exploring Constitutional Conflicts. Retrieved:
physician-assisted suicide. Specifically, it will show why I disagree with physician-assisted suicide. Physician-assisted suicide is too much like playing God. When people die should be up to their bodies and God, not a doctor who is not involved with them or their families.
In many religions, suicide is a sin, and if you commit suicide, you will go to Hell. This refers to any kind of suicide, even physician-assisted suicide. "As unrepentant simmer, suicides were denied burial in consecrated ground and expected to end in Hell" (Van Den Haag 136).
Even if it is not a sin, it is not normal. Normal people do not commit suicide; they have something wrong with them mentally or physically, and cannot deal with it, or deal with the pressures of life. People who commit suicide with the help of a physician because of a terminal disease are no different from anyone else. They…
Is physician-assisted suicide ethical if the patient requests medical assistance in terminating his or her own life?
In the U.S., the Supreme Court ruled in Washington v. Glucksberg (1997) that physician-assisted suicide is not protected by the Constitution. However, in other parts of the world, physician-assisted suicide is accepted socially and legally; and in the U.S., a patient who is terminally ill may engage in assisted-dying procedures, which are legal in six states and are legally differentiated from suicide (Buiting, Dieden et al., 2009). If one sets aside the legalistic parameters differentiating physician-assisted dying from physician-assisted suicide, can one say that the former is more ethical than the latter?
In other words, is physician-assisted suicide ethical if the patient requests medical assistance in terminating his or her own life?
In spite of what is permitted under the auspices of physician-assisted dying procedures, this paper will argue that…
Assignment 1: Is physician-assisted suicide morally acceptable when a person is suffering from a painful, incurable, terminal condition?
Premise 1: Physician-assisted suicide is not morally acceptable under any circumstances.
According to the American Medical Association (2018), “permitting physicians to engage in assisted suicide would ultimately cause more harm than good,” (p. 1). The reasoning behind the AMA’s position is threefold. First, the AMA (2018) claims that physician-assisted suicide is “incompatible with the physician’s role as healer,” (p. 1). Second, the AMA points out that there are too many ways the process can be abused. As alternatives to physician-assisted suicide, the AMA recommends improving access to pain relief and emotional support to patients with terminal illnesses.
Another reason for opposing physician-assisted suicide is the rapid pace at which medicine advances. If a person has been diagnosed with a terminal illness, there is still a possibility—however slim—that either a cure or an…
Physician Assisted Suicide in Patients With Unbearable Suffering or the Terminally Ill
One of the most hotly debated issues today is physician-assisted suicide. ecently, California became the fifth state to legalize physician-assisted suicide, and there is an increasing likelihood that other states will follow suit in the foreseeable future. The purpose of this study is to determine if the factors chosen have any bearing on those who choose to end their life with physician assisted suicide. In support of this purpose, the objectives of this study were as follows: (a) to research scholarly articles regarding physician-assisted suicide and gather pertinent information into a comprehensive profile; (b) to research whether unbearable suffering is the dominant motive to request physician-assisted suicide; (c) to research whether the race and level of education of the patient are contributing factors when physician-assisted suicide is requested; and, (d) to research whether the type of terminal illness…
Bauer-Maglin, N. & Perry, D. (2010). Final acts: Death, dying, and the choices we make. New Brunswick, NJ: Rutgers University Press.
Biller-Adorno, N. (2013, April 11). Physician-assisted suicide should be permitted. The New England Journal of Medicine, 368(15), 1451.
Black's law dictionary. (1990). St. Paul, MN: West Publishing Company.
Boudreau, J. D. & Somerville, M. A. (2013,April 11). Physician-assisted suicide. The New England Journal of Medicine, 385, 15.
List current core clinical vendor, product, as well as version or. That your are aware of as well as the application types (a/D/T, adiology, Laboratory, Pharmacy, Nursing Documentation, Order Communication).
2. Is there a need for IS Department to anticipate the need for a third-party consulting
Assistance beyond what the is provided by the vendors for handling of any aspect of the CPOE design, implementation, as well as training
3. How can the CPOE be implemented at the laboratory? >What are its advantages in this setting?
4. How can the CPOE be implemented at the ICU? >What are its advantages in this setting?
5. How can the CPOE be implemented at the patient registry? >What are its advantages in this setting?
6. How can the CPOE be implemented at the outpatient pharmacy? >What are its advantages in this setting?
7. What certification standards are needed to operate a CPOE?
Al-Dorzi, HM., Cherfan, a et al. (2011).Impact of computerized physician order entry (CPOE) system on the outcome of critically ill adult patients: a before-after study. BMC Medical Informatics and Decision Making 2011, 11:71 doi:10.1186/1472-6947-11-71
Collins S, Currie L, Bakken S, Cimino JJ: Interruptions during the use of a CPOE system for MICU rounds.
AMIA Annu Symp Proc 2006, 895.
Eslami S, de Keizer NF, Abu-Hanna a: The impact of computerized physician medication order entry in hospitalized patients -- a systematic review.
physician reports cards fair and balanced? Take a position on this issue and explain your view. Provide at least two examples from references that support your position.
According to my opinion the answer is fair and balance at some point and unfair and unbalanced at the same time because the online sites having option rate your doctors receives very few reactions and they are mostly responded by unhappy patients who are unhappy with something. The reason behind their unhappiness is they did not get what they wanted. On the other side, few happy patients visit these sites and talk about it but unhappy patients often visit these sites. For Example: 10 happy patients rated the doctors and all are good ratings so it would be not wise to select that particular doctor on the basis of few ratings. It is fair and balances in other aspect as well that patients…
Fielding, J. & Sutherland, C. (1999). Community health report cards:: Results of a national survey, American journal of preventive, retrieved May 30, 2011 from http://linkinghub.elsevier.com/retrieve/pii/S0749379799000331
Frank, E. & Brevan, J. (2000). Physician disclosure of healthy personal behaviors improves credibility and ability to motivate., Archives of family medicine, retrieved May 30, 2011 from http://www.ncbi.nlm.nih.gov /pubmed/10728118' target='_blank' REL='NOFOLLOW'>
ole of Family Physician
It is important for us to understand the role of a family physician before we begin our discussion on the importance of family physicians in any health care system of the community. Many reforms have been made in the health care systems of various communities all over the world. Almost all of these reforms lay their focus on the prevention as well as the treatment of any disease along with the promotion of health and management of conditions that have become a chronic problem for the patients. All of these areas are the center of the family physicians and therefore family medicine has a huge role to play in here.
In this paper, we shall look at the current health care system in Libya and see how the government and other organizations like WHO are playing their role to improve the health care system in the…
(2005). Libya country profile. Library of Congress Federal Research Division (April 2005).
(2004). Pfizer Clear Health Communication Initiative. What it Health Literacy? [Online].
(2004). The American Heritage Dictionary of the English Language, Fourth Edition; 2000. [Online].
Kates N. (1997). Psychiatry and family medicine: sharing care. Can J. Psychiatry. Vol. 42:913-14.
Currently, I am working as a surgical technologist in two hospitals in Arkansas - Arkansas Children Hospital and the VA Hospital. I do surgical scrub on various cases of all surgical services, general, orthopedics, vascular, ENT, neurology, urology, and burns. To update and enhance my skills, I attended different medical training courses.
Since my youth, I had been in the scene of medicine. At the age of seventeen I was diagnosed with diabetes. Hence, in y sophomore years in college, I did a presentation on diabetes where I provided information on the symptoms, complications, and how to cope with diabetes. During my Junior year, I had family members that were diagnosed with breast cancer, glaucoma, heart attacks and thyroid problems.
Such experiences are my motivations in becoming a Physician Assistant. The feeling that I get from providing medical services is unfathomable and cannot be measured by anything.
E. Conflict Resolution
Conflict resolution is inclusive of several specific steps which are stated to include:
(1) Fact finding: Identify all individuals who are affected by the behavior and get complete history about the patterns of physician's behavior, preferably in writing (assuring the complainant about confidentiality). Identify probable risk to all affected individuals including patients and the organization itself. Make sure and document this step.
(2) Meetings: meeting comes when manager has got the most complete knowledge about the issue and its consequences. It is advised to plan for the meeting beforehand. Set the agenda for the meeting, communicate about the issues and how it is affecting staff and the workflow, and what is expected or desired. listen, listen, listen to the physician (sometimes just listening itself resolves the issue or gives you an idea about what to do). Stay focused on the issue, don't send mixed messages…
Bartholomew K. Ending Nurse-to-nurse Hostility. Marblehead, MA: HealthPro, 2006.
Brown D. At med schools, a new degree of diversity. Washington Post; June 1, 2007:A1.
Early P, Soon C, Soon a. Cultural Intelligence: Individual Interactions Across Cultures. Stanford University Press, 2003.
Ford, John (2010) Contextualizing Disruptive Behavior in Health Care as a Conflict Management Challenge (nd) Conflict Management Practice Notes. Online available at: http://johnford.blogs.com/jfa/2009/03/contextualizing-disruptive-behavior-in-health-care-as-a-conflict-management-challenge.html
Envisioning Future of Physician Leader of Medical Group Practice
Health care industry to get financial and management praises are also adopting the strategies of retail giants Wal-Mart, Google and Amazon. A research study have suggested that merely 3% of American physicians are in regular contact with their patients through emails or whatever means and one fifth of Medicare recipients that had visited hospital will end up back at the hospital within a month or even less. It was found through research that this figure of high frequency of repeat patients can be reduced drastically if doctor or nurse followed up with the patients after checking them. Doctors or nurses don't bother to follow up with the patient after reasonable time of their check up like a week because they don't find any incentive in doing so (Nobel, 2011).
The management and organizational structure of hospital is as important as any…
Beer, Michael & Elise, Anna (1989), Organization Development: Theory, Practice and Research. 3rd ed., Homewood, BPIL Irwin.
Edwards, Richard L. And John A. Yankey. (2006). Effectively Managing Nonprofit
Organizations. NASW Press, 2006.
Lawrence P. Casalino, Elizabeth A. November, Robert A. Berenson and Hoangmai H. Pham
Therefore, at the very outset, the owner would have to decide what his business is really about, and the ways in which he would have to change in order for the business to change as well. He would have to make a serious attempt at trying to understand the complex relationship that a business owner has with his business, and when he does this, and then his business would take on new vitality and new meaning, and gain a new lease on life. The owner would also be able to comprehend better exactly why so many people are unable to get from their businesses exactly what they want, and why they fail to survive beyond the first few years. (Introduction: Amazon.com)
When Michael Gerber focuses on the 'business' of being a physician, and not on the work that it involves, he reveals a plan for the creation and development of…
Introduction. Retrieved at http://www.amazon.com/gp/reader/0887307280/ref=sib_fs_top/103-5?%5Fencoding=UTF8&p=S00J&checkSum=q3jTlM%2BW%2B%2Bd8%2BiwbQVhs0dUJBaEgz5CmGxQoPDKW%2Bb0%3D#reader-linkAccessed on 23 June, 2005
Michael E. Gerber: Biography. Retrieved at http://www.harpercollins.com/global_scripts/product_catalog/author_xml.asp?authorid=3555Accessed on 23 June, 2005
Physicians' Testimonials. 29 August, 2002. Retrieved at http://secure.emythworldwide.com/physician/testimonials.htm. Accessed on 23 June, 2005
The E-Myth Physician, Why most Medical Practices don't work and what to do about it: Book Review. Retrieved at http://www.campusi.com/isbn_0066214696.htm . Accessed on 23 June, 2005
Computerized Physician Order Entry (CPOE) systems are essential towards the improvement of the ordering processes within the health centers or hospitals. These systems are also valuable in relation to improvement of patient safety and enhancement of the quality of care or service delivery (Cohen A, et al., 2005). This is an indication that the systems are vital in the achievement of quality services with reference to quality care of patients within the health centers. Despite these benefits, there are unintended consequences in association with the implementation of the CPOE systems within the context of the hospitals or health centers (Kaushal et al., 2003). The main objective of this research analysis paper is to evaluate three critical forms of unintended consequences in relation to the implementation of CPOE systems in hospitals.
More/New Work for the Clinicians
Clear identification of the unintended consequence
One of the types of unintended consequences in relation…
Koppel R, Metlay JP, Cohen A, et al. (2005). Role of Computerized Physician Order Entry
systems in facilitating medication errors J. Am Med Inform Assoc; 293(10):1197-1203
Ash JS, Berg M, Coiera E. (2004). Some unintended consequences of information technology in health care: the nature of patient care information system-related errors. J Am Med
Inform Assoc; 11(2):104-112.
Physician-assisted suicide, or physician-assisted death, refers to “the process that allows terminally ill adults to request from their physician, receive from their pharmacist, and take a lethal dose of medication to end their life,” (Death with Dignity, n.d.). Although seemingly similar to euthanasia, physician-assisted death is different in that it tends to refer to situations where the patient does not act with autonomy. Physician-assisted death is still controversial and is illegal in most states. However, Oregon, Washington, Vermont, California, and Colorado have legalized physician-assisted death, and several other states have pending legislation to do so as of 2018 (Quill & Sussman, 2018). The medical community itself is divided on the practice of physician-assisted death. Arguments for physician-assisted death include the rights of patients to self-determination. Arguments against physician-assisted death include the obligation of the physician to heal, not kill, the potential for ambiguous situations where there is some risk…
Topic: Is physician assisted suicide morally acceptable when a person is suffering from a painful, incurable, terminal condition?
Physician-assisted dying has become a contentious issue that pits the rights of the patient for autonomy and self-determination against the principles surrounding the practice of medical care. Seven states have passed laws that allow physicians to help terminally ill patients by offering medications that hasten death (Whitcomb, 2018). However, the American Medical Association and other organizations disapprove of physician-assisted dying. This paper will outline the arguments on both sides, focusing on two online articles.
The first article is an opinion piece published by the American Medical Association. While this article is not scholarly and does not even provide a binding or governing tenet for the medical profession, it is nevertheless authored by a credible source. The authors argue that the goal of medical care is to preserve or extend life,…
Downward Transition From the Role of Physician to That of Nurse
This paper looks at the ideal of a self-concept paper with a view of a personal look at how a person seeks to be part of the medical profession in a change over from the role of the physician to that of a nurse, taking into context their personal views, experiences, and previous roles within the professions.
Leininger, M.M. (1992). Reflections on Nightingale with a focus on human care theory and leadership. Health care.
Porter Rose (2000, July 13), Mizzouu Weekly, [online] accessed at http://proteus.mig.missouri.edu/~news/PORTERMW00.shtml
Weingourt Rita. (1998 July-Sept), Using Margaret A. Newman's theory of health with elderly nursing home residents. Perspectives in Psychiatric Care, v34 n3 p25(6)
Judgment on Physician Assisted Death
Prosecutions, where the state stands as the main complainant, are held up as criminal prosecution. A State prosecutor is duty bound to prove sufficiently that the action of the accused was inconsistent with the existing laws. In the case of the physician who gave a lethal dose to assist a terminally ill patient in dying it is the duty of the prosecutor to defend the existent law. The prosecutor ought to present to the court sufficient information regarding the law on physician assisted deaths.
Decision Taken and Justification
The legality and legality of physician-assisted death have raised numerous debates some leading to the Abolishment of laws against assisted suicide others upholding the law. The different state has differing justification on assisted suicide with some allowing physician-assisted suicide on grounds of the patient's quality of life and others assessing the palliate care measure explored to determine…
Quill, T. E., & Battin, M. P. (2004). Physician-Assisted Dying: The Case for Palliative Care and Patient Choice. eds., . Baltimore, Maryland U.S.: Johns Hopkins University Press, 2004.
William, B. (2000). Depression, Hopelessness, and Desire for Hastened Death in Terminally Ill Patients with Cancer. Journal of the American Medical Association, 284(22), 2907-2911.
Secondarily, obtaining these answers will be assumed to also obtain practical strategies that family physicians can use to effect better and more equitable access to healthcare for those in their care, especially for populations that have traditionally been marginalized, or even ignored, by insurance companies. Another aim is to determine whether there is a close connection between family physicians and insurance companies. Perhaps these can be used as a basis for creating a platform fore more equitable access. Finally, the aim is to obtain personal accounts from healthcare users themselves to determine the extent of experienced inequality within the healthcare setting, as well as the perceived power, or lack thereof, of family physicians to create a remedy for this, which some authors appear to believe to exist (4).
As for the design of the research, a general to specific approach will be taken. Europe, the UK (5), and developing areas…
1. Riestberg a and Worz M. Duality in and Equality of Access to Healthcare Services. Available from European Communities; 2008: http://www.ehma.org/files/healthquest_germany_en.pdf
2. Fiscella K. Health Care Reform and Equity: Promise, Pitfalls, and Prescriptions. Available from the Annals of Family Medicine; 2012: http://www.annfammed.org/content/9/1/78.full
3. Hugo JFM, Couper ID, Thigiti J. And Loeliger S. Equity in health care: Does family medicine have a role? Available from African Journal of Primary Health Care & Family Medicine; 2010:
multispecialty physician group practice (MSGPs) is one portion of an integrated delivery system (IDSs), providing a variety of care to patients in several disciplines in a manner that enables more efficient care through a variety of methods and increased capabilities (Kovner & Knickman, 2011, p. 206). Specifically, the ability to make referrals, coordinate treatment amongst specialists, and provide more efficient scheduling and integration can have profound benefits for the overall efficiency and quality of care. The Mayo Clinic has been cited as an exceptional example of an MSGP not simply for its integrative and quality achievements, but also in the direct manner that this organization improves access to care by "[determining] a patient's need for charity care based on information such as the patient's individual and family or household income, assets, family size and availability of alternative sources of payment," and thus providing care to a population underserved by the…
Kovner, A.R., & Knickman, J.R. (2011). Health care delivery in the United States (10th ed.). New York: Springer Publishing Company.
Mayo Clinic (2011b) www.mayoclinic.org. Retrieved from http://www.mayoclinic.org/becomingpat-jax/care.html
ACA has had on physicians. This is related to my field of study, and to the article that I worked with last week. This issue can be examined in terms of how it affects private practice, how the demand conditions have changed and how the workload has changed. There are a lot of different dimensions to this story. I have chosen this focus because it interests me.
The Affordable Care Act allowed millions of Americans to enjoy medical insurance coverage, when they previously had not been able to do so. One of the predictions before the ACA was brought into force was that bringing millions of people into the health care system would strain the system's existing resources. The theory is that the system was already near capacity, so adding that much new demand would strain that capacity.
There have been a number of articles providing anecdotal evidence that there…
Riggs, K., Buttorff, C. & Alexander, C. (2015). Impact of out-of-pocket spending caps on financial burden of those with group health insurance. Journal of General Internal Medicine. Vol. 30 (5) 683-688.
Malpractice cases are not filed against physicians alone, there can be occasions during regular patient care that a nurse might come under attack for failure to follow standards of care and this can result in a malpractice case. The six elements on malpractice as are follows:
This refers to the relationship that the nurse has with the patient or in other words, it needs to be established that the nurse has the duty to provide care as the patient demanded. "Duty is the obligation of due care owed by one person to another as appropriate for the circumstances and as may be dictated by the law." (Sharpe, p. 18) The plaintiff must establish that the defendant had a legal obligation to provide expected care.
This refers to the link that is expected to exist between nurse's actions and the injury caused. In other words, the results of nurse's…
Sharpe, Charles. Nursing malpractice: Liability and risk management. Greenwood publishing group. 1999
Euthanasia comes from the Greek phrase meaning "good death," ("Euthanasia" 112). The various practices that fall under the general rubric of providing a person with the means for a "good death" include physician-assisted death, also referred to as physician-assisted suicide. Until recently, all forms of euthanasia were illegal in the United States and in most other developed countries but within the past generation, these laws have been liberalized so that citizens in democratic societies increasingly have access to a "good death." Physician-assisted suicide occurs under the guidance of an experienced and qualified physician, who is not legally obliged to agree to the practice. Therefore, no coercion takes place. The doctor is not permitted legally or ethically to coerce a patient into dying prematurely and the patient is likewise not ethically or legally allowed to persuade their doctor to intervene on their behalf. hat physician-assisted death laws do allow is for…
"Euthanasia." Chapter 10.
Lee, Richard. "Kant's Four Illustrations." Retrieved online: http://www.uark.edu/campus-resources/rlee/iethsu06/oh/k-4egs.html
"State-by-State Guide to Physician-Assisted Suicide." Retrieved online: http://euthanasia.procon.org/view .resource.php?resourceID=000132' target='_blank' REL='NOFOLLOW'>
Like imhotep and Asclepius, though to a lesser degree, Hippocrates' life is so shrouded in myth that it is difficult to state many facts about the man. He certainly existed, hwoever, and was one of the first to apply true rules of logic and science to the practice of medicine. This was possible largely because of the changes made in philosophy both by the pre-Socratics, who determined that the gods were not responsible for the laws of nature, and the major Athenian philosophers such as Socrates, Plato, and Aristotle, who developed a system of rigorous logic that was attached to investigations of truth. Hippocrates focused on keeping the body healthy through preventative medicine, and that the body would often return to its natural state unaided -- thus the injunction to "do no harm."
Galen, a Greek physician arriving on the scene centuries later, learned all he could about the internal…
L.O.L. In N.A.D.
Written by a physician who is also a writer, this article looks at the mind-bending jargon physicians use every day. She clearly shows how these nearly illegible acronyms become so common in the healthcare field that practitioners do not understand why nonprofessionals cannot figure them out immediately. Humorous and yet sad, the essay shows jargon serves a purpose, to "remove" the patient from the physician, and this is surprising.
Klass' primary writing strategy is humor, but it is a dark humor. The essay starts out lightly enough, with much of the medical jargon her essay concerns. However, as the essay continues, the tone becomes darker, and it is clear Klass is concerned about the jargon and its dehumanizing effects. She utilizes less offensive jargon to open the essay, (L.O.L = Little Old Lady), for example, and then uses an anecdote with her mother to show how the…
Klass, Perri. "She's Your Basic L.O.L. In N.A.D."
Inspiration Towards Choosing Medicine and Becoming a Physician
In the year 2014, the month of February the world woke to a shocking revelation of an outbreak of Ebola in parts of Africa, West Africa in particular. The WHO confirmed t he pandemic and wooed the world, governments, nations and individuals to helping putting together help of whatever form towards helping this part of the world from the pandemic. The news literally took over the news headlines, the blogs online, the websites and all tabloids and even radio were all a buzz with the sad news of the Ebola outbreak. The speed at which is spread at the devastating effects were of apocalyptic proportions.
The CDC activated the Emergency Operations Center meant to directly deal with the Ebola catastrophe, this center was specifically meant to coordinate the technical assistance and control the activities with other agencies of the US government, the…
CDC, (2016). 2014-2016 Ebola Outbreak in West Africa. Retrieved May 18, 2017 from https://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/
Physician-assisted suicide or death has emerged as a major controversial and medical-ethical issue in the modern health care system. This issue has attracted huge concerns and debates among policymakers, medical practitioners, and the public. These concerns and debates have led to the emergence of arguments and counter-arguments in support and opposition to physician-assisted suicide. In addition, physician-assisted suicide has become a topic of research by various scholars based on these concerns and its benefits and/or disadvantages. An example of a research that focuses on the issue is the study by Timothy E. Quill on why physician-assisted suicide should be allowed. The author argues for the acceptance of physician-assisted suicide based on his experience as a primary care physician and the assistance he provided to many patients to die with their full consent. Quill's research article is helpful in providing justification for the overall legalization and acceptance of physician-assisted suicide.
Messer, T. (2012, October 29). Physician-Assisted Death: In Consideration of the Right to Die.
Retrieved September 30, 2014, from http://www.nyam.org/social-work-leadership-institute-v2/geriatric-social-work/hppae/for-students/Physician-Assisted-Death-Paper-Submission-10-29-12-1.pdf
Quill, T.E. (2012). Physicians Should 'Assist in Suicide' When it is Appropriate. Journal of Law,
Medicine & Ethics, 40(1), 57-65.
Physician Assistant Program Narrative
Personal Statement: My Motivation towards Becoming a PA
We all have dreams and aspirations. As a young child, my dream was to become a chef. When asked why I wanted to become a chef, my answer was always consistent; "I wanted to delight people by preparing them delicious dishes." As I grew up, I became more informed and my view of the world became clearer -- and it was then that I realized that deep inside, I wanted to end up in a profession that impacted positively on the lives of others. A profession that brought delight to those I interacted with. Then, something happened that completely convinced me that I would most comfortably serve in any of the helping professions. A couple of months after my 10th birthday, my younger brother got bitten by a dog in his face -- right below his left eye.…
Importance of Physician Assisted Deaths
My Ethical Position on Physician Assisted Deaths as a Nurse
The Legal isks for Nurses
The Opposing View
Summary of Arguments in Favor of My Position
Importance of Physician-Assisted Deaths
Careful reflection is needed for physician-assisted deaths and euthanasia as they often always involve complex issues related to the family, the physician and the nursing staff. The critical question is about ethics that a nurse needs to follow when a patient asks for physician-assisted death. Also important are issues related to the personal professional values of the nursing staff. Though made legal in Canada, physician-assisted deaths still involve careful evaluation -- both medically and ethically, while deciding to agree to be a part of physician-assisted deaths. While there are several perspectives and often conflicting arguments to physician-assisted deaths, most agree that the issue of ethics is of prime importance while deciding on physician-assisted…
Chochinov, H. (2016). Physician-Assisted Death in Canada. JAMA, 315(3), 253. http://dx.doi.org/10.1001/jama.2015.17435
Downar, J., Bailey, T., & Kagan, J. (2014). Why physician-assisted death?. Canadian Medical Association Journal, 186(10), 778-779. http://dx.doi.org/10.1503/cmaj.114-0048
Landry, J., Foreman, T., & Kekewich, M. (2015). Ethical considerations in the regulation of euthanasia and physician-assisted death in Canada. Health Policy, 119(11), 1490-1498. http://dx.doi.org/10.1016/j.healthpol.2015.10.002
Paterson, C. A History of Ideas Concerning Suicide, Assisted Suicide and Euthanasia. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.1029229
Autobiography of Phillip Sgobba
Phillip Sgobba's passion for medicine was not the result of any innate desire nurtured from youth. True, he had been attracted to medicine and viewed it as a practice from which he could prosper -- but upon arriving at university, he doubted himself: his grades were mediocre at best. One subject especially -- Organic Chemistry -- simply befuddled him and no matter how he tried, he could not succeed at achieving excellent marks. Losing hope of ever advancing, he eventually dropped the class and ended the semester with a dismal 2.6 GPA. He was discouraged and began contemplating altering his course in life completely.
One evening, it was all altered for him -- because of a brutal attack, of which he was on the receiving end. Jumped by a gang of men on his way home one night, Phillip was badly beaten and suffered fractures to…
physicians and egistered nurses is an important one, which shapes the healthcare environment. Patients rely on physicians and nurses to provide their healthcare needs. The purpose of this discussion is to provide a description of current research, synthesis, demonstrations and other projects that have resulted in positive nurse physician relationships. More specifically the discussion will focus on the relationship between the two as it relates to increases in nurse satisfaction, decreases in nurse turnover, better working environment, and better patient outcomes with an emphasis on patient safety.
The shortage of registered nurses that has occurred in recent years, has place special attention on the need for nurses and the relationship between physicians and registered nurses. According to the journal International Labour eview, "Many health care systems are experiencing shortages of trained medical personnel. Both developed and developing countries appear to be facing a serious shortage of nurses (and physicians).…
The working relationship between physicians and registered nurses (extended class): OMA discussion paper. OMA Task Force on the Working Relationship between Physicians and Registered Nurses (Extended Class). 2002. Ontario Medical Association. Retreived February 27, 2005 from http://www.oma.org/pcomm/OMR/nov/02rnec.htm
Al-Almaei, S,.Mangoud, A., Albar, A.A., & Hanif, M. (2000). In Comparison: A Study of the Competence of Nurses and Physicians in Primary Care Practice. International Journal of Public Administration, 23(4), 461.
Clark, D.A., Clark P.F., (2003) Challenges Facing Nurses' Associations and Unions: A Global Perspective. International Labour Review. Volume: 142 (1). pg 29+.
Eithe way, such a volume simply could not be as pactical and useful as eithe the two independent volumes of the Physician's Desk Refeence o the single and easily navigable website un by Medline Plus. This website's seach-ability allows fo an easie coss-efeencing between phamaceuticals and nutitional supplements, as well, without tying to keep a book open to seveal pages at once.
Cost is also a majo facto in the two efeences. Though olde editions of the Physician's Desk Refeence can be found elatively cheaply (ionically, via online shopping), the cuent edition costs almost one hunded dollas puchased new. Medline Plus is fee, making the cost benefit of this option at least equal to the benefits deived fom ease of use and completeness of infomation. On this last point, the Physician's Desk Refeence often contains moe detailed infomation on vaious dugs, but these details ae pesented in a vey dy…
references also list common side effects and interaction warnings. Medline Plus, however, also presents all of this information as if in response to specific consumer questions, rather than in a simple list of facts as in the Physician's Desk Reference. Though this reference is still the standard of the industry, the fact that it is mainly directed towards physicians (cf. The title) makes it less easy to use. Overall, Medline Plus is a more effective resource for the average user today.
Car repair is the process of diagnosing the car problem to identify the fault within the car. While the cars manufactured before 2000 requires special tools to be repaired, however, the computer technology has been increasingly used to diagnose and repair many newly manufactured cars. Before mechanics start the repairing of cars, they often quote the prices for customers before starting the repairing work. To repair the car, mechanic uses both electronic methods to gather data in order to replace the faulty materials in the vehicle. A mechanic diagnoses the car and identifies the problem within the car before starting the repairing work. There are two approaches used to diagnose a faulty car:
Use of a repair manual
elying on one's analysis
Use of computer technology
A repair manual is a book that assists an auto mechanic to identify the problems within a car. The repair manual consists…
Alberta Canada (2012). General Practitioners and Family Physicians. Government of Alberta. Canada.
Armenia Development Agency (2010). Jewelry and Gemstone Overview. Armenia.
Hoover's (2012). Jewelry Stores Industry Description. Hoover's Inc.
MedicineNet (2012).Optometrist vs. Ophthalmologist, Do You Know The Difference. USA.
Nursing Administration -- Controlling
The FOCUS model requires the nursing administrator to find out what the main problem is, obtain information about this problem, communicate effectively with the nurses and patient, understand the needs of the nurses and the patient, and finally summarize these findings for the patient and nurses Dlugacz, 2009.
In this scenario, the process to be improved is responsiveness and willingness of the nurses to help the patient's situation.
Using the FOCUS model, the nursing leader should identify and clearly define the problem. To do this, they must recognize the role of the patient and the nurses in the situation and prioritize the potential improvements in the process Kreitner, 2008.
They also need to draft this problem statement in a clear way. The problem statement for this scenario is that the nurses feel inadequate in responding to the situation where the patient needs…
Dlugacz, Y.D. (2009). Value-Based Health Care: Linking Finance and Quality. New York: Wiley.
Kleespies, P.M., & Association, A.P. (2009). Behavioral Emergencies: An Evidence-Based Resource for Evaluating and Managing Risk of Suicide, Violence, and Victimization. Washington, D.C., DC: American Psychological Association.
Kreitner, R. (2008). Management. Mason, OH: Houghton Mifflin Company.
Zun, L.S., Chepenik, L.G., & Mallory, M.N.S. (2013). Behavioral Emergencies for the Emergency Physician. Cambridge, United Kingdom: Cambridge University Press.
In this way, any concerns that could come up and be problematic will be avoided and the information contained in the study can be accepted as being reliable, valid, and unique.
As has been mentioned, limitations are too often overlooked in studies, and it is often impossible to find all of the limitations that are contained in a study and spell them out for all to see. However, that does not mean that the limitations that are noticed should be overlooked. As long as they are legitimate, the more limitations that are discussed in the research the more significant the research will be found to be, since any weaknesses that it might have will be noted and dealt with. It is for this reason that this particular section will detail the limitations that this study faces.
The main limitation of this study, other than the biases of the researcher, is…
Armour, B.S., Pitts, M.M., Maclean, R., Cangialose, C., Kishel, M., Imai, H. & Etchason, J. (2001). The effect of explicit financial incentives on physician behavior. Archives in Internal Medicine, 161, 1261-1266.
Berwick, M. (1996). Payment by capitation and the quality of care. JAMA, 335, 1127-1230.
Campbell, S.M., Koland, M.O. & Buetow, S.A. (2004). Defining quality of care. Social Science and Medicine, 51, 1611-25.
Devettere, R.J. (2000). Practical decision making in healthcare ethics: Cases and concepts. Washington DC: Georgetown University Press.
Evidence of improved access and cost effectiveness should soon follow. Over the next two decades, e-health could deliver patient, provider, and planner/manager interactions for all aspects of health care (Detmer, 2000, p. 181). Detmer continued on to state that this could be a positive move from seeking out errors and problems to information systems whose processes prevent many adverse outcomes. When the problem becomes one of error and miscommunication, one needs to do all that is necessary in order to correct the problem. McKnight et al. continued to report how physicians and nurses both report how there were problems with having updated information both web based as well as written copy (McKnight et al., 2002).
A question that also comes to mind is the concern of training or lack there of. Not only should all current systems of information and resources be overhauled, there is also a need to train…
Detmer, D.E. (2000, July 6). Information technology for quality health care: a summary of United Kingdom and United States experiences. Quality in Health Care, 9, pp. 181-189.
McKnight, L.K., Stetson, P.D., Bakken, S., Curran, C., & Cimino, J.J. (2002, 2002). Perceived Information Needs and Communication Difficulties of Inpatient Physicians and Nurses. Journal of the American Medical Informatics Association, 9, pp. 64-69.
AAPA, NJPAS, and NJSSPA are professional bodies representing the Physician Assistants. AAPA is a nation wide body which claims to be the sole national level organization, which is representing the Physician Assistants in the United States and is working for the benefit of PAs in all specialty areas. This organization mainly provides support to the Physician Assistants in employment matters and other professional issues. AAPA stands for "American Academy of Physicians Assistants. On the other hand, NJPAS and NJSSPA are New Jersey-based organizations representing the PAs in the New Jersey region. NJPAS is basically a student organization, which provides educational and professional support to PA students while NJSSPA is a professional body of Physician Assistant practitioners operating at the state level.
The development of the website "NJPAS.com" will be beneficial for both the Physician Assistant students and the working students. This website will serve as a platform for sharing the…
The American Academy of Physician Assistants: from the World Wide Web:
New Jersey Physician Assistant Students: from the World Wide Web:
Ely, E.W., et al. (1999). Large-scale implementation of a respiratory therapist-driven protocol for ventilator weaning. Vol 159 American Journal of Respiratory Critical
-(2001). Mechanical ventilator weaning protocols-driven by non-physician health-care professionals. Vol 120 Chest: Clinical Investigation in Critical
Harbrecht, .G., et al. (2009). Improved outcomes with routine respiratory therapist evaluation of non-intensive care unit surgery patients. Vol 54 # 7, Respiratory Care:
Daedalus Enterprises. Retrieved on November 23, 2012 from http://www.upmc.com/careers/pathways/allied-health/respiratory/Documents/ImprovedOutcomes_NICU_Patients.pdf
Hess, D.R.(1998). Professionalism, respiratory care practice and physician acceptance of a respiratory consult service. Vol 43 # 7, Respiratory Care: American Association
of Respiratory Care. Retrieved on November 23, 2012 from http://aarc.org/daz/rcjournal/rcjournal/x.RCJOURNAL.COM02.21.07/content
Kollef, M.H., et al. (2000). The effect of respiratory therapist-initiative treatment protocols on patient outcomes and resource utilization. Vol 117, Chest: Clinical
Investigations in Critical Care. Retrieved on November 23, 2012 from http://journal.publication.chestnet.org
Marelich, G.P., et al. (2000). Protocol weaning of mechanical ventilation…
CRTO (2011). Orders for medical care. Professional Practice Guidelines. College of Respiratory Therapies of Ontario. Retrieved on November 23, 2012 from http://www.crto.on.ca/pdf.PPG/OrdersMC.pdf
Ely, E.W., et al. (1999). Large-scale implementation of a respiratory therapist-driven protocol for ventilator weaning. Vol 159 American Journal of Respiratory Critical
-(2001). Mechanical ventilator weaning protocols-driven by non-physician health-care professionals. Vol 120 Chest: Clinical Investigation in Critical
Nurse Practitioners Should Work Independently of Physicians
One of the problems facing health care is the inadequate number of primary-care physicians, more so among the rural population. There are fears that shortages will only get worse as a rising number of patients look for care Under Affordable Care Act. esides the provision of advanced nursing care, nurses have licenses to offer clinical care, including the ordering of X-rays and lab work, and are particularly helpful in helping patients having chronic conditions like high blood pressure and diabetes cope (Holmes, 2013).
Nearly one third of states now permit nurse practitioners to practice in the absence of physician supervision. Nursing groups as well as health-care interests are however lobbying that nurses be granted the same level of autonomy in all states as in the other states that do not require physician supervision. Some interest group, while still appreciating the efforts put forth…
Dueker, M.J., A.K. Jacox, D.E. Kalist, and S.J. Spurr. The Practice Boundaries and Advanced Practice Nurses: An Economic and Legal Analysis. Journal of Regulatory Economics, 27, 2005, 309-29.
Holmes, L. (2013, June 13). Should Nurse Practitioners be able to treat patients without Physician Oversight. Retrieved from The Wall Street Journal: http://www.wsj.com/articles/SB10001424127887324715704578480911396098592
John, P. (2009, January 10). The rise and impact of nurse practitioners and physician assistants on their own and cross-occupation incomes. Retrieved from FPO: http://www.freepatentsonline.com/article/Contemporary-Economic-Policy/211959183.html
Page, L. (2014, October 29). Physicians, NPs and PAs: Where's all this going? Retrieved from Medscape Multispeciality: http://www.medscape.com/features/content/6006318
Dr. Estes demonstrates her medical leadership capabilities through her incredibly articulate communications and her highly interpersonal approach. By ensuring that she, as a representative of management that is nonetheless first and foremost a medical practitioner, remains actively involved in the day-to-day operations of the hospital and a recognition of individual physicians, Dr. Estes is better equipped to forestall any issues from becoming hindrance's to MetroHealth's operations or any individual physician's performance.
Physician commitment to MetroHealth's goals is absolutely essential to its continuing survival in the marketplace. Especially given the large number of Medicare and Medicaid patients that the MetroHealth system cares for, commitment to organizational goals must be higher than any desire for personal gain or self-aggrandizement. Without such commitment on the part of the physicians, either the quality of service or the financial viability of MetroHealth -- and very likely both -- would be placed in serious…
This allows for the maintenance of a Network price list, as stipulated in the Physician's version of this clause while still tying price (as well as incorporating the discounts) to standard physician charges, as stipulated by the Network. The Physician's current version of the compensation clause is untenable, however, as it limits the freedom of market forces to have their effect on price, which is unfair to the network and will most likely create higher costs to the network and its clients thus eliminating benefits to clients.
Again, the terms of the Physician's version are unacceptable to the Network as it will eliminate any benefit to clients. The affiliation of hospitals with the Network is a possible point of negotiation as long as other hospital services are not charged to the Network.
The Network's indemnity clause creates fair and equal liability, ensuring that physicians and only physicians will be liable…
Petersen, L.; Woodard, L.; Urech, T.; Daw, C. & Sookana, S. (2006). Does Pay-for-Performance Improve the Quality of Health Care? Annals of internal medicine 145(4), pp. 265-72.
total I have 13 years in the nursing field. Throughout that combined time I have worked in nursing homes / assisted living facilities, home health, as well as in a hospital setting. During the time that I worked in the hospital I worked in a program called share the care. This entailed me working throughout the entire hospital as a nursing assistant, which gave me experience in various areas, i.e. The emergency room, intensive care, pediatrics, oncology and etc. By being apart of this program it has afforded me the opportunity to do what I truly love, be a part of the whole process of nursing sick patients back to health. This has always been a passion of mine.
A Nurse practitioner is a nurse who has completed a graduate nursing degree and training in providing preventive and medical health care to individuals and families in association with a physician.…
Greensboro AHEC Kids (2005). Nurse practitioner. Retrieved 09/23/05, from www.aheckids.com/nurprac.htm
U.S Department of Labor (2004-2005). Physicians Assistant. Occupational Outlook Handbook,, . Retrieved 09/23/05, from http://stats.bls.gov/oco/ocos081.htm
Evolution of Health Care Information Systems
The objective of this study is to compare and contrast a contemporary healthcare facility or physician's office health care facility or physician's office operation of 20 years ago and to identify at least two major events and technological advantages that influenced current HCIS practices. The physician's office and health care facility of 20 years ago was a paper-based operation. All records were paper records, appointments were written on calendars and prescriptions were handwritten, notations on the patient's health records was done by writing on the physical paper record and all hospital orders were written by hand. During the 1970s hospital growth and expansion occurred and the expenditures for Medicare and Medicaid were on the rise. At this time mainframes were still in use and microcomputers became available and not only were they smaller but they were also less expensive. However, transformation did not come…
Costs and Benefits of Health Information Technology (nd) Evidence Report/Technology Assessment Number 132. Southern California Evidence-based Practice Center, Santa Monica, CA. Retrieved from: http://www.ahrq.gov/research/findings/evidence-based-reports/hitsys-evidence-report.pdf
Friedman, S. (nd) Facts About Health Care Information Systems. eHow Retrieved from: http://www.ehow.com/about_6117257_health-care-information-systems.html
History and Evolution of Health Care Information Systems (nd) Chapter 4. Retrieved from: http://www.slideserve.com/paul/history-and-evolution-of-health-care-information-systems
The cases of Todd vs. Mr. Gomez
When dealing with a situation in which communications between a patient and a physician is difficult -- for example, if the patient has limited English proficiency or is deaf -- inevitably barriers are created which prevent a fully patient-centered communications process. Physicians often cite limited time as a reason for being insufficiently patient-focused. In the case study of Todd, the interaction was challenging because of the lack of the presence of an ASL interpreter. This was a lose-lose situation for both the patient and the physician. The physician was frustrated because of the extra time needed to complete the interaction by writing everything down; the patient was frustrated because of the fact the physician often misunderstood him and tried to lip-read as a shortcut or ask him yes and no questions which did not sufficiently address his concerns.
Perhaps the area…
Although the Affordable Health Care Act represents a step in the right direction towards encouraging all Americans to avail themselves of medical services, the bill fails to address the root causes of problems in the system. The American health care system is flawed because it is a for-profit model that places profits far ahead of patients. When profits come ahead of patients, the result is an inability to fulfill the ethical duties of being a health care worker. A progressive transformation of the American health care system would systematically undo the nefarious link between corporate interests and the interests of health care.
The relationship between doctors and drug companies has been well established and well documented. Major news media resources like The Atlantic, as well as professional peer-reviewed journals like the New England Journal of Medicine cover stories addressing the potential ethical conundrums inherent in a cozy connection…
Campbell, E.G. (2007). Doctors and drug companies -- Scrutinizing influential relationships. New England Journal of Medicine 2007;357: 1796-1797.
Carollo, K. (2010). Pay dirt: hundreds of doctors earned big money from drug companies. ABC News. 25 October, 2010. Retrieved online: http://abcnews.go.com/Health/Wellness/drug-companies-payments-doctors-revealed-database/story?id=11929217
"Let the Sunshine In," (2013). The Economist. Mar 2, 2013. Retrieved online: http://www.economist.com/news/business/21572784-new-efforts-reveal-ties-between-doctors-and-drug-firms-let-sunshine
Moynihan, R. (2003). Who pays for the pizza? BMJ 2003; 326:1189.
My life has centered upon answering a central question. This question has been a in my mind since I was 10 years old. At that age, my first image of medicine was largely influenced by the doctors and nurses who were always helping my grandfather battle a rare form of brain cancer. His illness was a life changing experience for me, as, at that age, I watched his condition gradually deteriorate over a period of three months, and I detested I could do nothing to help. This thought, however painful then, has motivated my entire life, and has led to my choosing of nursing as a profession,
Though some did not approve of this particular career path, I never gave up my dreams. For this reason, I began studying and volunteering so as to combine education in theory with education in practice. Giving back to…
Miller, . (1985). Herkovits v. Group Health Cooperative: Negligent Creation of Substantial Risk of Injury is a Compensable Harm. Puget Sound Law Review.
Retrieved and available for viewing at: http://digitalcommons.law.seattleu.edu/cgi/viewcontent.cgi?article=1214&context=sulr&sei-redir=1&referer=http%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3Dherkovits%2520v.%2520group%2520health%2520cooperative%253A%2520negligent%2520creation%2520of%2520%2520substantial%2520risk%2520of%2520injury%2520is%2520a%2520compensable%2520harm%26source%3Dweb%26cd%3D1%26ved%3D0CCMQFjAA%26url%3Dhttp%253A%252F%252Fdigitalcommons.law.seattleu.edu%252Fcgi%252Fviewcontent.cgi%253Farticle%253D1214%2526context%253Dsulr%26ei%3Df-mYT-aaK8SmiQLMkbDDDw%26usg%3DAFQjCNEKTiHzBxbVrEjyORcjH0OnmRAEjw#search=%22herkovits%20v.%20group%20health%20cooperative%3A%20negligent%20creation%20substantial%20risk%20injury%20compensable%20harm%
ithin any discipline, there are various ethical issues that constitute an overall rubric of the topic. In the case medicine, the thrust of the ethical template surrounds the reasons for, and moral imperatives surrounding the use experimental drugs and/or procedures. There are mandates and global legal maxims in place to protect human subjects; however the very nature of the topic also requires specific ethical paradigms that govern the field: beneficence, justice and autonomy for instance. .Beneficence is the core of the Hippocratic Oath -- "as to disease & #8230; do no harm." Justice -- models fairness and equity in all medical research regardless of race, age, or cognitive ability, and autonomy -- the respect for the individual in making a…
Hardi v. Mezzanotte, 818Z.2d 974 (District of Columbia May 8, 2001).
Hardi v. Mezzanotte Appeal, 99-CV 1386 99-CV-1540 (District of Columbia Court of Appeals March 20, 2003).
Medical Care Services
The current delivery of health care services represents one of the most important subjects for discussion both in the Obama Administration as well as the epublican one and the Administrations that preceded the Bush one. egardless of political color, it must be pointed out that the health care system in the United States does not only depend on the ideological orientation, but also on the people and their own beliefs in terms of human action and interaction. It is a clear fact that "Ten years ago, the U.S. healthcare system was declared "broken," and it has not improved. Fixes promised by managed care have not materialized. Premiums are rising. Hassles for patients and physicians abound. Nearly 45 million Americans are uninsured." (Garson, 2000)
One of the most severe problems facing the health care system in the United States is the discussion that is being held between those…
Garson, Arthur. "Current Perspective. The U.S. Healthcare System 2010. Problems, Principles, and Potential Solutions" 2000. Available at http://circ.ahajournals.org/content/101/16/2015.full#sec-7
ImpediMed. "Pre-emptive vs. Reactive Models of Care: Pre-emptive Care Model Prospectively Managing Lymphedema in Breast Cancer Patients" 2012. Available at http://www.impedimed.com/knowledge-center/health-insurance-providers/pre-emptive-versus-reactive-models-of-care.htm
Yale School of Medicine. "The PA Profession." 2013. Available at http://medicine.yale.edu/pa/profession/index.aspx
The Navy ICPA's referred cases in which they noticed something unusual, or which required further clarification from a physician to help support or contest the claim. Given that bias, one might expect that the overwhelming majority of cases would have the Navy Physician opposing the claim. This was not the case." (p.19).
Using the k statistic, the authors assessed the level of agreement between the physicians opinions and the final claim decision of the governing body issuing the claim benefits. A two sided z test was also used to compare the proportion of males in the study population to the proportion of male employees in a comparison population.
Any ethical concerns about this study must relate to the relationship that doctors have in deciding governmental adjudications. Medical doctors are often over-specialized and may lack a general knowledge that is more applicable to a claims adjuster.
Nurse Practitioner Employment Contract
EMPLOYMENT CONTRACT AGREEMENT BETWEEN THE FOLLOWING PARTIES:
The following party shall here in be referred to as "Corporation"
GROUP HEALTH CORPORATE,
The following party shall here in be referred to as "EMPLOYEE" or "NP"
MINNIE DAVIS ARNP,
TERMS OF EMPLOYMENT
The contract duration is for two years with an option for renewal for five (5) years thereafter.
The contracted position will be paid at a salary rate of $95,000 per year with a cost of living of 5% every 2 years. The pay is not based on performance.
The contract will be renewed the sixth month after review of the employee's performance.
Paychecks will be issued monthly.
The termination of this contract may be made under the following conditions.
Violation of State or Federal Law
Breach of the Contract by either Party
Performance of the NP
Desire to Leave the…
Certified in Medical Terminology
80 WPM Typing Aptitude
40-Hour Work Shifts A.M. And P.M.
Expediter Transcriptionist for RUSH/STAT Transcription
In-House IT to Ensure System Security and Operations
QUALITY CONTROL STRENGTHS: Quality control is essential to the customer, and to us, to ensure accurate and timely products and services. Our transcriptionists receive:
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Random Quality Verification/Checks
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