WorldWideScience

Sample records for nonmeritorious claims physicians

  1. Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014.

    Science.gov (United States)

    Schaffer, Adam C; Jena, Anupam B; Seabury, Seth A; Singh, Harnam; Chalasani, Venkat; Kachalia, Allen

    2017-05-01

    Although physician concerns about medical malpractice are substantial, national data are lacking on the rate of claims paid on behalf of US physicians by specialty. To characterize paid malpractice claims by specialty. A comprehensive analysis was conducted of all paid malpractice claims, with linkage to physician specialty, from the National Practitioner Data Bank from January 1, 1992, to December 31, 2014, a period including an estimated 19.9 million physician-years. All dollar amounts were inflation adjusted to 2014 dollars using the Consumer Price Index. The dates on which this analysis was performed were from May 1, 2015, to February 20, 2016, and from October 25 to December 16, 2016. For malpractice claims (n = 280 368) paid on behalf of physicians (in aggregate and by specialty): rates per physician-year, mean compensation amounts, the concentration of paid claims among a limited number of physicians, the proportion of paid claims that were greater than $1 million, severity of injury, and type of malpractice alleged. From 1992-1996 to 2009-2014, the rate of paid claims decreased by 55.7% (from 20.1 to 8.9 per 1000 physician-years; P < .001), ranging from a 13.5% decrease in cardiology (from 15.6 to 13.5 per 1000 physician-years; P = .15) to a 75.8% decrease in pediatrics (from 9.9 to 2.4 per 1000 physician-years; P < .001). The mean compensation payment was $329 565. The mean payment increased by 23.3%, from $286 751 in 1992-1996 to $353 473 in 2009-2014 (P < .001). The increases ranged from $17 431 in general practice (from $218 350 in 1992-1996 to $235 781 in 2009-2014; P = .36) to $114 410 in gastroenterology (from $276 128 in 1992-1996 to $390 538 in 2009-2014; P < .001) and $138 708 in pathology (from $335 249 in 1992-1996 to $473 957 in 2009-2014; P = .005). Of 280 368 paid claims, 21 271 (7.6%) exceeded $1 million (4304 of 69 617 [6.2%] in 1992-1996 and 4322 of 54 081 [8.0%] in 2009

  2. Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study

    Directory of Open Access Journals (Sweden)

    Hossein Joudaki

    2016-03-01

    Full Text Available Background We aimed to identify the indicators of healthcare fraud and abuse in general physicians’ drug prescription claims, and to identify a subset of general physicians that were more likely to have committed fraud and abuse. Methods We applied data mining approach to a major health insurance organization dataset of private sector general physicians’ prescription claims. It involved 5 steps: clarifying the nature of the problem and objectives, data preparation, indicator identification and selection, cluster analysis to identify suspect physicians, and discriminant analysis to assess the validity of the clustering approach. Results Thirteen indicators were developed in total. Over half of the general physicians (54% were ‘suspects’ of conducting abusive behavior. The results also identified 2% of physicians as suspects of fraud. Discriminant analysis suggested that the indicators demonstrated adequate performance in the detection of physicians who were suspect of perpetrating fraud (98% and abuse (85% in a new sample of data. Conclusion Our data mining approach will help health insurance organizations in low-and middle-income countries (LMICs in streamlining auditing approaches towards the suspect groups rather than routine auditing of all physicians.

  3. Creating Unidimensional Global Measures of Physician Practice Quality Based on Health Insurance Claims Data.

    Science.gov (United States)

    Martsolf, Grant R; Carle, Adam C; Scanlon, Dennis P

    2017-06-01

    To explore the extent to which commonly used claims-based process quality indicators can be used to create an internally valid global composite measure of physician practice quality. Health insurance claims data (October 2007-May 2010) from 134 physician practices in Seattle, WA. We use confirmatory and exploratory factor analysis to develop theory- and empirically driven internally valid composite measures based on 19 quality indicators. Health insurance claims data from nine insurance companies and self-funded employers were collected and aggregated by third-party organization. Our results did not support a single global measure using the entire set of quality indicators. We did identify an acceptable multidimensional model (RMSEA = 0.059; CFI = 0.934; TLI = 0.910). The four dimensions in our data were diabetes, depression, preventive care, and generic drug prescribing. Our study demonstrates that commonly used process indicators can be used to create a small set of useful composite measures. However, the lack of an internally valid single unidimensional global measure has important implications for policy approaches meant to improve quality by rewarding "high-quality physicians." © Health Research and Educational Trust.

  4. Estimating the completeness of physician billing claims for diabetes case ascertainment using population-based prescription drug data

    Directory of Open Access Journals (Sweden)

    L. M. Lix

    2016-03-01

    Full Text Available Introduction: Changes in physician reimbursement policies may hinder the collection of billing claims in administrative data; this can result in biased estimates of disease prevalence and incidence. However, the magnitude of data loss is largely unknown. The purpose of this study was to estimate completeness of capture of disease cases for Manitoba physicians paid by fee-for-service (FFS and non-fee-for-service (NFFS methods. Methods: Manitoba’s administrative data were used to identify a cohort (Z 20 years with a new diabetes medication between 1 April, 2007, and 31 March, 2009. Cohort members were classified by payment method of the prescribing physician (i.e. FFS vs. NFFS. The cohort was then classified as missing or not missing a diabetes diagnosis using physician claims and hospital records. Then, w2 statistics were used to test for differences in the characteristics of the two groups. Results: The cohort consisted of 12 394 individuals; 86.4% had a prescription for a diabetes medication from an FFS physician. A total of 1172 physicians (81.8% FFS prescribed these medications for the cohort. Cohort members with a prescription from an FFS physician were older and more likely to reside in the urban Winnipeg health region than those with a prescription from a NFFS physician. A greater percentage of NFFS physicians’ cases were missing a diabetes diagnosis (18.7%vs. 14.9%for FFS physicians. Conclusion: The results suggest minimal loss of physician claims associated with remuneration policies in Manitoba. This method of assessing data completeness could be applied to other chronic diseases and jurisdictions to estimate completeness.

  5. Medication adherence in patients with diabetes mellitus: does physician drug dispensing enhance quality of care? Evidence from a large health claims database in Switzerland

    Science.gov (United States)

    Huber, Carola A; Reich, Oliver

    2016-01-01

    Background The drug-dispensing channel is a scarcely explored determinant of medication adherence, which is considered as a key indicator for the quality of care among patients with diabetes mellitus. In this study, we investigated the difference in adherence between diabetes patients who obtained their medication directly from a prescribing physician (physician dispensing [PD]) or via a pharmacy. Methods A retrospective cohort study was conducted using a large health care claims database from 2011 to 2014. Patients with diabetes of all ages and receiving at least one oral antidiabetic drug (OAD) prescription were included. We calculated patients’ individual adherence to OADs defined as the proportion of days covered (PDC), which was measured over 1 year after patient identification. Good adherence was defined as PDC ≥80%. Multivariate logistic regression analysis was performed to assess the relationship between the PDC and the dispensing channel (PD, pharmacy). Results We identified a total of 10,430 patients prescribed drugs by a dispensing physician and 16,292 patients receiving drugs from a pharmacy. Medication adherence was poor in both patient groups: ~40% of the study population attained good adherence to OADs. We found no significant impact of PD on the adherence level in diabetes patients. Covariates associated significantly with good adherence were older age groups, male sex, occurrence of comorbidity and combined diabetes drug therapy. Conclusion In conclusion, adherence to antihyperglycemic medication is suboptimal among patients with diabetes. The results of this study provide evidence that the dispensing channel does not have an impact on adherence in Switzerland. Certainly, medication adherence needs to be improved in both supply settings. Physicians as well as pharmacists are encouraged to develop and implement useful tools to increase patients’ adherence behavior. PMID:27695299

  6. Sequential Pattern Mining of Electronic Healthcare Reimbursement Claims: Experiences and Challenges in Uncovering How Patients are Treated by Physicians

    Energy Technology Data Exchange (ETDEWEB)

    Pullum, Laura L [ORNL; Ramanathan, Arvind [ORNL; Hobson, Tanner C [ORNL

    2015-01-01

    We examine the use of electronic healthcare reimbursement claims (EHRC) for analyzing healthcare delivery and practice patterns across the United States (US). We show that EHRCs are correlated with disease incidence estimates published by the Centers for Disease Control. Further, by analyzing over 1 billion EHRCs, we track patterns of clinical procedures administered to patients with autism spectrum disorder (ASD), heart disease (HD) and breast cancer (BC) using sequential pattern mining algorithms. Our analyses reveal that in contrast to treating HD and BC, clinical procedures for ASD diagnoses are highly varied leading up to and after the ASD diagnoses. The discovered clinical procedure sequences also reveal significant differences in the overall costs incurred across different parts of the US, indicating a lack of consensus amongst practitioners in treating ASD patients. We show that a data-driven approach to understand clinical trajectories using EHRC can provide quantitative insights into how to better manage and treat patients. Based on our experience, we also discuss emerging challenges in using EHRC datasets for gaining insights into the state of contemporary healthcare delivery and practice in the US.

  7. The utility of functional capacity evaluation: the opinion of physicians and other experts in the field of return to work and disability claims

    NARCIS (Netherlands)

    H. Wind; V. Gouttebarge; P.P.F.M. Kuijer; J.K. Sluiter; M.H.W. Frings-Dresen

    2006-01-01

    Objectives: This qualitative study explored how Dutch experts perceive the utility of functional capacity evaluation (FCE) for return to work (RTW) and disability claim (DC) assessment purposes. Methods: Twenty-one RTW case managers and 29 DC experts were interviewed by telephone using a semi-struct

  8. Effect of Functional Capacity Evaluation information on the judgment of physicians about physical work ability in the context of disability claims

    NARCIS (Netherlands)

    Wind, H.; Gouttebarge, V.; Kuijer, P.P.F.M.; Sluiter, J.K.; Frings-Dresen, M.H.W.

    2009-01-01

    Purpose To test whether Functional Capacity Evaluation (FCE) information lead insurance physicians (IPs) to change their judgment about the physical work ability of claimants with musculoskeletal disorders (MSDs). Methods Twenty-seven IPs scored twice the physical work ability of two claimants for

  9. Claiming Copernicus.

    Science.gov (United States)

    Fara, Patricia

    2005-12-01

    The reputations of scientific heroes shift constantly, modified by politicians as well as by historians. Now that the Scientific Revolution has been reappraised, Nicolas Copernicus is portrayed as a friend of the Catholic Church rather than a scientific martyr. As a German-speaking Pole he has been claimed as a figure of national historical importance by both Germany and Poland, and since the early 20th century has been an important symbol of Polish independence.

  10. Primary care physicians shortage: a Korean example.

    Science.gov (United States)

    Cho, Kyung-Hwan; Roh, Yong-Kyun

    2003-01-01

    A mismatch in the demand and supply of primary care physicians could give rise to a disorganization of the health care system and public confusion about health care access. There is much evidence in Korea of the existence of a primary care physician shortage. The appropriate required ratio of primary care physicians to the total number of physicians is estimated by analyzing data for primary care insurance consumption in Korea. Sums of primary care expenditure and claims were calculated to estimate the need for primary care physicians by analyzing the nationwide health insurance claims data of the Korean National Medical Insurance Management Corporation (KNMIMC) between the years 1989-1998. The total number of physicians increased 183% from 1989 to 1998. However, the number of primary care physicians including general physicians, family physicians, general internists, and general pediatricians showed an increase of only 169% in those 10 years. The demand for primary care physicians reaches at least 58.6%, and up to 83.7%, of the total number of physicians in Korea. However, the number of primary care physicians comprises up to 22.0% of the total number of active physicians during the same research period, which showed a large gap between demand and supply of primary care physicians in Korea. To provide high quality care overall, a balanced supply of primary care physicians and specialists is required, based on the nation's demand for health services.

  11. Claiming Community

    DEFF Research Database (Denmark)

    Jensen, Steffen Bo

    As its point of departure this working paper takes the multitude of different uses and meanings of the concept of community in local politics in Cape Town. Instead of attempting to define it in substantive terms, the paper takes a social constructivist approach to the study of community...... is termed community work. First, the paper explores how community has become a governmental strategy, employed by the apartheid regime as well, although in different ways, as post-apartheid local government. Secondly, the paper explores the ways in which community becomes the means in which local residents...... lay claim on the state, as well as how it enters into local power struggles between different political groups within the township. In the third part, the paper explores how the meanings of community and the struggles to realise it have changed as South Africa, nationally and locally, has become...

  12. Physician Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Physician Compare, which meets Affordable Care Act of 2010 requirements, helps you search for and select physicians and other healthcare professionals enrolled in...

  13. Analysis of NHSLA claims in orthopedic surgery.

    Science.gov (United States)

    Khan, Irfan H; Jamil, Wiqqas; Lynn, Sam Mathew; Khan, Osman H; Markland, Kate; Giddins, Grey

    2012-05-01

    National Health Service (NHS) statistics in the United Kingdom demonstrate an increase in clinical negligence claims over the past 30 years. Reasons for this include elements of a cultural shift in attitudes toward the medical profession and the growth of the legal services industry. This issue affects medical and surgical health providers worldwide.The authors analyzed 2117 NHS Litigation Authority (NHSLA) orthopedic surgery claims between 1995 and 2001 with respect to these clinical areas: emergency department, outpatient care, surgery (elective or trauma operations), and inpatient care. The authors focused on the costs of settling and defending claims, costs attributable to clinical areas, common causes of claims, and claims relating to elective or trauma surgery. Numbers of claims and legal costs increased most notably in surgery (elective and trauma) and in the emergency department. However, claims are being defended more robustly. The annual cost for a successful defense has remained relatively stable, showing a slight decline. The common causes of claims are postoperative complication; wrong, delayed, or failure of diagnosis; inadequate consent; and wrong-site surgery. Certain surgical specialties (eg, spine and lower-limb surgery) have the most claims made during elective surgery, whereas upper-limb surgery has the most claims made during trauma surgery.The authors recommend that individual trusts liaise with orthopedic surgeons to devise strategies to address areas highlighted in our study. Despite differences in health care systems worldwide, the underlying issues are common. With improved understanding, physicians can deliver the service they promise their patients.

  14. 32 CFR 536.120 - Claims payable as maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable as maritime claims. 536.120 Section 536.120 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.120 Claims payable as maritime claims. A claim is cognizable under this subpart if...

  15. Medicaid Drug Claims Statistics

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Medicaid Drug Claims Statistics CD is a useful tool that conveniently breaks up Medicaid claim counts and separates them by quarter and includes an annual count.

  16. Workers Compensation Claim Data -

    Data.gov (United States)

    Department of Transportation — This data set contains DOT employee workers compensation claim data for current and past DOT employees. Types of data include claim data consisting of PII data (SSN,...

  17. Consumer Health: CAM Claims

    Science.gov (United States)

    Healthy Lifestyle Consumer health Don't take all CAM claims at face value. Do your homework when considering CAM therapies. By ... dose of skepticism. Federal Trade Commission. http://www.consumer.ftc.gov/articles/0167-miracle-health-claims. Accessed ...

  18. Federal Tort Claims Act.

    Science.gov (United States)

    1998-04-01

    1992) (claim based on insertion and removal of elbow prosthesis more than two years before filing claims barred by SOL); but see Jastremski v...States, 957 F.2d 108 (4th Cir. 1992) (operator of mobile lounge at Dulles Airport is not U.S. employee, but independent contractor); Bird v. United

  19. Formalizing Probabilistic Safety Claims

    Science.gov (United States)

    Herencia-Zapana, Heber; Hagen, George E.; Narkawicz, Anthony J.

    2011-01-01

    A safety claim for a system is a statement that the system, which is subject to hazardous conditions, satisfies a given set of properties. Following work by John Rushby and Bev Littlewood, this paper presents a mathematical framework that can be used to state and formally prove probabilistic safety claims. It also enables hazardous conditions, their uncertainties, and their interactions to be integrated into the safety claim. This framework provides a formal description of the probabilistic composition of an arbitrary number of hazardous conditions and their effects on system behavior. An example is given of a probabilistic safety claim for a conflict detection algorithm for aircraft in a 2D airspace. The motivation for developing this mathematical framework is that it can be used in an automated theorem prover to formally verify safety claims.

  20. Pattern of Visits to Older Family Physicians in Taiwan

    Directory of Open Access Journals (Sweden)

    Hao-Yen Liu

    2017-05-01

    Full Text Available Many family physicians still practice at an old age. Nevertheless, their practice patterns have scarcely been studied. To address this lack of research, the current study analyzed claims data for a total of 2,018,440 visits to 171 family physicians in 2011 sourced from Taiwan’s National Health Insurance Research Database. Family physicians aged 65 years and over had fewer patients (mean: 2330, standard deviation (SD: 2019 and visits (mean: 9220, SD: 8600 than younger physicians had. Furthermore, the average age of the patients who visited physicians aged 65 years and over was 51.9 (SD: 21.5 years, significantly higher than that of patients who visited younger physicians. However, the proportions of visits for upper respiratory tract infections, hypertension, diabetes mellitus, and dyslipidemia did not differ significantly among different age groups of physicians. In the future, the manpower planning of physicians should take into consideration the age structure and work profile of physicians.

  1. Characteristics of Orthopaedic Malpractice Claims of Pediatric and Adult Patients in Private Practice.

    Science.gov (United States)

    Oetgen, Matthew E; Parikh, P Divya

    2016-03-01

    Medical liability exposure varies based on scope of practice, patient demographics, and location of practice. There is a generally held belief that treatment of pediatric patients increases one's medicolegal risk. We examined a large national database of orthopaedic malpractice claims to determine if pediatric malpractice claims were associated with a less favorable medicolegal outcome compared with adults. Physician Insurers Association of America is an association of medical liability insurance carriers providing liability coverage for 60% of private practice physicians in the United States. The Physician Insurers Association of America data registry of closed medical liability claims was examined, including all orthopaedic claims between 1985 and 2012 in this review. Claims were categorized based on the age of the claimant (pediatric: less than 21 y, adult: 21 y or older). These groups were compared based on percentage of claims resulting in payment, indemnity paid, and years between occurrence of incident and filing of claim. In addition, the top 10 most prevalent claims were identified and compared between groups. A total of 25,702 closed orthopaedic claims were included. Pediatric claims accounted for 13% of the data. The average time from incident to claim filing was 1.92 years for pediatrics and 1.59 years for adults. Pediatric claims resulted in a higher percent of payment (33% vs. 30%) and average indemnity paid ($189,732 vs. $180,171) compared with adults. Five of the top 10 conditions resulting in a claim in each group were the same. Comparing these 5 conditions, in general there were minimal differences in the average time to claim filing between the groups, but larger average indemnity paid in the pediatric group. There appear to be moderate differences in outcomes of orthopaedic malpractice claims between adult and pediatric patients. The longer statute of limitations associated with pediatric claims does not appear to portend a less favorable

  2. Unfalsifiability of security claims.

    Science.gov (United States)

    Herley, Cormac

    2016-06-01

    There is an inherent asymmetry in computer security: Things can be declared insecure by observation, but not the reverse. There is no observation that allows us to declare an arbitrary system or technique secure. We show that this implies that claims of necessary conditions for security (and sufficient conditions for insecurity) are unfalsifiable. This in turn implies an asymmetry in self-correction: Whereas the claim that countermeasures are sufficient is always subject to correction, the claim that they are necessary is not. Thus, the response to new information can only be to ratchet upward: Newly observed or speculated attack capabilities can argue a countermeasure in, but no possible observation argues one out. Further, when justifications are unfalsifiable, deciding the relative importance of defensive measures reduces to a subjective comparison of assumptions. Relying on such claims is the source of two problems: once we go wrong we stay wrong and errors accumulate, and we have no systematic way to rank or prioritize measures.

  3. Closed Claim Query File

    Data.gov (United States)

    Social Security Administration — This file is used to hold information about disability claims that have been closed and have been selected for sampling.Sampling is the process whereby OQR reviews...

  4. SSA Disability Claim Data

    Data.gov (United States)

    Social Security Administration — The dataset includes fiscal year data for initial claims for SSA disability benefits that were referred to a state agency for a disability determination. Specific...

  5. Health Claims Data Warehouse (HCDW)

    Data.gov (United States)

    Office of Personnel Management — The Health Claims Data Warehouse (HCDW) will receive and analyze health claims data to support management and administrative purposes. The Federal Employee Health...

  6. 37 CFR 1.75 - Claim(s).

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Claim(s). 1.75 Section 1.75... GENERAL RULES OF PRACTICE IN PATENT CASES National Processing Provisions Specification § 1.75 Claim(s). (a.... (35 U.S.C. 6; 15 U.S.C. 1113, 1126)...

  7. The claim from adoption.

    Science.gov (United States)

    Petersen, Thomas Sobirk

    2002-08-01

    In this article several justifications of what I call 'the claim from adoption' are examined. The claim from adoption is that, instead of expending resources on bringing new children into the world using reproductive technology and then caring for these children, we ought to devote these resources to the adoption and care of existing destitute children. Arguments trading on the idea that resources should be directed to adoption instead of assisted reproduction because already existing people can benefit from such a use of resources whereas we cannot benefit individuals by bringing them into existence are rejected. It is then argued that a utilitarian argument proposed by Christian Munthe that supports the claim from adoption in some situations should be rejected because the support it offers does not extend to certain situations in which it seems morally obvious that resources should be expended on adoption rather than assisted reproduction. A version of the Priority View improves upon Munthe's utilitarianism by supporting the claim from adoption in the cases in which Munthe's argument failed. Some allegedly counterintuitive implications of the Priority View are then discussed, and it is concluded that the Priority View is more plausible than utilitarianism. In a concluding section on policy issues it is argued that, even though the claim from adoption can be justified in a variety of situations, it does not follow that, in these situations, governments should direct resources away from assisted reproduction and towards adoption.

  8. Public Claims: A Legal Evaluation

    Directory of Open Access Journals (Sweden)

    Tamer Budak

    2011-04-01

    Full Text Available In order for a claim to exist, the host there has to be two parties. In case of public claims one of the parties is the state, special provincial administration and municipalities; while the debtor consists of the natural and legal persons. The definition of public claims is provided by The Procedure Law of Collection of Public Claims. One claims, the quality of the public claims not cause any, may be excluded from the scope of Law No. 6183. All the claims of public administration are not public claims. However, any private claim can have the security of a public claim. For this reason the criteria used to define a public claim differ. Arrangements, which can render a public claim a privileged claim, exist in the relevant Code. The aim of this study is to define the concept of public claim expressed in the relevant code and to determine the conditions under which a claim not stated in the Code can be considered a public claim in the light of court decisions.

  9. Clinician feedback on using episode groupers with Medicare claims data.

    Science.gov (United States)

    Thomas, Fred; Caplan, Craig; Levy, Jesse M; Cohen, Marty; Leonard, James; Caldis, Todd; Mueller, Curt

    2010-01-01

    CMS is investigating techniques that might help identify costly physician practice patterns. One method presently under evaluation is to compare resource use for certain episodes of care using commercially available episode grouping software. Although this software has been used by the private sector to classify insured individuals' medical claims into episodes of care, it has never been used with fee-for-service Medicare claims except in the studies by the Medicare Payment Advisory Commission (MedPAC) and CMS. This study reviews and reports on clinician feedback on the most obvious and important decisions that must be faced by Medicare to use grouped claims data as the foundation for a physician performance measurement system. The panel reactions show the importance of bringing persons with clinical knowledge into the development process. The clinician feedback confirms that additional research is needed.

  10. Associations between physician characteristics and quality of care.

    Science.gov (United States)

    Reid, Rachel O; Friedberg, Mark W; Adams, John L; McGlynn, Elizabeth A; Mehrotra, Ateev

    2010-09-13

    Information on physicians' performance on measures of clinical quality is rarely available to patients. Instead, patients are encouraged to select physicians on the basis of characteristics such as education, board certification, and malpractice history. In a large sample of Massachusetts physicians, we examined the relationship between physician characteristics and performance on a broad range of quality measures. We calculated overall performance scores on 124 quality measures from RAND's Quality Assessment Tools for each of 10,408 Massachusetts physicians using claims generated by 1.13 million adult patients. The patients were continuously enrolled in 1 of 4 Massachusetts commercial health plans from 2004 to 2005. Physician characteristics were obtained from the Massachusetts Board of Registration in Medicine. Associations between physician characteristics and overall performance scores were assessed using multivariate linear regression. The mean overall performance score was 62.5% (5th to 95th percentile range, 48.2%-74.9%). Three physician characteristics were independently associated with significantly higher overall performance: female sex (1.6 percentage points higher than male sex; P < .001), board certification (3.3 percentage points higher than noncertified; P < .001), and graduation from a domestic medical school (1.0 percentage points higher than international; P < .001). There was no significant association between performance and malpractice claims (P = .26). Few characteristics of individual physicians were associated with higher performance on measures of quality, and observed associations were small in magnitude. Publicly available characteristics of individual physicians are poor proxies for performance on clinical quality measures.

  11. Handbook of Veterinary Claims.

    Science.gov (United States)

    1983-03-01

    11. I recoend disapproval of this claim due to lack of proof of causa - tion by the USAF. At the time this report is being written, there is no...alleged that nonsterile surgical technique resulted in peritonitis and subsequent lack of appetite, and that the latter resulted in bloody diarrhea, anemia

  12. First and foremost, physicians: the clinical versus leadership identities of physician leaders.

    Science.gov (United States)

    Quinn, Joann Farrell; Perelli, Sheri

    2016-06-20

    Purpose - Physicians are commonly promoted into administrative and managerial roles in US hospitals on the basis of clinical expertise and often lack the skills, training or inclination to lead. Several studies have sought to identify factors associated with effective physician leadership, yet we know little about how physician leaders themselves construe their roles. The paper aims to discuss these issues. Design/methodology/approach - Phenomenological interviews were performed with 25 physicians at three organizational levels with physicians affiliated or employed by four hospitals within one health care organization in the USA between August and September 2010. A rigorous comparative methodology of data collection and analysis was employed, including the construction of analytic codes for the data and its categorization based on emergent ideas and themes that are not preconceived and logically deduced hypotheses, which is characteristic of grounded theory. Findings - These interviews reveal differences in how part- vs full-time physician leaders understand and value leadership roles vs clinical roles, claim leadership status, and identify as physician leaders on individual, relational and organizational basis. Research limitations/implications - Although the physicians in the sample were affiliated with four community hospitals, all of them were part of a single not-for-profit health care system in one geographical locale. Practical implications - These findings may be of interest to hospital administrators and boards seeking deeper commitment and higher performance from physician leaders, as well as assist physicians in transitioning into a leadership role. Social implications - This work points to a broader and more fundamental need - a modified mindset about the nature and value of physician leadership. Originality/value - This study is unique in the exploration of the nature of physician leadership from the perspective of the physician on an individual, peer

  13. 21 CFR 101.71 - Health claims: claims not authorized.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Health claims: claims not authorized. 101.71 Section 101.71 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION FOOD LABELING Specific Requirements for Health Claims § 101.71...

  14. Analyzing claims by game theory and claim cost

    Institute of Scientific and Technical Information of China (English)

    LI Cong-wei; TANG Yao-gang; LIU Zhan-hong

    2006-01-01

    In managing an international project, claims are very important. In this paper, a complete information dynamic game model is designed; with the Nash equilibrium values, the huge influence of claim cost on claim strategy is testified and the importance of claims to both sides of a contract especially the contractor is elucidated. Claim chances are also discussed with game theory. At last, from the angle of a repeated game and by comparison with Pareto optimization and Nash equilibrium values, it is concluded that the best payoff can be obtained with a honest attitude and through cooperation between companies.

  15. FDA approval of comparative claims for prescription drugs--the Moxam case.

    Science.gov (United States)

    Marcus, D

    1983-01-01

    FDA allowance of comparative claims as part of the approved labeling for new prescription drugs creates special problems. Claims contained in prescription drug labeling are viewed by physicians as embodying not just the normal puffery of the manufacturer, but the considered views of government agency charged with protecting public health. Thus, labeling claims for prescription drugs have an impact and significance that promotional claims for other products do not. In the Moxam case--a dispute between Upjohn and Lilly over the FDA's approval of a comparative claim for a new Lilly antibiotic--the agency recognized this fundamental reality. Faced with the prospect of having to provide a procedure to permit competitors to challenge approval of comparative claims, the FDA has moved toward a policy of not permitting such claims in labeling, while allowing them in advertising.

  16. Physician Appraisals: Key Challenges

    Directory of Open Access Journals (Sweden)

    Klich Jacek

    2017-06-01

    Full Text Available The main purpose of the article is to identify key criteria being used for physician appraisals and to find how communication skills of physicians are valued in those appraisals. ScienceDirect and EBSCOhost databases were used for this search. The results show that a physician appraisal is underestimated both theoretically and empirically. The particular gap exists with respect to the communication skills of physicians, which are rarely present in medical training syllabi and physician assessments. The article contributes to the theoretical discourse on physician appraisals and points out at the inconsistency between the high status of physicians as a key hospital resource on the one hand and, on the other hand, at inadequate and poorly researched assessment of their performance with a special emphasis on communication skills. The article may inspire health managers to develop and implement up-to-date assessment forms for physicians and good managerial practices in this respect in hospitals and other health care units.

  17. Physician Fee Schedule Search

    Data.gov (United States)

    U.S. Department of Health & Human Services — This website is designed to provide information on services covered by the Medicare Physician Fee Schedule (MPFS). It provides more than 10,000 physician services,...

  18. Anesthesiologists Are Affiliated with Many Hospitals Only Reporting Anesthesia Claims Using Modifier QZ for Medicare Claims in 2013.

    Science.gov (United States)

    Miller, Thomas R; Abouleish, Amr; Halzack, Nicholas M

    2016-04-01

    We examined hospitals that exclusively used the billing modifier QZ in anesthesia claims for a 5% sample of Medicare beneficiaries in 2013. We used a national Medicare provider file to identify physician anesthesiologists and nurse anesthetists affiliated with these hospitals. Among the 538 hospitals that exclusively reported the modifier QZ, 47.5% had affiliated physician anesthesiologists. These hospitals accounted for 60.4% of the cases. Our results illustrate the challenges of using modifier QZ to describe anesthesia practice arrangements in hospitals. The modifier QZ does not seem to be a valid surrogate for no anesthesiologist being involved in the care provided.

  19. NURSING HOME CONTROL OF PHYSICIAN RESOURCES (NHCOPR)

    Science.gov (United States)

    Intrator, Orna; Lima, Julie; Wetle, Terrie Fox

    2014-01-01

    Objective Physician services are increasingly recognized as important contributors to quality care provision in nursing homes (NHs), but knowledge of ways in which NHs manage/ control physician resources is lacking. Data Primary data from surveys of NH Administrators and Directors of Nursing from a nationally representative sample of 1,938 freestanding U.S. NHs in 2009–2010 matched to Online Survey Certification and Reporting (OSCAR), aggregated NH Minimum Data Set (MDS) assessments and Medicare claims, and data from the Area Resource File (ARF). Methods The concept of NH Control of Physician Resources (NHCOPR) was measured using NH Administrators’ reports of management implementation of rules, policies, and procedures aimed at coordinating work activities. The NHCOPR scale was based on measures of formal relationships, physician oversight and credentialing. Scale values ranged from weakest (0) to tightest (3) control. Several hypotheses of expected associations between NHCOPR and other measures of NH and market characteristics were tested. Principal Findings The full NHCOPR score averaged 1.58 (SD=0.77) on the 0–3 scale. Nearly 30% of NHs had weak control (NHCOPR 2). NHCOPR exhibited good face- and predictive-validity as exhibited by positive associations with more beds, more Medicare services, cross coverage and number of physicians in the market. Conclusions The NHCOPR scale capturing NH’s formal structure of control of physician resources can be useful in studying the impact of NH’s physician resources on residents’ outcomes with potential for targeted interventions by education and promotion of NH administration of physician staff. PMID:24508327

  20. Claims in civil engineering contracts

    CERN Document Server

    Speirs, N A

    1999-01-01

    This paper considers claims arising during civil engineering construction contracts. The meaning of the word 'claim' is considered and its possible implications for additional cost and time to completion. The conditions of the construction contract selected will influence the risk apportionment between contractor and client and the price offered by the contractor for the work. Competitive bidding constraints and profit margins in the construction industry, however, may also influence the price offered. This in turn can influence the likelihood of claims arising. The client from his point of view is concerned to complete the work within an agreed time and budget. The circumstances under which claims may arise are reviewed in relation to typical conditions of contract. These circumstances are then related to the CERN LHC civil works. Ways of avoiding claims, where this is possible, are considered. Finally, the means of evaluation of claims and their settlement are considered.

  1. Claiming health in food products

    DEFF Research Database (Denmark)

    Lähteenmäki, Liisa

    2013-01-01

    Health-related information is increasingly used on food products to convey their benefits. Health claims as a subcategory of these messages link the beneficial component, functions or health outcomes with specific products. For consumers, health claims seem to carry the message of increased...... healthiness, but not necessarily making the product more appealing. The wording of the claim seems to have little impact on claim perception, yet the health image of carrier products is important. From consumer-related factors the relevance and attitudes towards functional foods play a role, whereas socio...... the information, but we still know relatively little about consumer understanding of the message content in claims and even less about the assessment of personal relevance of the claimed benefits. In future studies more emphasis should be put on including contextual influences and realistic conditions...

  2. Physician attitudes towards pharmacological cognitive enhancement: safety concerns are paramount.

    Directory of Open Access Journals (Sweden)

    Opeyemi C Banjo

    Full Text Available The ethical dimensions of pharmacological cognitive enhancement have been widely discussed in academic circles and the popular media, but missing from the conversation have been the perspectives of physicians - key decision makers in the adoption of new technologies into medical practice. We queried primary care physicians in major urban centers in Canada and the United States with the aim of understanding their attitudes towards cognitive enhancement. Our primary hypothesis was that physicians would be more comfortable prescribing cognitive enhancers to older patients than to young adults. Physicians were presented with a hypothetical pharmaceutical cognitive enhancer that had been approved by the regulatory authorities for use in healthy adults, and was characterized as being safe, effective, and without significant adverse side effects. Respondents overwhelmingly reported increasing comfort with prescribing cognitive enhancers as the patient age increased from 25 to 65. When asked about their comfort with prescribing extant drugs that might be considered enhancements (sildenafil, modafinil, and methylphenidate or our hypothetical cognitive enhancer to a normal, healthy 40 year old, physicians were more comfortable prescribing sildenafil than any of the other three agents. When queried as to the reasons they answered as they did, the most prominent concerns physicians expressed were issues of safety that were not offset by the benefit afforded the individual, even in the face of explicit safety claims. Moreover, many physicians indicated that they viewed safety claims with considerable skepticism. It has become routine for safety to be raised and summarily dismissed as an issue in the debate over pharmacological cognitive enhancement; the observation that physicians were so skeptical in the face of explicit safety claims suggests that such a conclusion may be premature. Thus, physician attitudes suggest that greater weight be placed upon the

  3. Professional liability claims against dentists

    National Research Council Canada - National Science Library

    Moscoso Matus, Karla; Smok Vásquez, Pía

    2015-01-01

    .... To determine the magnitude and frequency of professional liability claims against dentists. A retrospective analysis of the Medical Liability Unit of the Legal Medical Service of Chile database...

  4. An analysis of the warning letters issued by the FDA to pharmaceutical manufacturers regarding misleading health outcomes claims

    Directory of Open Access Journals (Sweden)

    Chatterjee S

    2012-12-01

    Full Text Available Objective: To evaluate the number and type of warning letters issued by the US Food and Drug Administration (FDA to pharmaceutical manufacturers for promotional violations.Methods: Two reviewers downloaded, printed and independently evaluated warning letters issued by the FDA to pharmaceutical manufacturers from years 2003-2008. Misleading claims were broadly classified as clinical, Quality-of-Life (QoL, and economic claims. Clinical claims included claims regarding unsubstantiated efficacy, safety and tolerability, superiority, broadening of indication and/or omission of risk information. QoL claims included unsubstantiated quality of life and/or health-related quality of life claims. Economic claims included any form of claim made on behalf of the pharmaceutical companies related to cost superiority of or cost savings from the drug compared to other drugs in the market.Results: In the 6-year study period, 65 warning letters were issued by FDA, which contained 144 clinical, three QoL, and one economic claim. On an average, 11 warning letters were issued per year. Omission of risk information was the most frequently violated claim (30.6% followed by unsubstantiated efficacy claims (18.6%. Warning letters were primarily directed to manufacturers of cardiovascular (14.6%, anti-microbial (14.6%, and CNS (12.5% drugs. Majority of the claims referenced in warning letters contained promotional materials directed to physicians (57%. Conclusion: The study found that misleading clinical outcome claims formed the majority of the promotional violations, and majority of the claims were directed to physicians. Since inadequate promotion of medications may lead to irrational prescribing, the study emphasizes the importance of disseminating reliable, credible, and scientific information to patients, and more importantly, physicians to protect public health.

  5. An analysis of the warning letters issued by the FDA to pharmaceutical manufacturers regarding misleading health outcomes claims.

    Science.gov (United States)

    Chatterjee, Satabdi; Patel, Harshali K; Sansgiry, Sujit S

    2012-10-01

    To evaluate the number and type of warning letters issued by the US Food and Drug Administration (FDA) to pharmaceutical manufacturers for promotional violations. Two reviewers downloaded, printed and independently evaluated warning letters issued by the FDA to pharmaceutical manufacturers from years 2003-2008. Misleading claims were broadly classified as clinical, Quality-of-Life (QoL), and economic claims. Clinical claims included claims regarding unsubstantiated efficacy, safety and tolerability, superiority, broadening of indication and/or omission of risk information. QoL claims included unsubstantiated quality of life and/or health-related quality of life claims. Economic claims included any form of claim made on behalf of the pharmaceutical companies related to cost superiority of or cost savings from the drug compared to other drugs in the market. In the 6-year study period, 65 warning letters were issued by FDA, which contained 144 clinical, three QoL, and one economic claim. On an average, 11 warning letters were issued per year. Omission of risk information was the most frequently violated claim (30.6%) followed by unsubstantiated efficacy claims (18.6%). Warning letters were primarily directed to manufacturers of cardiovascular (14.6%), anti-microbial (14.6%), and CNS (12.5%) drugs. Majority of the claims referenced in warning letters contained promotional materials directed to physicians (57%). The study found that misleading clinical outcome claims formed the majority of the promotional violations, and majority of the claims were directed to physicians. Since inadequate promotion of medications may lead to irrational prescribing, the study emphasizes the importance of disseminating reliable, credible, and scientific information to patients, and more importantly, physicians to protect public health.

  6. Confronting the disruptive physician.

    Science.gov (United States)

    Linney, B J

    1997-01-01

    Ignoring disruptive behavior is no longer an option in today's changing health care environment. Competition and managed care have caused more organizations to deal with the disruptive physician, rather than look the other way as many did in years past. But it's not an easy task, possibly the toughest of your management career. How should you confront a disruptive physician? By having clearly stated expectations for physician behavior and policies in place for dealing with problem physicians, organizations have a context from which to address the situation.

  7. Negotiation for physicians.

    Science.gov (United States)

    Hill, Micah J; DeCherney, Alan H

    2013-05-01

    Physicians are involved in negotiations on a daily basis. Interactions with patients, support staff, nurses, fellow physicians, administrators, lawyers, and third parties all can occur within the context of negotiation. This article reviews the basic principles of negotiation and negotiation styles, models, and practical tools.

  8. Incorporating statistical uncertainty in the use of physician cost profiles

    Directory of Open Access Journals (Sweden)

    McGlynn Elizabeth A

    2010-03-01

    Full Text Available Abstract Background Physician cost profiles (also called efficiency or economic profiles compare the costs of care provided by a physician to his or her peers. These profiles are increasingly being used as the basis for policy applications such as tiered physician networks. Tiers (low, average, high cost are currently defined by health plans based on percentile cut-offs which do not account for statistical uncertainty. In this paper we compare the percentile cut-off method to another method, using statistical testing, for identifying high-cost or low-cost physicians. Methods We created a claims dataset of 2004-2005 data from four Massachusetts health plans. We employed commercial software to create episodes of care and assigned responsibility for each episode to the physician with the highest proportion of professional costs. A physicians' cost profile was the ratio of the sum of observed costs divided by the sum of expected costs across all assigned episodes. We discuss a new method of measuring standard errors of physician cost profiles which can be used in statistical testing. We then assigned each physician to one of three cost categories (low, average, or high cost using two methods, percentile cut-offs and a t-test (p-value ≤ 0.05, and assessed the level of disagreement between the two methods. Results Across the 8689 physicians in our sample, 29.5% of physicians were assigned a different cost category when comparing the percentile cut-off method and the t-test. This level of disagreement varied across specialties (17.4% gastroenterology to 45.8% vascular surgery. Conclusions Health plans and other payers should incorporate statistical uncertainty when they use physician cost-profiles to categorize physicians into low or high-cost tiers.

  9. Medicare Part D Claims Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — This page contains information on Part D claims data for the purposes of research, analysis, reporting, and public health functions. These data will also be used to...

  10. Medicare Hospital Spending by Claim

    Data.gov (United States)

    U.S. Department of Health & Human Services — Also known as Medicare Spending per Beneficiary (MSPB) Spending Breakdowns by Claim Type file. The data displayed here show average spending levels during...

  11. Involve physicians in marketing.

    Science.gov (United States)

    Randolph, G T; Baker, K M; Laubach, C A

    1984-01-01

    Many everyday problems in medical group practice can be attacked by a marketing approach. To be successful, however, this kind of approach must have the full support of those involved, especially the physicians, since they are the principal providers of healthcare services. When marketing is presented in a broad context, including elements such as patient mix, population distribution, and research, physicians are more likely to be interested and supportive. The members of Geisinger Medical Center's Department of Cardiovascular Medicine addressed their patient appointment backlog problem with a marketing approach. Their method is chronicled here and serves as a fine example of how physician involvement in marketing can lead to a positive outcome.

  12. Physician Referral Patterns

    Data.gov (United States)

    U.S. Department of Health & Human Services — The physician referral data was initially provided as a response to a Freedom of Information (FOIA) request. These files represent data from 2009 through June 2013...

  13. Physician-Owned Hospitals

    Data.gov (United States)

    U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...

  14. Physicians' Job Satisfaction.

    African Journals Online (AJOL)

    AmL

    the workplace, these conditions can lead to increased absenteeism, conflict and ..... need to encourage and acknowledge teamwork and information sharing. ... demonstrated in terms of both pay and benefits physicians at private hospitals.

  15. Hitler's Jewish Physicians.

    Science.gov (United States)

    Weisz, George M

    2014-07-01

    The mystery behind the behavior of infamous personalities leaves many open questions, particularly when related to the practice of medicine. This paper takes a brief look at two Jewish physicians who played memorable roles in the life of Adolf Hitler.

  16. Physician Shared Patient Patterns

    Data.gov (United States)

    U.S. Department of Health & Human Services — The physician referral data linked below was provided as a response to a Freedom of Information Act (FOIA) request. These files represent the number of encounters a...

  17. Physician Compare Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — This is the official dataset associated with the Medicare.gov Physician Compare Website provided by the Centers for Medicare and Medicaid Services (CMS). These data...

  18. Kickbacks, self-referrals, and false claims: the hazy boundaries of health-care fraud.

    Science.gov (United States)

    Krause, Joan H

    2013-09-01

    The fraud and abuse laws that govern conduct related to the federal health-care programs, such as Medicare and Medicaid, impose broad and complex limitations on billing practices and financial relationships among providers. Given the potential consequences of engaging in fraudulent behavior, it is crucial that physicians appreciate the types of activities that may run afoul of these laws. This article summarizes the major aspects of the fraud laws that are most likely to have a daily impact on physician practice: the Civil False Claims Act, the Medicare and Medicaid Anti-Kickback Statute, and the so-called Stark Law prohibition on physician self-referrals.

  19. 40 CFR 1620.5 - Administrative claim; evidence and information to be submitted.

    Science.gov (United States)

    2010-07-01

    ... expenses incurred by reason of the incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and suffering before death are claimed, a physician's detailed statement... or permanent disability, the prognosis, period of hospitalization, and any diminished earning...

  20. 5 CFR 177.105 - Administrative claim; evidence and information to be submitted.

    Science.gov (United States)

    2010-01-01

    ... burial expenses incurred by reason of the incident causing death, or itemized receipts of payment for such expenses. (7) If damages for pain and suffering before death are claimed, a physician's detailed..., period of hospitalization, and any diminished earning capacity. In addition, the claimant may be required...

  1. 45 CFR 35.4 - Administrative claims; evidence and information to be submitted.

    Science.gov (United States)

    2010-10-01

    ... his last employment or occupation. (3) Full names, addresses, birth dates, kinship, and marital status... pain and suffering prior to death are claimed, a physician's detailed statement specifying the injuries suffered, duration of pain and suffering, any drugs administered for pain and the decedent's...

  2. 38 CFR 3.155 - Informal claims.

    Science.gov (United States)

    2010-07-01

    ... organization, an attorney, or agent may not be accepted as an informal claim if a power of attorney was not... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Informal claims. 3.155..., Compensation, and Dependency and Indemnity Compensation Claims § 3.155 Informal claims. (a) Any...

  3. 40 CFR 716.55 - Confidentiality claims.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Confidentiality claims. 716.55 Section... ACT HEALTH AND SAFETY DATA REPORTING General Provisions § 716.55 Confidentiality claims. (a)(1... clearly identify the material subject to the claim. (3) Any respondent may assert a confidentiality claim...

  4. 44 CFR 62.20 - Claims appeals.

    Science.gov (United States)

    2010-10-01

    ... OF CLAIMS Claims Adjustment, Claims Appeals, and Judicial Review § 62.20 Claims appeals. (a... resolution by appraisal or other pre-litigation remedies. (d) Litigation preclusion. An insured who files... resolution. (1) FEMA will acknowledge, in writing, receipt of a policyholder's appeal and include in...

  5. Reserving by detailed conditioning on individual claim

    Science.gov (United States)

    Kartikasari, Mujiati Dwi; Effendie, Adhitya Ronnie; Wilandari, Yuciana

    2017-03-01

    The estimation of claim reserves is an important activity in insurance companies to fulfill their liabilities. Recently, reserving method of individual claim have attracted a lot of interest in the actuarial science, which overcome some deficiency of aggregated claim method. This paper explores the Reserving by Detailed Conditioning (RDC) method using all of claim information for reserving with individual claim of liability insurance from an Indonesian general insurance company. Furthermore, we compare it to Chain Ladder and Bornhuetter-Ferguson method.

  6. Physician Cost Profiling — Reliability and Risk of Misclassification

    Science.gov (United States)

    Adams, John L.; Mehrotra, Ateev; Thomas, J. William; McGlynn, Elizabeth A.

    2010-01-01

    BACKGROUND Insurance products with incentives for patients to choose physicians classified as offering lower-cost care on the basis of cost-profiling tools are increasingly common. However, no rigorous evaluation has been undertaken to determine whether these tools can accurately distinguish higher-cost physicians from lower-cost physicians. METHODS We aggregated claims data for the years 2004 and 2005 from four health plans in Massachusetts. We used commercial software to construct clinically homogeneous episodes of care (e.g., treatment of diabetes, heart attack, or urinary tract infection), assigned each episode to a physician, and created a summary profile of resource use (i.e., cost) for each physician on the basis of all assigned episodes. We estimated the reliability (signal-to-noise ratio) of each physician’s cost-profile score on a scale of 0 to 1, with 0 indicating that all differences in physicians’ cost profiles are due to a lack of precision in the measure (noise) and 1 indicating that all differences are due to real variation in costs of services (signal). We used the reliability results to estimate the proportion of physicians in each specialty whose cost performance would be classified inaccurately in a two-tiered insurance product in which the physicians with cost profiles in the lowest quartile were labeled as “lower cost.” RESULTS Median reliabilities ranged from 0.05 for vascular surgery to 0.79 for gastroenterology and otolaryngology. Overall, 59% of physicians had cost-profile scores with reliabilities of less than 0.70, a commonly used marker of suboptimal reliability. Using our reliability results, we estimated that 22% of physicians would be misclassified in a two-tiered system. CONCLUSIONS Current methods for profiling physicians with respect to costs of services may produce misleading results. PMID:20237347

  7. 32 CFR 536.97 - Scope for claims under the National Guard Claims Act.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for claims under the National Guard Claims Act. 536.97 Section 536.97 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  8. 32 CFR 536.98 - Claims payable under the National Guard Claims Act.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims payable under the National Guard Claims Act. 536.98 Section 536.98 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National Guard...

  9. 32 CFR 536.99 - Claims not payable under the National Guard Claims Act.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Claims not payable under the National Guard Claims Act. 536.99 Section 536.99 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Claims Cognizable Under the National...

  10. Responding to Claims of Misrepresentation

    Science.gov (United States)

    Santelices, Maria Veronica; Wilson, Mark

    2010-01-01

    In their paper "Unfair Treatment? The Case of Freedle, the SAT, and the Standardization Approach to Differential Item Functioning" (Santelices & Wilson, 2010), the authors studied claims of differential effects of the SAT on Latinos and African Americans through the methodology of differential item functioning (DIF). Previous…

  11. Nordic scepticism towards health claims

    DEFF Research Database (Denmark)

    Pedersen, Susanne; Grunert, Klaus G.

    2008-01-01

    Imagine that you are shopping in a supermarket and find a package of pork chops labelled "omega-3 added" or that the yogurt "contains phosphatidylserine, which can improve your memory"; would you buy these pork chops or this yogurt? Most Nordic consumers would choose products without health claims....

  12. Instrumentation problems for physicians.

    Science.gov (United States)

    Turner, G O

    1980-01-01

    The physician has, for whatever reasons, diminished his or her level of involvement on the team dedicated to developing, refining, and evaluating medical technology. As a result, the challenge confronting the physician and the technology development team today is to orchestrate a team structure that will ensure the greatest input and commitment from physicians and other professionals during current and future technology development. The charges of cost escalation and dehumanization in our system of health care delivery will also be discussed, as will the lack of, or confusion about, access to data concerning cost of a given instrument, and fuzzy semantics and perspectives on technology and instrumentation. The author suggests answers to, or means to ameliorate, the problems.

  13. Physicians' Abdominal Auscultation

    DEFF Research Database (Denmark)

    John, Gade; Peter, Kruse; Andersen, Ole Trier

    1998-01-01

    Background: Abdominal auscultation has an important position in the physical examination of the abdomen. Little is known about rater agreement. The aim of this study was to describe rater agreement and thus, indirectly, the value of the examination. Methods: In a semi-virtual setup 12 recordings...... of the intestinal sounds from 8 patients with acute abdominal pain and 4 healthy volunteers were presented to 100 physicians. The physicians were asked to characterize the intestinal sounds as normal or pathologic. Fisher's exact test was used for comparison between groups of physicians. Results: Overall, 72......% of the answers with regard to healthy volunteers concluded that the sounds were normal (equalling agreement), whereas 64% of answers with regard to intestinal obstruction concluded that the sounds were pathologic (but agreement was higher due to agreement on wrong diagnosis in one case). Bowel sounds from...

  14. Marital stability among physicians.

    Science.gov (United States)

    Rose, K D; Rosow, I

    1972-03-01

    Analysis of 57,514 initial complaints for divorce, separate maintenance, and annulment filed in California during the first six months of 1968 reveals that physicians are considerably less prone to marital failure than men of comparable age in the general population. Furthermore, when compared to professionals in general, doctors also appear less prone to marital collapse. For physicians, marriages break down in the greatest numbers and at the greatest rate between the ages of 35 and 44. Women doctors are at least 40% more prone to marital instability than men, and black physicians are nearly 70% more prone to divorce than their white colleagues. Of the individual specialists, orthopedists and psychiatrists possibly have the highest rates of marital demise.

  15. [Hippocrates' treatise physician].

    Science.gov (United States)

    Frøland, Anders

    2005-01-01

    This small treatise does not appear to have been published in Danish in its entirety. It gives a vivid picture of the physician in ancient Greece. The well known first chapter describes the attitudes and attributes of the doctor. It goes on discussing in some detail how the light should be in the surgery, the instruments to be used, the preparations of bandages and drugs, and the use of cupping instruments. The author stresses both the needs of the patient and the necessity of the physician's dignity and integrity.

  16. Leasing physician office space.

    Science.gov (United States)

    Murray, Charles

    2009-01-01

    When leasing office space, physicians should determine the effective lease rate (ELR) for each building they are considering before making a selection. The ELR is based on a number of factors, including building quality, building location, basic form of lease agreement, rent escalators and add-on factors in the lease, tenant improvement allowance, method of square footage measurement, quality of building management, and other variables. The ELR enables prospective physician tenants to accurately compare lease rates being quoted by building owners and to make leasing decisions based on objective criteria.

  17. Content analysis of false and misleading claims in television advertising for prescription and nonprescription drugs.

    Science.gov (United States)

    Faerber, Adrienne E; Kreling, David H

    2014-01-01

    False and misleading advertising for drugs can harm consumers and the healthcare system, and previous research has demonstrated that physician-targeted drug advertisements may be misleading. However, there is a dearth of research comparing consumer-targeted drug advertising to evidence to evaluate whether misleading or false information is being presented in these ads. To compare claims in consumer-targeted television drug advertising to evidence, in order to evaluate the frequency of false or misleading television drug advertising targeted to consumers. A content analysis of a cross-section of television advertisements for prescription and nonprescription drugs aired from 2008 through 2010. We analyzed commercial segments containing prescription and nonprescription drug advertisements randomly selected from the Vanderbilt Television News Archive, a census of national news broadcasts. For each advertisement, the most-emphasized claim in each ad was identified based on claim iteration, mode of communication, duration and placement. This claim was then compared to evidence by trained coders, and categorized as being objectively true, potentially misleading, or false. Potentially misleading claims omitted important information, exaggerated information, made lifestyle associations, or expressed opinions. False claims were factually false or unsubstantiated. Of the most emphasized claims in prescription (n = 84) and nonprescription (n = 84) drug advertisements, 33 % were objectively true, 57 % were potentially misleading and 10 % were false. In prescription drug ads, there were more objectively true claims (43 %) and fewer false claims (2 %) than in nonprescription drug ads (23 % objectively true, 7 % false). There were similar numbers of potentially misleading claims in prescription (55 %) and nonprescription (61 %) drug ads. Potentially misleading claims are prevalent throughout consumer-targeted prescription and nonprescription drug advertising on

  18. Information for travellers' physicians.

    Science.gov (United States)

    Allison, D J; Blinco, K

    1990-07-01

    Physicians can obtain advice about international travel for their patients from many different sources of information. The authors review some of the most common sources based on their experience at the International Travellers' Clinic operated by the New Brunswick Department of Health and Community Services in Fredericton. They identify readily available handbooks and periodicals and compare two computer software programs.

  19. Information for Travellers' Physicians

    OpenAIRE

    Allison, David J; Blinco, Kimberley

    1990-01-01

    Physicians can obtain advice about international travel for their patients from many different sources of information. The authors review some of the most common sources based on their experience at the International Travellers' Clinic operated by the New Brunswick Department of Health and Community Services in Fredericton. They identify readily available handbooks and periodicals and compare two computer software programs.

  20. Medication counselling: physicians' perspective.

    Science.gov (United States)

    Bonnerup, Dorthe Krogsgaard; Lisby, Marianne; Eskildsen, Anette Gjetrup; Saedder, Eva Aggerholm; Nielsen, Lars Peter

    2013-12-01

    Medication reviews have the potential to lower the incidence of prescribing errors. To benefit from a medication review, the prescriber must adhere to medication counselling. Adherence rates vary from 39 to 100%. The aim of this study was to examine counselling-naive hospital physicians' perspectives and demands to medication counselling as well as study factors that might increase adherence to the counselling. The study was conducted as a questionnaire survey among physicians at Aarhus University Hospital, Denmark. The questionnaire was developed based on focus group interviews and literature search, and was pilot-tested among 30 physicians before being sent to 669 physicians. The questionnaire consisted of 35 items divided into four categories: attitudes (19 items), behaviours (3 items), assessment (8 items) and demographics (5 items). The response rate was 60% (400/669). Respondents were employed at psychiatric, medical or surgical departments. Eighty-five per cent of respondents agreed that patients would benefit of an extra medication review, and 72% agreed that there was a need for external medication counselling. The most important factor that could increase adherence was the clinical relevance of the counselling as 78% rated it of major importance. The most favoured method for receiving counselling was via the electronic patient record.

  1. Physicians and Insider Trading.

    Science.gov (United States)

    Kesselheim, Aaron S; Sinha, Michael S; Joffe, Steven

    2015-12-01

    Although insider trading is illegal, recent high-profile cases have involved physicians and scientists who are part of corporate governance or who have access to information about clinical trials of investigational products. Insider trading occurs when a person in possession of information that might affect the share price of a company's stock uses that information to buy or sell securities--or supplies that information to others who buy or sell--when the person is expected to keep such information confidential. The input that physicians and scientists provide to business leaders can serve legitimate social functions, but insider trading threatens to undermine any positive outcomes of these relationships. We review insider-trading rules and consider approaches to securities fraud in the health care field. Given the magnitude of the potential financial rewards, the ease of concealing illegal conduct, and the absence of identifiable victims, the temptation for physicians and scientists to engage in insider trading will always be present. Minimizing the occurrence of insider trading will require robust education, strictly enforced contractual provisions, and selective prohibitions against high-risk conduct, such as participation in expert consulting networks and online physician forums, by those individuals with access to valuable inside information.

  2. Physicians in transition.

    Science.gov (United States)

    Bluestein, P

    1995-12-01

    The study of physicians as managed care executives has been relatively recent. Much of what was written in the past focused primarily on doctors who had taken hospital-based administrative positions, especially as medical directors or vice presidents of medical affairs.1 But the '80s brought rising health care costs and the emergence of the "O's"--HMOs, PPOs, UROs, EPOs, PHOs, H2Os, and Uh-Ohs--in response. It also brought a growing number of physicians who traded their white coats and their particular "ologies" for the blue suits of executive management. I am convinced that it is important now, and will be increasingly important in the future, to better understand that transition. That belief led me to undertake, with the help and support of ACPE, the survey that is reported in this article. A questionnaire was sent in 1994 to a random sample of 300 managed care physician executive members of ACPE. Responses were returned by 225 members, a response rate of better than 80 percent. Twenty-five of the responses were not applicable, having been returned by physicians who had never made a transition from clinical careers. The remaining 230 responses form the basis for this report.

  3. Counties Without a Physician.

    Science.gov (United States)

    Getz, Virginia

    1982-01-01

    Uses a budgeting technique to determine if free-market incentives or forces would provide an economic base sufficient to support medical professionals who might practice in the approximately 140 U.S. counties that lack a physician (located mainly in a narrow band from west Texas north through South Dakota). (AH)

  4. The ideal physician entrepreneur.

    Science.gov (United States)

    Bottles, K

    2000-01-01

    How does the sometimes elusive and high-stakes world of venture capital really work? How can physician executives with innovative ideas or new technologies approach venture capitalists to help them raise capital to form a start-up company? These important questions are explored in this new column on the physician as entrepreneur. The ideal physician executive is described as: (1) an expert in an area that Wall Street perceives as hot; (2) a public speaker who can enthusiastically communicate scientific and business plans to a variety of audiences; (3) a team leader who is willing to share equity in the company with other employees; (4) a recruiter and a motivator; (5) an implementer who can achieve milestones quickly that allow the company to go public as soon as possible; and (6) a realist who does not resent the terms of the typical deal. The lucrative world of the venture capitalists is foreign territory for physician executives and requires a great idea, charisma, risk-taking, connections, patience, and perseverance to navigate it successfully.

  5. Physician Satisfaction and Physician Well-Being: Should Anyone Care?

    Directory of Open Access Journals (Sweden)

    Lawrence P. Casalino

    2015-05-01

    Full Text Available We present a model of hypothesized relationships between physician satisfaction, physician well-being and the quality of care, in addition to a review of relevant literature. The model suggests that physicians who are stressed, burned out, depressed, and/or have poor self-care are more likely to be dissatisfied, and vice-versa. Both poor physician well-being and physician dissatisfaction are hypothesized to lead to diminished physician concentration, effort, empathy, and professionalism. This results in misdiagnoses and other medical errors, a higher rate of inappropriate referrals and prescriptions, lower patient satisfaction and adherence to physician recommendations, and worse physician performance in areas not observed by others. Research to date largely supports the model, but high quality studies are few. Research should include studies that are prospective, larger, and have a stronger analytic design, ideally including difference in differences analyses comparing quality of care for patients of physicians who become dissatisfied to those who remain satisfied, and vice versa.Keywords: physician satisfaction, physician dissatisfaction, quality of care, physician well-being, physician burnout 

  6. Political liberalism and religious claims

    Science.gov (United States)

    2016-01-01

    This article gives an overview of 4 important lacunae in political liberalism and identifies, in a preliminary fashion, some trends in the literature that can come in for support in filling these blind spots, which prevent political liberalism from a correct assessment of the diverse nature of religious claims. Political liberalism operates with implicit assumptions about religious actors being either ‘liberal’ or ‘fundamentalist’ and ignores a third, in-between group, namely traditionalist religious actors and their claims. After having explained what makes traditionalist religious actors different from liberal and fundamentalist religious actors, the author develops 4 areas in which political liberalism should be pushed further theoretically in order to correctly theorize the challenge which traditional religious actors pose to liberal democracy. These 4 areas (blind spots) are: (1) the context of translation; (2) the politics of exemptions; (3) the multivocality of theology; and (4) the transnational nature of norm-contestation. PMID:28344375

  7. Positive Aesthetics : claims and problems

    OpenAIRE

    Alcaraz León, María José

    2010-01-01

    In this paper I present an overview of the doctrine known as Positive Aesthetics regarding aesthetic judgements about nature. According to this view, all pristine nature is always beautiful and, generally, although not necessarily, human intervention tends to introduce ugliness in nature. One of the strong practical motivations behind this claim is an attempt to ground our reasons to preserve natural environments in aesthetic reasons. Positive Aesthetics has been defended within contrary appr...

  8. Degrees of Truthfulness in Accepted Scientific Claims

    National Research Council Canada - National Science Library

    Ahmed Hassan Mabrouk

    2008-01-01

    ...";">: Sciences adopt different methodologies in deriving claims and establishing theories. As a result, two accepted claims or theories belonging to two different sciences may not necessarily carry the same degree of truthfulness...

  9. Market power and provider consolidation in physician markets.

    Science.gov (United States)

    Kleiner, Samuel A; White, William D; Lyons, Sean

    2015-03-01

    Physician services comprise a substantial share of total health care spending, and the price of health care services has been cited as a key contributor to the disproportionately high rate of health care spending in the US. However, despite a large literature analyzing market power in the hospital and insurance industries, less is known about the extent to which physicians exercise market power. In this study we make use of a private health insurance claims data set to analyze physician market power for two specialties within three mid-sized US metropolitan areas. Using a method developed for hospital competition analysis, we estimate measures of consumer willingness-to-pay for physician practices within each of these markets and relate these to the prices paid to these practices for a set of physician services. Our results are suggestive of the presence of market power in the markets that we analyze. We simulate physician practice mergers for the two largest practices in each market for each specialty analyzed. Results suggest that practice mergers could result in price increases deemed significant by antitrust authorities in some markets but not in others.

  10. Physician Information Seeking Behaviors: Are Physicians Successful Searchers?

    Science.gov (United States)

    Swiatek-Kelley, Janice

    2010-01-01

    In the recent past, physicians found answers to questions by consulting colleagues, textbooks, and professional journals. Now, the availability of medical information through electronic resources has changed physician information-seeking behaviors. Evidence-based medicine is now the accepted decision-making paradigm, and a physician's ability to…

  11. Physician Information Seeking Behaviors: Are Physicians Successful Searchers?

    Science.gov (United States)

    Swiatek-Kelley, Janice

    2010-01-01

    In the recent past, physicians found answers to questions by consulting colleagues, textbooks, and professional journals. Now, the availability of medical information through electronic resources has changed physician information-seeking behaviors. Evidence-based medicine is now the accepted decision-making paradigm, and a physician's ability to…

  12. A Physician's Guide to Radon

    Science.gov (United States)

    This booklet has been developed for physicians by the U.S. Environmental Protection Agency in consultation with the American Medical Association (AMA). Its purpose is to enlist physicians in the national effort to inform the American public about radon.

  13. The future for physician assistants.

    Science.gov (United States)

    Cawley, J F; Ott, J E; DeAtley, C A

    1983-06-01

    Physician assistants were intended to be assistants to primary care physicians. Physicians in private practice have only moderately responded to the availability of these professionals. Cutbacks in the numbers of foreign medical graduates entering American schools for graduate medical education, concern for overcrowding in some specialties, and the economic and clinical capabilities of physician assistants have lead to new uses for these persons. Physician assistants are employed in surgery and surgical subspecialties; in practice settings in institutions such as medical, pediatric, and surgical house staff; and in geriatric facilities, occupational medicine clinics, emergency rooms, and prison health systems. The projected surplus of physicians by 1990 may affect the use of physician assistants by private physicians in primary care.

  14. 38 CFR 14.665 - Claims.

    Science.gov (United States)

    2010-07-01

    ... writing on VA Form 2-4760, Employee's Claim for Reimbursement for Personal Property Damaged or Lost Incident to Employment. It will be submitted to the personnel office where the claim originates within 2... of the reasonable market value of the article or articles. (3) A statement as to any claims...

  15. 32 CFR 757.14 - Claims asserted.

    Science.gov (United States)

    2010-07-01

    ... of an insurance contract of the injured party. (2) Recovery may also be possible under State workers... Medical Care Recovery Act (MCRA) Claims and Claims Asserted Pursuant to 10 U.S.C. 1095 § 757.14 Claims... Government to non-Federal medical care providers. (e) Alternate theories of recovery. (1) Often,...

  16. 5 CFR 180.104 - Allowable claims.

    Science.gov (United States)

    2010-01-01

    ... mobile homes may be allowed only in cases of collision, theft, or vandalism. (5) Money. Claims for money... claimant's supervisor. (4) Mobile homes. Claims may be allowed for damage to or loss of mobile homes and their contents under the provisions of § 180.104(c)(2). Claims for structural damage to mobile...

  17. 14 CFR 1261.105 - Unallowable claims.

    Science.gov (United States)

    2010-01-01

    ... agency of the Government other than NASA. (d) Business property. Claims may not be allowed for property... property. Claims may not be allowed for worn-out unserviceable property. (g) Illegal possession. Claims may... (official Government business, as used here, does not include travel between quarters and place of...

  18. Changing physician prescribing behaviour.

    Science.gov (United States)

    Gray, J

    2006-01-01

    Didactic approaches to educating physicians and/or other health professionals do not produce changes in learner behaviour. Similarly, printed materials and practice guidelines have not been shown to change prescribing behaviour. Evidence-based educational approaches that do have an impact on provider behaviour include: teaching aimed at identified learning needs; interactive educational activities; sequenced and multifaceted interventions; enabling tools such as patient education programs, flow charts, and reminders; educational outreach or academic detailing; and audit and feedback to prescribers. Dr. Jean Gray reflects over the past 25 years on how there has been a transformation in the types of activities employed to improve prescribing practices in Nova Scotia. The evolution of Continuing Medical Education (CME) has resulted in the creation of the Drug Evaluation Alliance of Nova Scotia (DEANS) program, which is one exemplar of an evidence-based educational approach to improving physician prescribing in that province. Key words: Evidence-based, education, prescribing.

  19. Private insurers' payments for routine physician office visits vary substantially across the United States.

    Science.gov (United States)

    Baker, Laurence; Bundorf, M Kate; Royalty, Anne

    2013-09-01

    Anecdotal reports suggest that substantial variation exists in private insurers' payments for physician services, but systematic evidence is lacking. Using a retrospective analysis of insurance claims for routine office visits, consultations, and preventive visits from more than forty million physician claims in 2007, we examined variations in private payments to physicians and the extent to which variation is explained by patients' and physicians' characteristics and by geographic region. We found much variation in payments for these routine evaluation and management services. Physicians at the high end of the payment distribution were generally paid more than twice what physicians at the low end were paid for the same service. Little variation was explained by patients' age or sex, physicians' specialty, place of service, whether the physician was a "network provider," or type of plan, although about one-third of the variation was associated with the geographic area of the practice. Interventions that promote more price-consciousness on the part of patients could help reduce health care spending, but more data on the specific causes of price variation are needed to determine appropriate policy responses.

  20. [Burnout in physicians].

    Science.gov (United States)

    Kurzthaler, Ilsemarie; Kemmler, Georg; Fleischhacker, W Wolfgang

    2017-06-01

    Burnout is a syndrome characterized by emotional exhaustion, depersonalization and low personal accomplishment. The primary objective of this study was to investigate both the prevalence and severity of burnout symptoms in a sample of clinical physicians from different speciality disciplines. A total of 69 clinical physicians ≤55 years who are working at the Medical University/regional Hospital Innsbruck were included into a cross-sectional study. Next to the assessment of sociodemographic and work-related variables the Maslach Burnout Inventory (MBI) was used to investigate burnout symtoms. Overall, 8.8% of the study population showed high emotional exhaustion with high or moderate depersonalization and low personal accomplishment and therefore had a high risk to develop a burnout syndrom. 11.8% showed a moderade burnout risk. Neither sociodemographic variables nor the degree of educational qualification or speciality discipline had an influence on burnout symptoms. However, there was a positive correlation between scientific activity and personal accomplihment. Our results suggest that the dimension of burnout symtoms among clinical physicians in Austria has be taken seriously. Further research is needed to develop specific programs in terms of burnout prevention and burnout therapy.

  1. Physicians in literature: three portrayals.

    Science.gov (United States)

    Cameron, I A

    1986-02-01

    Literature can provide an objective glimpse of how the public perceives physicians. Physicians have been recipients of the full range of human response in literature, from contempt to veneration. This article examines the impressions of three authors: Mark Twain, Sir Arthur Conan Doyle, and Arthur Hailey. Their descriptions provide insight into the complex relationship physicians have with their colleagues and patients.

  2. Physician-industry relations. Part 1: individual physicians.

    Science.gov (United States)

    Coyle, Susan L

    2002-03-05

    This is part 1 of a 2-part paper on ethics and physician-industry relationships. Part 1 offers advice to individual physicians; part 2 gives recommendations to medical education providers and medical professional societies. Physicians and industry have a shared interest in advancing medical knowledge. Nonetheless, the primary ethic of the physician is to promote the patient's best interests, while the primary ethic of industry is to promote profitability. Although partnerships between physicians and industry can result in impressive medical advances, they also create opportunities for bias and can result in unfavorable public perceptions. Many physicians and physicians-in-training think they are impervious to commercial influence. However, recent studies show that accepting industry hospitality and gifts, even drug samples, can compromise judgment about medical information and subsequent decisions about patient care. It is up to the physician to judge whether a gift is acceptable. A very general guideline is that it is ethical to accept modest gifts that advance medical practice. It is clearly unethical to accept gifts or services that obligate the physician to reciprocate. Conflicts of interest can arise from other financial ties between physicians and industry, whether to outside companies or self-owned businesses. Such ties include honorariums for speaking or writing about a company's product, payment for participating in clinic-based research, and referrals to medical resources. All of these relationships have the potential to influence a physician's attitudes and practices. This paper explores the ethical quandaries involved and offers guidelines for ethical business relationships.

  3. Physician practice management companies: should physicians be scared?

    Science.gov (United States)

    Scott-Rotter, A E; Brown, J A

    1999-01-01

    Physician practice management companies (PPMCs) manage nonclinical aspects of physician care and control physician groups by buying practice assets. Until recently, PPMCs were a favorite of Wall Street. Suddenly, in early 1998, the collapse of the MedPartners-PhyCor merger led to the rapid fall of most PPMC stock, thereby increasing wariness of physicians to sell to or invest in PPMCs. This article explores not only the broken promises made by and false assumptions about PPMCs, but also suggests criteria that physicians should use and questions would-be PPMC members should ask before joining. Criteria include: demonstrated expertise, a company philosophy that promotes professional autonomy, financial stability, freedom from litigation, and satisfied physicians already in the PPMC. The authors recommend that physicians seek out relatively small, single-specialty PPMCs, which hold the best promise of generating profits and permitting professional control over clinical decisions.

  4. Perception of health claims among Nordic consumers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Lähteenmäki, Liisa; Boztug, Yasemin

    2009-01-01

    . Claims were constructed from an underlying universe combining different active ingredients (familiar, unfamiliar), type of claim (combination of information about ingredient, physiological function and health benefit), framing (positive, negative) and use of qualifier (with, without 'may'). Across pairs......Health claim perception was investigated by a web-based instrument with a sample of 4612 respondents in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden). Respondents decided which of a pair of claims sounded better, was easier to understand, and was more convincing in their opinion......, the claims differed in the health benefit addressed (cardiovascular health, dementia, bodyweight). Results showed that respondents could be grouped into two roughly equally sized classes that differed in the type of claim preferred: one class prefers 'long' claims that give the full story consisting...

  5. Unwarranted claims of drug efficacy in pharmaceutical sales visits: are drugs approved on the basis of surrogate outcomes promoted appropriately?

    Science.gov (United States)

    Habibi, Roojin; Lexchin, Joel; Mintzes, Barbara; Holbrook, Anne

    2017-06-29

    This study compares physicians' recall of the claims of benefits on cardiovascular disease and diabetes made by pharmaceutical sales representatives for drugs approved on the basis of a surrogate outcome, i.e., an off-label claim, compared with those approved on the basis of a serious morbidity or mortality (clinical) outcome. Physicians in primary care practices in Montreal, Vancouver, Sacramento and Toulouse, who saw sales representatives as part of their usual practice and served a non-referral population, were contacted in blocks of 25 from a randomized list of all physicians practising in the relevant metropolitan area. We compared how frequently physicians reported that sales reps made claims of serious morbidity or mortality (clinically meaningful) benefits for drugs approved on the basis of surrogate outcomes vs. drugs approved on the basis of clinical outcomes. There were 448 promotions for 58 unique brand name cardiovascular and diabetes drugs. Claims of clinically meaningful benefit were reported in 156 (45%) of the 347 promotions for surrogate outcome drugs, constituting unwarranted efficacy claims, i.e., off-label promotion. Claims of clinical benefit were reported in 72 of the 101 promotions (71%) for drugs approved on the basis of clinical outcomes, adjusted OR = 0.3 (95% CI 0.2, 0.6), P sales visit promotions for drugs approved only on the basis of surrogate outcomes extended beyond the regulator-approved efficacy information for the product in almost half of promotions. Unapproved claims of drug efficacy constitute a form of off-label promotion and merit greater attention from regulators. © 2017 The British Pharmacological Society.

  6. Benchmarking medical group practices using claims data: methodological and practical problems.

    Science.gov (United States)

    Dove, H G; Greene, B R

    2000-10-01

    As claims data for physicians and groups of physicians has improved in quality and quantity, health information vendors have begun marketing information about medical groups' productivity, utilization, and quality. Based on interviews with product developers and our understanding of the evolution of their products, several methodological and practical issues remain. For now and the immediate future, health information vendors will continue to face the limitations of physicians' claims data. Vendors and purchasers should be aware of common data shortcomings such as inadequate monthly enrollment figures, possible physician upcoding to circumvent utilization management restrictions, and incorrect coding when a test is used to rule out a disease. In the longer term, several avenues seem likely to make medical groups' data better and richer because of computer-based medical records and efficiencies possible from the Internet. The field of benchmarking products for group practices is still an immature market. However, several trends suggest such products are highly desirable. Provider organizations which bear medical risk need benchmarking data to help improve their efficiency. There are many important nonprovider organizations that need good information on group practices' utilization patterns and outcomes to help them plan new products and negotiate with physicians.

  7. Roles of the Team Physician.

    Science.gov (United States)

    Kinderknecht, James

    2016-07-01

    The roles of the team physician are much more than providing medical coverage at a sport's event. The team physician has numerous administrative and medical responsibilities. The development of an emergency action plan is an essential administrative task as an example. The implementation of the components of this plan requires the team physician to have the necessary medical knowledge and skill. An expertise in returning an athlete to play after an injury or other medical condition is a unique attribute of the trained team physician. The athlete's return to participation needs to start with the athlete's safety and best medical interests but not inappropriately restrict the individual from play. The ability to communicate on numerous levels needs to be a characteristic of the team physician. There are several potential ethical conflicts the team physician needs to control. These conflicts can create unique medicolegal issues. The true emphasis of the team physician is to focus on what is best for the athlete.

  8. Patients' and physicians' attitudes regarding the physician's professional appearance.

    Science.gov (United States)

    Gjerdingen, D K; Simpson, D E; Titus, S L

    1987-07-01

    Although physician appearance has been a topic of interest to medical historians for more than two centuries, little objective investigation has been made into patients' and physicians' attitudes toward the physician's appearance. This study analyzed responses from 404 patients, residents, and staff physicians regarding their attitudes toward various aspects of the male and female physician's professional appearance. Positive responses from all participants were associated with traditional items of dress such as the dress, shirt and tie, dress shoes, and nylons, and for physician-identifying items such as a white coat and a name tag. Negative responses were associated with casual items such as blue jeans, scrub suits, athletic shoes, clogs, and sport socks. Negative ratings were also associated with overly feminine items such as prominent ruffles and female dangling earrings and such temporarily fashionable items as long hair on men, male earrings, and patterned hose on women. Overall, patients were less discriminating in their attitude toward physician appearance than physicians. Patients rated traditional items less positively and casual items less negatively. This study confirms the importance of the physician's appearance in physician-patient communication.

  9. Fraud worries insurance companies but should concern physicians too, industry says

    Science.gov (United States)

    Baer, N

    1997-01-01

    The amount of insurance fraud is increasing in Canada. This should worry physicians, because all personal-injury claims must be substantiated by a medical certificate. The vast majority of physicians are honest and ethical, fraud investigators say, but some are being duped as patients scheme to cheat the insurance industry. In one sensational auto-insurance-fraud case, some Ontario physicians are being investigated about possible involvement in a self-referral scheme. Nicole Baer looks at insurance fraud and the challenges it poses for doctors. PMID:9012734

  10. Do Physicians Change Prescription Practice in Response to Financial Incentives?

    Science.gov (United States)

    Park, Sylvia; Han, Euna

    2016-07-01

    We assessed the impact on physician prescription behaviors of an outpatient prescription incentive program providing financial rewards to primary care physicians for saving prescription costs in South Korea. A 10% sample of clinics (N = 1,625) was randomly selected from all clinics in the National Health Insurance claims database for the years 2009-2012, and all claims with the primary diagnosis of peptic ulcer or gastro-esophageal reflux diseases were extracted from those clinics' data. A clinic-level random-effects model was used. After the program, clinics in general medicine showed a lower prescription rate (by 0.8 percentage points), lower number of medicines prescribed (by 0.02), lower prescription duration (by 0.15 days), and lower drug expenditure per claim (by 740 won). Small clinics on the <25th percentile of a regional sum of monthly drug expenditure had shorter prescription duration (by 0.76 days), while large clinics on the ≥75th percentile and clinics in group practice had a higher prescription rate (by 1.5 and 2.5 percentage points, respectively) and a higher number of medicines prescribed (by 0.03 for group practice only) after the program. The outpatient prescription incentive program worked as intended only in certain subgroup clinics for the target medicines.

  11. A Critical Analysis of Claims and Their Authenticity in Indian Drug Promotional Advertisements

    Directory of Open Access Journals (Sweden)

    Gurpreet Kaur Randhawa

    2015-01-01

    Full Text Available Introduction. Drug promotional advertisements (DPAs form a major marketing technique of pharmaceutical companies for promoting their products and disseminating ambiguous drug information which can affect prescribing pattern of physicians. Drug information includes product characteristics, various marketing claims with references in support to increase its credibility and authenticity. Material and Methods. An observational study was carried out on fifty printed drug advertisement brochures which were collected from different OPDs of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar, India. These advertisements were analyzed and claims were categorized into true, false, exaggerated, vague, and controversial on criteria as reported by Rohraa et al. (2006. References of DPAs in support of the claims were critically analyzed for their retrievability from web and validity pertaining to claims. Results. Out of 209 claims from 50 advertisements, only 46% were found to be true, 21% false, 16% vague, 7% exaggerated, and 10% controversial in nature. Out of 160 references given in support of claims, 49 (30% of references were irretrievable. Out of 111 (70% retrievable references, 92 (83% references were found valid. Conclusion. Drug information provided in the DPAs was biased, incomplete, unauthentic, and unreliable with references exhibiting questionable credibility.

  12. A Critical Analysis of Claims and Their Authenticity in Indian Drug Promotional Advertisements.

    Science.gov (United States)

    Randhawa, Gurpreet Kaur; Singh, Navyug Raj; Rai, Jaswant; Kaur, Gobindnoor; Kashyap, Resham

    2015-01-01

    Introduction. Drug promotional advertisements (DPAs) form a major marketing technique of pharmaceutical companies for promoting their products and disseminating ambiguous drug information which can affect prescribing pattern of physicians. Drug information includes product characteristics, various marketing claims with references in support to increase its credibility and authenticity. Material and Methods. An observational study was carried out on fifty printed drug advertisement brochures which were collected from different OPDs of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar, India. These advertisements were analyzed and claims were categorized into true, false, exaggerated, vague, and controversial on criteria as reported by Rohraa et al. (2006). References of DPAs in support of the claims were critically analyzed for their retrievability from web and validity pertaining to claims. Results. Out of 209 claims from 50 advertisements, only 46% were found to be true, 21% false, 16% vague, 7% exaggerated, and 10% controversial in nature. Out of 160 references given in support of claims, 49 (30%) of references were irretrievable. Out of 111 (70%) retrievable references, 92 (83%) references were found valid. Conclusion. Drug information provided in the DPAs was biased, incomplete, unauthentic, and unreliable with references exhibiting questionable credibility.

  13. Analysis of accelerated death benefit claims at a Japanese life insurance company.

    Science.gov (United States)

    Kobayashi, Miyoharu; Kudomi, Hiroyuki

    2002-01-01

    We studied accelerated death benefit (ADB) claims at the Dai-ichi Mutual Life Insurance Company (Dai-ichi Life). The ADB provision is designed to pay all or a portion of the death benefit if the insured is expected to die within 6 months. Dai-ichi Life paid 243 ADB claims and did not pay 17 ADB claims between December 1994 and March 1998. Of the 260 ADB claims, 253 (97.3%) were caused by malignant neoplasm, 2 by intracranial hemorrhage, 2 by angina pectoris, 1 by dilated cardiomyopathy, 1 by hepatic cirrhosis, and 1 by bleeding gastric ulcer. The age range of the 243 paid claims at the time when the attendant physician predicted a life expectancy below 6 months was 21.6-72.6 years (48.7 +/- 8.7 years [Mean +/- SD]). By the end of March 2000, 236 cases were followed up among the above 243 paid ADB claims. Of the 236 followed-up cases, 149 (63.1%) died within 6 months and 203 (86.0%) died within 1 year. The range of survival periods of these 236 cases was 6-1516 days (210 +/- 237 days). Of the 217 dead cases due to malignant neoplasm, 45 (20.7%) died of gastric cancer, 44 (20.3%) of lung cancer, 24 (11.1%) of liver cancer, 16 (7.4%) of colon cancer, 13 (6.0%) of rectum cancer, and 12 (5.5%) of pancreatic cancer.

  14. 32 CFR 536.119 - Scope for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for maritime claims. 536.119 Section 536.119 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS AGAINST THE UNITED STATES Maritime Claims § 536.119 Scope for maritime claims. The AMCSA applies worldwide and includes claims that arise on...

  15. The physician leader as logotherapist.

    Science.gov (United States)

    Washburn, E R

    1998-01-01

    Today's physicians feel helpless and angry about changing conditions in the medical landscape. This is due, in large part, to our postmodernist world view and the influence of corporations on medical practice. The life and work of existentialist psychiatrist Viktor Frankl is proposed as a role model for physicians to take back control of their profession. Physician leaders are in the best position to bring the teachings and insight of Frankl's logotherapy to rank-and-file physicians in all practice settings, as well as into the board rooms of large medical corporations. This article considers the spiritual and moral troubles of American medicine, Frankl's answer to that affliction, and the implications of logotherapy for physician organizations and leadership. Physician executives are challenged to take up this task.

  16. Probiotics and prebiotics: health claim substantiation

    OpenAIRE

    Salminen, Seppo; van Loveren, Henk

    2012-01-01

    ‘Probiotics’ and ‘prebiotics’ by definition should have health benefits. Health claims on microorganisms proposed as probiotics and probiotic stimulating agents (prebiotics) suggest that there is a relationship between the specific food and maintaining good health or that the food can reduce the risk of a disease. The Health Claim Regulation in European Union aims at a level consumer protection. Thereby, health claim assessment focuses on defining the probiotics and prebiotics, assessing the ...

  17. Disenfranchised Grief and Physician Burnout.

    Science.gov (United States)

    Lathrop, Deborah

    2017-07-01

    Over the span of their career, physicians experience changes to their professional role and professional identity. The process of continual adaptation in their work setting incurs losses. These losses can be ambiguous, cumulative, and may require grieving. Grief in the workplace is unsanctioned, and may contribute to physicians' experience of burnout (emotional exhaustion, depersonalization, low sense of achievement). Acknowledging loss, validating grief, and being prescient in dealing with physician burnout is essential. © 2017 Annals of Family Medicine, Inc.

  18. Physicians in Nursing Homes: Effectiveness of Physician Accountability and Communication

    Science.gov (United States)

    Lima, Julie C; Intrator, Orna; Wetle, Terrie

    2015-01-01

    Objectives To develop a measure of the perceptions of nursing home (NH) Directors of Nursing (DON) on the adequacy of physician care and to examine its variation as well as its construct validity. Design A nationwide cross-sectional study with primary data collection Setting 2043 NHs surveyed August 2009 – April 2011 Participants Directors of Nursing (DONs) and NH Administrators responded to questions pertaining to their perceptions of the care provided by physicians in their NH. Measurements Ten items were used to create three domains: medical staff attentiveness, physician communication, and staff concerns about physician practice. These were combined into an overall summary score measure called “Effectiveness of Physician Accountability and Communication” (EPAC). EPAC construct validity was ascertained from other DON questions and from a complementary survey of NH Administrators. RESULTS The established EPAC score is the first measure to capture specific components of the adequacy of physician care in NHs. EPAC exhibited good construct validity: more effective practices were correlated with greater physician involvement in discussions of Do-Not-Resuscitate orders, the frequency that the Medical Director checked on the medical care delivered by attending physician, the tightness of nursing home's control of its physician resources, and the DON's perception of whether or not avoidable hospitalizations and ER visits could be reduced with greater physician attention to resident needs. Conclusion As increased attention is given to the quality of care provided to vulnerable elders, effective measures of processes of care are essential. The EPAC measure provides an important new metric that can be used in these efforts. The goal is that future studies could use EPAC and its individual domains to shed light on the manner through which physician presence is related to resident outcomes in the NH setting. PMID:25858283

  19. Determinants of consumer understanding of health claims

    DEFF Research Database (Denmark)

    Grunert, Klaus G; Scholderer, Joachim; Rogeaux, Michel

    2011-01-01

    as safe, risky or other. In addition to the open questions on claim understanding, respondents rated a number of statements on claim interpretation for agreement and completed scales on interest in healthy eating, attitude to functional foods, and subjective knowledge on food and health. Results showed...... that respondents with a positive attitude to functional foods are more likely to be classified as riskywith regard to their claim understanding, whereas respondents with negative or neutral attitudes are more likely to be classified into the other category. Implications for testing claim understanding...

  20. Assessing comorbidity using claims data: an overview.

    Science.gov (United States)

    Klabunde, Carrie N; Warren, Joan L; Legler, Julie M

    2002-08-01

    Comorbidity, additional disease beyond the condition under study that increases a patient's total burden of illness, is one dimension of health status. For investigators working with observational data obtained from administrative databases, comorbidity assessment may be a useful and important means of accounting for differences in patients' underlying health status. There are multiple ways of measuring comorbidity. This paper provides an overview of current approaches to and issues in assessing comorbidity using claims data, with a particular focus on established indices and the SEER-Medicare database. In addition, efforts to improve measurement of comorbidity using claims data are described, including augmentation of claims data with medical record, patient self-report, or health services utilization data; incorporation of claims data from sources other than inpatient claims; and exploration of alternative conditions, indices, or ways of grouping conditions. Finally, caveats about claims data and areas for future research in claims-based comorbidity assessment are discussed. Although the use of claims databases such as SEER-Medicare for health services and outcomes research has become increasingly common, investigators must be cognizant of the limitations of comorbidity measures derived from these data sources in capturing and controlling for differences in patient health status. The assessment of comorbidity using claims data is a complex and evolving area of investigation.

  1. Physician revalidation in Europe.

    Science.gov (United States)

    Merkur, Sherry; Mossialos, Elias; Long, Morgan; McKee, Martin

    2008-08-01

    Despite the increasing attention on patient mobility, there remains a lack of European-level interest in assuring the sustained competence of health professionals. Specifically, the existing European legal framework fails to recognise the introduction of periodic revalidation and requirements to participate in continuing professional development in some countries. This study shows that the definitions and mechanisms of revalidation vary significantly across member states. While some countries, eg Austria, Germany and Spain, look to continuing medical education as a means to promote recertification and quality of care, other countries, eg Belgium, France and the Netherlands, also incorporate peer review. In the UK the proposed revalidation scheme would include elements of relicensure through appraisal and feedback as well as physician recertification. Divergence between countries also exists in monitoring and enforcement. The European Commission should explore the implications for professional mobility of the diversity in the regulation of the medical profession.

  2. Fractals for physicians.

    Science.gov (United States)

    Thamrin, Cindy; Stern, Georgette; Frey, Urs

    2010-06-01

    There is increasing interest in the study of fractals in medicine. In this review, we provide an overview of fractals, of techniques available to describe fractals in physiological data, and we propose some reasons why a physician might benefit from an understanding of fractals and fractal analysis, with an emphasis on paediatric respiratory medicine where possible. Among these reasons are the ubiquity of fractal organisation in nature and in the body, and how changes in this organisation over the lifespan provide insight into development and senescence. Fractal properties have also been shown to be altered in disease and even to predict the risk of worsening of disease. Finally, implications of a fractal organisation include robustness to errors during development, ability to adapt to surroundings, and the restoration of such organisation as targets for intervention and treatment.

  3. Association of Industry Payments to Physicians With the Prescribing of Brand-name Statins in Massachusetts.

    Science.gov (United States)

    Yeh, James S; Franklin, Jessica M; Avorn, Jerry; Landon, Joan; Kesselheim, Aaron S

    2016-06-01

    Pharmaceutical industry payments to physicians may affect prescribing practices and increase costs if more expensive medications are prescribed. Determine the association between industry payments to physicians and the prescribing of brand-name as compared with generic statins for lowering cholesterol. Cross-sectional linkage of the Part D Medicare prescriptions claims data with the Massachusetts physicians payment database including all licensed Massachusetts physicians who wrote prescriptions for statins paid for under the Medicare drug benefit in 2011. The exposure variable was a physician's industry payments as listed in the Massachusetts database. The outcome was the physician's rate of prescribing brand-name statins. We used linear regression to analyze the association between the intensity of physicians' industry relationships (as measured by total payments) and their prescribing practices, as well as the effects of specific types of payments. Among the 2444 Massachusetts physicians in the Medicare prescribing database in 2011, 899 (36.8%) received industry payments. The most frequent payment was for company-sponsored meals (n = 639 [71.1%]). Statins accounted for 1 559 003 prescription claims; 356 807 (22.8%) were for brand-name drugs. For physicians with no industry payments listed, the median brand-name statin prescribing rate was 17.8% (95% CI, 17.2%-18.4%). For every $1000 in total payments received, the brand-name statin prescribing rate increased by 0.1% (95% CI, 0.06%-0.13%; P associated with a 4.8% increase in the rate of brand-name prescribing (P = .004); other forms of payments were not. Industry payments to physicians are associated with higher rates of prescribing brand-name statins. As the United States seeks to rein in the costs of prescription drugs and make them less expensive for patients, our findings are concerning.

  4. 76 FR 36176 - Fully Developed Claim (Fully Developed Claims-Applications for Compensation, Pension, DIC, Death...

    Science.gov (United States)

    2011-06-21

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Fully Developed Claim (Fully Developed Claims--Applications for Compensation, Pension, DIC, Death Pension, and/or Accrued Benefits); Correction AGENCY: Veterans Benefits Administration, Department...

  5. Social media: physicians-to-physicians education and communication.

    Science.gov (United States)

    Fehring, Keith A; De Martino, Ivan; McLawhorn, Alexander S; Sculco, Peter K

    2017-06-01

    Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians. Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique. Social networking instead is mostly centered on sharing of data, discussion of confidential topics, and job seeking. Quality of educational contents and data confidentiality represent the major drawbacks of these platforms. Orthopedic surgeons must be aware that the quality of the videos should be better controlled and regulated to avoid inaccurate information that may have a significant impact especially on trainees that are more prone to use this type of resources. Sharing of data and discussion of confidential topics should be extremely secure according the HIPAA regulations in order to protect patients' confidentiality.

  6. 31 CFR 535.222 - Suspension of claims eligible for Claims Tribunal.

    Science.gov (United States)

    2010-07-01

    ... Iran, dated January 19, 1981, and all claims for equitable or other judicial relief in connection with... or counterclaim in any pending or subsequent judicial proceeding commenced by the Government of Iran... on a claim or part thereof shall operate as a final resolution and discharge of such claim or...

  7. 32 CFR 751.6 - Claims payable.

    Science.gov (United States)

    2010-07-01

    ... was not authorized for the convenience of the Government. The maximum payment authorized by the... not vandalism. The amount payable on vandalism claims is limited to the maximum payment authorized by...) Mobile homes and contents in shipment. Claims for damage to mobile homes and contents in shipment...

  8. 49 CFR 22.69 - Claim process.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Claim process. 22.69 Section 22.69 Transportation Office of the Secretary of Transportation SHORT-TERM LENDING PROGRAM (STLP) Loan Administration § 22.69 Claim process. After reasonable efforts have been exhausted to collect on a delinquent debt,...

  9. 32 CFR 279.4 - Claims process.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Claims process. 279.4 Section 279.4 National... RETROACTIVE STOP LOSS SPECIAL PAY COMPENSATION § 279.4 Claims process. (a) The last day for submission of... members may not be knowledgeable of the process and will require additional assistance after filing...

  10. Perception of health claims among Nordic consumers

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Lähteenmäki, Liisa; Boztug, Yasemin;

    2009-01-01

    Health claim perception was investigated by a web-based instrument with a sample of 4612 respondents in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden). Respondents decided which of a pair of claims sounded better, was easier to understand, and was more convincing in their opinio...

  11. 27 CFR 24.29 - Claims.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Claims. 24.29 Section 24.29 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS WINE Administrative and Miscellaneous Provisions Authorities § 24.29 Claims....

  12. 16 CFR 460.22 - Tax claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Tax claims. 460.22 Section 460.22 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.22 Tax claims. Do not say or imply that your product qualifies for a tax benefit unless it is true....

  13. 16 CFR 460.19 - Savings claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Savings claims. 460.19 Section 460.19 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.19 Savings claims. (a) If you say or imply in your ads, labels, or other...

  14. 16 CFR 460.21 - Government claims.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Government claims. 460.21 Section 460.21 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES LABELING AND ADVERTISING OF HOME INSULATION § 460.21 Government claims. Do not say or imply that a government agency uses,...

  15. A Claim of Falsification of History.

    Science.gov (United States)

    Kirman, Joseph M.

    1994-01-01

    Presents excerpts from the draft Statement of Claim filed by Canadian World War II veterans against the Canadian Broadcasting Corporation and others associated with the making of the documentary series, "The Valour and the Horror." Includes an overview and two examples of what the plaintiffs claimed were historical errors. (CFR)

  16. 32 CFR 1659.1 - Claims.

    Science.gov (United States)

    2010-07-01

    ... Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM EXTRAORDINARY EXPENSES OF REGISTRANTS § 1659.1 Claims. (a) Claims for payment of actual and reasonable expenses of: (1) Emergency medical care, including hospitalization of registrants who suffer illness or injury; and (2) The...

  17. CLAIM HEDGING IN AN INCOMPLETE MARKET

    Institute of Scientific and Technical Information of China (English)

    SUN Wangui; WANG Chunfeng

    2005-01-01

    In this paper,we compare the performance of the optimal attainable payoffs (of a general claim) derived by the variance-optimal approach and the indifference argument under the mean-variance preference in an incomplete market.Both payoffs are expressed by the signed variance-optimal martingale measure.Our results are applied to the claim hedging under partial information.

  18. 24 CFR 17.43 - Allowable claims.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Allowable claims. 17.43 Section 17.43 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development..., superior authority. (6) Clothing and accessories. Claims may be allowed for damage to, or loss of, clothing...

  19. Forecasting claims in motor vehicle insurance

    NARCIS (Netherlands)

    Berridge, S.J.

    1998-01-01

    The forecasting of claims is central to the successful operation of an insurance company. Based on six years of claim and policy data for full cover car insurance from a major New Zealand insurance company, we set premiums for rating categories using a simple credibility method, a modified credibili

  20. Forecasting claims in motor vehicle insurance

    NARCIS (Netherlands)

    Berridge, S.J.

    1998-01-01

    The forecasting of claims is central to the successful operation of an insurance company. Based on six years of claim and policy data for full cover car insurance from a major New Zealand insurance company, we set premiums for rating categories using a simple credibility method, a modified credibili

  1. Optimal claim behaviour for vehicle damage insurances

    NARCIS (Netherlands)

    N.P. Dellaert (Nico); J.B.G. Frenk (Hans); L.P. van Rijsoort

    1993-01-01

    textabstractIn this paper we analyse the optimal claim behaviour of a risk sensitive policy holder having a vehicle damage insurance. It is proved that the optimal decision is of the form: to claim for damages only if its amount exceeds a certain limit. Moreover, we also derive the optimal stopping

  2. Psychotropic medication claims among religious clergy.

    Science.gov (United States)

    Frenk, Steven M; Mustillo, Sarah A; Foy, Steven L; Arroyave, Whitney D; Hooten, Elizabeth G; Lauderback, Kari H; Meador, Keith G

    2013-03-01

    This study examined psychotropic medication claims in a sample of Protestant clergy. It estimated the proportion of clergy in the sample who had a claim for psychotropic medication (i.e., anti-depressants and anxiolytics) in 2005 and examined associations between sociodemographic characteristics, occupational distress and having a claim. Protestant clergy (n = 749) from nine denominations completed a mail survey and provided access to their pharmaceutical records. Logistic regression models assessed the effect of sociodemographic characteristics and occupational distress on having a claim. The descriptive analysis revealed that 16 % (95 % Confidence interval [CI] 13.3 %-18.5 %) of the clergy in the sample had a claim for psychotropic medication in 2005 and that, among clergy who experienced frequent occupational distress, 28 % (95 % CI 17.5 %-37.5 %) had a claim. The regression analysis found that older clergy, female clergy, and those who experienced frequent occupational distress were more likely to have a claim. Due to recent demographic changes in the clergy population, including the increasing mean age of new clergy and the growing number of female clergy, the proportion of clergy having claims for psychotropic medication may increase in the coming years. To the best of our knowledge, this is the first study to examine the use of psychotropic medication among clergy.

  3. 33 CFR 136.107 - Subrogated claims.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Subrogated claims. 136.107 Section 136.107 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... PROCEDURES; DESIGNATION OF SOURCE; AND ADVERTISEMENT General Procedure § 136.107 Subrogated claims. (a)...

  4. 22 CFR 213.5 - Fraud claims.

    Science.gov (United States)

    2010-04-01

    ... of the debtor or any party having an interest in the claim to the USAID Office of Inspector General... the Department of Justice (DOJ), and/or returning it to the CFO for further action. (b) The CFO will... presentation of a false claim or misrepresentation on the part of the debtor or any party having an interest...

  5. Communicating Drug Information to Physicians

    Science.gov (United States)

    Herman, Colman M.; Rodowskas, Christopher A.

    1976-01-01

    Reviews the studies of researchers who have attempted to identify the sources of drug information, both professional and commercial, utilized by physicians, discussing relationship between physicians' sources and the choice of drugs and severity of conditions being treated. Also notes new sources of drug information being considered by the Food…

  6. Physician Requirements-1990. For Cardiology.

    Science.gov (United States)

    Tracy, Octavious; Birchette-Pierce, Cheryl

    Professional requirements for physicians specializing in cardiology were estimated to assist policymakers in developing guidelines for graduate medical education. The determination of physician requirements was based on an adjusted needs rather than a demand or utilization model. For each illness, manpower requirements were modified by the…

  7. Dermatological legal claims in Japan.

    Science.gov (United States)

    Ogawa, Sachiko; Isogawa, Naoyuki; Ushiro, Shin; Ayuzawa, Junko; Furue, Masutaka

    2008-07-01

    Health-care safety management has recently been highlighted for patient safety. However, specialist-based risks in clinical settings have hardly been discussed in Japan so far. A review of dermatological legal claims may delineate these risks. This study examined court precedents from the databases "Courts in Japan" and LEX/DB. Thirty-four dermatology-related civil cases were found from 1968-2006. Of the 34 cases, 32 (94%) were judged and two (6%) were retried. Of these 32 cases, 11 (34%) were appealed to higher courts. Among the 34 litigations, the defendants of eight (23%) were dermatology specialists, 20 (59%) were non-dermatologists and six (18%) of unknown specialty. The defendants' negligence was determined at either level in court in 25 of the 34 cases. The negligence in these 25 cases was categorized into five groups: (i) delayed diagnosis (none); (ii) complication during diagnosis procedure (one, 4%); (iii) inappropriate treatment (nine, 36%); (iv) complication during treatment procedure (10, 40%); and (v) insufficient informed consent (five, 20%). The present study may help to improve strategies for health-care safety management in the dermatological field in Japan.

  8. Awareness during anesthesia: a closed claims analysis.

    Science.gov (United States)

    Domino, K B; Posner, K L; Caplan, R A; Cheney, F W

    1999-04-01

    Awareness during general anesthesia is a frightening experience, which may result in serious emotional injury and post-traumatic stress disorder. We performed an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project to explore the contribution of intraoperative awareness to professional liability in anesthesia. The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims for intraoperative awareness were reviewed by the reviewers to identify patterns of causation and standard of care. Logistic regression analysis was used to identify independent patient and anesthetic factors associated with claims for recall during general anesthesia compared to other general anesthesia malpractice claims. Awareness claims accounted for 79 (1.9%) of 4,183 claims in the database, including 18 claims for awake paralysis, i.e., the inadvertent paralysis of an awake patient, and 61 claims for recall during general anesthesia, ie., recall of events while receiving general anesthesia. The majority of awareness claims involved women (77%), younger than 60 yr of age (89%), American Society of Anesthesiologists physical class I-II (68%), who underwent elective surgery (87%). Most (94%) claims for awake paralysis represented substandard care involving errors in labeling and administration, whereas care was substandard in only 43% of the claims for recall during general anesthesia (P recall during general anesthesia were more likely to involve women (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 1.58, 6.06) and anesthetic techniques using intraoperative opioids (OR = 2.12, 95% CI = 1.20, 3.74), intraoperative muscle relaxants (OR = 2.28, 95% CI = 1.22, 4.25), and no volatile anesthetic (OR = 3.20, 95% CI = 1.88, 5.46). Deficiencies in labeling and vigilance were common causes for awake paralysis. Claims for recall during general anesthesia

  9. Shared consultant physician posts.

    LENUS (Irish Health Repository)

    Cooke, J

    2012-01-31

    Our aim was to assess the acceptability and cost-efficiency of shared consultancy posts. Two consultant physicians worked alternate fortnights for a period of twelve months. Questionnaires were distributed to general practitioners, nurses, consultants and junior doctors affected by the arrangement. Patients or their next of kin were contacted by telephone. 1\\/17 of consultants described the experience as negative. 14\\/19 junior doctors reported a positive experience. 11 felt that training had been improved while 2 felt that it had been adversely affected. 17\\/17 GPs were satisfied with the arrangement. 1\\/86 nurses surveyed reported a negative experience. 1\\/48 patients were unhappy with the arrangement. An extra 2.2 (p<0.001) patients were seen per clinic. Length of stay was shortened by 2.49 days (p<0.001). A saving of 69,212 was made due to decreased locum requirements. We present data suggesting structured shared consultancy posts can be broadly acceptable and cost efficient in Ireland.

  10. Physicians' strikes and the competing bases of physicians' moral obligations.

    Science.gov (United States)

    MacDougall, D Robert

    2013-09-01

    Many authors have addressed the morality of physicians' strikes on the assumption that medical practice is morally different from other kinds of occupations. This article analyzes three prominent theoretical accounts that attempt to ground such special moral obligations for physicians--practice-based accounts, utilitarian accounts, and social contract accounts--and assesses their applicability to the problem of the morality of strikes. After critiquing these views, it offers a fourth view grounding special moral obligations in voluntary commitments, and explains why this is a preferable basis for understanding physicians' moral obligations in general and especially as pertaining to strikes.

  11. What makes a physician revenue cycle tick.

    Science.gov (United States)

    Freeman, Thomas; Stephen, Stan

    2011-09-01

    Hospitals should boost the revenue cycle performance of acquired physician practices by: Effectively assimilating the physician practice into the overall organization. Standardizing revenue cycle processes, policies, and tools between the hospital and physician practice. Enhancing physician/patient scheduling policies and procedures. Regularly auditing physician documentation and periodically comparing hospital charges against practice charges. Improving procedures for responding to denials.

  12. 42 CFR 456.722 - Electronic claims management system.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Electronic claims management system. 456.722... Electronic Claims Management System for Outpatient Drug Claims § 456.722 Electronic claims management system... electronic claims management (ECM) system to perform on-line, real-time (that is, immediate)...

  13. Special article: physician burnout-the experience of three physicians

    Directory of Open Access Journals (Sweden)

    Raschke RA

    2015-04-01

    Full Text Available No abstract available. Article truncated at 150 words. Our fellowship held a discussion on physician burnout which was facilitated by Kris Cooper PhD, a psychologist who has long experience working with struggling physicians. We were joined by three physicians who volunteered to share their personal experiences regarding burnout. Each of these three physicians are exceptional in their devotion to their profession, high self-expectation, and level of professional achievement. Yet the commendable personal characteristics they share may have actually set them up to ultimately suffer burnout. Each of them responded to burnout in a different way. The first physician is an intensivist who left work suddenly 6 months ago, likely never to return. Over a long career, this physician had earned the respect of his colleagues and was beloved by the nurses for seeming to always knowing the right thing to do and dedicating himself fully to the care of the sickest patients and their families. For most of ...

  14. An Evaluation of Algorithms for Identifying Metastatic Breast, Lung, or Colorectal Cancer in Administrative Claims Data.

    Science.gov (United States)

    Whyte, Joanna L; Engel-Nitz, Nicole M; Teitelbaum, April; Gomez Rey, Gabriel; Kallich, Joel D

    2015-07-01

    Administrative health care claims data are used for epidemiologic, health services, and outcomes cancer research and thus play a significant role in policy. Cancer stage, which is often a major driver of cost and clinical outcomes, is not typically included in claims data. Evaluate algorithms used in a dataset of cancer patients to identify patients with metastatic breast (BC), lung (LC), or colorectal (CRC) cancer using claims data. Clinical data on BC, LC, or CRC patients (between January 1, 2007 and March 31, 2010) were linked to a health care claims database. Inclusion required health plan enrollment ≥3 months before initial cancer diagnosis date. Algorithms were used in the claims database to identify patients' disease status, which was compared with physician-reported metastases. Generic and tumor-specific algorithms were evaluated using ICD-9 codes, varying diagnosis time frames, and including/excluding other tumors. Positive and negative predictive values, sensitivity, and specificity were assessed. The linked databases included 14,480 patients; of whom, 32%, 17%, and 14.2% had metastatic BC, LC, and CRC, respectively, at diagnosis and met inclusion criteria. Nontumor-specific algorithms had lower specificity than tumor-specific algorithms. Tumor-specific algorithms' sensitivity and specificity were 53% and 99% for BC, 55% and 85% for LC, and 59% and 98% for CRC, respectively. Algorithms to distinguish metastatic BC, LC, and CRC from locally advanced disease should use tumor-specific primary cancer codes with 2 claims for the specific primary cancer >30-42 days apart to reduce misclassification. These performed best overall in specificity, positive predictive values, and overall accuracy to identify metastatic cancer in a health care claims database.

  15. Physician wellness: a missing quality indicator.

    Science.gov (United States)

    Wallace, Jean E; Lemaire, Jane B; Ghali, William A

    2009-11-14

    When physicians are unwell, the performance of health-care systems can be suboptimum. Physician wellness might not only benefit the individual physician, it could also be vital to the delivery of high-quality health care. We review the work stresses faced by physicians, the barriers to attending to wellness, and the consequences of unwell physicians to the individual and to health-care systems. We show that health systems should routinely measure physician wellness, and discuss the challenges associated with implementation.

  16. Examining Fluoroquinolone Claims Among Gonorrhea-Associated Prescription Drug Claims, 2000-2010.

    Science.gov (United States)

    Owusu-Edusei, Kwame; Carroll, Danya S; Gift, Thomas L

    2015-11-01

    After the release of CDC's revised gonorrhea treatment guidelines in April 2007, a study reported the declining use of fluoroquinolones to treat gonorrhea among health departments participating in the Sexually Transmitted Disease Surveillance Network. In this study, we examine the proportion of fluoroquinolone claims among gonorrhea-associated prescription drug claims from a large insurance database from 2000 through 2010. We extracted drug claims associated with gonorrhea diagnosis claims from the MarketScan database for 2000-2010 and calculated the proportion of the drug claims for fluoroquinolones on a monthly basis. We then used an interrupted time series analysis to investigate trend characteristics of fluoroquinolone claims before and after the gonorrhea treatment guidelines were revised in April 2007. Although there was a monthly decline in the proportion of fluoroquinolone claims before April 2007 (-0.11 percentage points, pfluoroquinolones after April 2007, implying a gradual permanent decline over the analytic period. Our results are consistent with the findings of the previous study and indicate a gradual and permanent decline (over the analytic period) in the proportion of fluoroquinolone claims among gonorrhea-associated prescription drug claims. However, because this is a convenience sample of claims data, these findings cannot be generalized to the entire privately insured population in the U.S. Published by Elsevier Inc.

  17. Physician Compare National Downloadable File

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Physician Compare National Downloadable File is organized at the individual eligible professional level; each line is unique at the professional/enrollment...

  18. Working with Generation X physicians.

    Science.gov (United States)

    Shields, Mark C; Shields, Margaux T

    2003-01-01

    Learn ways to integrate Generation X physicians into your hospital or practice. Discover how their career goals differ from the earlier generation's and find out how health care organizations can help meet those goals.

  19. Unique Physician Identification Number (UPIN) Directory

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Unique Physician Identification Number (UPIN) Directory contains selected information on physicians, doctors of Osteopathy, limited licensed practitioners and...

  20. Physicians' fears of malpractice lawsuits are not assuaged by tort reforms.

    Science.gov (United States)

    Carrier, Emily R; Reschovsky, James D; Mello, Michelle M; Mayrell, Ralph C; Katz, David

    2010-09-01

    Physicians contend that the threat of malpractice lawsuits forces them to practice defensive medicine, which in turn raises the cost of health care. This argument underlies efforts to change malpractice laws through legislative tort reform. We evaluated physicians' perceptions about malpractice claims in states where more objective indicators of malpractice risk, such as malpractice premiums, varied considerably. We found high levels of malpractice concern among both generalists and specialists in states where objective measures of malpractice risk were low. We also found relatively modest differences in physicians' concerns across states with and without common tort reforms. These results suggest that many policies aimed at controlling malpractice costs may have a limited effect on physicians' malpractice concerns.

  1. 33 CFR 25.109 - Insurance and other subrogated claims.

    Science.gov (United States)

    2010-07-01

    ... single claim. The total award of combined claims may not exceed the monetary jurisdiction of the... of insurance; (3) The policy number; (4) Whether a claim has been or will be presented to an insurer...

  2. 75 FR 8105 - Alaska Native Claims Selection

    Science.gov (United States)

    2010-02-23

    ... Native Claims Settlement Act will be issued to NANA Regional Corporation, Inc., Successor in Interest to... these lands will also be conveyed to NANA Regional Corporation, Inc. when the surface estate is...

  3. FDA Warns About Stem Cell Claims

    Science.gov (United States)

    ... Home For Consumers Consumer Updates FDA Warns About Stem Cell Claims Share Tweet Linkedin Pin it More sharing ... blood-forming system. back to top Regulation of Stem Cells FDA regulates stem cells in the U.S. to ...

  4. Must Metaethical Realism Make a Semantic Claim?

    Science.gov (United States)

    Kahane, Guy

    2013-02-01

    Mackie drew attention to the distinct semantic and metaphysical claims made by meta ethical realists, arguing that although our evaluative discourse is cognitive and objective, there are no objective evaluative facts. This distinction, however, also opens up a reverse possibility: that our evaluative discourse is antirealist, yet objective values do exist. I suggest that this seemingly far-fetched possibility merits serious attention; realism seems com mitted to its intelligibility, and, despite appearances, it isn't incoherent, ineffable, inherently implausible or impossible to defend. I argue that reflection on this possibility should lead us to revise our understanding of the debate between realists and antirealists. It is not only that the realist's semantic claim is insufficient for realism to be true, as Mackie argued; it's not even necessary. Robust metaethical realism is best understood as making a purely metaphysical claim. It is thus not enough for antirealists to show that our discourse is antirealist. They must directly attack the realist's metaphysical claim.

  5. Basic Stand Alone Medicare Inpatient Claims PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — This release contains the Basic Stand Alone (BSA) Inpatient Public Use Files (PUF) named CMS 2008 BSA Inpatient Claims PUF with information from 2008 Medicare...

  6. Physician motivation, satisfaction and survival.

    Science.gov (United States)

    Zimberg, S E; Clement, D G

    1997-01-01

    Physicians are working harder today and enjoying it less. What has happened to create such dissatisfaction among those in one of the most autonomous professions? What can be done to address the anger, fear and unhappiness? This article is an analysis of the factors influencing human motivation. Maslow's hierarchy of needs--physiological, safety/security, social/affiliation, esteem and self-actualization--is used to suggest ways physicians can satisfy their needs in turbulent financial and professional times.

  7. Abortion and compelled physician speech.

    Science.gov (United States)

    Orentlicher, David

    2015-01-01

    Informed consent mandates for abortion providers may infringe the First Amendment's freedom of speech. On the other hand, they may reinforce the physician's duty to obtain informed consent. Courts can promote both doctrines by ensuring that compelled physician speech pertains to medical facts about abortion rather than abortion ideology and that compelled speech is truthful and not misleading. © 2015 American Society of Law, Medicine & Ethics, Inc.

  8. Tolerance, Professional Judgment, and the Discretionary Space of the Physician.

    Science.gov (United States)

    Sulmasy, Daniel P

    2017-01-01

    Arguments against physicians' claims of a right to refuse to provide tests or treatments to patients based on conscientious objection often depend on two premises that are rarely made explicit. The first is that the protection of religious liberty (broadly construed) should be limited to freedom of worship, assembly, and belief. The second is that because professions are licensed by the state, any citizen who practices a licensed profession is required to provide all the goods and services determined by the profession to fall within the scope of practice of that professional specialty and permitted by the state, regardless of any personal religious, philosophical, or moral objection. In this article, I argue that these premises ought to be rejected, and therefore the arguments that depend on them ought also to be rejected. The first premise is incompatible with Locke's conception of tolerance, which recognizes that fundamental, self-identifying beliefs affect public as well as private acts and deserve a broad measure of tolerance. The second premise unduly (and unrealistically) narrows the discretionary space of professional practice to an extent that undermines the contributions professions ought to be permitted to make to the common good. Tolerance for conscientious objection in the public sphere of professional practice should not be unlimited, however, and the article proposes several commonsense, Lockean limits to tolerance for physician claims of conscientious objection.

  9. Accuracy of claims-based algorithms for epilepsy research: Revealing the unseen performance of claims-based studies.

    Science.gov (United States)

    Moura, Lidia M V R; Price, Maggie; Cole, Andrew J; Hoch, Daniel B; Hsu, John

    2017-04-01

    To evaluate published algorithms for the identification of epilepsy cases in medical claims data using a unique linked dataset with both clinical and claims data. Using data from a large, regional health delivery system, we identified all patients contributing biologic samples to the health system's Biobank (n = 36K). We identified all subjects with at least one diagnosis potentially consistent with epilepsy, for example, epilepsy, convulsions, syncope, or collapse, between 2014 and 2015, or who were seen at the epilepsy clinic (n = 1,217), plus a random sample of subjects with neither claims nor clinic visits (n = 435); we then performed a medical chart review in a random subsample of 1,377 to assess the epilepsy diagnosis status. Using the chart review as the reference standard, we evaluated the test characteristics of six published algorithms. The best-performing algorithm used diagnostic and prescription drug data (sensitivity = 70%, 95% confidence interval [CI] 66-73%; specificity = 77%, 95% CI 73-81%; and area under the curve [AUC] = 0.73, 95%CI 0.71-0.76) when applied to patients age 18 years or older. Restricting the sample to adults aged 18-64 years resulted in a mild improvement in accuracy (AUC = 0.75,95%CI 0.73-0.78). Adding information about current antiepileptic drug use to the algorithm increased test performance (AUC = 0.78, 95%CI 0.76-0.80). Other algorithms varied in their included data types and performed worse. Current approaches for identifying patients with epilepsy in insurance claims have important limitations when applied to the general population. Approaches incorporating a range of information, for example, diagnoses, treatments, and site of care/specialty of physician, improve the performance of identification and could be useful in epilepsy studies using large datasets. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  10. Nutrition and health claims as marketing tools.

    Science.gov (United States)

    van Buul, Vincent J; Brouns, Fred J P H

    2015-01-01

    European regulations mandate that only substantiated and approved statements can be used as nutrition- and health-related claims in food marketing. A thorough understanding of consumer perceptions of these approved claims is needed to assess their impact on both the purchase intention of functional foods and the development of innovative functional food concepts. In this paper, a conceptual framework on the European consumers' perception of nutrition and health claims on these functional foods is proposed. Through a literature review, common independent variables are structured, and an analysis of these variables shows that nutrition and health claims are mostly only perceived positive by specific target consumers (who need the product, accept the ingredient, understand the benefit, and trust the brand). These consumers indicate that the products with substantiated and approved claims help them in reaching overall health goals. This increased expectation in functional efficacy may mediate an increase in repurchase intent, overall liking, and the amount consumers are willing to spend. Other consumers, however, may have adverse reactions towards nutrition and health claims on functional foods. Implications for the consumer and the industry are discussed.

  11. A review of workers' compensation claims: the frequency of claim denial and medical treatment delay.

    Science.gov (United States)

    Kelley, C R; Amparo, J M

    2000-01-01

    A retrospective chart review of 257 patients who presented between January to March 1998, was conducted to identify the frequency of workers' compensation claim denial among patients who reported to Straub Clinic and Hospital. Results showed that 12.8% of claims were either "denied" or temporarily "denied pending investigation". Analysis of all the claims found that only 2% resulted in delayed medical care. Further analysis of the denied claims revealed the vast majority of claims (78.8%) were denied because the medical provider and the patient had incorrect workers' compensation carrier information. Other independent variables studied (size of the employer, category of employer, injury type, status of case, length of case and number of visits) did not predict either denial of the claim or treatment delay. This study suggests that the efficiency of our State's Workers' Compensation system would be greatly improved by developing a system to provide medical care providers with accurate insurance information.

  12. European consumers and health claims: attitudes, understanding and purchasing behaviour

    National Research Council Canada - National Science Library

    Wills, Josephine M; Storcksdieck genannt Bonsmann, Stefan; Kolka, Magdalena; Grunert, Klaus G

    2012-01-01

    .... But do consumers understand and trust health claims? This paper provides an overview of recent research on consumers and health claims including attitudes, understanding and purchasing behaviour...

  13. The Effect of Physician and Hospital Market Structure on Medical Technology Diffusion.

    Science.gov (United States)

    Karaca-Mandic, Pinar; Town, Robert J; Wilcock, Andrew

    2017-04-01

    To examine the influence of physician and hospital market structures on medical technology diffusion, studying the diffusion of drug-eluting stents (DESs), which became available in April 2003. Medicare claims linked to physician demographic data from the American Medical Association and to hospital characteristics from the American Hospital Association Survey. Retrospective claims data analyses. All fee-for-service Medicare beneficiaries who received a percutaneous coronary intervention (PCI) with a cardiac stent in 2003 or 2004. Each PCI record was joined to characteristics on the patient, the procedure, the cardiologist, and the hospital where the PCI was delivered. We accounted for the endogeneity of physician and hospital market structure using exogenous variation in the distances between patient, physician, and hospital locations. We estimated multivariate linear probability models that related the use of a DES in the PCI on market structure while controlling for patient, physician, and hospital characteristics. DESs diffused faster in markets where cardiology practices faced more competition. Conversely, we found no evidence that the structure of the hospital market mattered. Competitive pressure to maintain or expand PCI volume shares compelled cardiologists to adopt DESs more quickly. © Health Research and Educational Trust.

  14. Physician wages across specialties: informing the physician reimbursement debate.

    Science.gov (United States)

    Leigh, J Paul; Tancredi, Daniel; Jerant, Anthony; Kravitz, Richard L

    2010-10-25

    Disparities in remuneration between primary care and other physician specialties may impede health care reform by undermining the sustainability of a primary care workforce. Previous studies have compared annual incomes across specialties unadjusted for work hours. Wage (earnings-per-hour) comparisons could better inform the physician payment debate. In a cross-sectional analysis of data from 6381 physicians providing patient care in the 2004-2005 Community Tracking Study (adjusted response rate, 53%), we compared wages across broad and narrow categories of physician specialties. Tobit and linear regressions were run. Four broad specialty categories (primary care, surgery, internal medicine and pediatric subspecialties, and other) and 41 specific specialties were analyzed together with demographic, geographic, and market variables. In adjusted analyses on broad categories, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 48%, 36%, and 45% higher, respectively, than for primary care specialties. In adjusted analyses for 41 specific specialties, wages were significantly lower for the following than for the reference group of general surgery (wage near median, $85.98): internal medicine and pediatrics combined (-$24.36), internal medicine (-$24.27), family medicine (-$23.70), and other pediatric subspecialties (-$23.44). Wage rankings were largely impervious to adjustment for control variables, including age, race, sex, and region. Wages varied substantially across physician specialties and were lowest for primary care specialties. The primary care wage gap was likely conservative owing to exclusion of radiologists, anesthesiologists, and pathologists. In light of low and declining medical student interest in primary care, these findings suggest the need for payment reform aimed at increasing incomes or reducing work hours for primary care physicians.

  15. Evaluation of Physicians and Physician Extenders: Manpower Resources

    Science.gov (United States)

    1981-07-01

    47 61 32 Physician 126 64,195 !5__35 Physical therapist 62 2,251 5,767 2,303 Radiation therapy technologist 92 848 437 310 Rad i ographer 795 26,715...percent (combining medicine and osteopathy graduates). The projected increase in physician graduates from 1975 to 1990 represents a far greater...23,683 24,196 24,689 Ch iId Psychiatry 2,067 2,242 2,384 2,557 2,618 2,877 Physical t’ledicine anid Rehabil itation ---------- 1,443 1,:503 1,557 1,615

  16. How to motivate physicians and develop a physician champion.

    Science.gov (United States)

    McGrath, Debra

    2006-01-01

    Physician champions and leaders are essential to the success ofa CCIS implementation. Physician champions or leaders can be developed by recognizing the qualities of a leader and cultivating them. Finally, sustainable second-order change is facilitated bv a transformational leader--a leader who is charismatic, considers individual characteristics and needs of the constituency, and stimulates the constituency intellectually. A transformational leader does not accept the status quo but rather is continually questioning and offering constructive problem solutions. Transformational leadership may require more patience, time, tolerance, and resources, but it is worth the effort.

  17. Psychiatric rehabilitation education for physicians.

    Science.gov (United States)

    Rudnick, Abraham; Eastwood, Diane

    2013-06-01

    As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011).

  18. Everyday Citizenship: Identity Claims and Their Reception

    Directory of Open Access Journals (Sweden)

    Nick Hopkins

    2015-10-01

    Full Text Available Citizenship involves being able to speak and be heard as a member of the community. This can be a formal right (e.g., a right to vote. It can also be something experienced in everyday life. However, the criteria for being judged a fellow member of the community are multiple and accorded different weights by different people. Thus, although one may self-define alongside one’s fellows, the degree to which these others reciprocate depends on the weight they give to various membership criteria. This suggests we approach everyday community membership in terms of an identity claims-making process in which first, an individual claims membership through invoking certain criteria of belonging, and second, others evaluate that claim. Pursuing this logic we report three experiments investigating the reception of such identity-claims. Study 1 showed that in Scotland a claim to membership of the national ingroup was accepted more if couched in terms of place of birth and ancestry rather than just in terms of one’s subjective identification. Studies 2 and 3 showed that this differential acceptance mattered for the claimant’s ability to be heard as a community member. We discuss the implications of these studies for the conceptualization of community membership and the realization of everyday citizenship rights.

  19. CLAIMS FOR REIMBURSEMENT OF EDUCATION FEES

    CERN Document Server

    Personnel Division

    1999-01-01

    REMINDERYou are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:the academic year is defined as the period going from 1st September to 31st August, only paid bills can be subject to reimbursement, a claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child, bills for one child may be grouped on a claim by periods of term, semester or academic year, the months of July and August should be included in the third term, or the second semester, or the academic year, for each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have received and paid all bills, including those for...

  20. CLAIMS FOR REINBURSEMENT OF EDUCATION FEES

    CERN Multimedia

    PE-ADS

    1999-01-01

    You are reminded that, in accordance with Article R A 8.07 of the Staff Regulations 'the relevant bills shall be grouped so that not more than three claims in respect of each child are submitted in an academic year'.For this purpose:-\tthe academic year is defined as the period going from 1st September to 31st August,-\tonly paid bills can be subject to reimbursement,-\ta claim for reimbursement of education fees may only include bills for expenses incurred during a given academic year for a given child,-\tbills for one child may be grouped on a claim by periods of term, semester or academic year,-\tthe months of July and August should be included in the third term, or the second semester, or the academic year,-\tfor each dependent child, a maximum of 3 claims can be submitted for the reimbursement of expenses incurred during one academic year, therefore, any bill submitted for reimbursement after the third claim will not be reimbursed.Please make sure that you have receive...

  1. 76 FR 35086 - Proposed Information Collection (Fully Developed Claim (Fully Developed Claims-Applications for...

    Science.gov (United States)

    2011-06-15

    ... Compensation, Pension, DIC, Death Pension, and/or Accrued Benefits)) Activity: Comment Request AGENCY: Veterans... to process compensation and pension claims within 90 days after receipt of the claim. DATES: Written... Docket Management System (FDMS) at http://www.Regulations.gov ; or to Nancy J. Kessinger,...

  2. Physician-Supplier Procedure Summary Master File

    Data.gov (United States)

    U.S. Department of Health & Human Services — This file is a 100 percent summary of all Part B Carrier and DMERC Claims processed through the Common Working File and stored in the National Claims History...

  3. 48 CFR 52.232-23 - Assignment of Claims.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 2 2010-10-01 2010-10-01 false Assignment of Claims. 52....232-23 Assignment of Claims. As prescribed in 32.806(a)(1), insert the following clause: Assignment of Claims (JAN 1986) (a) The Contractor, under the Assignment of Claims Act, as amended, 31 U.S.C. 3727, 41...

  4. 32 CFR 536.19 - Disaster claims planning.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Disaster claims planning. 536.19 Section 536.19... AGAINST THE UNITED STATES The Army Claims System § 536.19 Disaster claims planning. All ACOs will prepare... requirements related to disaster claims planning. ...

  5. Worst-Case-Optimal Dynamic Reinsurance for Large Claims

    DEFF Research Database (Denmark)

    Korn, Ralf; Menkens, Olaf; Steffensen, Mogens

    2012-01-01

    We control the surplus process of a non-life insurance company by dynamic proportional reinsurance. The objective is to maximize expected (utility of the) surplus under the worst-case claim development. In the large claim case with a worst-case upper limit on claim numbers and claim sizes, we fin...

  6. 20 CFR 702.441 - Claims for loss of hearing.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Claims for loss of hearing. 702.441 Section... and Supervision Hearing Loss Claims § 702.441 Claims for loss of hearing. (a) Claims for hearing loss... regulations. (b) An audiogram shall be presumptive evidence of the amount of hearing loss on the...

  7. 47 CFR 64.1 - Traffic damage claims.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Traffic damage claims. 64.1 Section 64.1... RULES RELATING TO COMMON CARRIERS Traffic Damage Claims § 64.1 Traffic damage claims. (a) Each carrier... files for each damage claim of a traffic nature filed with the carrier, showing the name, address, and...

  8. 34 CFR 35.5 - Investigation of claims.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Investigation of claims. 35.5 Section 35.5 Education Office of the Secretary, Department of Education TORT CLAIMS AGAINST THE GOVERNMENT Procedures § 35.5 Investigation of claims. When a claim is received, the Department will make such investigation as may be...

  9. 5 CFR 831.1808 - Special processing for fraud claims.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Special processing for fraud claims. 831... Retirement and Disability Fund § 831.1808 Special processing for fraud claims. When an agency sends a claim indicating fraud, presentation of a false claim, misrepresentation by the debtor or any other party...

  10. 5 CFR 845.408 - Special processing for fraud claims.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Special processing for fraud claims. 845... Recovery of a Debt From the Civil Service Retirement Fund § 845.408 Special processing for fraud claims. When an agency sends a claim indicating fraud, presentation of a false claim, misrepresentation by the...

  11. 37 CFR 7.12 - Claim of color.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Claim of color. 7.12 Section... § 7.12 Claim of color. (a) If color is claimed as a feature of the mark in the basic application and/or registration, the international application must include a statement that color is claimed as...

  12. 20 CFR 638.526 - Tort and other claims.

    Science.gov (United States)

    2010-04-01

    ... shall collect all of the facts, including accident and medical reports and the names and addresses of witnesses, and submit the claim for a decision to the DOL Regional Solicitor's Office. All tort claims for... claimant to the Regional Solicitor, who shall determine if the claim is cognizable under the Tort Claims...

  13. 20 CFR 211.15 - Verification of compensation claimed.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Verification of compensation claimed. 211.15... CREDITABLE RAILROAD COMPENSATION § 211.15 Verification of compensation claimed. Compensation claimed by an... Board before it may be credited. An employee's claim to compensation not credited shall be processed...

  14. 49 CFR 1021.4 - Notice of claim and demand.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Notice of claim and demand. 1021.4 Section 1021.4... § 1021.4 Notice of claim and demand. Initiation of administrative collection of enforcement claims will be commenced by the enforcement collection designee mailing a letter of notice of claim and demand to...

  15. 42 CFR 415.172 - Physician fee schedule payment for services of teaching physicians.

    Science.gov (United States)

    2010-10-01

    ... teaching physicians. 415.172 Section 415.172 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES... PROVIDERS, SUPERVISING PHYSICIANS IN TEACHING SETTINGS, AND RESIDENTS IN CERTAIN SETTINGS Physician Services in Teaching Settings § 415.172 Physician fee schedule payment for services of teaching physicians....

  16. Euthanasia and physicians' moral duties.

    Science.gov (United States)

    Seay, Gary

    2005-10-01

    Opponents of euthanasia sometimes argue that it is incompatible with the purpose of medicine, since physicians have an unconditional duty never to intentionally cause death. But it is not clear how such a duty could ever actually be unconditional, if due consideration is given to the moral weight of countervailing duties equally fundamental to medicine. Whether physicians' moral duties are understood as correlative with patients' moral rights or construed noncorrelatively, a doctor's obligation to abstain from intentional killing cannot be more than a defeasible duty.

  17. [Sherlock Holmes as amateur physician].

    Science.gov (United States)

    Madsen, S

    1998-03-30

    The medical literature contains numerous articles dealing with Sherlock Holmes and his companion Dr. Watson. Some of the articles are concerned with the medical and scientific aspects of his cases. Other articles adopt a more philosophical view: They compare the methods of the master detective with those of the physician--the ideal clinician should be as astute in his profession as the detective must be in his. It this article the author briefly reviews the abilities of Sherlock Holmes as an amateur physician. Often Holmes was brilliant, but sometimes he made serious mistakes. In one of his cases (The Adventure of the Lion's Mane) he misinterpreted common medical signs.

  18. Modeling total expenditure on warranty claims

    CERN Document Server

    Mitra, Abhimanyu

    2010-01-01

    We approximate the distribution of total expenditure of a retail company over warranty claims incurred in a fixed period [0, T], say the following quarter. We consider two kinds of warranty policies, namely, the non-renewing free replacement warranty policy and the non-renewing pro-rata warranty policy. Our approximation holds under modest assumptions on the distribution of the sales process of the warranted item and the nature of arrivals of warranty claims. We propose a method of using historical data to statistically estimate the parameters of the approximate distribution. Our methodology is applied to the warranty claims data from a large car manufacturer for a single car model and model year.

  19. Maintaining Toxic Tort Claims against the Federal Government: A Case Study of Liability Theories Defenses and Remedies

    Science.gov (United States)

    1990-02-18

    issue is United States v. Kubrick . 2 Plaintiff received neomycin treatment in 1968 and later developed a hearing loss. In January 1969, a physician...advised Ji.t was highly possible (or likely?) this druq was the cause. While pursuing a VA claim in 1971, Kubrick was told neomycin caused his injuries...These comments merely prompt suspicion. Although he knew the cause within two years of filing, the Court said Kubrick could have discovered it earlier. 33

  20. 32 CFR 537.16 - Scope for maritime claims.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 3 2010-07-01 2010-07-01 true Scope for maritime claims. 537.16 Section 537.16 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS ON BEHALF OF THE UNITED STATES § 537.16 Scope for maritime claims. The Army Maritime Claims Settlement Act (10 U.S.C. 4803-4804) applies...

  1. Approaches of the insurance companies to the settlement of claims

    OpenAIRE

    2010-01-01

    This paper analyzes the approaches of the insurance companies on the Czech insurance market to the settlement of claims. It deals with activities of the settlement of claims from report of a claim to the payment of an indemnity. In the analysis of the approaches of insurance companies to the settlement of claims this paper focuses on the five topics: direct settlement, elektronic file application, approach to the solutions of the insurance fraud, product advantage in connection with the claim...

  2. 32 CFR 537.15 - Statutory authority for maritime claims and claims involving civil works of a maritime nature.

    Science.gov (United States)

    2010-07-01

    ... claims involving civil works of a maritime nature. 537.15 Section 537.15 National Defense Department of....15 Statutory authority for maritime claims and claims involving civil works of a maritime nature. (a... affirmative claims involving civil works of a maritime nature is set out at 33 U.S.C. 408. ...

  3. 'Choose your master well'. Medical training, testimonies and claims to authority.

    Science.gov (United States)

    Massar, Natacha

    2010-01-01

    This paper explores the ways in which a doctor could use his master's name to enhance his authority and back his claims to being a qualified physician. This is looked at mainly in two contexts: when applying for the position of public physician, and in medical treatises. I argue that the influence of teachers was widely recognised in Greek society. This meant that using the name of one's master to defend one's skills was accepted by both colleagues and laymen and could therefore be used in very different contexts. Sometimes this argument had to be confirmed by witnesses, in which case fellow-pupils or patients treated during a pupil's apprenticeship could come in useful.

  4. The Mindful Physician and Pooh

    Science.gov (United States)

    Winter, Robin O.

    2013-01-01

    Resident physicians are particularly susceptible to burnout due to the stresses of residency training. They also experience the added pressures of multitasking because of the increased use of computers and mobile devices while delivering patient care. Our Family Medicine residency program addresses these problems by teaching residents about the…

  5. Choosing among the physician databases.

    Science.gov (United States)

    Heller, R H

    1988-04-01

    Prudent examination and knowing how to ask the "right questions" can enable hospital marketers and planners to find the most accurate and appropriate database. The author compares the comprehensive AMA physician database with the less expensive MEDEC database to determine their strengths and weaknesses.

  6. Incest and the family physician.

    Science.gov (United States)

    Boekelheide, P D

    1978-01-01

    This paper is a review of incest from epidemiologic, familial, and individual points of view. The incest taboo has characterized almost every culture and society throughout the ages. Respect for the incest barrier is a cultural demand made by society and is not a physiological or biological imperative. Overt incest occurs in a dysfunctional family through tension-reducing "acting out." The family physician is in a unique position to observe and understand the family dynamics which both help maintain defenses against the incestuous wishes as well as, in some families, contribute to the practice of incest. For 2,000 years physicians have taken the Hippocratic oath, with its explicit love relationship clause, as a reminder of their ethical responsibilities towards their patients. Examples of para-incestuous relationships between vulnerable individuals and authoritative helping figures are cited. A psychodynamic rationale is offered as to why sexual relationships between patients and their family physicians are not therapeutically beneficial. Clues for assessment and ten preventive measures are presented to enable physicians to monitor themselves and the families in their practice.

  7. Physician burnout: A neurologic crisis.

    Science.gov (United States)

    Sigsbee, Bruce; Bernat, James L

    2014-12-09

    The prevalence of burnout is higher in physicians than in other professions and is especially high in neurologists. Physician burnout encompasses 3 domains: (1) emotional exhaustion: the loss of interest and enthusiasm for practice; (2) depersonalization: a poor attitude with cynicism and treating patients as objects; and (3) career dissatisfaction: a diminished sense of personal accomplishment and low self-value. Burnout results in reduced work hours, relocation, depression, and suicide. Burned-out physicians harm patients because they lack empathy and make errors. Studies of motivational factors in the workplace suggest several preventive interventions: (1) Provide counseling for physicians either individually or in groups with a goal of improving adaptive skills to the stress and rapid changes in the health care environment. (2) Identify and eliminate meaningless required hassle factors such as electronic health record "clicks" or insurance mandates. (3) Redesign practice to remove pressure to see patients in limited time slots and shift to team-based care. (4) Create a culture that promotes career advancement, mentoring, and recognition of accomplishments. © 2014 American Academy of Neurology.

  8. TQM: a paradigm for physicians.

    Science.gov (United States)

    Snyder, D A

    1993-01-01

    Change, even when for the better, is always accompanied by apprehension and even outright fear. It is therefore not surprising to hear health care workers, especially physicians, expressing their concerns about this "new" management philosophy through a spectrum of reactions that vary from skeptical or grudging acceptance to outright dismissal of all of the new "alphabet soup" associated with TQM.

  9. Hitler’s Jewish Physicians

    Directory of Open Access Journals (Sweden)

    George M. Weisz

    2014-07-01

    Full Text Available The mystery behind the behavior of infamous personalities leaves many open questions, particularly when related to the practice of medicine. This paper takes a brief look at two Jewish physicians who played memorable roles in the life of Adolf Hitler.

  10. Hitler’s Jewish Physicians

    Science.gov (United States)

    Weisz, George M.

    2014-01-01

    The mystery behind the behavior of infamous personalities leaves many open questions, particularly when related to the practice of medicine. This paper takes a brief look at two Jewish physicians who played memorable roles in the life of Adolf Hitler. PMID:25120923

  11. Business plan writing for physicians.

    Science.gov (United States)

    Cohn, Kenneth H; Schwartz, Richard W

    2002-08-01

    Physicians are practicing in an era in which they are often expected to write business plans in order to acquire, develop, and implement new technology or programs. This task is yet another reminder of the importance of business principles in providing quality patient care amid allocation of increasingly scarce resources. Unfortunately, few physicians receive training during medical school, residencies, or fellowships in performing such tasks. The process of writing business plans follows an established format similar to writing a consultation, in which the risks, benefits, and alternatives to a treatment option are presented. Although administrative assistance may be available in compiling business plans, it is important for physicians to understand the rationale, process, and pitfalls of business planning. Writing a business plan will serve to focus, clarify, and justify a request for scarce resources, and thus, increase its chance of success, both in terms of funding and implementation. A well-written business plan offers a plausible, coherent story of an uncertain future. Therefore, a business plan is not merely an exercise to obtain funding but also a rationale for investment that can help physicians reestablish leadership in health care.

  12. Physician Requirements-1990. For Nephrology.

    Science.gov (United States)

    Rosenbach, Joan K.

    Professional requirements for physicians specializing in nephrology were estimated to assist policymakers in developing guidelines for graduate medical education. In estimating service requirements for nephrology, a nephrology Delphi panel reviewed reference and incidence-prevalence and utilization data for 34 conditions that are treated in the…

  13. Physicians? Opinions of Phytotherapy Products

    Directory of Open Access Journals (Sweden)

    Murat Kartal

    2011-05-01

    Full Text Available Aim: This study has been conducted to determine of family physicians’ level of knowledge and perspectives with herbal products therapy (phytotherapy - and herbal products.Material and Methods; Present study, which is a type of descriptive study, is designed with the participation of the family physician specialists and assistants working public or private health organizations in several cities in between June 2007 and April 2008 by via electronic mail. In this research, a specifically developed questionnaire including 11 questions was applied for the physicians. Results: 150 physicians participated in to the research from 30 provinces. The half of the study participants (75 people was male. The mean age was 34.4. The 63.1% of the participating physicians stated that they applied or interested in phytotherapy. The 36.9% of physicians determined that they were against to phytotherapy or not interested. The major reasons of the opposition or indifference are lack of evidence-based and not having enough study in this subject (50.0%, the insufficient legal regulations (16.7%, only being able to be a the placebo effect (8.3%, and the thinking of being able to have harmful side effects (4.2%. There was not statistically significant difference between gender and interest in phytotherapy (p: 0.567. The 28.2% of the participating physicians stated that they ask to their patients whether using herbal products or not before their treatment or prescription. Conclusion  Phytotherapy, which is frequently mentioned and used in currently, is a fact to be considered whether it is interested or not. Many studies show that it is useful while the physicians taking medical history to inquire about if the patient use of this any product, to detect possible interactions and harms. In addition, the studies emphasize that the production and consumption of herbal products is still not designed with legal regulation, there is no standardization of quality and evidence

  14. Handling the Dependence of Claim Severities with Copula Models

    Directory of Open Access Journals (Sweden)

    Yulia Resti

    2010-01-01

    Full Text Available Problem statement: Several studies have been carried out on the modeling of claim severity data in actuarial literature as well as in insurance practice. Since it is well established that the claim cost distributions generally have positive support and are positively skewed, the regression models of Gamma and Lognormal have been used by practitioners for modeling claim severities. However, the fitting of claim severities via regression models assumes that the claim types are independent. Approach: In this study, independent assumption between claim types will be investigated as we will consider three types of Malaysian motor insurance claims namely Third Party Body Injury (TPBI, Third Party Property Damage (TPPD and Own Damage (OD and applied the normal, t, Frank and Clayton copulas for modeling dependence structures between these claim types. Results: The AIC and BIC indicated that the Clayton is the best copula for modeling dependence between TPBI and OD claims and between TPPD and OD claims, whereas the t-copula is the best copula for modeling dependence between TPBI and TPPD claims. Conclusion: This study modeled the dependence between insurance claim types using copulas on the Malaysian motor insurance claim severity data. The main advantage of using copula is that each marginal distribution can be specified independently based on the distribution of individual variable and then joined by the copula which takes into account the dependence between these variables. Based on the results, the estimated of copula parameter for claim severities indicate that the dependence between claim types is significant.

  15. Involving physicians in TQM. To gain physician support for quality management, hospital administrators must treat physicians as customers.

    Science.gov (United States)

    McCarthy, G J

    1993-12-01

    The process of integrating physicians into a hospital's total quality management (TQM) program is not simple. Physicians will not view TQM as an acceptable strategy in the absence of a positive working relationship with hospital managers. Physicians must see hospital managers as colleagues who can help improve their medical practices both in efficiency and patient care. The first step in involving physicians in TQM is creating an environment that enhances physician relationships. The CEO should be actively involved with the medical staff, and senior hospital managers should work at cultivating physician relationships. Physician needs and the centrality of the physician-management relationship should enter into every management discussion. Also, managers must solicit physician feedback regularly. Managers can introduce physicians to TQM by accompanying them to off-site TQM programs for a few days. Managers should also coordinate a continuing education program at the hospital, inviting a physician to address medical staff about TQM. Physicians are more likely to respond positively to one of their peers than they would to a consultant or business manager. Managers should then invite hospital-based physicians to participate on TQM interdisciplinary teams to resolve a problem chosen by the senior medical staff. The problem should be one that promises to be a quick fix, thereby ensuring demonstrable success of TQM and allaying any doubts. After an initial demonstration of TQM's success, the cycle is repeated. A year or two later, managers should invite off-site clinicians to join interdisciplinary teams on issues important to them.

  16. Ethical principles for physician rating sites.

    Science.gov (United States)

    Strech, Daniel

    2011-12-06

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites' effects on physicians' performance, patient outcomes, or the public's trust in health care, most contributions refer to normative arguments, hypothetical effects, or indirect evidence. This paper aims, first, to structure the ethical debate about the basic concept of physician rating sites: allowing patients to rate, comment, and discuss physicians' performance, online and visible to everyone. Thus, it provides a more thorough and transparent starting point for further discussion and decision making on physician rating sites: what should physicians and health policy decision makers take into account when discussing the basic concept of physician rating sites and its possible implications on the physician-patient relationship? Second, it discusses where and how the preexisting evidence from the partly related field of public reporting of physician performance can serve as an indicator for specific needs of evaluative research in the field of physician rating sites. This paper defines the ethical principles of patient welfare, patient autonomy, physician welfare, and social justice in the context of physician rating sites. It also outlines basic conditions for a fair decision-making process concerning the implementation and regulation of physician rating sites, namely, transparency, justification, participation, minimization of conflicts of interest, and openness for revision. Besides other issues described in this paper, one trade-off presents a special challenge and will play an important role when deciding about more- or less-restrictive physician rating sites regulations: the potential psychological and financial harms for

  17. Lickona Promotes False Claims about Sex Education.

    Science.gov (United States)

    Bennetta, William J.

    1994-01-01

    In articles on sex and character education in the November 1993 "Educational Leadership," Thomas Lickona parrots slogans and fake history and statistics contrived by the Religious Right. Lickona blames Darwin's evolution theory for variable morality and repeats fabricated success claims for Teen-Aid and Sex Respect, right-wing programs funded…

  18. A multilevel analysis of intercompany claim counts

    NARCIS (Netherlands)

    Antonio, K.; Frees, E.W.; Valdez, E.A.

    2009-01-01

    In this paper, we use multilevel models to analyze data on claim counts provided by the General Insurance Association of Singapore, an organization consisting of most of the general insurers in Singapore. Our data comes from the financial records of automobile insurance policies followed over a peri

  19. 44 CFR 11.76 - Claims procedures.

    Science.gov (United States)

    2010-10-01

    ... over to a shipping officer, supply officer, or contract packer indicating: (i) Name (or designation) and address of the shipping officer, supply officer, or contract packer indicating; (ii) Date the... applicable case enumerated in § 11.73(c)(8). (h) Money. Claims for loss of money deposited for safekeeping...

  20. Issues surrounding health claims for barley.

    Science.gov (United States)

    Ames, Nancy P; Rhymer, Camille R

    2008-06-01

    Government-approved health claims support dietary intervention as a safe and practical approach to improving consumer health and provide industry with regulatory guidelines for food product labels. Claims already allowed in the United States, United Kingdom, Sweden, and The Netherlands for reducing cholesterol through consumption of oat or barley soluble fiber provide a basis for review, but each country may have different criteria for assessing clinical evidence for a physiological effect. For example, the FDA-approved barley health claim was based on a petition that included 39 animal model studies and 11 human clinical trials. Since then, more studies have been published, but with few exceptions, clinical data continue to demonstrate that the consumption of barley products is effective for lowering total and LDL cholesterol. More research is needed to fully understand the mechanism of cholesterol reduction and the role of beta-glucan molecular weight, viscosity, and solubility. In an assessment of the physiological efficacy of a dietary intervention, consideration should also be given to the potential impact of physical and thermal food-processing treatments and genotypic variation in the barley source. New barley cultivars have been generated specifically for food use, possessing increased beta-glucan, desirable starch composition profiles, and improved milling/processing traits. These advances in barley production, coupled with the establishment of a government-regulated health claim for barley beta-glucan, will stimulate new processing opportunities for barley foods and provide consumers with reliable, healthy food choices.

  1. Rejecting knowledge claims inside and outside science.

    Science.gov (United States)

    Collins, Harry

    2014-10-01

    Citizens, policy-makers and scientists all face the problem of assessing maverick scientific claims. Via a case study, I show the different resources available to experts and non-experts when they make these judgements and reflect upon what this means for technological decision-making in the public domain.

  2. Automating claims management improves revenue cycle.

    Science.gov (United States)

    Nivison, Matthew

    2008-02-01

    One healthcare organization was able to improve revenue cycle operations by automating its claims management. Using web-based technology enabled the organization to streamline internal workflow processes, redeploy staff, and reduce overhead costs. As a result, cash flow increased 7 percent, and A/R days dropped 16 percent.

  3. Consumer perceptions of nutrition and health claims

    NARCIS (Netherlands)

    Trijp, van H.C.M.; Lans, van der I.A.

    2007-01-01

    The number of food products containing extra or reduced levels of specific ingredients (e.g. extra calcium) that bring particular health benefits (e.g. stronger bones) is still increasing. Nutrition- and health-related (NH) claims promoting these ingredient levels and their health benefit differ in

  4. A multilevel analysis of intercompany claim counts

    NARCIS (Netherlands)

    Antonio, K.; Frees, E.W.; Valdez, E.A.

    2009-01-01

    In this paper, we use multilevel models to analyze data on claim counts provided by the General Insurance Association of Singapore, an organization consisting of most of the general insurers in Singapore. Our data comes from the financial records of automobile insurance policies followed over a peri

  5. Competing jurisdictions : settling land claims in Africa

    NARCIS (Netherlands)

    Evers, Sandra; Spierenburg, M.; Wels, H.

    2005-01-01

    The papers included in this volume were earlier presented at a conference on the settlement of land claims in Africa, which was held in Amsterdam in September 2003. The papers are written primarily from an anthropological perspective. Contributions: Introduction: competing jurisdictions: settling la

  6. 75 FR 55344 - Alaska Native Claims Selection

    Science.gov (United States)

    2010-09-10

    ... conveyance of surface estate for certain lands to NANA Regional Corporation, Inc., Successor in Interest to... Claims Settlement Act. The subsurface estate in these lands will be conveyed to NANA Regional Corporation, Inc. when the surface estate is conveyed to NANA Regional Corporation, Inc., Successor in Interest...

  7. Micmac Indians Present Aboriginal Rights Claim

    Science.gov (United States)

    Northian, 1978

    1978-01-01

    Nova Scotia's Micmac Indian leaders presented their claim for aboriginal rights to the Federal Government April 25, 1977 in an historic and symbolic ceremony on their home ground at the Eskasoni Reserve. The article discusses this event and some of the Micmacs' demands. (NQ)

  8. 22 CFR 33.8 - Claim procedures.

    Science.gov (United States)

    2010-04-01

    ... must be supported by documentary evidence. Foreign language documents must be accompanied by an... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Claim procedures. 33.8 Section 33.8 Foreign..., including: (i) The date and cost of acquisition supported by invoices or other acceptable proof of...

  9. Claimed walking distance of lower limb amputees

    NARCIS (Netherlands)

    Geertzen, JHB; Bosmans, JC; Van der Schans, CP; Dijkstra, PU

    2005-01-01

    Purpose: Walking ability in general and specifically for lower limb amputees is of major importance for social mobility and ADL independence. Walking determines prosthesis prescription. The aim of this study was to mathematically analyse factors influencing claimed walking distance of lower limb amp

  10. Competing jurisdictions : settling land claims in Africa

    NARCIS (Netherlands)

    Evers, S.; Spierenburg, M.; Wels, H.

    2005-01-01

    The papers included in this volume were earlier presented at a conference on the settlement of land claims in Africa, which was held in Amsterdam in September 2003. The papers are written primarily from an anthropological perspective. Contributions: Introduction: competing jurisdictions: settling

  11. Micmac Indians Present Aboriginal Rights Claim

    Science.gov (United States)

    Northian, 1978

    1978-01-01

    Nova Scotia's Micmac Indian leaders presented their claim for aboriginal rights to the Federal Government April 25, 1977 in an historic and symbolic ceremony on their home ground at the Eskasoni Reserve. The article discusses this event and some of the Micmacs' demands. (NQ)

  12. Physician prescribing behavior and its impact on patient-level outcomes.

    Science.gov (United States)

    Joyce, Geoffrey F; Carrera, Mariana P; Goldman, Dana P; Sood, Neeraj

    2011-12-01

    Concerns over rising drug costs, pharmaceutical advertising, and potential conflicts of interest have focused attention on physician prescribing behavior. We examine how broadly physicians prescribe within the 10 most prevalent therapeutic classes, the factors affecting their choices, and the impact of their prescribing behavior on patient-level outcomes. Retrospective study from 2005 to 2007 examining prescribers with at least 5 initial prescriptions within a class from 2005 to 2007. Medical and pharmacy claims are linked to prescriber information from 146 different health plans, reflecting 1975 to 8923 unique providers per drug class. Primary outcomes are the number of distinct drugs in a class initially prescribed by a physician over 1- and 3-year periods, medication possession ratio, and out-of-pocket costs. In 8 of 10 therapeutic classes, the median physician prescribes at least 3 different drugs and fewer than 1 in 6 physicians prescribe only brand drugs. Physicians prescribing only 1 or 2 drugs in a class are more likely to prescribe the most advertised drug. Physicians who prescribe fewer drugs are less likely to see patients with other comorbid conditions and varied formulary designs. Prescribing fewer drugs is associated with lower rates of medication adherence and higher out-ofpocket costs for drugs, but the effects are small and inconsistent across classes. Physicians prescribe more broadly than commonly perceived. Though narrow prescribers are more likely to prescribe highly advertised drugs, few physicians prescribe these drugs exclusively. Narrow prescribing has modest effects on medication adherence and out-of-pocket costs in some classes.

  13. A physician's due: measuring physician billing performance, benchmarking results.

    Science.gov (United States)

    Woodcock, Elizabeth W; Browne, Robert C; Jenkins, Jennifer L

    2008-07-01

    A 2008 study focused on four key performance indicators (KPIs) and staffing levels to benchmark the FYO7 performance of physician group billing operations. A comparison of the change in the KPIs from FYO3 to FYO7 for a number of these billing operations disclosed across-the-board improvements. Billing operations did not show significant changes in staffing levels during this time, pointing to the existence of obstacles that prevent staff reductions in this area.

  14. Relation Between Physicians' Work Lives and Happiness.

    Science.gov (United States)

    Eckleberry-Hunt, Jodie; Kirkpatrick, Heather; Taku, Kanako; Hunt, Ronald; Vasappa, Rashmi

    2016-04-01

    Although we know much about work-related physician burnout and the subsequent negative effects, we do not fully understand work-related physician wellness. Likewise, the relation of wellness and burnout to physician happiness is unclear. The purpose of this study was to examine how physician burnout and wellness contribute to happiness. We sampled 2000 full-time physician members of the American Academy of Family Physicians. Respondents completed a demographics questionnaire, questions about workload, the Physician Wellness Inventory, the Maslach Burnout Inventory, and the Subjective Happiness Scale. We performed a hierarchical regression analysis with the burnout and wellness subscales as predictor variables and physician happiness as the outcome variable. Our response rate was 22%. Career purpose, personal accomplishment, and perception of workload manageability had significant positive correlations with physician happiness. Distress had a significant negative correlation with physician happiness. A sense of career meaning and accomplishment, along with a lack of distress, are important factors in determining physician happiness. The number of hours a physician works is not related to happiness, but the perceived ability to manage workload was significantly related to happiness. Wellness-promotion efforts could focus on assisting physicians with skills to manage the workload by eliminating unnecessary tasks or sharing workload among team members, improving feelings of work accomplishment, improving career satisfaction and meaning, and managing distress related to patient care.

  15. Investigating Compliance with Standard Precautions During Residency Physicians in Gynecology and Obstetrics.

    Science.gov (United States)

    Carvalho, Milton Jorge de; Pereira, Fernanda Maria Vieira; Gir, Elucir; Lam, Simon Ching; Barbosa, Caio Parente

    2016-07-01

    Physician compliance with standard precautions is important in the specialty of gynecology and obstetrics because of the high frequency of invasive procedures. The current study investigated compliance with standard precautions among resident physicians working in gynecology and obstetrics. A cross-sectional study was conducted among resident physicians in gynecology and obstetrics in their first (R1), second (R2) and third (R3) years of residency at a teaching hospital in a city in São Paulo. A structured questionnaire that included demographic and professional aspects and the Standard Precautions Adherence Scale were used to collect data. Statistical analysis was performed using IBM® SPSS version 20. Ethical aspects were considered. Fifty-eight resident physicians participated in the study. Of the enrolled participants, 27 (46.6%) were in R1, 12 (20.7%) were in R2 and 19 (32.8%) were in R3. The standard precautions compliance score was 4.1, which was classified as intermediate. There were no significant differences in the compliance scores of the resident physicians across the three years of residency (H=2.34, p=0.310). Compliance with standard precautions among resident physicians was intermediate. Preventive measures in clinical practice are not fully adopted in the specialty of gynecology and obstetrics. More important, many professionals claimed lack of sufficient training in standard precautions in the workplace. Such circumstances should draw the attention of hospital management with regard to occupational health risks.

  16. Patient–physician communication regarding electronic cigarettes

    Directory of Open Access Journals (Sweden)

    Michael B. Steinberg

    2015-01-01

    Discussion: Physician communication about e-cigarettes may shape patients' perceptions about the products. More research is needed to explore the type of information that physicians share with their patients regarding e-cigarettes and harm reduction.

  17. What's a Primary Care Physician (PCP)?

    Science.gov (United States)

    ... and the Internet What's a Primary Care Physician (PCP)? KidsHealth > For Parents > What's a Primary Care Physician ( ... getting the right amount of exercise. Types of PCPs Different types of PCPs treat kids and teens. ...

  18. AMA Physician Select: Online Doctor Finder

    Science.gov (United States)

    ... Membership | JAMA Network | AMA Store DoctorFinder This online physician Locator helps you find a perfect match for ... with basic professional information on virtually every licensed physician in the United States. This includes more than ...

  19. Medicares Physician Quality Reporting System (PQRS)...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Medicares Physician Quality Reporting System (PQRS) allows providers to report measures of process quality and health outcomes. The authors of Medicares Physician...

  20. Organizational aspects of physician joint ventures.

    Science.gov (United States)

    Rublee, D A; Rosenfield, R H

    1987-03-01

    This article describes organizational forms of physician joint ventures. Four models are described that typify physician involvement in health care joint ventures: limited partnership syndication, venture capital company, provider network, and alternative delivery system. Important practical issues are discussed.

  1. Physician Asthma Management Practices in Canada

    Directory of Open Access Journals (Sweden)

    Robert Jin

    2000-01-01

    Full Text Available OBJECTIVES: To establish national baseline information on asthma management practices of physicians, to compare the reported practices with the Canadian Consensus recommendations and to identify results potentially useful for interventions that improve physician asthma management practices.

  2. Medicare Provider Data - Physician and Other Supplier

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Physician and Other Supplier Public Use File (Physician and Other Supplier PUF) provides information on services and procedures provided to Medicare...

  3. Hospital characteristics and patient populations served by physician owned and non physician owned orthopedic specialty hospitals

    Directory of Open Access Journals (Sweden)

    Vaughan-Sarrazin Mary S

    2007-09-01

    Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.

  4. Organizational commitment of military physicians.

    Science.gov (United States)

    Demir, Cesim; Sahin, Bayram; Teke, Kadir; Ucar, Muharrem; Kursun, Olcay

    2009-09-01

    An individual's loyalty or bond to his or her employing organization, referred to as organizational commitment, influences various organizational outcomes such as employee motivation, job satisfaction, performance, accomplishment of organizational goals, employee turnover, and absenteeism. Therefore, as in other sectors, employee commitment is crucial also in the healthcare market. This study investigates the effects of organizational factors and personal characteristics on organizational commitment of military physicians using structural equation modeling (SEM) on a self-report, cross-sectional survey that consisted of 635 physicians working in the 2 biggest military hospitals in Turkey. The results of this study indicate that professional commitment and organizational incentives contribute positively to organizational commitment, whereas conflict with organizational goals makes a significantly negative contribution to it. These results might help develop strategies to increase employee commitment, especially in healthcare organizations, because job-related factors have been found to possess greater impact on organizational commitment than personal characteristics.

  5. Liver transplantation for nontransplant physicians

    Directory of Open Access Journals (Sweden)

    Amany AbdelMaqsod Sholkamy

    2014-01-01

    Full Text Available Many of the nontransplant physicians who manage hepatic patients (internists and hepatologists keep asking about liver transplantation. The purpose of this article is to highlight important topics a nontransplant colleague may require in his practice. There are many topics in this respect; however, three most important topics need to be highlighted; those are; the time of referral to transplantation, the indications and contraindications and the metabolic issues regarding a transplanted patient. Still, there are no clear guidelines for the management of many of the metabolic issues regarding liver transplanted patients. And this why, collaborative efforts of transplant and nontransplant physicians are needed to conduct multicenter, long term randomized controlled trials and proper follow up programs.

  6. [Imhotep--builder, physician, god].

    Science.gov (United States)

    Mikić, Zelimir

    2008-01-01

    The medicine had been practiced in ancient Egypt since the earliest, prehistoric days, many millenia before Christ, and was quite developed in later periods. This is evident from the sceletal findings, surgical instruments found in tombs, wall printings, the reliefs and inscriptions, and most of all, from the sparse written material known as medical papyri. However, there were not many physicians from that time whose names had been recorded. The earliest physician in ancient Egypt known by name was Imhotep. WHO WAS IMHOTEP?: Imhotep lived and worked during the time of the 3rd Dynasty of Old Kingdom and served under the pharaoh Djoser (reigned 2667-2648 BC) as his vizier or chief minister, high priest, chief builder and carpenter. He obviously was an Egyptian polymath, a learned man and scribe and was credited with many inventions. As one of the highest officials of the pharaoh Djoser Imhotep is credited with designing and building of the famous Step Pyramid of Djoser at Saqqarah, near the old Egyptian capital of Memphis. Imhotep is also credited with inventing the method of stone-dressed building and using of columns in architecture and is considered to be the first architect in history known by name. It is believed that, as the high priest, Imhotel also served as the nation's chief physician in his time. As the builder of the Step Pyramid, and as a physician, he also had to take medical care of thousands of workers engaged in that great project. He is also credited with being the founder of Egyptian medicine and with being the author of the so-called Smith papirus containing a collection of 48 specimen clinical records with detailed accurate record of the features and treatment of various injuries. As such he emerges as the first physician of ancient Egypt known by name and, at the same time, as the first physician known by name in written history of the world. GOD: As Imhotep was considered by Egyptian people as the "inventor of healing", soon after the death, he

  7. Ultra-processed family foods in Australia: nutrition claims, health claims and marketing techniques.

    Science.gov (United States)

    Pulker, Claire Elizabeth; Scott, Jane Anne; Pollard, Christina Mary

    2017-07-17

    To objectively evaluate voluntary nutrition and health claims and marketing techniques present on packaging of high-market-share ultra-processed foods (UPF) in Australia for their potential impact on public health. Cross-sectional. Packaging information from five high-market-share food manufacturers and one retailer were obtained from supermarket and manufacturers' websites. Ingredients lists for 215 UPF were examined for presence of added sugar. Packaging information was categorised using a taxonomy of nutrition and health information which included nutrition and health claims and five common food marketing techniques. Compliance of statements and claims with the Australia New Zealand Food Standards Code and with Health Star Ratings (HSR) were assessed for all products. Almost all UPF (95 %) contained added sugars described in thirty-four different ways; 55 % of UPF displayed a HSR; 56 % had nutrition claims (18 % were compliant with regulations); 25 % had health claims (79 % were compliant); and 97 % employed common food marketing techniques. Packaging of 47 % of UPF was designed to appeal to children. UPF carried a mean of 1·5 health and nutrition claims (range 0-10) and 2·6 marketing techniques (range 0-5), and 45 % had HSR≤3·0/5·0. Most UPF packaging featured nutrition and health statements or claims despite the high prevalence of added sugars and moderate HSR. The degree of inappropriate or inaccurate statements and claims present is concerning, particularly on packaging designed to appeal to children. Public policies to assist parents to select healthy family foods should address the quality and accuracy of information provided on UPF packaging.

  8. Transitioning to value-based physician compensation.

    Science.gov (United States)

    Epstein, Johanna

    2014-12-01

    An effective strategy for creating a viable physician compensation plan should include nine key steps or tactics: Get physicians on board early. Engage a physician champion. Create a compensation committee. Address department-level issues and differences. Verify the plan's affordability. Adopt a routine review schedule. Understand the payer environment and keep in contact with payers. Stay abreast of industry trends. Maintain an ongoing dialogue with physicians.

  9. Cholesterol treatment practices of primary care physicians.

    OpenAIRE

    Hyman, D J; Maibach, E W; Flora, J A; Fortmann, S.P.

    1992-01-01

    The active involvement of primary care physicians is necessary in the diagnosis and treatment of elevated blood cholesterol. Empirical evidence suggests that primary care physicians generally initiate dietary and pharmacological treatment at threshold values higher than is currently recommended. To determine current treatment thresholds and establish factors that distinguish physicians who are more likely to initiate therapy at lower cholesterol values, 119 primary care physicians in four nor...

  10. Mentoring to Help Prevent Physician Burnout.

    Science.gov (United States)

    Herring, Malcolm; Forbes Kaufman, Rachel; Bogue, Richard

    2016-07-01

    The importance of a person's spirit and eternal destiny are eclipsed in American medi- cine. The most alarming effect of this eclipse is that the prevalence of burnout among physicians is high (about 46 percent) and growing.' It is alarming because trends that deplete the physician's spirit tragically impair the physician's capacity as a healer and as one who renews the spirit.

  11. Patient expectations from consultation with family physician.

    NARCIS (Netherlands)

    Tähepöld, H.; Brink-Muinen, A. van den; Maaroos, H.I.

    2006-01-01

    Aim: To assess patient expectations from a consultation with a family physician and determine the level and area of patient involvement in the communication process. Method: We videotaped 403 consecutive patient-physician consultations in the offices of 27 Estonian family physicians. All videotaped

  12. Regulatory environment and claims - limits and opportunities.

    Science.gov (United States)

    Martin, Ambroise

    2010-01-01

    During the past decade, the use of claims became more and more important in many countries in relation to the increased awareness of consumer about the link between foods and health, offering to industry a valuable opportunity to differentiate and valorize their products and to promote innovation. However, more and more stringent regulations are developed, all based on the general principles adopted by the Codex Alimentarius Commission. In addition to the different regulatory processes and administrative requirements according to the country, the high level (and cost) of scientific substantiation of claims, the constraints introduced by nutrient profiles and the poor knowledge of the impact on consumer depending on the cultural contexts may limit these opportunities or, at least complicate their use. All these issues are briefly analyzed, highlighting some striking convergences and differences between countries.

  13. Dolphin-Assisted Therapy: Claims versus Evidence

    OpenAIRE

    Fiksdal, Britta L.; Daniel Houlihan; Barnes, Aaron C.

    2012-01-01

    The purpose of this paper is to review and critique studies that have been conducted on dolphin-assisted therapy for children with various disorders. Studies have been released claiming swimming with dolphins is therapeutic and beneficial for children with autism, attention deficit hyperactivity disorder, physical disabilities, and other psychological disorders. The majority of the studies conducted supporting the effectiveness of dolphin-assisted therapy have been found to have major methodo...

  14. Rights as entitlements and rights as claims

    Directory of Open Access Journals (Sweden)

    Azevedo, Marco Antônio Oliveira de

    2010-01-01

    Full Text Available Há pelo menos dois registros diferentes sobre o significado de “direitos”. Segundo um deles, os direitos são relações entre dois termos: uma pessoa e um bem; para o outro, os direitos são relações entre três termos: um indivíduo, uma pessoa e uma ação ou algo. Os registros são diferentes, mas não são totalmente incompatíveis. De acordo com a interpretação de direitos como entitlements, trata-se de direitos morais ou legais, ou seja, as relações de ordem moral ou jurídica das pessoas com bens (de benefícios concedidos a pessoas por uma lei humana, moral ou legal. Como uma espécie de direitos, os direitos humanos são vistos como direitos (entitlements das pessoas ou dos indivíduos a bens essenciais, dos quais podem-se inferir reivindicações (claims contra outras pessoas ou contra governos e representantes. Falamos sobre direitos humanos geralmente desta forma. Mas de acordo com o outro registro, os direitos em sentido próprio têm que ser interpretados como claims. Neste artigo, pretendo apresentar alguns argumentos em favor da vantagem de expor todos os enunciados significativos dos direitos como entitlements em termos explícitos de claims

  15. 27 CFR 20.24 - Allowance of claims.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY LIQUORS DISTRIBUTION AND USE OF DENATURED ALCOHOL AND RUM Administrative Provisions Authorities § 20.24 Allowance of claims. The appropriate TTB officer is authorized to allow claims for...

  16. 27 CFR 22.23 - Allowance of claims.

    Science.gov (United States)

    2010-04-01

    ... OF THE TREASURY LIQUORS DISTRIBUTION AND USE OF TAX-FREE ALCOHOL Administrative Provisions Authorities § 22.23 Allowance of claims. The appropriate TTB officer is authorized to allow claims for...

  17. Center for Medicare & Medicaid Services (CMS) , Medicare Claims data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 2003 forward. CMS compiles claims data for Medicare and Medicaid patients across a variety of categories and years. This includes Inpatient and Outpatient claims,...

  18. 32 CFR 842.110 - Claims not payable.

    Science.gov (United States)

    2010-07-01

    ... property by a continuing trespass or by a technical trespass such as overflights of aircraft. (l) Claims... the provisions of the Trading With the Enemy Act. (q) Claims for damages caused by the United States...

  19. Repeat workers' compensation claims: risk factors, costs and work disability

    Directory of Open Access Journals (Sweden)

    Collie Alex

    2011-06-01

    Full Text Available Abstract Background The objective of our study was to describe factors associated with repeat workers' compensation claims and to compare the work disability arising in workers with single and multiple compensation claims. Methods All initial injury claims lodged by persons of working age during a five year period (1996 to 2000 and any repeat claims were extracted from workers' compensation administrative data in the state of Victoria, Australia. Groups of workers with single and multiple claims were identified. Descriptive analysis of claims by affliction, bodily location, industry segment, occupation, employer and workplace was undertaken. Survival analysis determined the impact of these variables on the time between the claims. The economic impact and duration of work incapacity associated with initial and repeat claims was compared between groups. Results 37% of persons with an initial claim lodged a second claim. This group contained a significantly greater proportion of males, were younger and more likely to be employed in manual occupations and high-risk industries than those with single claims. 78% of repeat claims were for a second injury. Duration between the claims was shortest when the working conditions had not changed. The initial claims of repeat claimants resulted in significantly (p lower costs and work disability than the repeat claims. Conclusions A substantial proportion of injured workers experience a second occupational injury or disease. These workers pose a greater economic burden than those with single claims, and also experience a substantially greater cumulative period of work disability. There is potential to reduce the social, health and economic burden of workplace injury by enacting prevention programs targeted at these workers.

  20. Review article: burnout in emergency medicine physicians.

    Science.gov (United States)

    Arora, Manit; Asha, Stephen; Chinnappa, Jason; Diwan, Ashish D

    2013-12-01

    Training and the practice of emergency medicine are stressful endeavours, placing emergency medicine physicians at risk of burnout. Burnout syndrome is associated with negative outcomes for patients, institutions and the physician. The aim of this review is to summarise the available literature on burnout among emergency medicine physicians and provide recommendations for future work in this field. A search of MEDLINE (1946-present) (search terms: 'Burnout, Professional' AND 'Emergency Medicine' AND 'Physicians'; 'Stress, Psychological' AND 'Emergency Medicine' AND 'Physicians') and EMBASE (1988-present) (search terms: 'Burnout' AND 'Emergency Medicine' AND 'Physicians'; 'Mental Stress' AND 'Emergency Medicine' AND 'Physicians') was performed. The authors focused on articles that assessed burnout among emergency medicine physicians. Most studies used the Maslach Burnout Inventory to quantify burnout, allowing for cross-study (and cross-country) comparisons. Emergency medicine has burnout levels in excess of 60% compared with physicians in general (38%). Despite this, most emergency medicine physicians (>60%) are satisfied with their jobs. Both work-related (hours of work, years of practice, professional development activities, non-clinical duties etc.) and non-work-related factors (age, sex, lifestyle factors etc.) are associated with burnout. Despite the heavy burnout rates among emergency medicine physicians, little work has been performed in this field. Factors responsible for burnout among various emergency medicine populations should be determined, and appropriate interventions designed to reduce burnout.

  1. Enhancing physician engagement: an international perspective.

    Science.gov (United States)

    Kaissi, Amer

    2014-01-01

    The purpose of this article is to provide specific recommendations to enhance physician engagement in health care organizations. It summarizes the evidence on physician engagement, drawing on peer-reviewed articles and reports from the gray literature, and suggests an integrative framework to help health care managers better understand and improve physician engagement. While we examine some other international examples and experiences, we mainly focus on physician engagement in Canada, the United States, and the United Kingdom. Physician engagement can be conceptualized as an ongoing two-way social process in which both the individual and organizational/cultural components are considered. Building on several frameworks and examples, we propose a new integrative framework for enhancing physician engagement in health care organizations. We suggest that in order to enhance physician engagement, organizations should focus on the following strategies: developing clear and efficient communication channels with physicians; building trust, understanding, and respect with physicians; and identifying and developing physician leaders. We propose that the time is now for health care managers to set aside traditional differences and historical conflicts and to engage their physicians for the betterment of their organizations.

  2. Physicians' attitudes about their professional appearance.

    Science.gov (United States)

    Gjerdingen, D K; Simpson, D E

    1989-01-01

    Thirty-five residents and 77 staff physicians from three residency programs in Minnesota and Wisconsin completed questionnaires about their attitudes toward various components of the physician's appearance. Most participants showed positive responses to traditional physician attire such as white coat, name tag, shirt and tie, dress pants, skirt or dress, nylons, and dress shoes. Negative responses were associated with casual items such as sandals, clogs, athletic shoes, scrub suits, and blue jeans. Cronbach's alpha analysis identified four cohesive appearance scales: traditional male appearance, casual male appearance, traditional female appearance, and casual female appearance. Older physician participants favored a more traditional appearance than did younger physicians, and of the physicians who were 35 years and younger, staff physicians tended to show more conservative views toward professional appearance than did residents.

  3. Recovering fraudulent claims for Australian federal expenditure on pharmaceuticals and medical devices.

    Science.gov (United States)

    Faunce, Thomas; Urbas, Gregor; Skillen, Lesley; Smith, Marc

    2010-12-01

    The Australian Federal Government expends increasingly large amounts of money on pharmaceuticals and medical devices. It is likely, given government experience in other jurisdictions, that a significant proportion of this expenditure is paid as a result of fraudulent claims presented by corporations. In the United States, legislation such as the False Claims Act 1986 (US), the Fraud Enforcement and Recovery Act 2009 (US), the Stark (Physician Self-Referral) Statute 1995 (US), the Anti-Kickback Statute 1972 (US), the Food, Drug and Cosmetic Act 1938 (US), the Social Security Act 1965 (US), and the Patient Protection and Affordable Care Act 2010 (US) has created systematic processes allowing the United States Federal Government to recover billions of dollars in fraudulently made claims in the health and procurement areas. The crucial component involves the creation of financial incentives for information about fraud to be revealed from within the corporate sector to the appropriate state officials. This article explores the opportunities for creating a similar system in Australia in the health care setting.

  4. 48 CFR 32.1105 - Assignment of claims.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Assignment of claims. 32... CONTRACTING REQUIREMENTS CONTRACT FINANCING Electronic Funds Transfer 32.1105 Assignment of claims. The use of EFT payment methods is not a substitute for a properly executed assignment of claims in accordance...

  5. 40 CFR 307.21 - Nature of eligible claims.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 27 2010-07-01 2010-07-01 false Nature of eligible claims. 307.21... Nature of eligible claims. (a) Claims may be asserted against the Fund for necessary costs incurred for... nature, differing materially from those ordinarily encountered and generally recognized as inherent...

  6. 76 FR 44504 - Claims for Patent and Copyright Infringement

    Science.gov (United States)

    2011-07-26

    ... SPACE ADMINISTRATION 14 CFR Part 1245 RIN 2700-AD63 Claims for Patent and Copyright Infringement AGENCY... considers necessary to file a claim for patent or copyright infringement, and they also provide for written... Act (51 U.S.C. 20113) authorizes the Administrator of NASA to settle administrative claims of...

  7. 32 CFR 1636.2 - The claim of conscientious objection.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false The claim of conscientious objection. 1636.2 Section 1636.2 National Defense Other Regulations Relating to National Defense SELECTIVE SERVICE SYSTEM CLASSIFICATION OF CONSCIENTIOUS OBJECTORS § 1636.2 The claim of conscientious objection. A claim...

  8. 19 CFR 191.0a - Claims filed under NAFTA.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Claims filed under NAFTA. 191.0a Section 191.0a Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) DRAWBACK § 191.0a Claims filed under NAFTA. Claims for drawback filed under the...

  9. 20 CFR 362.10 - Principal types of claims allowable.

    Science.gov (United States)

    2010-04-01

    ... which the loss or damage occurred: (1) In a common or natural disaster; (2) When the property was... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Principal types of claims allowable. 362.10... PROCEDURES EMPLOYEES' PERSONAL PROPERTY CLAIMS § 362.10 Principal types of claims allowable. (a) In...

  10. 33 CFR 211.22 - Real estate Claims Officers.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Real estate Claims Officers. 211..., DEPARTMENT OF DEFENSE REAL ESTATE ACTIVITIES OF THE CORPS OF ENGINEERS IN CONNECTION WITH CIVIL WORKS PROJECTS Real Estate Claims § 211.22 Real estate Claims Officers. In each Division Office the Division...

  11. 42 CFR 431.972 - Claims sampling procedures.

    Science.gov (United States)

    2010-10-01

    ... Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Estimating Improper Payments in Medicaid and CHIP § 431.972 Claims sampling procedures. (a) Claims universe... been if the claim had not been denied) through Title XIX (Medicaid) or Title XXI (CHIP). (2) The State...

  12. 9 CFR 56.6 - Presentation of claims for indemnity.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Presentation of claims for indemnity. 56.6 Section 56.6 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... LOW PATHOGENIC AVIAN INFLUENZA § 56.6 Presentation of claims for indemnity. Claims for the...

  13. 9 CFR 52.4 - Presentation of claims.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Presentation of claims. 52.4 Section 52.4 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF... PSEUDORABIES § 52.4 Presentation of claims. (a) When swine have been destroyed under § 52.2(a), any claim...

  14. 24 CFR 200.153 - Presentation of claim.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Presentation of claim. 200.153 Section 200.153 Housing and Urban Development Regulations Relating to Housing and Urban Development... Claims for Losses § 200.153 Presentation of claim. In the event the insured lender is entitled under...

  15. 49 CFR 378.4 - Documentation of claims.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Documentation of claims. 378.4 Section 378.4... Documentation of claims. (a) Claims for overcharge, duplicate payment, or overcollection shall be accompanied by... provide sufficient information and documentation to allow a carrier to conduct an investigation and pay...

  16. 42 CFR 430.40 - Deferral of claims for FFP.

    Science.gov (United States)

    2010-10-01

    ... accordance with 45 CFR part 16. ... 42 Public Health 4 2010-10-01 2010-10-01 false Deferral of claims for FFP. 430.40 Section 430.40... Medicaid Payments § 430.40 Deferral of claims for FFP. (a) Requirements for deferral. Payment of a claim...

  17. 77 FR 44155 - Administration of Mining Claims and Sites

    Science.gov (United States)

    2012-07-27

    ... (BLM) is issuing this rule to amend regulations on locating, recording, and maintaining mining claims... locate new placer mining claims; and Publishing the regulations in final form gives time to placer mining... regulation, a claimant who records a new 66-acre placer mining claim must pay an initial maintenance fee of...

  18. Truthiness and Falsiness of Trivia Claims Depend on Judgmental Contexts

    Science.gov (United States)

    Newman, Eryn J.; Garry, Maryanne; Unkelbach, Christian; Bernstein, Daniel M.; Lindsay, D. Stephen; Nash, Robert A.

    2015-01-01

    When people rapidly judge the truth of claims presented with or without related but nonprobative photos, the photos tend to inflate the subjective truth of those claims--a "truthiness" effect (Newman et al., 2012). For example, people more often judged the claim "Macadamia nuts are in the same evolutionary family as peaches" to…

  19. 15 CFR 2.5 - Adjudication and settlement of claims.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Adjudication and settlement of claims. 2.5 Section 2.5 Commerce and Foreign Trade Office of the Secretary of Commerce PROCEDURES FOR... claims. (a) Upon receipt of a claim by the Assistant General Counsel for Finance and Litigation, the...

  20. 38 CFR 17.114 - Submittal of claim for reimbursement.

    Science.gov (United States)

    2010-07-01

    ... amount of reimbursement claimed on each article of personal effects is not in excess of the fair value... MEDICAL Reimbursement for Loss by Natural Disaster of Personal Effects of Hospitalized Or Nursing Home Patients § 17.114 Submittal of claim for reimbursement. The claim for reimbursement for personal...

  1. 13 CFR 142.3 - What is a claim?

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false What is a claim? 142.3 Section 142.3 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION PROGRAM FRAUD CIVIL REMEDIES ACT REGULATIONS Overview and Definitions § 142.3 What is a claim? (a) Claim means any request, demand,...

  2. 32 CFR 842.6 - Signature on the claim form.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 6 2010-07-01 2010-07-01 false Signature on the claim form. 842.6 Section 842.6... ADMINISTRATIVE CLAIMS General Information § 842.6 Signature on the claim form. The claimant or authorized agent... authorized agent signing for a claimant shows, after the signature, the title or capacity and...

  3. Gender, family status and physician labour supply.

    Science.gov (United States)

    Wang, Chao; Sweetman, Arthur

    2013-10-01

    With the increasing participation of women in the physician workforce, it is important to understand the sources of differences between male and female physicians' market labour supply for developing effective human resource policies in the health care sector. Gendered associations between family status and physician labour supply are explored in the Canadian labour market, where physicians are paid according to a common fee schedule and have substantial discretion in setting their hours of work. Canadian 1991, 1996, 2001 and 2006 twenty percent census files with 22,407 physician observations are used for the analysis. Although both male and female physicians have statistically indistinguishable hours of market work when never married and without children, married male physicians have higher market hours, and their hours are unchanged or increased with parenthood. In contrast, female physicians have lower market hours when married, and much lower hours when a parent. Little change over time in these patterns is observed for males, but for females two offsetting trends are observed: the magnitude of the marriage-hours effect declined, whereas that for motherhood increased. Preferences and/or social norms induce substantially different labour market outcomes. In terms of work at home, the presence of children is associated with higher hours for male physicians, but for females the hours increase is at least twice as large. A male physician's spouse is much less likely to be employed, and if employed, has lower market hours in the presence of children. In contrast, a female physician's spouse is more likely to be employed if there are three or more children. Both male and female physicians have lower hours of work when married to another physician. Overall, there is no gender difference in physician market labour supply after controlling for family status and demographics.

  4. [Are American physicians more satisfied?--results from an International Study of Physicians in University Hospitals].

    Science.gov (United States)

    Janus, K; Amelung, V E; Baker, L C; Gaitanides, M; Rundall, T G; Schwartz, F W

    2009-04-01

    Understanding the factors that affect physicians' job satisfaction is important not only to physicians themselves, but also to patients, health system managers, and policy makers. Physicians represent the crucial resource in health-care delivery. In order to enhance efficiency and quality in health care, it is indispensable to analyse and consider the motivators of physicians. Physician job satisfaction has significant effects on productivity, the quality of care, and the supply of physicians. The purpose of our study was to assess the associations between work-related monetary and non-monetary factors and physicians' work satisfaction as perceived by similar groups of physicians practicing at academic medical centres in Germany and the U.S.A., two countries that, in spite of differing health-care systems, simultaneously experience problems in maintaining their physician workforce. We used descriptive statistics, factor and correlation analyses to evaluate physicians' responses to a self-administered questionnaire. Our study revealed that overall German physicians were less satisfied than U.S. physicians. With respect to particular work-related predictors of job satisfaction we found that similar factors contributed to job satisfaction in both countries. To improve physicians' satisfaction with working conditions, our results call for the implementation of policies that reduce the time burden on physicians to allow more time for interaction with patients and colleagues, increase monetary incentives, and enhance physicians' participation in the development of care management processes and in managerial decisions that affect patient care.

  5. Adding flexibility to physician training.

    Science.gov (United States)

    Mahady, Suzanne E

    2011-05-02

    Demographic changes among junior doctors are driving demand for increased flexibility in advanced physician training, but flexible training posts are lacking. Suitable flexible training models include flexible full-time, job-share and part-time positions. Major barriers to establishing flexible training positions include difficulty in finding job-share partners, lack of funding for creating supernumerary positions, and concern over equivalence of educational quality compared with full-time training. Pilot flexible training positions should be introduced across the medical specialties and educational outcomes examined prospectively.

  6. A reflection of the coding of meaning in patient-physician interaction: Jürgen Habermas' theory of communication applied to sequence analysis.

    Science.gov (United States)

    Skirbekk, Helge

    2004-08-01

    This paper introduces parts of Jürgen Habermas' theory of communication in an attempt to understand how meaning is coded in patient-physician communication. By having a closer look at how patients and physicians make assertions with their utterances, light will be shed on difficult aspects of reaching understanding in the clinical encounter. Habermas' theory will be used to differentiate assertions into validity claims referring to truth, truthfulness and rightness. An analysis of hypothetical physician-replies to a patient suffering from back pains will substantiate the necessity for such a theory.

  7. 77 FR 65631 - Retrospective Review Under E.O. 13563: Seamen's Claims; Admiralty Extension Act Claims; and...

    Science.gov (United States)

    2012-10-30

    ... process to more effectively address claims arising under the Suits in Admiralty Act, the Admiralty... added regulations implement a process to resolve administrative claims arising under the Admiralty... clarification of its regulations pertaining to seamen's claims, administrative action taken against MarAd, and...

  8. Older Male Physicians Have Lower Risk of Trochanteric but Not Cervical Hip Fractures

    Directory of Open Access Journals (Sweden)

    Hsiu-Nien Shen

    2015-02-01

    Full Text Available Background: Osteoporosis is pathophysiologically related to trochanteric fractures, and this condition is more preventable by lifestyle modifications than cervical fractures. We investigated whether older physicians, who are health-conscious people, are at a lower risk of hip fractures because of fewer trochanteric fractures. Methods: Data regarding older (≥65 years physicians (n = 4303 and matched non-medical persons (control were retrieved from Taiwan’s National Health Insurance claims. All of the subjects were obtained from NHIRD with index dates from 1 January 2000 to 31 December 2008. Cox proportional hazard and competing risk regression models were established to estimate the hazard ratio (HR of hip fracture associated with older physicians. Results: The incidence rates of trochanteric fractures were lower in older physicians than in controls (1.73 and 3.07 per 1000 person-years, respectively, whereas the rates of cervical fractures were similar between the two groups (2.45 and 2.12 per 1000 person-years, respectively. Older physicians yielded 46% lower hazard of trochanteric fractures than controls (adjusted HR 0.54, 95% confidence interval 0.37–0.79; by contrast, hazards of cervical fractures were comparable between the two groups. The HRs estimated from the competing risk models remained unchanged. Conclusions: Our findings indicated that health risk awareness may pose a significant preventive effect on trochanteric hip fractures.

  9. Factors affecting the opinions of family physicians regarding generic drugs – a questionnaire based study

    Directory of Open Access Journals (Sweden)

    Pawel Lewek

    2014-12-01

    Full Text Available A range of factors are believed to exert a negative influence on opinions of physicians about generic drugs.The aim of this study was to survey the opinions of primary care doctors on generics, and determine the factors which may affect them. A questionnaire comprising thirty eight questions was distributed among primary care doctors working in seventy out-patient clinics of the Lodzkie province, Poland, during the period of January 1, 2010 – December 31, 2010. A total of170 of 183 participants completed the survey (average age 48.5; 70.0% women: a 92.9%response rate. While 38.8% of physicians claimed that generics were worse than brand name drugs, 54.1% considered them to be better. However, 36.5% of the doctors did not choose generics for their own use. Two key opinions were identified among the responses concerning the effectiveness of generic drugs: use of generic drugs by the physician (p<0.001, and their opinion that pharmacists do inform patients about generic drugs (p<0.05. Although existing evidence confirms that generic and brand name drugs are equally effective, many physicians doubt this, which prevents them from being used as cost effective drug therapy. In order to increase healthcare savings through the use of generics, these factors should be addressed: for example, convincing a physician to adopt generics for personal use may be an efficient way to support more cost effective treatment of his patients.

  10. Factors affecting the opinions of family physicians regarding generic drugs--a questionnaire based study.

    Science.gov (United States)

    Lewek, Pawel; Smigielski, Janusz; Kardas, Przemyslaw

    2014-12-17

    A range of factors are believed to exert a negative influence on opinions of physicians about generic drugs.The aim of this study was to survey the opinions of primary care doctors on generics, and determine the factors which may affect them. A questionnaire comprising thirty eight questions was distributed among primary care doctors working in seventy out-patient clinics of the Lodzkie province, Poland, during the period of January 1, 2010 - December 31, 2010. A total of 170 of 183 participants completed the survey (average age 48.5; 70.0% women): a 92.9% response rate. While 38.8% of physicians claimed that generics were worse than brand name drugs, 54.1% considered them to be better. However, 36.5% of the doctors did not choose generics for their own use. Two key opinions were identified among the responses concerning the effectiveness of generic drugs: use of generic drugs by the physician (pgeneric drugs (pgeneric and brand name drugs are equally effective, many physicians doubt this, which prevents them from being used as cost effective drug therapy. In order to increase healthcare savings through the use of generics, these factors should be addressed: for example, convincing a physician to adopt generics for personal use may be an efficient way to support more cost effective treatment of his patients.

  11. From community to commodity: the ethics of pharma-funded social networking sites for physicians.

    Science.gov (United States)

    Landa, Amy Snow; Elliott, Carl

    2013-01-01

    A growing number of doctors in the United States are joining online professional networks that cater exclusively to licensed physicians. The most popular are Sermo, with more than 135,000 members, and Doximity, with more than 100,000. Both companies claim to offer a valuable service by enabling doctors to "connect" in a secure online environment. But their business models raise ethical concerns. The sites generate revenue by selling access to their large networks of physician-users to clients that include global pharmaceutical companies, market research and consulting firms, and hedge funds and other investors. In exchange for a fee, these clients are offered a variety of tools to monitor, analyze, and solicit physicians' opinions. In Sermo's case, clients are also offered opportunities to conduct "awareness campaigns" on the site that are aimed at influencing physician sentiment about specific drugs and medical devices. In effect, these online networks have created an even more efficient means for the pharmaceutical industry to track physician sentiment, disseminate messages, and cultivate key opinion leaders. This paper argues that the dual nature of these sites (a) undermines their integrity and transparency as forums for the exchange of medical opinion and (b) presents an ethical conflict for the doctors who use them.

  12. Workaholism: are physicians at risk?

    Science.gov (United States)

    Rezvani, A; Bouju, G; Keriven-Dessomme, B; Moret, L; Grall-Bronnec, M

    2014-09-01

    Work addiction (WA), often called 'workaholism', is a relatively recent concept that has not yet been clearly defined. Ongoing studies have found prevalence rates that are highly variable due to the diversity of the models used and the populations studied. To assess the characteristics of WA among hospital medical staff. All physicians practising at a French university hospital were invited to participate in a survey based on two questionnaires: the Work Addiction Risk Test (WART) for WA and the Job Contents Questionnaire (JCQ) to assess psychosocial constraints at work. There were 444 responding physicians. The response rate was 45%. Thirteen per cent of respondents were considered to be highly work addicted and a further 35% were considered mildly work addicted. Professors had the highest average WART score, but neither age nor sex was associated with WA. Furthermore, all 3D scores obtained using the JCQ correlated with the WART score; the highest correlation coefficient being obtained between the WART score and the job demands score, indicating that workaholics experienced high job demands. WA especially affects professors, who have the highest status amongst doctors in the hospital hierarchy. This study highlights the importance of constraints and workload, which are consistent with individual vulnerability factors. These factors may help identify ways of preventing and managing this type of addiction, through improvement of working conditions and organizational structures. © The Author 2014. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  13. Developing Physician Migration Estimates for Workforce Models.

    Science.gov (United States)

    Holmes, George M; Fraher, Erin P

    2017-02-01

    To understand factors affecting specialty heterogeneity in physician migration. Physicians in the 2009 American Medical Association Masterfile data were matched to those in the 2013 file. Office locations were geocoded in both years to one of 293 areas of the country. Estimated utilization, calculated for each specialty, was used as the primary predictor of migration. Physician characteristics (e.g., specialty, age, sex) were obtained from the 2009 file. Area characteristics and other factors influencing physician migration (e.g., rurality, presence of teaching hospital) were obtained from various sources. We modeled physician location decisions as a two-part process: First, the physician decides whether to move. Second, conditional on moving, a conditional logit model estimates the probability a physician moved to a particular area. Separate models were estimated by specialty and whether the physician was a resident. Results differed between specialties and according to whether the physician was a resident in 2009, indicating heterogeneity in responsiveness to policies. Physician migration was higher between geographically proximate states with higher utilization for that specialty. Models can be used to estimate specialty-specific migration patterns for more accurate workforce modeling, including simulations to model the effect of policy changes. © Health Research and Educational Trust.

  14. Medical informed consent: general considerations for physicians.

    Science.gov (United States)

    Paterick, Timothy J; Carson, Geoff V; Allen, Marjorie C; Paterick, Timothy E

    2008-03-01

    Medical informed consent is essential to the physician's ability to diagnose and treat patients as well as the patient's right to accept or reject clinical evaluation, treatment, or both. Medical informed consent should be an exchange of ideas that buttresses the patient-physician relationship. The consent process should be the foundation of the fiduciary relationship between a patient and a physician. Physicians must recognize that informed medical choice is an educational process and has the potential to affect the patient-physician alliance to their mutual benefit. Physicians must give patients equality in the covenant by educating them to make informed choices. When physicians and patients take medical informed consent seriously, the patient-physician relationship becomes a true partnership with shared decision-making authority and responsibility for outcomes. Physicians need to understand informed medical consent from an ethical foundation, as codified by statutory law in many states, and from a generalized common-law perspective requiring medical practice consistent with the standard of care. It is fundamental to the patient-physician relationship that each partner understands and accepts the degree of autonomy the patient desires in the decision-making process.

  15. Physician-Organization Collaboration Reduces Physician Burnout and Promotes Engagement: The Mayo Clinic Experience.

    Science.gov (United States)

    Swensen, Stephen; Kabcenell, Andrea; Shanafelt, Tait

    2016-01-01

    The process of creating healthy organization-physician relationships is critical to organizational success. Partnerships in process improvement can nurture these relationships and mitigate burnout by meeting physicians' psychological needs. To flourish, physicians need some degree of choice (control over their lives), camaraderie (social connectedness), and an opportunity for excellence (being part of something meaningful). Organizations can provide these opportunities by establishing constructive organization-physician relationships and developing physician leaders. We present a case study from the Mayo Clinic that supports the foundational principles of a physician-engagement model. We developed the Listen-Act-Develop model as an integrated strategy to reduce burnout and engage physicians in the mission of the organization. The intent of the model is to maximize physician wellness by fostering engagement and mitigating the drivers of burnout. This model provides a path to increase physician satisfaction and meaning in work and to improve organizational effectiveness.

  16. The problem of the possible rationality of suicide and the ethics of physician-assisted suicide.

    Science.gov (United States)

    Wittwer, Héctor

    2013-01-01

    Opponents of the legalization of physician assisted suicide (PAS) often claim that physicians must not give a helping hand to suicidal patients because (i) it is morally forbidden to help somebody to carry out an action which is inherently irrational and which will probably cause him severe harm, and (ii) the act of self-killing is necessarily irrational and self-harming. The article focuses on the second premise of this paternalistic argument against the moral permissibility of PAS and its legalization. First, it is shown that this premise can be understood in two ways, depending on whether the predicate "irrational" is taken to refer to a human being's lack of the capacity to decide and act rationally or irrationally, or to the property of the decision to end one's life. Whereas the first variant of the premise stating that all suicidal individuals lack the capacity to act rationally can only be verified or falsified by empirical studies, the second assumption is a normative one which only philosophy can deal with. Restated in another way, it says that is always rationally forbidden to kill oneself because the decision to end one's own life is necessarily irrational. The five arguments which have been brought forward to justify this claim are analyzed and criticized. It is argued that there is no valid argument for the necessary irrationality of suicide. Hence, the claim that PAS is morally forbidden and, therefore, ought not to be legalized cannot rest on that premise.

  17. HMO strategies for managing workers' compensation claims.

    Science.gov (United States)

    Gallagher, P A

    1996-03-01

    Health maintenance organizations (HMOs) have become very active in managing workers' compensation medical expense benefits. A survey of 316 HMOs shows that this activity takes the form of various network models and a range of services--such as utilization review and case management--that may not be linked to a provider network. Of the HMOs surveyed, 78 reported that, by using managed care services and provider discounts, they were able to save from 20 percent to 30 percent on occupational health claim costs.

  18. Association Claims in the Sequencing Era

    Directory of Open Access Journals (Sweden)

    Sara L. Pulit

    2014-03-01

    Full Text Available Since the completion of the Human Genome Project, the field of human genetics has been in great flux, largely due to technological advances in studying DNA sequence variation. Although community-wide adoption of statistical standards was key to the success of genome-wide association studies, similar standards have not yet been globally applied to the processing and interpretation of sequencing data. It has proven particularly challenging to pinpoint unequivocally disease variants in sequencing studies of polygenic traits. Here, we comment on a number of factors that may contribute to irreproducible claims of association in scientific literature and discuss possible steps that we can take towards cultural change.

  19. Bargaining with Claims in Economic Environments

    OpenAIRE

    Herrero, Carmen

    1998-01-01

    In this paper a reconstruction of the theory of bargaining with claims in economic environments is addressed. The spirit of that reconstruction is similar to that of the standard bargaining theory made by Roemer. En este trabajo se aborda el problema de la reconstrucción de la teoría de negociación con derechos en entornos económicos. El espíritu de la reconstrucción y las técnicas son semejantes a las de Roemer para el problema clásico de negociación.

  20. Women Claimed Right to participate in Government

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    In the early 1900s, when Western women were just starting to fight for their rights to participate in government and political affairs, China’s women, who had just broken away from a feudal monarchy, also claimed that they wanted to participate in government and political affairs.In 1912, the Revolution of 1911, led by Sun Yat-sen-pioneer of China’s democratic revolution-overthrew the last feudal monarchy and the bourgeois Republic of China was founded. The women following sun Yat-sen were to put into action their demand to participate in government and political affairs.

  1. USAGE OF FOOD HEALTH CLAIMS AND RELATED CONSUMER UNDERSTANDING

    Directory of Open Access Journals (Sweden)

    Naima KHURSHID

    2014-11-01

    Full Text Available Very few studies in various countries have been conducted in the context of effect of food health claims onto consumer health and purchase behavior. Health claim messages vary from country to country; but overall consumers view these claims as useful. Generally it is observed that consumers prefer short and concise health claim messages as compared to more long and complex ones. Moreover consumers are of the viewpoint that health claims are more effective if supported and approved by government. Foods with health claims are viewed healthier by consumers, but in some cases consumers may get discouraged by health claims when they are unable to properly comprehend the intended message of nutrition claims. Consumers remain vague between distinguishing health claims, content and structure-function of nutrients. Furthermore there is past evidence that in few instances consumers have improved their dietary choices and knowledge regarding health concern because of use of health claims by manufacturers and governing bodies. This study is a review of contemporary health claim practices in the global upfront.

  2. Impact of corporate social responsibility claims on consumer food choice

    DEFF Research Database (Denmark)

    Mueller Loose, Simone; Remaud, Hervé

    2013-01-01

    Purpose - The study assesses the impact of two different corporate social responsibility (CSR) claims, relating to social and environmental dimensions, on consumers’ wine choice across international markets. It is analysed how point of purchase CSR claims compete with other food claims...... and their awareness, penetration and consumers’ trust are examined. Design/methodology/approach - A discrete choice experiment with a visual shelf simulation was used to elicit consumer preferences and to estimate marginal willingness to pay for CSR and other food claims across the UK, France, Germany, the US...... food categories and different origins. Practical implications - CSR claims are competing with existing food claims and have a lower awareness, lower purchase penetration and less positive impact on consumer choice than organic claims. Producers are recommended to focus on communicating environmental...

  3. Impact of corporate social responsibility claims on consumer food choice

    DEFF Research Database (Denmark)

    Mueller Loose, Simone; Remaud, Hervé

    2013-01-01

    Purpose - The study assesses the impact of two different corporate social responsibility (CSR) claims, relating to social and environmental dimensions, on consumers’ wine choice across international markets. It is analysed how point of purchase CSR claims compete with other food claims...... a higher marginal willingness to pay. Consumer valuation of CSR claims significantly differs across international markets, but is consistently lower than for organic claims. Research limitations/implications - The study was limited to wine and future research is required to generalise findings to other...... rather than social CSR activities. The relative value of CSR claims differs across countries and companies need to adapt their strategies to specific market conditions. Originality/value - This is the first cross-national study that analyses the impact of CSR claims on consumer food choice relative...

  4. Health claims in Europe: probiotics and prebiotics as case examples.

    Science.gov (United States)

    van Loveren, Henk; Sanz, Yolanda; Salminen, Seppo

    2012-01-01

    Health claims regarding foods imply a relationship between a specific food and maintenance of good health, or that food can reduce the risk of disease. Health claim legislation in the European Union sets out from the concept of consumer protection. Health claim assessment focuses on defining given foods, assessing their health relationship, and evaluating relevant studies with an emphasis on controlled human intervention research. Challenges include the focus of claims on healthy populations, although most intervention studies have been conducted among patients. A further problem attends the risk reduction claim, which requires changes in generally accepted biomarkers reflecting the risk of disease. Scientific assessment and guidance documents direct the development of health claims both in Europe and elsewhere. Experience from completed assessments should make it possible to provide consumers with reliable claims to help them make healthier choices and develop lifestyles supporting long-term well-being.

  5. Physician-Assisted Dying: Acceptance by Physicians Only for Patients Close to Death.

    Science.gov (United States)

    Zenz, Julia; Tryba, Michael; Zenz, Michael

    2014-12-01

    This study reports on German physicians' views on legalization of euthanasia and physician-assisted suicide, comparing this with a similar survey of UK doctors. A questionnaire was handed out to attendants of a palliative care and a pain symposium. Complete answers were obtained from 137 physicians. Similar to the UK study, about 30% of the physicians surveyed support euthanasia in case of terminal illness and more support physician-assisted suicide. In contrast, in both countries, a great majority of physicians oppose medical involvement in hastening death in non-terminal illnesses. The public and parliamentary discussion should face this opposition to assisted suicide by pain and palliative specialists.

  6. Conscientious objection, barriers, and abortion in the case of rape: a study among physicians in Brazil.

    Science.gov (United States)

    Diniz, Debora; Madeiro, Alberto; Rosas, Cristião

    2014-05-01

    In Brazil, to have a legal abortion in the case of rape, the woman's statement that rape has occurred is considered sufficient to guarantee the right to abortion. The aim of this study was to understand the practice and opinions about providing abortion in the case of rape among obstetricians-gynecologists (OBGYNs) in Brazil. A mixed-method study was conducted from April to July 2012 with 1,690 OBGYNs who responded to a structured, electronic, self-completed questionnaire. In the quantitative phase, 81.6% of the physicians required police reports or judicial authorization to guarantee the care requested. In-depth telephone interviews with 50 of these physicians showed that they frequently tested women's rape claim by making them repeat their story to several health professionals; 43.5% of these claimed conscientious objection when they were uncertain whether the woman was telling the truth. The moral environment of illegal abortion alters the purpose of listening to a patient - from providing care to passing judgement on her. The data suggest that women's access to legal abortion is being blocked by these barriers in spite of the law. We recommend that FEBRASGO and the Ministry of Health work together to clarify to physicians that a woman's statement that rape occurred should allow her to access a legal abortion.

  7. [Legal aspects of medical expert testimony and non-economic damage in civil liability of physician].

    Science.gov (United States)

    Pauković, Hrvoje

    2008-01-01

    In the establishment of civil liability of physicians for damage caused, it is extremely important to establish all relevant facts for the court to render the appropriate verdict. One of the crucial instruments in the establishment of a presumed civil liability of physicians as well as in the establishment of the criteria for the assessment of a proper award, is the medical expert testimony--utilised as an essential proof. The comprehension of medical and legal professionals' replies to questions which every profession must answer in order to provide an objective access to the claim and a right and full establishment of the factual situation, is the imperative for a correct application of the law in the handling and settling of these claims, especially in the light of the new set up of the concept of non-economic damage. The medical and legal profession shall help placing the problems of civil liability of physicians into real frameworks, preventing any attempts of unnecessary stigmatization of medical profession and cases of unjustified and unfounded indemnification, and it shall objectively and professionally, based on the law, enable a full and absolute protection of patients and third parties and their rights to physical and mental health.

  8. Physician communication in the operating room.

    Science.gov (United States)

    Kirschbaum, Kristin A; Rask, John P; Fortner, Sally A; Kulesher, Robert; Nelson, Michael T; Yen, Tony; Brennan, Matthew

    2015-01-01

    In this study, communication research was conducted with multidisciplinary groups of operating-room physicians. Theoretical frameworks from intercultural communication and rhetoric were used to (a) measure latent cultural communication variables and (b) conduct communication training with the physicians. A six-step protocol guided the research with teams of physicians from different surgical specialties: anesthesiologists, general surgeons, and obstetrician-gynecologists (n = 85). Latent cultural communication variables were measured by surveys administered to physicians before and after completion of the protocol. The centerpiece of the 2-hour research protocol was an instructional session that informed the surgical physicians about rhetorical choices that support participatory communication. Post-training results demonstrated scores increased on communication variables that contribute to collaborative communication and teamwork among the physicians. This study expands health communication research through application of combined intercultural and rhetorical frameworks, and establishes new ways communication theory can contribute to medical education.

  9. Views of United States Physicians and Members of the American Medical Association House of Delegates on Physician-assisted Suicide.

    Science.gov (United States)

    Whitney, Simon N.; Brown, Byron W.; Brody, Howard; Alcser, Kirsten H.; Bachman, Jerald G.; Greely, Henry T.

    2001-01-01

    Ascertained the views of physicians and physician leaders toward legalization of physician-assisted suicide. Results indicated members of AMA House of Delegates strongly oppose physician-assisted suicide, but rank-and-file physicians show no consensus either for or against its legalization. Although the debate is adversarial, most physicians are…

  10. The PMA Scale: A Measure of Physicians' Motivation to Adopt Medical Devices.

    Science.gov (United States)

    Hatz, Maximilian H M; Sonnenschein, Tim; Blankart, Carl Rudolf

    2017-04-01

    Studies have often stated that individual-level determinants are important drivers for the adoption of medical devices. Empirical evidence supporting this claim is, however, scarce. At the individual level, physicians' adoption motivation was often considered important in the context of adoption decisions, but a clear notion of its dimensions and corresponding measurement scales is not available. To develop and subsequently validate a scale to measure the motivation to adopt medical devices of hospital-based physicians. The development and validation of the physician-motivation-adoption (PMA) scale were based on a literature search, internal expert meetings, a pilot study with physicians, and a three-stage online survey. The data collected in the online survey were analyzed using exploratory factor analysis (EFA), and the PMA scale was revised according to the results. Confirmatory factor analysis (CFA) was conducted to test the results from the EFA in the third stage. Reliability and validity tests and subgroup analyses were also conducted. Overall, 457 questionnaires were completed by medical personnel of the National Health Service England. The EFA favored a six-factor solution to appropriately describe physicians' motivation. The CFA confirmed the results from the EFA. Our tests indicated good reliability and validity of the PMA scale. This is the first reliable and valid scale to measure physicians' adoption motivation. Future adoption studies assessing the individual level should include the PMA scale to obtain more information about the role of physicians' motivation in the broader adoption context. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Variation in long-term antipsychotic polypharmacy and high-dose prescribing across physicians and hospitals.

    Science.gov (United States)

    Latimer, Eric A; Naidu, Adonia; Moodie, Erica E M; Clark, Robin E; Malla, Ashok K; Tamblyn, Robyn; Wynant, Willy

    2014-10-01

    This study had two aims: to measure the prevalence of long-term prescribing of high doses of antipsychotics and antipsychotic polypharmacy in a large Canadian province and to estimate the relative contributions of patient-, physician-, and hospital-level factors. Government hospital discharge, physician, and pharmaceutical claims data were linked to identify individuals with schizophrenia who in 2004 had antipsychotics available to them for at least 11 months. Individuals on a high dose throughout that period, as well as individuals on multiple concurrent antipsychotics (polypharmacy), were identified. Logistic and generalized linear mixed models using patient-, physician-, and hospital-level predictors were estimated. Among the 12,150 individuals identified, 11.9% were on a high dose and 10.4% on antipsychotic polypharmacy continually, with 3.7% in both groups. After adjustment for potential confounders, analyses showed that systematic propensity for physicians to prescribe high doses accounted for 10.9% of the remaining unexplained variance, and physicians as a group who prescribed high doses across a hospital or psychiatry department accounted for 3.0%. For antipsychotic polypharmacy the corresponding percentages were 9.7% and 6.2%. Even after adjustment, the variation in high-dose prescribing and antipsychotic polypharmacy remained substantial. Long-term high-dose and antipsychotic polypharmacy prescribing appeared partly driven by some physicians' and some hospitals' propensities to prescribe in this way independently of patient characteristics. Given the weight of the evidence against high-dose prescribing and antipsychotic polypharmacy, measures addressed to physicians and hospitals most likely to prescribe high doses, antipsychotic polypharmacy, or both should be considered.

  12. Updates on nutrition and health claims

    Directory of Open Access Journals (Sweden)

    Alejandro Perales-Albert

    2013-12-01

    Full Text Available There is concern about the influence of social determinants related to advertising, communication and information on the selection of food for healthy eating and safe. From this point of view, Spain created the European Regulation 1924/2006 (ER1924/2006, its aim is to ensure and promote access to safe food that benefit health and prevent information received by consumers is inaccurate, ambiguous or misleading. The aims of regulation are to prevent nutritional and attributed health claims to food without reason or if there is sufficient scientific evidence. In this sense, a group of professionals from the University of Alicante in December 2012 performed the First Day of Food and Nutrition, organized by the Center Alinua of the Faculty of Health Sciences, University of Alicante, related to updates on nutrition and health claims and its implications public health.By the interest and importance of this topic, this is a summary of the position papers from agents involved: consumers, government, food business, the gremial’s dietitian, the Academy and public health.

  13. Physician communication coaching effects on patient experience.

    Science.gov (United States)

    Seiler, Adrianne; Knee, Alexander; Shaaban, Reham; Bryson, Christine; Paadam, Jasmine; Harvey, Rohini; Igarashi, Satoko; LaChance, Christopher; Benjamin, Evan; Lagu, Tara

    2017-01-01

    Excellent communication is a necessary component of high-quality health care. We aimed to determine whether a training module could improve patients' perceptions of physician communication behaviors, as measured by change over time in domains of patient experience scores related to physician communication. We designed a comprehensive physician-training module focused on improving specific "etiquette-based" physician communication skills through standardized simulations and physician coaching with structured feedback. We employed a quasi-experimental pre-post design, with an intervention group consisting of internal medicine hospitalists and residents and a control group consisting of surgeons. The outcome was percent "always" scores for questions related to patients' perceptions of physician communication using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey and a Non-HCAHPS Physician-Specific Patient Experience Survey (NHPPES) administered to patients cared for by hospitalists. A total of 128 physicians participated in the simulation. Responses from 5020 patients were analyzed using HCAHPS survey data and 1990 patients using NHPPES survey data. The intercept shift, or the degree of change from pre-intervention percent "always" responses, for the HCAHPS questions of doctors "treating patients with courtesy" "explaining things in a way patients could understand," and "overall teamwork" showed no significant differences between surgical control and hospitalist intervention patients. Adjusted NHPPES percent excellent survey results increased significantly post-intervention for the questions of specified individual doctors "keeping patient informed" (adjusted intercept shift 9.9% P = 0.019), "overall teamwork" (adjusted intercept shift 11%, P = 0.037), and "using words the patient could understand" (adjusted intercept shift 14.8%, p = 0.001). A simulation based physician communication coaching method focused on specific "etiquette

  14. Psychotherapy, a concept for the nonpsychiatric physician.

    Science.gov (United States)

    KAHN, J P

    1962-05-01

    Patients tend to repeat with their physician, as with other significant people in their lives, their earlier previous patterns of behavior. The physician as well as the patient is involved in the physician-patient relationship. He will tend to respond to his patients in accordance with his earlier life experiences and his characteristic repetitive behavioral pattern. For both physician and patient, the relationship between them extends beyond the immediate reality situation. Psychotherapy is the utilization of psychological measures in the treatment of sick persons and the deliberate utilization by the physician of the physician-patient relationship for the benefit of the patient. The kind of psychotherapy that is practical and utilizable by the nonpsychiatric physician is that which uses education, reassurance, support and the management of the patient's problems either directly or indirectly or through the intermediary of other people or agencies. The symbolic aspect of the physician-patient relationship is based essentially on the fact that a sick person, because of his anxiety and because of the threat to his physical and psychic integrity, is more dependent and more anxious than he would be if he were well, and therefore he has a correspondingly greater need for the authoritative and protective figure he finds in the physician. Psychotherapy is not directed exclusively to the treatment of flagrantly or obviously neurotic or psychotic patients. It should be and is directed to all sick persons. Limitations in psychotherapy are set by various determinants, among which are the nature of the precipitating factor in the illness, the nature of the sick person, the skill, knowledge and abilities of the physician, and the nature of the physician-patient relationship. In psychotherapy, as in all medicine, the physician should not do anything which may disturb the patient if the disturbance is of no value or if it cannot be followed through with special skills.

  15. Ethical Principles for Physician Rating Sites

    OpenAIRE

    Strech, Daniel

    2011-01-01

    During the last 5 years, an ethical debate has emerged, often in public media, about the potential positive and negative effects of physician rating sites and whether physician rating sites created by insurance companies or government agencies are ethical in their current states. Due to the lack of direct evidence of physician rating sites’ effects on physicians’ performance, patient outcomes, or the public’s trust in health care, most contributions refer to normative arguments, hypothetical ...

  16. Still on physicians' attitude to medical marijuana

    OpenAIRE

    Olukayode Abayomi; Emmanuel Babalola

    2014-01-01

    Desai and Patel highlighted in a recent review that and ldquo;there are several issues related to medical marijuana, which concern public health such as its medical use, harmful effects, laws and physicians role. and rdquo; Certainly, physician's perspectives and position on the relative harm and benefits of marijuana contribute to the growing controversy over its legalization in western countries. Interestingly, the seeming resistance of physicians in western countries to marijuana prescrip...

  17. Service motives and profit incentives among physicians.

    Science.gov (United States)

    Godager, Geir; Iversen, Tor; Ma, Ching-To Albert

    2009-03-01

    We model physicians as health care professionals who care about their services and monetary rewards. These preferences are heterogeneous. Different physicians trade off the monetary and service motives differently, and therefore respond differently to incentive schemes. Our model is set up for the Norwegian health care system. First, each private practice physician has a patient list, which may have more or less patients than he desires. The physician is paid a fee-for-service reimbursement and a capitation per listed patient. Second, a municipality may obligate the physician to perform 7.5 h/week of community services. Our data are on an unbalanced panel of 435 physicians, with 412 physicians for the year 2002, and 400 for 2004. A physician's amount of gross wealth and gross debt in previous periods are used as proxy for preferences for community service. First, for the current period, accumulated wealth and debt are predetermined. Second, wealth and debt capture lifestyle preferences because they correlate with the planned future income and spending. The main results show that both gross debt and gross wealth have negative effects on physicians' supply of community health services. Gross debt and wealth have no effect on fee-for-service income per listed person in the physician's practice, and positive effects on the total income from fee-for-service. The higher income from fee-for-service is due to a longer patient list. Patient shortage has no significant effect on physicians' supply of community services, a positive effect on the fee-for-service income per listed person, and a negative effect on the total income from fee for service. These results support physician preference heterogeneity.

  18. Teaching Home Environmental Health to Resident Physicians

    OpenAIRE

    Zickafoose, Joseph S.; Greenberg, Stuart; Dorr G Dearborn

    2011-01-01

    Healthy Homes programs seek to integrate the evaluation and management of a multitude of health and safety risks in households. The education of physicians in the identification, evaluation, and management of these home health and safety issues continues to be deficient. Healthy Homes programs represent a unique opportunity to educate physicians in the home environment and stimulate ongoing, specific patient-physician discussions and more general learning about home environmental health. The ...

  19. The physician of the future.

    Science.gov (United States)

    Thomas, E L

    1966-04-09

    The good physician of the future will need to master not only the basic and traditional medical skills but many new concepts and techniques as well. He will need to be, as always, a compassionate and intelligent man. If he is to retain his status as a healer in the eyes of his patients, he will have to be fully aware of what is happening in the social and technological environment, or he will run the risk of being relegated to the position of a high-grade technician.He will have new physical tools and new thinking tools to help him. To understand and use these, and also to understand the technical world of the future, he will need a sound knowledge of the physical sciences and some fluency in the language of modern mathematics.

  20. Literary Library for Physicians (II

    Directory of Open Access Journals (Sweden)

    Fernando A. NAVARRO

    2015-10-01

    Full Text Available The adequate practice of medicine is a difficult job if some intimate and deep feelings of patients, such pain, loneliness, depression and helplessness facing an incurable disease or the fear of dying, are not fully understood. A good way to gain a satisfactory understanding of such feelings might be the reading of the great literary works of all times. In this “Medical library for physicians” an essential list of seventy literary works from the Modern to the Contemporary periods has been collected. Their plot is about the disease, the madness, the hospital, the professionalism and the historical and social images of the physicians. In the second part of the article, a brief review of the last thirty?five books is carried out. It considers from Sinuhe egyptiläinen (1945 by Mika Waltari to Nemesis (1943 by Philip Roth.

  1. Spirituality and the physician executive.

    Science.gov (United States)

    Kaiser, L R

    2000-01-01

    The "s" word can now be spoken without flinching in health care organizations. Spirituality is becoming a common topic in management conferences around the world. Many U.S. corporations are recognizing the role of spirituality in creating a new humanistic capitalism that manages beyond the bottom line. Spirituality refers to a broad set of principles that transcend all religions. It is the relationship between yourself and something larger, such as the good of your patient or the welfare of the community. Spirituality means being in right relationship to all that is and understanding the mutual interdependence of all living beings. Physician executives should be primary proponents of spirituality in their organizations by: Modeling the power of spirituality in their own lives; integrating spiritual methodologies into clinical practice; fostering an integrative approach to patient care; encouraging the organization to tithe its profits for unmet community health needs; supporting collaborative efforts to improve the health of the community; and creating healing environments.

  2. [Comments on the Confucian physician].

    Science.gov (United States)

    Li, Jian-xiang

    2009-09-01

    Confucianism gradually permeated and influenced the development of TCM from the Song dynasty, and the term "Confucian physician" is still in use today. With the impact of Confucianism, whether in the compilation of the medical classics or the explanation and conclusion of the medical theories as well as in medical education and ethics, all developed dramatically. But the Confucianism had also a negative effect on the development of medicine. For example, SU Dong-po cured the epidemics with "Sheng san zi", but he exaggerated its action and recorded it. The later intellectuals learnt from him without differentiation and many people suffered. Another example is, with the influence of ideas of "serve the parents" and "help the public", adult children treated their parents by cutting their own thigh. Even some wealthy and intelligent people blindly applied the prescription without differentiation.

  3. Case reviews in the family physician's office.

    Science.gov (United States)

    Kates, N; Craven, M; Webb, S; Low, J; Perry, K

    1992-02-01

    The majority of patients with emotional or psychiatric disorders are treated in the primary care setting without psychiatric input. Psychiatrists need to find ways of helping family physicians manage these patients without necessarily taking over their care. One way of achieving this is for a psychiatric consultant to visit the family physician's office on a regular basis to discuss the physician's problem cases. This paper describes such a pilot project, outlines the kinds of problems family physicians discussed and recommendations that were made, and discusses the benefits of this collaborative approach.

  4. No exodus: physicians and managed care networks.

    Science.gov (United States)

    O'Malley, Ann S; Reschovsky, James D

    2006-05-01

    After remaining stable since 1996-97, the percentage of U.S. physicians who do not contract with managed care plans rose from 9.2 percent in 2000-01 to 11.5 percent in 2004-05, according to a national study from the Center for Studying Health System Change (HSC). While physicians have not left managed care networks in large numbers, this small but statistically significant increase could signal a trend toward greater out-of-pocket costs for patients and a decline in patient access to physicians. The increase in physicians without managed care contracts was broad-based across specialties and other physician and practice characteristics. Compared with physicians who have one or more managed care contracts, physicians without managed care contracts are more likely to have practiced for more than 20 years, work part time, lack board certification, practice solo or in two-physician groups, and live in the western United States. The study also found substantial variation in the proportion of physicians without managed care contracts across communities, suggesting that local market conditions influence decisions to contract with managed care plans.

  5. Difficulties facing physician mothers in Japan.

    Science.gov (United States)

    Yamazaki, Yuka; Kozono, Yuki; Mori, Ryo; Marui, Eiji

    2011-01-01

    Despite recent increases in the number of female physicians graduating in Japan, their premature resignations after childbirth are contributing to the acute shortage of physicians. Previous Japanese studies have explored supportive measures in the workplace, but have rarely focused on the specific problems or concerns of physician-mothers. Therefore, this study explored the challenges facing Japanese physician-mothers in efforts to identify solutions for their retention. Open-ended questionnaires were mailed to 646 alumnae of Juntendo University School of Medicine. We asked subjects to describe their opinions about 'The challenges related to female physicians' resignations'. Comments gathered from alumnae who graduated between 6 and 30 years ago and have children were analyzed qualitatively. Overall, 249 physicians returned the questionnaire (response rate 38.5%), and 73 alumnae with children who graduated in the stated time period provided comments. The challenges facing physician-mothers mainly consisted of factors associated with Japanese society, family responsibilities, and work environment. Japanese society epitomized by traditional gender roles heightened stress related to family responsibilities and promoted gender discrimination at work environment. Additionally, changing Japanese society positively influenced working atmosphere and husband's support. Moreover, the introduction of educational curriculums that alleviated traditional gender role was proposed for pre- and post- medical students. Traditional gender roles encourage discrimination by male physicians or work-family conflicts. The problems facing female physicians involve more than just family responsibilities: diminishing the notion of gender role is key to helping retain them in the workforce.

  6. Career satisfaction and burnout among Ghanaian physicians.

    Science.gov (United States)

    Opoku, Samuel T; Apenteng, Bettye A

    2014-03-01

    Thus far, there has been limited inquiry into the factors associated with physician career satisfaction and burnout in Ghana, although the two have been linked to the brain drain problem. The objective of this study was to assess career satisfaction and burnout among physicians practicing in a developing nation, Ghana. A 21-item instrument was used to assess career satisfaction among actively practicing Ghanaian physicians, using items adapted from the Physician Worklife Study survey. Burnout was assessed using the Abbreviated Maslach's Burnout Inventory. Two hundred physicians participated in the online survey from December 2012 to February 2013. Generally, physicians in Ghana expressed moderate overall career satisfaction. However, they were least satisfied with the availability of resources, their compensation and work-life balance. Overall, burnout was low in the study population; however physicians exhibited moderate levels of emotional exhaustion. Career satisfaction was negatively associated with the burnout dimensions of depersonalization, emotional exhaustion and low personal accomplishment. Health policy-makers in Ghana should address issues relating to resource adequacy, compensation and the work-life balance of physicians in order to improve the overall career satisfaction of an already dwindling physician workforce.

  7. 32 CFR 536.78 - Settlement authority for claims under the Military Claims Act.

    Science.gov (United States)

    2010-07-01

    ... compensation of federal employees for job-related injuries (see § 536.44), or untimely filing, TJAG or TAJAG... satisfaction of the claim. (6) Authority to further delegate payment authority is set forth in § 536.3(g)(1)...

  8. 77 FR 22204 - Administrative Claims Under the Federal Tort Claims Act and Related Statutes

    Science.gov (United States)

    2012-04-13

    ... addition. II. Background The FTCA surrenders the sovereign immunity of the United States for the negligent... (formerly Sec. 15.4) has been amended to clarify that the $25,000 jurisdictional limit applies to the... amended to clarify that the $25,000 jurisdictional limit applies to the aggregate of claims resulting from...

  9. 77 FR 22236 - Administrative Claims Under the Federal Tort Claims Act and Related Statutes

    Science.gov (United States)

    2012-04-13

    ... addition. II. Background The FTCA surrenders the sovereign immunity of the United States for the negligent... (formerly Sec. 15.4) has been amended to clarify that the $25,000 jurisdictional limit applies to the... amended to clarify that the $25,000 jurisdictional limit applies to the aggregate of claims resulting from...

  10. European consumers and health claims: attitudes, understanding and purchasing behaviour.

    Science.gov (United States)

    Wills, Josephine M; Storcksdieck genannt Bonsmann, Stefan; Kolka, Magdalena; Grunert, Klaus G

    2012-05-01

    Health claims on food products are often used as a means to highlight scientifically proven health benefits associated with consuming those foods. But do consumers understand and trust health claims? This paper provides an overview of recent research on consumers and health claims including attitudes, understanding and purchasing behaviour. A majority of studies investigated selective product-claim combinations, with ambiguous findings apart from consumers' self-reported generic interest in health claims. There are clear indications that consumer responses differ substantially according to the nature of carrier product, the type of health claim, functional ingredient used or a combination of these components. Health claims tend to be perceived more positively when linked to a product with an overall positive health image, whereas some studies demonstrate higher perceived credibility of products with general health claims (e.g. omega-3 and brain development) compared to disease risk reduction claims (e.g. bioactive peptides to reduce risk of heart disease), others report the opposite. Inconsistent evidence also exists on the correlation between having a positive attitude towards products with health claims and purchase intentions. Familiarity with the functional ingredient and/or its claimed health effect seems to result in a more favourable evaluation. Better nutritional knowledge, however, does not automatically lead to a positive attitude towards products carrying health messages. Legislation in the European Union requires that the claim is understood by the average consumer. As most studies on consumers' understanding of health claims are based on subjective understanding, this remains an area for more investigation.

  11. The Validity of Claims-Based Algorithms to Identify Serious Hypersensitivity Reactions and Osteonecrosis of the Jaw.

    Directory of Open Access Journals (Sweden)

    Nicole C Wright

    Full Text Available Validation of claims-based algorithms to identify serious hypersensitivity reactions and osteonecrosis of the jaw has not been performed in large osteoporosis populations. The objective of this project is to estimate the positive predictive value of the claims-based algorithms in older women with osteoporosis enrolled in Medicare. Using the 2006-2008 Medicare 5% sample data, we identified potential hypersensitivity and osteonecrosis of the jaw cases based on ICD-9 diagnosis codes. Potential hypersensitivity cases had a 995.0, 995.2, or 995.3 diagnosis code on emergency department or inpatient claims. Potential osteonecrosis of the jaw cases had ≥1 inpatient or outpatient physician claim with a 522.7, 526.4, 526.5, or 733.45 diagnosis code or ≥2 claims of any type with a 526.9 diagnosis code. All retrieved records were redacted and reviewed by experts to determine case status: confirmed, not confirmed, or insufficient information. We calculated the positive predictive value as the number of confirmed cases divided by the total number of retrieved records with sufficient information. We requested 412 potential hypersensitivity and 304 potential osteonecrosis of the jaw records and received 174 (42% and 84 (28% records respectively. Of 84 potential osteonecrosis of the jaw cases, 6 were confirmed, resulting in a positive predictive value (95% CI of 7.1% (2.7, 14.9. Of 174 retrieved potential hypersensitivity records, 95 were confirmed. After exclusion of 25 records with insufficient information for case determination, the overall positive predictive value (95% CI for hypersensitivity reactions was 76.0% (67.5, 83.2. In a random sample of Medicare data, a claim-based algorithm to identify serious hypersensitivity reactions performed well. An algorithm for osteonecrosis of the jaw did not, partly due to the inclusion of diagnosis codes that are not specific for osteoporosis of the jaw.

  12. The Validity of Claims-Based Algorithms to Identify Serious Hypersensitivity Reactions and Osteonecrosis of the Jaw.

    Science.gov (United States)

    Wright, Nicole C; Curtis, Jeffrey R; Arora, Tarun; Smith, Wilson K; Kilgore, Meredith L; Saag, Kenneth G; Safford, Monika M; Delzell, Elizabeth S

    2015-01-01

    Validation of claims-based algorithms to identify serious hypersensitivity reactions and osteonecrosis of the jaw has not been performed in large osteoporosis populations. The objective of this project is to estimate the positive predictive value of the claims-based algorithms in older women with osteoporosis enrolled in Medicare. Using the 2006-2008 Medicare 5% sample data, we identified potential hypersensitivity and osteonecrosis of the jaw cases based on ICD-9 diagnosis codes. Potential hypersensitivity cases had a 995.0, 995.2, or 995.3 diagnosis code on emergency department or inpatient claims. Potential osteonecrosis of the jaw cases had ≥1 inpatient or outpatient physician claim with a 522.7, 526.4, 526.5, or 733.45 diagnosis code or ≥2 claims of any type with a 526.9 diagnosis code. All retrieved records were redacted and reviewed by experts to determine case status: confirmed, not confirmed, or insufficient information. We calculated the positive predictive value as the number of confirmed cases divided by the total number of retrieved records with sufficient information. We requested 412 potential hypersensitivity and 304 potential osteonecrosis of the jaw records and received 174 (42%) and 84 (28%) records respectively. Of 84 potential osteonecrosis of the jaw cases, 6 were confirmed, resulting in a positive predictive value (95% CI) of 7.1% (2.7, 14.9). Of 174 retrieved potential hypersensitivity records, 95 were confirmed. After exclusion of 25 records with insufficient information for case determination, the overall positive predictive value (95% CI) for hypersensitivity reactions was 76.0% (67.5, 83.2). In a random sample of Medicare data, a claim-based algorithm to identify serious hypersensitivity reactions performed well. An algorithm for osteonecrosis of the jaw did not, partly due to the inclusion of diagnosis codes that are not specific for osteoporosis of the jaw.

  13. Degrees of Truthfulness in Accepted Scientific Claims.

    Directory of Open Access Journals (Sweden)

    Ahmed Hassan Mabrouk

    2008-12-01

    Full Text Available Normal 0 false false false EN-MY X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin-top:0cm; mso-para-margin-right:0cm; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0cm; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin;} Abstract: Sciences adopt different methodologies in deriving claims and establishing theories. As a result, two accepted claims or theories belonging to two different sciences may not necessarily carry the same degree of truthfulness. Examining the different methodologies of deriving claims in the sciences of ʿaqīdah (Islamic Creed, fiqh (Islamic Jurisprudence and physics, the study shows that ʿaqīdah provides a holistic understanding of the universe. Physics falls short of interpreting physical phenomena unless these phenomena are looked at through the ʿaqīdah holistic view. Left to itself, error may creep into laws of physics due to the methodology of conducting the physical experiments, misinterpreting the experimental results, or accepting invalid assumptions. As for fiqh, it is found that apart from apparent errors, fiqh views cannot be falsified. It is, therefore, useful to consider ʿaqīdah as a master science which would permit all other sciences to live in harmony.

  14. Proof of payment for all reimbursement claims

    CERN Multimedia

    HR Department

    2006-01-01

    Members of the personnel are kindly requested to note that only documents proving that a payment has been made are accepted as proof of payment for any claims for reimbursement, including specifically the reimbursement of education fees. In particular, the following will be accepted as proof of payment: bank or post office bank statements indicating the name of the institution to which the payment was made; photocopies of cheques made out to the institution to which the payments were made together with bank statements showing the numbers of the relevant cheques; proof of payment in the form of discharged payment slips; invoices with acknowledgement of settlement, receipts, bank statements detailing operations crediting another account or similar documents. As a result, the following documents in particular will no longer be accepted as proof of payment: photocopies of cheques that are not submitted together with bank or post office bank statements showing the numbers of the relevant cheques; details of ...

  15. Dolphin-Assisted Therapy: Claims versus Evidence

    Directory of Open Access Journals (Sweden)

    Britta L. Fiksdal

    2012-01-01

    Full Text Available The purpose of this paper is to review and critique studies that have been conducted on dolphin-assisted therapy for children with various disorders. Studies have been released claiming swimming with dolphins is therapeutic and beneficial for children with autism, attention deficit hyperactivity disorder, physical disabilities, and other psychological disorders. The majority of the studies conducted supporting the effectiveness of dolphin-assisted therapy have been found to have major methodological concerns making it impossible to draw valid conclusions. Readers will be informed of the history of, theory behind, and variations of dolphin-assisted therapy along with a review and critique of studies published which purportedly support its use.

  16. Prebiotics, Fermentable Dietary Fiber, and Health Claims.

    Science.gov (United States)

    Delcour, Jan A; Aman, Per; Courtin, Christophe M; Hamaker, Bruce R; Verbeke, Kristin

    2016-01-01

    Since the 1970s, the positive effects of dietary fiber on health have increasingly been recognized. The collective term "dietary fiber" groups structures that have different physiologic effects. Since 1995, some dietary fibers have been denoted as prebiotics, implying a beneficial physiologic effect related to increasing numbers or activity of the gastrointestinal microbiota. Given the complex composition of the microbiota, the demonstration of such beneficial effects is difficult. In contrast, an exploration of the metabolites of dietary fiber formed as a result of its fermentation in the colon offers better perspectives for providing mechanistic links between fiber intake and health benefits. Positive outcomes of such studies hold the promise that claims describing specific health benefits can be granted. This would help bridge the "fiber gap"-that is, the considerable difference between recommended and actual fiber intakes by the average consumer.

  17. Estimation of physician supply by specialty and the distribution impact of increasing female physicians in Japan

    Directory of Open Access Journals (Sweden)

    Yasunaga Hideo

    2009-10-01

    Full Text Available Abstract Background Japan has experienced two large changes which affect the supply and distribution of physicians. They are increases in medical school enrollment capacity and in the proportion of female physicians. The purpose of this study is to estimate the future supply of physicians by specialty and to predict the associated impact of increased female physicians, as well as to discuss the possible policy implications. Methods Based on data from the 2004 and 2006 National Survey of Physicians, Dentists and Pharmacists, we estimated the future supply of physicians by specialty, using multistate life tables. Based on possible scenarios of the future increase in female physicians, we also estimated the supply of physicians by specialty. Results Even if Japan's current medical school enrollment capacity is maintained in subsequent years, the number of physicians per 1000 population is expected to increase from 2.2 in 2006 to 3.2 in 2036, which is a 46% increase from the current level. The numbers of obstetrician/gynecologists (OB/GYNs and surgeons are expected to temporarily decline from their current level, whereas the number of OB/GYNs per 1000 births will still increase because of the declining number of births. The number of surgeons per 1000 population, even with the decreasing population, will decline temporarily over the next few years. If the percentage of female physicians continues to increase, the overall number of physicians will not be significantly affected, but in specialties with current very low female physician participation rates, such as surgery, the total number of physicians is expected to decline significantly. Conclusion At the current medical school enrollment capacity, the number of physicians per population is expected to continue to increase because of the skewed age distribution of physicians and the declining population in Japan. However, with changes in young physicians' choices of medical specialties and as the

  18. Construction of a Physician Skills Inventory

    Science.gov (United States)

    Richard, George V.; Zarconi, Joseph; Savickas, Mark L.

    2012-01-01

    The current study applied Holland's RIASEC typology to develop a "Physician Skills Inventory". We identified the transferable skills and abilities that are critical to effective performance in medicine and had 140 physicians in 25 different specialties rate the importance of those skills. Principal component analysis of their responses produced…

  19. Tailoring hospital marketing efforts to physicians' needs.

    Science.gov (United States)

    Mackay, J M; Lamb, C W

    1988-12-01

    Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.

  20. Influence of pharmacists expertise on physicians prescription ...

    African Journals Online (AJOL)

    The influence of pharmacist factors on physician prescription decisions was identified ... Keywords: Physician prescription behaviour, Pharmacist factor, ... addition to the influence of marketing promotion .... from the drug sales, obtaining clinic rental ... also analyzed the current status of pharmacist's ..... the buyer-seller dyad.

  1. Physician Behaviors that Correlate with Patient Satisfaction.

    Science.gov (United States)

    Comstock, Loretto M.; And Others

    1982-01-01

    The behavior of 15 internal medicine residents was observed through a one-way mirror and ratings by the patients of satisfaction with their physicians were obtained. The teaching of caring skills and which physician caring skills affect the patients' satisfaction are discussed. (Author/MLW)

  2. A history of physician suicide in America.

    Science.gov (United States)

    Legha, Rupinder K

    2012-12-01

    Over the course of the last century, physicians have written a number of articles about suicide among their own. These articles reveal how physicians have fundamentally conceived of themselves, how they have addressed vulnerability among their own, and how their self-identification has changed over time, due, in part, to larger historical changes in the profession, psychiatry, and suicidology. The suicidal physician of the Golden Age (1900-1970), an expendable deviant, represents the antithesis of that era's image of strength and invincibility. In contrast, the suicidal physician of the modern era (1970 onwards), a vulnerable human being deserving of support, reflects that era's frustration with bearing these unattainable ideals and its growing emphasis on physician health and well-being. Despite this key transition, specifically the acknowledgment of physicians' limitations, more recent articles about physician suicide indicate that Golden Age values have endured. These persistent emphases on perfection and discomfort with vulnerability have hindered a comprehensive consideration of physician suicide, despite one hundred years of dialogue in the medical literature.

  3. 10 CFR 712.32 - Designated Physician.

    Science.gov (United States)

    2010-01-01

    ... Designated Physician must be qualified to provide professional expertise in the area of occupational medicine... school of medicine or osteopathy; (2) Have a valid, unrestricted state license to practice medicine in... requirements; and (4) Be eligible for the appropriate DOE access authorization. (c) The Designated Physician...

  4. Urban-Rural Flows of Physicians

    Science.gov (United States)

    Ricketts, Thomas C.; Randolph, Randy

    2007-01-01

    Context: Physician supply is anticipated to fall short of national requirements over the next 20 years. Rural areas are likely to lose relatively more physicians. Policy makers must know how to anticipate what changes in distribution are likely to happen to better target policies. Purpose: To determine whether there was a significant flow of…

  5. Nurse-physician communication: an organizational accountability.

    Science.gov (United States)

    Arford, Patricia H

    2005-01-01

    Dysfunctional nurse-physician communication has been linked to medication errors, patient injuries, and patient deaths. The organization is accountable for providing a context that supports effective nurse-physician communication. Organizational strategies to create such a context are synthesized from the structural, human resource, political, and cultural frameworks of organizational behavior.

  6. Physicians' Internet Information-Seeking Behaviors

    Science.gov (United States)

    Bennett, Nancy L.; Casebeer, Linda L.; Kristofco, Robert E.; Strasser, Sheryl M.

    2004-01-01

    Introduction: Our understanding about the role of the Internet as a resource for physicians has improved in the past several years with reports of patterns for use and measures of impact on medical practice. The purpose of this study was to begin to shape a theory base for more fully describing physicians' information-seeking behaviors as they…

  7. Physician Performance Assessment: Prevention of Cardiovascular Disease

    Science.gov (United States)

    Lipner, Rebecca S.; Weng, Weifeng; Caverzagie, Kelly J.; Hess, Brian J.

    2013-01-01

    Given the rising burden of healthcare costs, both patients and healthcare purchasers are interested in discerning which physicians deliver quality care. We proposed a methodology to assess physician clinical performance in preventive cardiology care, and determined a benchmark for minimally acceptable performance. We used data on eight…

  8. Physician morality and perinatal decisions.

    Science.gov (United States)

    Minkoff, Howard; Zafra, Katherine; Amrita, Sabharwal; Wilson, Tracey E; Homel, Peter

    2016-11-01

    Given the same set of "facts" (e.g. fetal prognosis) different physicians may not give the same advice to patients. Studies have shown that people differ in how they prioritize moral domains, but how those domains influence counseling and management has not been assessed among obstetricians. Our objective was to see if, given the same set of facts, obstetricians' counseling would vary depending on their prioritization of moral domains. Obstetricians completed questionnaires that included validated scales of moral domains (e.g. autonomy, community, divinity), demographic data, and hypothetical scenarios (e.g. how aggressively they would pursue the interests of a potentially compromised child, the degree of deference they gave to parents' choices, and their relative valuation of fetal rights and women's rights). Multivariate logistic regression using backwards conditional selection was used to explore how participants responded to the moral dilemma scenarios. Among the 249 participating obstetricians there was wide variation in counseling, much of which reflected differences in prioritization of moral domains. For example, requiring a higher likelihood of neonatal survival before recommending a cesarean section with cord prolapse was associated with Fairness/Reciprocity, an autonomy domain which emphasizes treating individuals equally (OR=1.42, 90% CI=1.06-1.89, p=0.05). Honoring parents' request to wait longer to suspend attempts to resuscitate an infant with no heart rate or pulse was associated with the community domains (involving concepts of loyalty and hierarchy) of In-Group/Loyalty; OR 1.30, 90% CI=1.04-1.62, p=0.05 and Authority/Respect (OR=1.34, 90% CI=1.06-1.34, p=0.045). Carrying out an unconsented cesarean section was associated with In-Group Loyalty (OR=1.26, 90% CI=1.01-1.56, p=0.08) and religiosity (OR=1.08, 90% CI=1.00-1.16, p=0.08). The advice that patients receive may vary widely depending on the underlying moral values of obstetricians. Physicians

  9. Descriptive study of claims for occupational mental disorders or suicide

    OpenAIRE

    Lee, Jihoon; Kim, Inah; Roh, Sooyong

    2016-01-01

    Background This study aimed to identify the characteristics of claimed mental disorders. Because the workers believed the cause of the mental disorders was work-related stress or a specific event, we could identify the major work-related stressor for claimed cases. Methods We included claimed cases of occupational mental disorder or suicide reported during 2010–2014 to the Korea Workers Compensation and Welfare Service (KCOMWEL), established by Industrial Accidents Insurance (IACI) Act. We co...

  10. 9 CFR 317.313 - Nutrient content claims; general principles.

    Science.gov (United States)

    2010-01-01

    ... product, e.g., “low sodium” or “contains 100 calories.” (2) An implied nutrient content claim is any claim...) sodium per serving, not a low sodium product.” The disclaimer must be in easily legible print or type and... shall be followed by the criteria for the claim as required by § 317.312(f) (e.g., “very low sodium,...

  11. Can complexity science inform physician leadership development?

    Science.gov (United States)

    Grady, Colleen Marie

    2016-07-04

    Purpose The purpose of this paper is to describe research that examined physician leadership development using complexity science principles. Design/methodology/approach Intensive interviewing of 21 participants and document review provided data regarding physician leadership development in health-care organizations using five principles of complexity science (connectivity, interdependence, feedback, exploration-of-the-space-of-possibilities and co-evolution), which were grouped in three areas of inquiry (relationships between agents, patterns of behaviour and enabling functions). Findings Physician leaders are viewed as critical in the transformation of healthcare and in improving patient outcomes, and yet significant challenges exist that limit their development. Leadership in health care continues to be associated with traditional, linear models, which are incongruent with the behaviour of a complex system, such as health care. Physician leadership development remains a low priority for most health-care organizations, although physicians admit to being limited in their capacity to lead. This research was based on five principles of complexity science and used grounded theory methodology to understand how the behaviours of a complex system can provide data regarding leadership development for physicians. The study demonstrated that there is a strong association between physician leadership and patient outcomes and that organizations play a primary role in supporting the development of physician leaders. Findings indicate that a physician's relationship with their patient and their capacity for innovation can be extended as catalytic behaviours in a complex system. The findings also identified limiting factors that impact physicians who choose to lead, such as reimbursement models that do not place value on leadership and medical education that provides minimal opportunity for leadership skill development. Practical Implications This research provides practical

  12. Pharmaceutical marketing research and the prescribing physician.

    Science.gov (United States)

    Greene, Jeremy A

    2007-05-15

    Surveillance of physicians' prescribing patterns and the accumulation and sale of these data for pharmaceutical marketing are currently the subjects of legislation in several states and action by state and national medical associations. Contrary to common perception, the growth of the health care information organization industry has not been limited to the past decade but has been building slowly over the past 50 years, beginning in the 1940s when growth in the prescription drug market fueled industry interest in understanding and influencing prescribing patterns. The development of this surveillance system was not simply imposed on the medical profession by the pharmaceutical industry but was developed through the interactions of pharmaceutical salesmen, pharmaceutical marketers, academic researchers, individual physicians, and physician organizations. Examination of the role of physicians and physician organizations in the development of prescriber profiling is directly relevant to the contemporary policy debate surrounding this issue.

  13. FEMA Hazard Mitigation Assistance Repetitive Flood Claims (RFC) Data

    Data.gov (United States)

    Department of Homeland Security — This dataset contains closed and obligated projects funded under the following Hazard Mitigation Assistance (HMA) grant programs: Repetitive Flood Claims (RFC). The...

  14. Joint Asymptotic Distributions of Smallest and Largest Insurance Claims

    Directory of Open Access Journals (Sweden)

    Hansjörg Albrecher

    2014-07-01

    Full Text Available Assume that claims in a portfolio of insurance contracts are described by independent and identically distributed random variables with regularly varying tails and occur according to a near mixed Poisson process. We provide a collection of results pertaining to the joint asymptotic Laplace transforms of the normalised sums of the smallest and largest claims, when the length of the considered time interval tends to infinity. The results crucially depend on the value of the tail index of the claim distribution, as well as on the number of largest claims under consideration.

  15. Are the claims made in orthopaedic print advertisements valid?

    Science.gov (United States)

    Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P

    2014-05-01

    Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p advertisements. High-quality evidence is required by orthopaedic surgeons to influence clinical practice and this evidence should be sought by manufacturers wishing to market a successful product.

  16. Perceived relevance and foods with health-related claims

    DEFF Research Database (Denmark)

    Dean, M.; Lampila, P.; Shepherd, R.

    2012-01-01

    consumers’ responses to health claims that either promise to reduce a targeted disease risk or improve well-being in comparison to other types of health-related messages, and how attitudes towards nutritionally healthy eating, functional food and previous experience relating to products with health claims...... affect the consumers’ perceptions of nutrition and health claims. The data (N = 2385) were collected by paper and pencil surveys in Finland, the UK, Germany and Italy on a target group of consumers over 35 year old, solely or jointly responsible for the family’s food shopping. The results showed...... by health claims consumers also need to have a positive attitude towards functional food products....

  17. Care partnerships between family physicians and rheumatologists.

    Science.gov (United States)

    Lou, Benjamin; DE Civita, Mirella; Ehrmann Feldman, Debbie; Bissonauth, Asvina; Bernatsky, Sasha

    2011-09-01

    To describe care partnerships between family physicians and rheumatologists. A random sample (20%, n = 478) of family physicians was mailed a questionnaire, asking if there was at least 1 particular rheumatologist to whom the physician tended to refer patients. If the answer was affirmative, the physician would be considered as having a "care partnership" with that rheumatologist. The family physician then rated, on a 5-point scale, factors of importance regarding the relationship with that rheumatologist. The questionnaire was completed by 84/462 (18.2%) of family physicians; 52/84 (61.9%) reported having rheumatology care partnerships according to our definition. Regarding interactions with rheumatologists, most respondents rated the following as important (score ≥ 4): adequate communication and information exchange (44/50, 88.0%); waiting time for new patients (40/50, 80.0%); clear and appropriate balance of responsibilities (39/49, 79.6%); and patient feedback and preferences (34/50, 68%). Male family physicians were more likely than females to accord high importance to personal knowledge of the rheumatologist, and to physical proximity of the rheumatologist's practice. Regarding relationships with rheumatologists, 30/50 (60.0%) of respondents felt communication and information exchange were adequate, and 35/50 (70.0%) felt they had a clear balance of responsibilities. Almost two-thirds of family physicians have rheumatology care partnerships, according to our definition. In this partnership, establishing adequate communication and shorter waiting time seem of paramount importance to family physicians. A balanced sharing of responsibilities and patients' preferences are also valued. Although many physicians reported adequate communication and clear and appropriate balance of responsibilities in their current interactions with rheumatologists, there appears to be room for improvement.

  18. [The occupational physician in France].

    Science.gov (United States)

    Matsuda, Shinya

    2013-10-01

    The French Labor law defines the role and its allocation criteria of the occupational physician (OP) the same as in Japan. In France, occupational medicine is one of the medical specialties. The OP resident must follow the 4 years clinical training before certification. After having finished their residency, they are entitled to work for the occupational health service office of a company or company association (in the case of small and medium sized companies). The most important characteristics of the French system is that they cover all workers regardless of company size. The main role of the OP is prevention of work related diseases and accidents. They are not allowed to do clinical services except for emergency cases. Their main activities are health examinations, health education, patrol and advice for better working condition. Formerly, it was rather difficult to attract the medical students for OP resident course because of its prevention oriented characteristics. A growing concern about the importance of health management at the work site, however, has changed the situation. Now, the number of candidates for OP resident course is increasing. Their task has expanded to cover mental health and other life style related diseases. The 2011 modification of law redefines the role of the OP as a director of an occupational health service office who has a total responsibility of multidisciplinary services. The French and Japanese occupational health systems have many of similarities. A comparative study by researchers of UOEH is expected to yield useful information.

  19. Walter sutton: physician, scientist, inventor.

    Science.gov (United States)

    Ramirez, Gregory J; Hulston, Nancy J; Kovac, Anthony L

    2015-01-01

    Walter S. Sutton (1877-1916) was a physician, scientist, and inventor. Most of the work on Sutton has focused on his recognition that chromosomes carry genetic material and are the basis for Mendelian inheritance. Perhaps less well known is his work on rectal administration of ether. After Sutton's work on genetics, he completed his medical degree in 1907 and began a 2-year surgical fellowship at Roosevelt Hospital, New York City, NY, where he was introduced to the technique of rectal administration of ether. Sutton modified the work of others and documented 100 cases that were reported in his 1910 landmark paper "Anaesthesia by Colonic Absorption of Ether". Sutton had several deaths in his study, but he did not blame the rectal method. He felt that his use of rectal anesthesia was safe when administered appropriately and believed that it offered a distinct advantage over traditional pulmonary ether administration. His indications for its use included (1) head and neck surgery; (2) operations when ether absorption must be minimized due to heart, lung, or kidney problems; and (3) preoperative pulmonary complications. His contraindications included (1) cases involving alimentary tract or weakened colon; (2) laparotomies, except when the peritoneal cavity was not opened; (3) incompetent sphincter or anal fistula; (4) orthopnea; and (5) emergency cases. Sutton wrote the chapter on "Rectal Anesthesia" in one of the first comprehensive textbooks in anesthesia, James Tayloe Gwathmey's Anesthesia. Walter Sutton died of a ruptured appendix in 1916 at age 39.

  20. Health Care Service Utilization of Dementia Patients before and after Institutionalization: A Claims Data Analysis

    Science.gov (United States)

    Schwarzkopf, Larissa; Hao, Yi; Holle, Rolf; Graessel, Elmar

    2014-01-01

    Background Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse. Methods We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization. Results In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy) remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles. Conclusion Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care. PMID:25337076

  1. Health Care Service Utilization of Dementia Patients before and after Institutionalization: A Claims Data Analysis

    Directory of Open Access Journals (Sweden)

    Larissa Schwarzkopf

    2014-06-01

    Full Text Available Background: Community-based and institutional dementia care has been compared in cross-sectional studies, but longitudinal information on the effect of institutionalization on health care service utilization is sparse. Methods: We analyzed claims data from 651 dementia patients via Generalized Estimation Equations to assess health care service utilization profiles and corresponding expenditures from four quarters before to four quarters after institutionalization. Results: In all domains, utilization increased in the quarter of institutionalization. Afterwards, the use of drugs, medical aids, and non-physician services (e.g., occupational therapy and physiotherapy remained elevated, but use of in- and outpatient treatment decreased. Cost of care showed corresponding profiles. Conclusion: Institutional dementia care seems to be associated with an increased demand for supportive services but not necessarily for specialized medical care.

  2. The Jefferson Scale of Physician Empathy: a preliminary psychometric study and group comparisons in Korean physicians.

    Science.gov (United States)

    Suh, Dae Hun; Hong, Jong Soo; Lee, Dong Hun; Gonnella, Joseph S; Hojat, Mohammadreza

    2012-01-01

    Empathy is an important element of professionalism in medicine. Thus, evaluation and enhancement empathy in physicians is important, regardless of geographical boundaries. This study was designed to evaluate the psychometrics of a Korean version of the Jefferson Scale of Physician Empathy (JSPE) among Korean physicians. The Korean version of JSPE was completed by 229 physicians in Korea. Item-total score correlations were all positive and statistically significant. Cronbach's coefficient alpha was 0.84. The mean score was 98.2 (SD = 12.0), which was lower than that reported for American and Italian physicians. The emerged factor structure of the translated version was somewhat similar to that reported for American physicians, although the order was different. Significant differences in the mean empathy scores were observed between men and women and among physicians in different specialties. Our findings provide evidence in support of reliability and construct validity of the Korean version of JSPE for assessing empathy among Korean physicians. The disparity between Korean physicians and physicians from other countries may be explained by differences in the culture of medical education and medical practice. It suggests an exploration of cross-cultural differences in physician empathy.

  3. The attitudes of pharmacists and physicians in Bosnia and Herzegovina towards adverse drug reaction reporting

    Directory of Open Access Journals (Sweden)

    Tarik Catic

    2016-04-01

    Full Text Available Introduction: Adverse drug reactions (ADRs are threat to the patient’s safety and the quality of life, and they increase the cost of health care. Spontaneous ADR reporting system mainly relies on physicians, but also pharmacists, nurses, and even patients. The aim of this study was to explore attitudes, barriers, and possible improvements to ADR reporting practices in Bosnia and Herzegovina.Methods: A self-reported questionnaire was developed to collect data on the perception of pharmacovigilance practice and ADR reporting. The survey was conducted in the period between September, 2014 and October, 2014.Results: The response rate was 73% (44 of 60 and 93% (148 of 160 among the pharmacist and family medicine physician groups, respectively. Regarding the attitudes to pharmacovigilance practice and reporting, both the pharmacists and physicians found the practices important. The majority of pharmacists and physicians in year 2014 did not report any ADR, while 18% of the pharmacists and 12% of the physicians, who participated in this study, reported one ADR. Reporting procedure, uncertainty, and their exposure were the main barriers to reporting ADRs for the pharmacists. The physicians claimed lack of knowledge to whom to report an ADR as the main barrier. A significant number of the respondents thought that additional education in ADR reporting would have a positive impact, and would increase the ADR reporting rate.Conclusions: Despite the overall positive attitude towards ADR reporting, the reporting rate in Bosnia and Herzegovina is still low. Different barriers to the ADR reporting have been identified, and there is also the need for improvements in the traditional education in this field.

  4. Physician Practice Consolidation Driven By Small Acquisitions, So Antitrust Agencies Have Few Tools To Intervene.

    Science.gov (United States)

    Capps, Cory; Dranove, David; Ody, Christopher

    2017-09-01

    The growing concentration of physician markets throughout the United States has been raising antitrust concerns, yet the Department of Justice and the Federal Trade Commission have challenged only a small number of mergers and acquisitions in this field. Using proprietary claims data from states collectively containing more than 12 percent of the US population, we found that 22 percent of physician markets were highly concentrated in 2013, according to federal merger guidelines. Most of the increases in physician practice size and market concentration resulted from numerous small transactions, rather than a few large transactions. Among highly concentrated markets that had increases large enough to raise antitrust concerns, only 28 percent experienced any individual acquisition that would have been presumed to be anticompetitive under federal merger guidelines. Furthermore, most acquisitions were below the dollar thresholds that would have required the parties to report the transaction to antitrust authorities. Under present mechanisms, federal authorities have only limited ability to counteract consolidation in most US physician markets. Project HOPE—The People-to-People Health Foundation, Inc.

  5. Impact of a pay-for-performance program on low performing physicians.

    Science.gov (United States)

    Chen, Judy Ying; Kang, Ning; Juarez, Deborah Taira; Hodges, Krista A; Chung, Richard S; Legorreta, Antonio P

    2010-01-01

    Studies have shown that the lowest performing physicians in pay-for-performance (P4P) programs improved the most; however, it is unclear whether this would occur without the P4P program or be sustained. The objective of this study is to investigate the impact of P4P in a Preferred Provider Organization (PPO) on low performing physicians over a 4-year period. We used administrative claims data from a PPO health plan in Hawaii, which implemented a P4P program, and a PPO plan in the South, which did not implement a P4P program. The difference-indifference model was used to compare the quality scores between the two physician groups in preventive measures, a heart failure measure, and an HbA1c testing measure. We found that P4P programs may be effective in incentivizing low performing physicians to improvement quality of care and sustain improvement, and the positive benefit of the P4P program may not be realized until the 3rd or 4th year of the program.

  6. Warranting the use of causal claims

    Directory of Open Access Journals (Sweden)

    Menno Rol

    2012-06-01

    Full Text Available To what use can causal claims established in good studies be put? We give examples of studies from which inaccurate inferences were made about target policy situations. The usual diagnosis is that the studies in question lack external validity, which means that the same results do not hold in the target as in study. That’s a label that just repeats what we already knew. We offer a deeper analysis. Our analysis points to the need for interdisciplinarity and to the demand to focus not on the study – as the expression ‘external validity’ invites you to do – but on the target.The call for interdisciplinary approaches to real life problems is common since it is widely acknowledged that what happens in the real world seldom falls under the auspices of any single research domain. Our focus is on one specific real life problem: how to use causal claims from good studies to help predict whether the policies tested will work in a new situation.  Our analysis of what it takes to back up these predictions points up very specific stages in the process of prediction where we are bound to get it wrong if we do not diversify our concepts, our knowledge and our methods.We isolate two reasons inferences from study to target fail. First, policy variables do not produce results on their own; they need helping factors. The distribution of helping factors is likely to be unique or local for each study, so one cannot expect external validity to be all that common. Second, researchers often give too concrete a description of the cause in the study for it to carry over to the target. Abstraction is necessary to get causes that travel.There is no sure-fire way to guard against these problems. But the unavailability of one perfect tool does not imply there are no second best contrivances. Two general pointers for Good Practice in policy advice follow from our diagnosis: focus on the concrete details in the target and use cross discipline heuristics that

  7. Hospitals' marketing challenge: influencing physician behavior.

    Science.gov (United States)

    MacStravic, R C

    1985-05-01

    Physicians' referring and admitting behavior as well as their clinical management practices are major determinants of hospitals' profitability under prospective payment. Four techniques are available to hospitals that seek to increase market share: Recruitment and retention strategies. In planning the mix of specialties represented on staff, hospitals should consider the effects of a physician's practice on the hospital's case mix. Peer pressure. Peer review programs in hospitals as well as through medical or specialty societies may help persuade physicians to alter their use of services. Education and information programs. Hospitals can assist physicians in patient management by conducting economic grand rounds, developing committees to study and communicate cost data to physicians, and providing information on alternatives to hospitalization. Incentives. Putting physicians at risk by linking planned expenditures to hospital financial performance can influence practice patterns. Other techniques include offering limited partnerships to medical staff members and merging the hospital and medical staff into one corporation. Hospitals may also need to influence physicians away from ventures that compete directly with the institution, such as ambulatory surgery centers.

  8. Regulatory focus affects physician risk tolerance.

    Science.gov (United States)

    Veazie, Peter J; McIntosh, Scott; Chapman, Benjamin P; Dolan, James G

    2014-01-01

    Risk tolerance is a source of variation in physician decision-making. This variation, if independent of clinical concerns, can result in mistaken utilization of health services. To address such problems, it will be helpful to identify nonclinical factors of risk tolerance, particularly those amendable to intervention-regulatory focus theory suggests such a factor. This study tested whether regulatory focus affects risk tolerance among primary care physicians. Twenty-seven primary care physicians were assigned to promotion-focused or prevention-focused manipulations and compared on the Risk Taking Attitudes in Medical Decision Making scale using a randomization test. Results provide evidence that physicians assigned to the promotion-focus manipulation adopted an attitude of greater risk tolerance than the physicians assigned to the prevention-focused manipulation (p = 0.01). The Cohen's d statistic was conventionally large at 0.92. Results imply that situational regulatory focus in primary care physicians affects risk tolerance and may thereby be a nonclinical source of practice variation. Results also provide marginal evidence that chronic regulatory focus is associated with risk tolerance (p = 0.05), but the mechanism remains unclear. Research and intervention targeting physician risk tolerance may benefit by considering situational regulatory focus as an explanatory factor.

  9. Family physicians and HIV infection.

    Science.gov (United States)

    Hall, N; Crochette, N; Blanchi, S; Lavoix, A; Billaud, E; Baron, C; Abgueguen, P; Perré, P; Rabier, V

    2015-01-01

    We aimed to describe the current and desired involvement of family physicians (FPs) in the treatment of HIV patients (screening practices, potential training and patient follow-up) to reduce the duration and frequency of their hospital treatment. We conducted a descriptive cross-sectional survey between 2011 and 2012 with the support of COREVIH (Regional Coordinating Committee on HIV). We sent a self-assessment questionnaire to all FPs of the Pays de la Loire region to enquire about their HIV screening practices and expectations for the management of HIV patients. A total of 871 FPs completed the questionnaire (response rate: 30.4%). A total of 54.2% said to provide care to HIV patients; the mean number of HIV patients per FP was estimated at 1.4. With regard to HIV screening, 12.2% systematically suggest an HIV serology to their patients and 72.7% always suggest it to pregnant women. About 45.4% of responding FPs said to be willing to manage HIV patients (clinical and biological monitoring, compliance checks and prescription renewal). FPs mainly reported the lack of training and the low number of HIV patients as a barrier to their further involvement in the management of HIV patients. The responding FPs provide care to very few HIV patients. They are, however, willing to be more involved in the routine care of these patients. Medical training provided by COREVIH would help improve HIV screening. The management of HIV patients could thus be handed over to willing FPs. Copyright © 2015. Published by Elsevier SAS.

  10. Education and the physician's office laboratory.

    Science.gov (United States)

    Fischer, P M; Addison, L A; Koneman, E W; Crowley, J

    1986-03-21

    The field of physicians' office laboratory testing has witnessed an increase in test volume and advances in technology, but little attention to educational issues. If this field is to continue to grow and to perform high-quality testing, primary care physicians will need to be trained in the role of laboratory director. Office staff will require "in the office" continuing education. Formal technician and technologist training will need to focus some attention on office test procedures. The development of these new educational programs will require the cooperative efforts of primary care physician educators, pathologists, allied health faculty, and the diagnostic equipment industry.

  11. Development of the physician satisfaction survey instrument.

    Science.gov (United States)

    Soo Hoo, W E; Ramer, L

    1998-01-01

    Continuous quality improvement (CQI) activities depend on valid and reliable instruments to generate data. An evaluation of internal and external customer satisfaction is one of the pillars of the CQI process. This article describes the development of a valid and reliable instrument for measuring physicians' satisfaction with the orthopedic nursing units at a major medical trauma center. The physician satisfaction survey instrument was found to be internally consistent (alpha = .95). Confirmatory factor analysis revealed that 68% of the variance in physician satisfaction scores (eigenvalue = 8.14) was explained by using a single-factor model.

  12. 22 CFR 40.63 - Misrepresentation; Falsely claiming citizenship.

    Science.gov (United States)

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Misrepresentation; Falsely claiming citizenship... Immigration Violators § 40.63 Misrepresentation; Falsely claiming citizenship. (a) Fraud and misrepresentation... applicable if the fraud or misrepresentation was committed by an alien at the time the alien sought entry...

  13. 40 CFR 303.33 - Filing a claim.

    Science.gov (United States)

    2010-07-01

    ... COMMUNITY RIGHT-TO-KNOW PROGRAMS CITIZEN AWARDS FOR INFORMATION ON CRIMINAL VIOLATIONS UNDER SUPERFUND... regulation is required to file a claim for such an award with the Deputy Assistant Administrator for Criminal... information was provided. (c) All claim submissions must be submitted to the Office of Criminal...

  14. Cause and Event: Supporting Causal Claims through Logistic Models

    Science.gov (United States)

    O'Connell, Ann A.; Gray, DeLeon L.

    2011-01-01

    Efforts to identify and support credible causal claims have received intense interest in the research community, particularly over the past few decades. In this paper, we focus on the use of statistical procedures designed to support causal claims for a treatment or intervention when the response variable of interest is dichotomous. We identify…

  15. Theoretical Claims and Empirical Evidence in Maori Education Discourse

    Science.gov (United States)

    Rata, Elizabeth

    2012-01-01

    Post-Marxist critical sociology of education has influenced the development of indigenous ("kaupapa") Maori educational theory and research. Its effects are examined in four claims made for Maori education by indigenous theorists. The claims are: indigenous kaupapa Maori education is a revolutionary initiative; it is a cultural solution to Maori…

  16. 20 CFR 210.7 - Verification of service claimed.

    Science.gov (United States)

    2010-04-01

    ... records are incomplete or missing, the service claimed and not established by these records will be... incomplete or missing, the service claimed and not established by these records will be verified from any other books and records of the employer. (d) If the employer's records do not establish the...

  17. 9 CFR 381.413 - Nutrient content claims; general principles.

    Science.gov (United States)

    2010-01-01

    ... from the product, or not include the nutrient in the product, may bear such a claim (e.g., “low sodium... attaches (e.g., “chicken breast meat, a low sodium food”). (f) A nutrient content claim shall be in type... (mg) sodium per serving, not a low sodium product.” The disclaimer must be in easily legible print...

  18. 77 FR 14686 - Claims for Patent and Copyright Infringement

    Science.gov (United States)

    2012-03-13

    ... SPACE ADMINISTRATION 14 CFR Part 1245 RIN 2700-AD63 Claims for Patent and Copyright Infringement AGENCY... necessary to file a claim for patent or copyright infringement, and they also provide for written... INFORMATION: On July 26, 2011, the Administrator published a notice of proposed rulemaking (NPRM) for...

  19. 46 CFR 310.9 - Medical attention and injury claims.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Medical attention and injury claims. 310.9 Section 310.9 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION TRAINING MERCHANT MARINE TRAINING... Medical attention and injury claims. (a) Medical attention and hospitalization. The school shall...

  20. Does a Claims Diagnosis of Autism Mean a True Case?

    Science.gov (United States)

    Burke, James P.; Jain, Anjali; Yang, Wenya; Kelly, Jonathan P.; Kaiser, Marygrace; Becker, Laura; Lawer, Lindsay; Newschaffer, Craig J.

    2014-01-01

    The purpose of this study was to validate autism spectrum disorder cases identified through claims-based case identification algorithms against a clinical review of medical charts. Charts were reviewed for 432 children who fell into one of the three following groups: (a) more than or equal to two claims with an autism spectrum disorder diagnosis…

  1. 20 CFR 429.203 - When is a claim allowable?

    Science.gov (United States)

    2010-04-01

    ... paragraph (a) of this section and the other provisions of this subpart, any claim you make for damage to, or... excluded under this subpart: (1) Property damage in quarters or other authorized places. Claims are allowable for damage to, or loss of, property arising from fire, flood, hurricane, other natural...

  2. 78 FR 65489 - Standard Claims and Appeals Forms

    Science.gov (United States)

    2013-10-31

    ... benefits sought. An ``incomplete claim'' would generally be a written communication expressing a desire for..., which provides that ``VA may accept as a claim for benefits under 38 U.S.C. 1151 . . . any communication... that non-standard communications, such as emails within the eBenefits system, do not...

  3. Theoretical Claims and Empirical Evidence in Maori Education Discourse

    Science.gov (United States)

    Rata, Elizabeth

    2012-01-01

    Post-Marxist critical sociology of education has influenced the development of indigenous ("kaupapa") Maori educational theory and research. Its effects are examined in four claims made for Maori education by indigenous theorists. The claims are: indigenous kaupapa Maori education is a revolutionary initiative; it is a cultural solution…

  4. 38 CFR 3.2600 - Review of benefit claims decisions.

    Science.gov (United States)

    2010-07-01

    ... ADJUDICATION Universal Adjudication Rules That Apply to Benefit Claims Governed by Part 3 of This Title... Disagreement with a decision of an agency of original jurisdiction on a benefit claim has a right to a review... an agency of original jurisdiction (including the decision being reviewed or any prior decision...

  5. Knowledge claim evaluation : a fundamental issue for knowledge management

    NARCIS (Netherlands)

    Peters, K.; Maruster, L.; Jorna, R.J.J.M.

    2010-01-01

    Purpose - This paper aims to present a classification of approaches toward knowledge claim evaluation (KCE), which is the process of evaluating and testing knowledge claims in organizations, and to position KCE as a fundamental research issue for KM. Design/methodology/approach - The paper draws

  6. 20 CFR 702.225 - Withdrawal of a claim.

    Science.gov (United States)

    2010-04-01

    ... HARBOR WORKERS' COMPENSATION ACT AND RELATED STATUTES ADMINISTRATION AND PROCEDURE Claims Procedures... request for withdrawal is approved, such withdrawal shall be without prejudice to the filing of another claim, subject to the time limitation provisions of section 13 of the Act and of the regulations in...

  7. 21 CFR 101.14 - Health claims: general requirements.

    Science.gov (United States)

    2010-04-01

    ... claim, to FDA's satisfaction, to be safe and lawful under the applicable food safety provisions of the... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Health claims: general requirements. 101.14 Section 101.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN...

  8. 48 CFR 6104.403 - Response to claim [Rule 403].

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Response to claim . 6104.403 Section 6104.403 Federal Acquisition Regulations System CIVILIAN BOARD OF CONTRACT APPEALS, GENERAL SERVICES ADMINISTRATION TRAVEL AND RELOCATION EXPENSES CASES 6104.403 Response to claim ....

  9. 9 CFR 51.32 - Claims not allowed.

    Science.gov (United States)

    2010-01-01

    ... COOPERATIVE CONTROL AND ERADICATION OF LIVESTOCK OR POULTRY DISEASES ANIMALS DESTROYED BECAUSE OF BRUCELLOSIS Indemnity for Sheep, Goats, and Horses § 51.32 Claims not allowed. Claims for indemnity for goats, sheep, and horses destroyed because of brucellosis will not be allowed if any of the following...

  10. 9 CFR 55.5 - Presentation of claims for indemnity.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Presentation of claims for indemnity. 55.5 Section 55.5 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT... CHRONIC WASTING DISEASE Chronic Wasting Disease Indemnification Program § 55.5 Presentation of claims...

  11. 42 CFR 433.139 - Payment of claims.

    Science.gov (United States)

    2010-10-01

    ... the amount of liability. The establishment of third party liability takes place when the agency...) MEDICAL ASSISTANCE PROGRAMS STATE FISCAL ADMINISTRATION Third Party Liability § 433.139 Payment of claims. (a) Basic provisions. (1) For claims involving third party liability that are processed on or...

  12. 48 CFR 1404.804-70 - Release of claims.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Release of claims. 1404.804-70 Section 1404.804-70 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR GENERAL ADMINISTRATIVE MATTERS Contract Files 1404.804-70 Release of claims. (a) The CO shall insert the clause at...

  13. Altering health-pleasure trade-off via advertising claims

    NARCIS (Netherlands)

    Bialkova, Svetlana; Bialkova, S.E.; Sasse, L.; Fenko, Anna; Verlegh, P.; Voorveld, H.; de Pelsmacker, P.

    2014-01-01

    The study investigated whether and how advertising claims (taste vs. health benefit) influenced consumer taste perception and buying intentions of potato chips. Participants (N=154) were exposed to the front of the product package and were invited to taste the product. Taste benefit claims lead to

  14. 39 CFR 777.28 - Claims and appeals.

    Science.gov (United States)

    2010-07-01

    ... relocation representative should assist eligible displaced persons in the preparation of claims for moving... relocation representative with the displaced person, to preclude technical difficulties in processing the... of the displaced person's claim, the Postal Service will promptly authorize payment of the...

  15. 20 CFR 325.4 - Claim for unemployment benefits.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Claim for unemployment benefits. 325.4 Section 325.4 Employees' Benefits RAILROAD RETIREMENT BOARD REGULATIONS UNDER THE RAILROAD UNEMPLOYMENT INSURANCE ACT REGISTRATION FOR RAILROAD UNEMPLOYMENT BENEFITS § 325.4 Claim for unemployment benefits. (a...

  16. 42 CFR 60.39 - Death and disability claims.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Death and disability claims. 60.39 Section 60.39... ASSISTANCE LOAN PROGRAM The Lender and Holder § 60.39 Death and disability claims. (a) Death. The Secretary... death. (b) Disability. (1) The Secretary will discharge a borrower's liability on the loan in...

  17. 38 CFR 36.4324 - Guaranty claims; subsequent accounting.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Guaranty claims; subsequent accounting. 36.4324 Section 36.4324 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS... § 36.4324 Guaranty claims; subsequent accounting. (a) Subject to the limitation that the total...

  18. Theoretical Claims and Empirical Evidence in Maori Education Discourse

    Science.gov (United States)

    Rata, Elizabeth

    2012-01-01

    Post-Marxist critical sociology of education has influenced the development of indigenous ("kaupapa") Maori educational theory and research. Its effects are examined in four claims made for Maori education by indigenous theorists. The claims are: indigenous kaupapa Maori education is a revolutionary initiative; it is a cultural solution…

  19. Health claims made on multivitamin and mineral supplements

    Directory of Open Access Journals (Sweden)

    Jelena Jovičić

    2011-12-01

    Full Text Available Introduction: Basic purpose of health claims is consumers' benefit by providing information about healthy eating habits. It is necessary for health claims to be scientifically substantiated and truthful. Health claims should not attribute to food the property of preventing, treating or curing a human disease. Use of health claims should be followed by a statement indicating the importance of a varied and balanced diet and a healthy lifestyle. The objective of this research was to examine the compliance of health claims made on multivitamin and mineral dietary supplements' labels on the Serbian market with national regulation concerning health safety of dietary products.Methods: An assessment of labels of MVMs was done in two privately owned pharmacies in Novi Sad, Serbia in August 2010.Results: In total, 48 MVMs were sampled and 22 health claims were detected. Seven out of 22 health claims were in compliance with the national regulation. The main reason for health claims on foreign MVMs not to be compliant with the regulation in Serbia was inadequate or nonexistent translation of original labels.Conclusion: Detected use of terms such as "prevention", "treatment" and "indications" on vitamin and mineral dietary supplements' labels is both forbidden and misleading to consumers. Coupled with inadequate or nonexistent translation of the labels, it leads to a low level of protection of Serbian consumers. It is necessary to establish an effective monitoring system for dietary supplements' labeling on a national scale in order toprotect consumers and their wellbeing.

  20. 42 CFR 457.212 - Disallowance of claims for FFP.

    Science.gov (United States)

    2010-10-01

    ...) Reconsideration procedures. The reconsideration procedures are those set forth in 45 CFR part 16. (d... 42 Public Health 4 2010-10-01 2010-10-01 false Disallowance of claims for FFP. 457.212 Section 457...; Reduction of Federal Medical Payments § 457.212 Disallowance of claims for FFP. (a) Notice of...

  1. 42 CFR 457.210 - Deferral of claims for FFP.

    Science.gov (United States)

    2010-10-01

    ... reconsideration in accordance with 45 CFR part 16. ... 42 Public Health 4 2010-10-01 2010-10-01 false Deferral of claims for FFP. 457.210 Section 457.210...; Reduction of Federal Medical Payments § 457.210 Deferral of claims for FFP. (a) Requirements for...

  2. 42 CFR 430.42 - Disallowance of claims for FFP.

    Science.gov (United States)

    2010-10-01

    ... reconsideration procedures are those set forth in 45 CFR part 16 for Medicaid and for many other programs... 42 Public Health 4 2010-10-01 2010-10-01 false Disallowance of claims for FFP. 430.42 Section 430... Medicaid Payments § 430.42 Disallowance of claims for FFP. (a) Notice of disallowance and of right...

  3. 7 CFR 226.14 - Claims against institutions.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Claims against institutions. 226.14 Section 226.14... against institutions. (a) State agencies shall disallow any portion of a claim for reimbursement and recover any payment to an institution not properly payable under this part. State agencies may...

  4. 15 CFR 2.4 - Procedure for filing claims.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Procedure for filing claims. 2.4 Section 2.4 Commerce and Foreign Trade Office of the Secretary of Commerce PROCEDURES FOR HANDLING AND... (28 CFR Part 14). (b) Claims shall be filed with the Assistant General Counsel for Finance...

  5. 7 CFR 220.14 - Claims against school food authorities.

    Science.gov (United States)

    2010-01-01

    ... may refer to CND through the FNSRO for determination any action it proposes to take under this section.... (e) If CND does not concur with the State agency's action in paying a claim or a reclaim, or in failing to collect an overpayment, CND shall assert a claim against the State agency for the amount...

  6. 40 CFR 304.21 - Referral of claims.

    Science.gov (United States)

    2010-07-01

    ... CLAIMS Jurisdiction of Arbitrator, Referral of Claims, and Appointment of Arbitrator § 304.21 Referral of... submitted pursuant to the procedures established by this part by an Arbitrator appointed pursuant to § 304... effective, any such modification must be signed by the Arbitrator and all other parties. The joint...

  7. 14 CFR 1261.414 - Compromise of claims.

    Science.gov (United States)

    2010-01-01

    ... the Claims Collection Litigation Report. See § 1261.417(e) or 4 CFR 105.2(b). Claims for which the... potential income; (3) Inheritance prospects; (4) The possibility that assets have been concealed or... which collateral or other property will bring at forced sale may properly be considered in...

  8. 40 CFR 13.26 - Payment of compromised claims.

    Science.gov (United States)

    2010-07-01

    ... will be required to execute a confess-judgment agreement which accelerates payment of the balance due... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Payment of compromised claims. 13.26... STANDARDS Compromise of Debts § 13.26 Payment of compromised claims. The Administrator normally will not...

  9. 33 CFR 136.9 - Falsification of claims.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Falsification of claims. 136.9 Section 136.9 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED... PROCEDURES; DESIGNATION OF SOURCE; AND ADVERTISEMENT General § 136.9 Falsification of claims....

  10. A unifying framework for the problem of adjudicating conflicting claims

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Østerdal, Lars Peter Raahave; Moreno-Terero, Juan D.

    2012-01-01

    In a recent paper, Thomson and Yeh [Thomson, W., Yeh, C.-H., 2008. Operators for the adjudication of conflicting claims. Journal of Economic Theory 143, 177–198] introduced the concept of operators on the space of rules for the problem of adjudicating conflicting claims. They focused on three ope...

  11. 10 CFR 765.21 - Procedures for processing reimbursement claims.

    Science.gov (United States)

    2010-01-01

    ... AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.21... uranium or thorium processing site licensees for approved costs of remedial action will be made... Department's determination to approve, approve in part, or deny a claim will be provided to the licensee...

  12. 9 CFR 51.30 - Claims for indemnity.

    Science.gov (United States)

    2010-01-01

    ... if the claimant has submitted a complete indemnity claim form to the Veterinarian in Charge and the claim has been approved by the Veterinarian in Charge or by an APHIS representative designated by him or her. The Veterinarian in Charge or an APHIS representative designated by the Veterinarian in Charge...

  13. Knowledge Discovery from Massive Healthcare Claims Data

    Energy Technology Data Exchange (ETDEWEB)

    Chandola, Varun [ORNL; Sukumar, Sreenivas R [ORNL; Schryver, Jack C [ORNL

    2013-01-01

    The role of big data in addressing the needs of the present healthcare system in US and rest of the world has been echoed by government, private, and academic sectors. There has been a growing emphasis to explore the promise of big data analytics in tapping the potential of the massive healthcare data emanating from private and government health insurance providers. While the domain implications of such collaboration are well known, this type of data has been explored to a limited extent in the data mining community. The objective of this paper is two fold: first, we introduce the emerging domain of big"healthcare claims data to the KDD community, and second, we describe the success and challenges that we encountered in analyzing this data using state of art analytics for massive data. Specically, we translate the problem of analyzing healthcare data into some of the most well-known analysis problems in the data mining community, social network analysis, text mining, and temporal analysis and higher order feature construction, and describe how advances within each of these areas can be leveraged to understand the domain of healthcare. Each case study illustrates a unique intersection of data mining and healthcare with a common objective of improving the cost-care ratio by mining for opportunities to improve healthcare operations and reducing hat seems to fall under fraud, waste,and abuse.

  14. Forensic bitemark identification: weak foundations, exaggerated claims

    Science.gov (United States)

    Saks, Michael J.; Albright, Thomas; Bohan, Thomas L.; Bierer, Barbara E.; Bowers, C. Michael; Bush, Mary A.; Bush, Peter J.; Casadevall, Arturo; Cole, Simon A.; Denton, M. Bonner; Diamond, Shari Seidman; Dioso-Villa, Rachel; Epstein, Jules; Faigman, David; Faigman, Lisa; Fienberg, Stephen E.; Garrett, Brandon L.; Giannelli, Paul C.; Greely, Henry T.; Imwinkelried, Edward; Jamieson, Allan; Kafadar, Karen; Kassirer, Jerome P.; Koehler, Jonathan ‘Jay’; Korn, David; Mnookin, Jennifer; Morrison, Alan B.; Murphy, Erin; Peerwani, Nizam; Peterson, Joseph L.; Risinger, D. Michael; Sensabaugh, George F.; Spiegelman, Clifford; Stern, Hal; Thompson, William C.; Wayman, James L.; Zabell, Sandy; Zumwalt, Ross E.

    2016-01-01

    Abstract Several forensic sciences, especially of the pattern-matching kind, are increasingly seen to lack the scientific foundation needed to justify continuing admission as trial evidence. Indeed, several have been abolished in the recent past. A likely next candidate for elimination is bitemark identification. A number of DNA exonerations have occurred in recent years for individuals convicted based on erroneous bitemark identifications. Intense scientific and legal scrutiny has resulted. An important National Academies review found little scientific support for the field. The Texas Forensic Science Commission recently recommended a moratorium on the admission of bitemark expert testimony. The California Supreme Court has a case before it that could start a national dismantling of forensic odontology. This article describes the (legal) basis for the rise of bitemark identification and the (scientific) basis for its impending fall. The article explains the general logic of forensic identification, the claims of bitemark identification, and reviews relevant empirical research on bitemark identification—highlighting both the lack of research and the lack of support provided by what research does exist. The rise and possible fall of bitemark identification evidence has broader implications—highlighting the weak scientific culture of forensic science and the law's difficulty in evaluating and responding to unreliable and unscientific evidence. PMID:28852538

  15. Pediatric laparoscopy: Facts and factitious claims

    Directory of Open Access Journals (Sweden)

    Raveenthiran V

    2010-01-01

    Full Text Available Background: Pediatric laparoscopy (LS is claimed to be superior to open surgery (OS. This review questions the scientific veracity of this assertion by systematic analysis of published evidences comparing LS versus OS in infants and children. Materials and Methods: Search of PubMed data base and the available literature on pediatric LS is analyzed. Results: One hundred and eight articles out of a total of 426 papers were studied in detail. Conclusions: High quality evidences indicate that LS is, at the best, as invasive as OS; and is at the worst, more invasive than conventional surgery. There are no high quality evidences to suggest that LS is minimally invasive, economically profitable and is associated with fewer complications than OS. Evidences are equally distributed for and against the benefits of LS regarding postoperative pain. Proof of cosmetic superiority of LS or otherwise is not available. The author concludes that pediatric laparoscopy, at the best, is simply comparable to laparotomy and its superiority over the latter could not be sustained on the basis of available scientific evidences. Benefits of laparoscopy appear to recede with younger age. Concerns are raised on the quick adoption, undue promotion and frequent misuse of laparoscopy in children.

  16. People with easier to pronounce names promote truthiness of claims.

    Directory of Open Access Journals (Sweden)

    Eryn J Newman

    Full Text Available When people make judgments about the truth of a claim, related but nonprobative information rapidly leads them to believe the claim--an effect called "truthiness". Would the pronounceability of others' names also influence the truthiness of claims attributed to them? We replicated previous work by asking subjects to evaluate people's names on a positive dimension, and extended that work by asking subjects to rate those names on negative dimensions. Then we addressed a novel theoretical issue by asking subjects to read that same list of names, and judge the truth of claims attributed to them. Across all experiments, easily pronounced names trumped difficult names. Moreover, the effect of pronounceability produced truthiness for claims attributed to those names. Our findings are a new instantiation of truthiness, and extend research on the truth effect as well as persuasion by showing that subjective, tangential properties such as ease of processing can matter when people evaluate information attributed to a source.

  17. Controlling large malpractice claims: the unexpected impact of damage caps.

    Science.gov (United States)

    Gronfein, W P; Kinney, E D

    1991-01-01

    Indiana's comprehensive malpractice reforms, inaugurated in 1975, include a cap on damages, a mandated medical review before trial, and a state insurance fund to pay claims equal to or greater than $100,000. We have found that the amount of compensation going to claimants with such large malpractice claims in Indiana is, on average, substantially higher than in Michigan and Ohio. Indiana's mean claim severity between 1977 and 1988 was $404,832, while the means for Michigan and Ohio were $290,022 and $303,220, respectively, with the difference between these three means being highly significant. Although data on claim and claimant characteristics reveal considerable interstate variation, the results of regression analyses show that Indiana claim payment amounts are higher than Michigan or Ohio payments, independent of the effect of factors such as sex, age, severity of injury, allegations of negligence, and year of settlement.

  18. 76 FR 66758 - Remedies for Small Copyright Claims

    Science.gov (United States)

    2011-10-27

    ...The U.S. Copyright Office is undertaking a study at the request of Congress to assess whether and, if so, how the current legal system hinders or prevents copyright owners from pursuing copyright infringement claims that have a relatively small economic value (``small copyright claims''); and recommend potential changes in administrative, regulatory, and statutory authority to improve the adjudication of these small copyright claims. The Office thus seeks comment on how copyright owners have handled small copyright claims and the obstacles they have encountered, as well as potential alternatives to the current legal system that could better accommodate such claims. This is a general inquiry and the Office will publish additional notices on this topic.

  19. Health claims as communication tools that enhance brand loyalty

    DEFF Research Database (Denmark)

    Krystallis, Athanasios; Chrysochou, Polymeros

    2011-01-01

    strategy. Brands carrying a health claim are thus expected to have an advantage over their counterparts. In this study, we aim to investigate whether health claims, with emphasis on the low-fat claims, can act as a means to improve the performance of brands and further enhance their loyalty levels. Based......: a) fat content; b) enrichment; and c) way of processing. Then, the Dirichlet model's fit to the empirical data is examined, leading to the theoretical estimation of loyalty measures. Findings suggest that, on average, brands with a low-fat claim perform better in the market compared with their high......-fat counterparts. Moreover, in comparison with other health-related attributes the fat content attribute exhibits slightly higher loyalty, signifying the importance of the "low-fat" claim as a means of communication....

  20. Access to care: the physician's perspective.

    Science.gov (United States)

    Tice, Alan; Ruckle, Janessa E; Sultan, Omar S; Kemble, Stephen

    2011-02-01

    Private practice physicians in Hawaii were surveyed to better understand their impressions of different insurance plans and their willingness to care for patients with those plans. Physician experiences and perspectives were investigated in regard to reimbursement, formulary limitations, pre-authorizations, specialty referrals, responsiveness to problems, and patient knowledge of their plans. The willingness of physicians to accept new patients from specific insurance company programs clearly correlated with the difficulties and limitations physicians perceive in working with the companies (p<0.0012). Survey results indicate that providers in private practice were much more likely to accept University Health Alliance (UHA) and Hawaii Medical Services Association (HMSA) Commercial insurance than Aloha Care Advantage and Aloha Quest. This was likely related to the more favorable impressions of the services, payments, and lower administrative burden offered by those companies compared with others.

  1. Marketing to physicians in a digital world.

    Science.gov (United States)

    Manz, Christopher; Ross, Joseph S; Grande, David

    2014-11-13

    Pharmaceutical marketing can lead to overdiagnosis, overtreatment, and overuse of medications. Digital advertising creates new pathways for reaching physicians, allowing delivery of marketing messages at the point of care, when clinical decisions are being made.

  2. Physician Fee Schedule Carrier Specific Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) has condensed all 56 Physician Fee Schedule (PFS) carrier specific pricing files into one zip file. It is...

  3. Facilitating Physician Access to Medical Reference Information

    OpenAIRE

    2005-01-01

    Context: Computer-based medical reference information is augmenting—and in some cases, replacing—many traditional sources. For Kaiser Permanente (KP) physicians, this change presents both advantages and obstacles to finding medical reference information.

  4. Medicare Physician and Other Supplier Interactive Dataset

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Centers for Medicare and Medicaid Services (CMS) has prepared a public data set, the Medicare Provider Utilization and Payment Data - Physician and Other...

  5. 77 FR 5217 - Retrospective Review Under E.O. 13563: Seamen's Claims; Admiralty Extension Act Claims; and...

    Science.gov (United States)

    2012-02-02

    ... to adopt a procedural process to more effectively address claims arising under the Suits in Admiralty... Clarification Act and implement a process to resolve administrative claims arising under the Admiralty Extension...) is evaluating the continued validity of its rules and determining whether they effectively address...

  6. Do Insurers Have to Pay for Bad Behaviour in Settling Claims? Legal Aspects of Insurers' Wrongful Claims Handling

    NARCIS (Netherlands)

    W.H. van Boom (Willem)

    2011-01-01

    textabstractAbstract: This article presents a comparative legal analysis of wrongful claims handling by insurance companies in indemnity and liability insurance. From the outset, it is clear that it may be difficult to draw the line between legitimate claims denial and refusal to pay, on the one han

  7. Do Insurers Have to Pay for Bad Behaviour in Settling Claims? Legal Aspects of Insurers' Wrongful Claims Handling

    NARCIS (Netherlands)

    W.H. van Boom (Willem)

    2011-01-01

    textabstractAbstract: This article presents a comparative legal analysis of wrongful claims handling by insurance companies in indemnity and liability insurance. From the outset, it is clear that it may be difficult to draw the line between legitimate claims denial and refusal to pay, on the one han

  8. Nutrition labelling, marketing techniques, nutrition claims and health claims on chip and biscuit packages from sixteen countries.

    Science.gov (United States)

    Mayhew, Alexandra J; Lock, Karen; Kelishadi, Roya; Swaminathan, Sumathi; Marcilio, Claudia S; Iqbal, Romaina; Dehghan, Mahshid; Yusuf, Salim; Chow, Clara K

    2016-04-01

    Food packages were objectively assessed to explore differences in nutrition labelling, selected promotional marketing techniques and health and nutrition claims between countries, in comparison to national regulations. Cross-sectional. Chip and sweet biscuit packages were collected from sixteen countries at different levels of economic development in the EPOCH (Environmental Profile of a Community's Health) study between 2008 and 2010. Seven hundred and thirty-seven food packages were systematically evaluated for nutrition labelling, selected promotional marketing techniques relevant to nutrition and health, and health and nutrition claims. We compared pack labelling in countries with labelling regulations, with voluntary regulations and no regulations. Overall 86 % of the packages had nutrition labels, 30 % had health or nutrition claims and 87 % displayed selected marketing techniques. On average, each package displayed two marketing techniques and one health or nutrition claim. In countries with mandatory nutrition labelling a greater proportion of packages displayed nutrition labels, had more of the seven required nutrients present, more total nutrients listed and higher readability compared with those with voluntary or no regulations. Countries with no health or nutrition claim regulations had fewer claims per package compared with countries with regulations. Nutrition label regulations were associated with increased prevalence and quality of nutrition labels. Health and nutrition claim regulations were unexpectedly associated with increased use of claims, suggesting that current regulations may not have the desired effect of protecting consumers. Of concern, lack of regulation was associated with increased promotional marketing techniques directed at children and misleadingly promoting broad concepts of health.

  9. Developing physician leaders in academic medical centers.

    Science.gov (United States)

    Bachrach, D J

    1997-01-01

    While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.*

  10. Physician alignment strategies and real estate.

    Science.gov (United States)

    Czerniak, Thomas A

    2012-06-01

    When addressing locations of facilities after acquiring physician practices, hospitals should: Acknowledge the hospital's ambulatory plan is the driver rather than real estate assumed with the physician practices, Review the hospital ambulatory service plan for each submarket, Review the location of facilities within the service area and their proximity to one another, Sublease or sell existing facilities that are not appropriate, Ensure that the size and characteristics of each facility in the market are appropriate and consistent with the hospital's image.

  11. Sigmund Freud's physicians and "the monster".

    Science.gov (United States)

    Tainmont, J

    2007-01-01

    Freud received treatment from several physicians--including rhinologists, oro-facial surgeons or radiotherapists--for a cancer of the palate. Furthermore, as a consequence of his operation, Freud was required to wear a prosthesis that he probably named "the monster". This paper provides some details about the physicians who cured Freud and looks at the prosthesis he was forced to wear until his death.

  12. Physician’s Assistants Attitudes and Performance

    Science.gov (United States)

    1978-06-01

    Sick Call 2 Physicals Exams 43 ’Heekend Sick Call 2 Field Duty/Down Range 29 Preventive Med Officer 2 Stockade 27 OIC 2 Sports coverage 21 Lecturer...Psychiatry Primary/Health Care Clinic 23 Podiatry Aid Station/Squadron Air Station 19 Surgery In Bn 15 Where Needed Dispensary 13 Delivering Babies...in ER 1 Dealing with TM Problem 1 As Physician under supervision 1 Replacement for GMO 1 Podiatry /Orthopedics 1 Help physician TMC level deal with

  13. Physician Burnout: Coaching a Way Out

    OpenAIRE

    2014-01-01

    Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Professional coaching, long utilized in the business world, provides a results-oriented a...

  14. Physician Burnout: Coaching a Way Out

    OpenAIRE

    2014-01-01

    ABSTRACT Twenty-five to sixty percent of physicians report burnout across all specialties. Changes in the healthcare environment have created marked and growing external pressures. In addition, physicians are predisposed to burnout due to internal traits such as compulsiveness, guilt, and self-denial, and a medical culture that emphasizes perfectionism, denial of personal vulnerability, and delayed gratification. Professional coaching, long utilized in the business world, provides a results-o...

  15. Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians

    Directory of Open Access Journals (Sweden)

    Nir Eyal

    2016-03-01

    Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.

  16. U.K. physicians' attitudes toward active voluntary euthanasia and physician-assisted suicide.

    Science.gov (United States)

    Dickinson, George E; Lancaster, Carol J; Clark, David; Ahmedzai, Sam H; Noble, William

    2002-01-01

    A comparison of the views of geriatric medicine physicians and intensive care physicians in the United Kingdom on the topics of active voluntary euthanasia and physician-assisted suicide revealed rather different attitudes. Eighty percent of geriatricians, but only 52% of intensive care physicians, considered active voluntary euthanasia as never justified ethically. Gender and age did not play a major part in attitudinal differences of the respondents. If the variability of attitudes of these two medical specialties are anywhere near illustrative of other physicians in the United Kingdom, it would be difficult to formulate and implement laws and policies concerning euthanasia and assisted suicide. In addition, ample safeguards would be required to receive support from physicians regarding legalization.

  17. [Sponsoring of physicians in private practice].

    Science.gov (United States)

    Rieger, Hans-Jürgen

    2005-04-01

    The financing of advanced medical training for physicians by the pharmaceutical industry has been the subject of legal discussions for more than two decades. Recent legal changes have renewed the importance of industry sponsoring. At the 106th national convention of the German physicians, the model ordinance for the German medical profession ("Musterberufsordnung für die deutschen Arztinnen und Arzte-MBO-A") has been reformed, and for the first time individual physicians are now permitted, under certain circumstances, to receive financial support from sponsors to participate in medical-training events. A recent legal reform to modernize the healthcare system ("GKV-Modernisierungsgesetz"--GMG) obliges physicians to observe the law that regulates advertising of medicinal products ("Heilmittelwerbegesetz"--HWG); consequently, the physicians can commit a misdemeanor when accepting prohibited financial support. This essay discusses the implications of this legal reform for the most important types of commercially-sponsored medical training. The GMG reform has introduced an obligation for physicians to absolve continuous medical training, however the resulting legal situation has not changed the requirement that this training remain free of commercial interests.

  18. Family physician perspectives on primary immunodeficiency diseases

    Directory of Open Access Journals (Sweden)

    Jordan eOrange

    2016-03-01

    Full Text Available Primary immunodeficiency diseases (PID include over 250 diverse disorders. The current study assessed management of PID by family practice physicians. The American Academy of Allergy, Asthma, and Immunology Primary Immunodeficiency Committee and the Immune Deficiency Foundation conducted an incentivized mail survey of family practice physician members of the American Medical Association and the American Osteopathic Association in direct patient care. Responses were compared with subspecialist immunologist responses from a similar survey. Surveys were returned by 528 (of 4500 surveys mailed family practice physicians, of whom 44% reported following ≥1 patient with a PID. Selective immunoglobulin A (IgA, deficiency (21%, and chronic granulomatous disease (11% were most common and were followed by significantly more subspecialist immunologists (P<.0001. Use of intravenously administered Ig, and live viral vaccinations across PID was significantly different (P<.0001. Few family practice physicians were aware of professional guidelines for diagnosis and management of PID (4% vs. 79% of subspecialist immunologists, P<.0001. Family practice physicians will likely encounter patients with a PID diagnoses during their career. Differences in how family practice physicians and subspecialist immunologists manage patients with PID underscore areas where improved educational and training initiatives may benefit patient care.

  19. Interactions between physicians and drug industry

    Directory of Open Access Journals (Sweden)

    Begul Yagci Kupeli

    2016-12-01

    Full Text Available Ethical issues involving drug industry physician relationship have resulted in an ongoing debate about its appropriateness for many years in medical World. The most familiar marketing strategies of drug companies include individual gifts for physicians and sponsorship for educational and social activities. This interaction begins during medical school years of doctors and types of interactions are modified according to factors such as physician's position, title and number of patients. Although data reveal the opposite, most doctors deny or underestimate the influence of drug companies on their drug prescription. Both sides have common interests such as effective drug usage and observation, conduction of creative scientific studies. However, they have conflict of interests in some aspects. Physicians mostly care about patients' well-being and scientific improvement while drug companies are mostly involved in commercial benefit. Furthermore, some of the marketing strategies may have significant consequences on health of society such as rising drug costs, wrong or excessive usage of drugs. Regulations and guidelines have been designed in order to overcome these issues. However, the most important role in modelling of physician-drug industry interaction belongs to physicians. [Cukurova Med J 2016; 41(4.000: 777-781

  20. An overlooked source of physician-scientists.

    Science.gov (United States)

    Puljak, Livia

    2007-12-01

    A shortage of physician-scientists in the United States is an ongoing problem. Various recommendations have been made to address this issue; however, none of them have ameliorated the situation. Foreign medical school graduates with postdoctoral training in the United States are an overlooked and untapped resource for combating the dearth of physician-scientists. Evaluation of the scientific staff at the University of Texas Southwestern Medical Center revealed that 11% of all postdoctoral fellows were international medical graduates. Interestingly, a survey taken by these individuals revealed a lack of institutional and/or mentor support for career development and preparation for becoming physician-scientists. Foreign postdoctoral fellows with medical degrees are not even eligible for physician-scientist grants and awards since they are not US citizens. Although physicians educated in the United States usually matriculate from medical school with high educational debt that prevents most of them from entering into scientific careers, doctors trained outside the United States generally have minimal, if any, debt. Furthermore, many of them have a keen interest in remaining in the United States once they complete their postdoctoral training. Thus, foreign-trained medical professionals who have pursued scientific training in the United States can be one of the solutions for the current dearth of physician-scientists.

  1. The professional responsibility model of physician leadership.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L

    2013-02-01

    The challenges physician leaders confront today call to mind Odysseus' challenge to steer his fragile ship successfully between Scylla and Charybdis. The modern Scylla takes the form of ever-increasing pressures to provide more resources for professional liability, compliance, patient satisfaction, central administration, and a host of other demands. The modern Charybdis takes the form of ever-increasing pressures to procure resources when fewer are available and competition is continuously increasing the need for resources, including managed care, hospital administration, payers, employers, patients who are uninsured or underinsured, research funding, and philanthropy. This publication provides physician leaders with guidance for identifying and managing common leadership challenges on the basis of the professional responsibility model of physician leadership. This model is based on Plato's concept of leadership as a life of service and the professional medical ethics of Drs John Gregory and Thomas Percival. Four professional virtues should guide physician leaders: self-effacement, self-sacrifice, compassion, and integrity. These professional virtues direct physician leaders to treat colleagues as ends in themselves, to provide justice-based resource management, to use power constrained by medical professionalism, and to prevent and respond effectively to organizational dysfunction. The professional responsibility model guides physician leaders by proving an explicit "tool kit" to complement managerial skills. Copyright © 2013 Mosby, Inc. All rights reserved.

  2. Making Claims The Claim as a Knowledge Design, Capture, and Sharing Tool in HCI

    CERN Document Server

    McCrickard, Scott

    2012-01-01

    Human-centered informatics (HCI) is a young discipline that is still defining its core components, with approaches rooted in engineering, science, and creative design. In the spirit of this book series, this book explores HCI as an intersection point for different perspectives of computing and information technology, seeking to understand how groups of designers can communicate with an increasingly diverse set of colleagues on a broadening set of problems. In so doing, this book traces the evolution of claims as a way to capture and share knowledge, particularly in comparison to other approach

  3. Ginger and its health claims: molecular aspects.

    Science.gov (United States)

    Butt, Masood Sadiq; Sultan, M Tauseef

    2011-05-01

    Recent research has rejuvenated centuries-old traditional herbs to cure various ailments by using modern tools like diet-based therapy and other regimens. Ginger is one of the classic examples of an herb used for not only culinary preparations but also for unique therapeutic significance owing to its antioxidant, antimicrobial, and anti-inflammatory potential. The pungent fractions of ginger, namely gingerols, shogaols, paradols, and volatile constituents like sesquiterpenes and monoterpenes, are mainly attributed to the health-enhancing perspectives of ginger. This review elucidates the health claims of ginger and the molecular aspects and targets, with special reference to anticancer perspectives, immunonutrition, antioxidant potential, and cardiovascular cure. The molecular targets involved in chemoprevention like the inhibition of NF-κB activation via impairing nuclear translocation, suppresses cIAP1 expression, increases caspase-3/7 activation, arrests cell cycle in G2 + M phases, up-regulates Cytochrome-c, Apaf-1, activates PI3K/Akt/I kappaB kinases IKK, suppresses cell proliferation, and inducts apoptosis and chromatin condensation. Similarly, facts are presented regarding the anti-inflammatory response of ginger components and molecular targets including inhibition of prostaglandin and leukotriene biosynthesis and suppression of 5-lipoxygenase. Furthermore, inhibition of phosphorylation of three mitogen-activated protein kinases (MAPKs), extracellular signal-regulated kinases 1 and 2 (ERK1/2), and c-Jun N-terminal kinase (JNK) are also discussed. The role of ginger in reducing the extent of cardiovascular disorders, diabetes mellitus, and digestive problems has also been described in detail. Although, current review articles summarized the literature pertaining to ginger and its components. However, authors are still of the view that further research should be immediately carried out for meticulousness.

  4. Discussion of “Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems”

    DEFF Research Database (Denmark)

    Bates, D. W.; Baysari, M. T.; Dugas, M.

    2013-01-01

    With these comments on the paper “Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems”, written by Martin Jung and coauthors, with Dr. Elske Ammenwerth as senior author, the journal wants to stimulate a broad discussion on computerized physician order...... entry systems. An international group of experts have been invited by the editor of Methods to comment on this paper. Each of the invited commentaries forms one section of this paper....

  5. Attitudes of patients and physicians regarding physician dress and demeanor in the emergency department.

    Science.gov (United States)

    Colt, H G; Solot, J A

    1989-02-01

    To compare the opinions of patients and physicians regarding physician dress and demeanor in the emergency department, we conducted a cross-sectional survey of 190 ED patients and 129 medical specialists, family practitioners, surgeons, and emergency physicians in a community hospital. Seventy-three percent of physicians and 43% of patients thought that physical appearance influenced patient opinion of medical care. Forty-nine percent of patients believed emergency physicians should wear white coats, but only 18% disliked scrub suits. Patients were more tolerant of casual dress than were physicians. Both groups disliked excessive jewelry, prominent ruffles or ribbons, long fingernails, blue jeans, and sandals. Opinions and practices of emergency physicians were similar to those of other medical specialists. Most physicians (96%) addressed patients by surname or title, but 43% of patients preferred being called by their first names. The age, gender, income, and education of patients did not influence how they wished to be addressed. Larger studies are needed to assess the influence of age, sex, race, and depth of feeling regarding first-name address and physician attire in the ED.

  6. 9 CFR 381.460 - Nutrient content claims for calorie content.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Nutrient content claims for calorie... § 381.460 Nutrient content claims for calorie content. (a) General requirements. A claim about the... term; (2) The claim is made in accordance with the general requirements for nutrient content claims...

  7. 9 CFR 317.360 - Nutrient content claims for calorie content.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Nutrient content claims for calorie... Labeling § 317.360 Nutrient content claims for calorie content. (a) General requirements. A claim about the... term; (2) The claim is made in accordance with the general requirements for nutrient content claims...

  8. A Unifying Framework for the Problem of Adjudicating Conflicting Claims

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    the structure of such a space. In this paper, we generalize their analysis upon presenting and studying a general family of operators inspired by three apparently unrelated approaches to the problem of adjudicating conflicting claims. We study the structural properties of this family and show, in particular......In a recent paper, Thomson and Yeh [Operators for the adjudication of conflicting claims, Journal of Economic Theory 143 (2008) 177-198] introduced the concept of operators on the space of rules for the problem of adjudicating conflicting claims. They focussed on three operators in order to uncover...

  9. Legal assumptions for private company claim for additional (supplementary payment

    Directory of Open Access Journals (Sweden)

    Šogorov Stevan

    2011-01-01

    Full Text Available Subject matter of analyze in this article are legal assumptions which must be met in order to enable private company to call for additional payment. After introductory remarks discussion is focused on existence of provisions regarding additional payment in formation contract, or in shareholders meeting general resolution, as starting point for company's claim. Second assumption is concrete resolution of shareholders meeting which creates individual obligations for additional payments. Third assumption is defined as distinctness regarding sum of payment and due date. Sending of claim by relevant company body is set as fourth legal assumption for realization of company's right to claim additional payments from member of private company.

  10. A Unifying Framework for the Problem of Adjudicating Conflicting Claims

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    In a recent paper, Thomson and Yeh [Operators for the adjudication of conflicting claims, Journal of Economic Theory 143 (2008) 177-198] introduced the concept of operators on the space of rules for the problem of adjudicating conflicting claims. They focussed on three operators in order to uncover...... the structure of such a space. In this paper, we generalize their analysis upon presenting and studying a general family of operators inspired by three apparently unrelated approaches to the problem of adjudicating conflicting claims. We study the structural properties of this family and show, in particular...

  11. Kaufbereitschaft für Lebensmittel mit Claims

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica

    2010-01-01

    Auf Lebensmitteln finden sich zunehmend nährwert- und gesundheitsbezogene Angaben ("Health Claims"). Oft sind diese nach Ansicht der Verbraucherorganisationen missverständlich und irreführend. Dem soll die neue EU-Verordnung EG 1934/2006 Abhilfe schaffen. Die Forschung zu Konsumentenverhalten und...... Claims ist jedoch noch lückenhaft. Eine Studie zeigt, dass Lebensmittel mit Claims bevorzugt gewählt und positiv beurteilt werden. Dies unterstreicht die Wichtigkeit des Einbezugs der Verbraucherperspektive bei der Gesetzgebung zu Lebensmittelinformationen....

  12. The end of medical confidentiality? Patients, physicians and the state in history.

    Science.gov (United States)

    Rieder, Philip; Louis-Courvoisier, Micheline; Huber, Philippe

    2016-09-01

    Medical confidentiality has come under attack in the public sphere. In recent disasters both journalists and politicians have questioned medical confidentiality and claimed that in specific contexts physicians should be compelled to communicate data on their patients' health. The murders of innocent individuals by a suicidal pilot and a Swiss convicted criminal have generated polemical debates on the topic. In this article, historical data on medical confidentiality is used to show that medical practices of secrecy were regularly attacked in the past, and that the nature of medical confidentiality evolved through time depending on physicians' values and judgements. Our demonstration is based on three moments in history. First, at the end of the 16th century, lay authorities put pressure on physicians to disclose the names of patients suffering from syphilis. Second, in the 18th century, physicians faced constant demands for information about patients' health from relatives and friends. Third, employers and insurance companies in the 20th century requested medical data on sick employees. In these three different situations, history reveals that the concept of medical confidentiality was plastic, modelled in the first instance to defend well-to-do patients, in the second instance it was adapted to accommodate the physician's social role and, finally, to defend universal values and public health. Medical secrecy was, and is today, a medical and societal norm that is shaped collectively. Any change in its definition and enforcement was and should be the result of negotiations with all social actors concerned. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Clinical Criteria for Physician Aid in Dying.

    Science.gov (United States)

    Orentlicher, David; Pope, Thaddeus Mason; Rich, Ben A

    2016-03-01

    More than 20 years ago, even before voters in Oregon had enacted the first aid in dying (AID) statute in the United States, Timothy Quill and colleagues proposed clinical criteria AID. Their proposal was carefully considered and temperate, but there were little data on the practice of AID at the time. (With AID, a physician writes a prescription for life-ending medication for a terminally ill, mentally capacitated adult.) With the passage of time, a substantial body of data on AID has developed from the states of Oregon and Washington. For more than 17 years, physicians in Oregon have been authorized to provide a prescription for AID. Accordingly, we have updated the clinical criteria of Quill, et al., based on the many years of experience with AID. With more jurisdictions authorizing AID, it is critical that physicians can turn to reliable clinical criteria. As with any medical practice, AID must be provided in a safe and effective manner. Physicians need to know (1) how to respond to a patient's inquiry about AID, (2) how to assess patient decision making capacity, and (3) how to address a range of other issues that may arise. To ensure that physicians have the guidance they need, Compassion & Choices convened the Physician Aid-in-Dying Clinical Criteria Committee, in July 2012, to create clinical criteria for physicians who are willing to provide AID to patients who request it. The committee includes experts in medicine, law, bioethics, hospice, nursing, social work, and pharmacy. Using an iterative consensus process, the Committee drafted the criteria over a one-year period.

  14. [Physician practice patterns and attitudes to euthanasia in Germany. A representative survey of physicians].

    Science.gov (United States)

    Kirschner, R; Elkeles, T

    1998-04-01

    Growing life expectancy and increasing pharmaceutical and technical methods in medicine are leading to more and more discussions among the general population and among physicians as to whether methods to shorten the sufferings of mortally ill persons should be legalised further. In Australia 60% of physicians wish to be able to perform active euthanasia if this would be legal. In the Netherlands physicians do not commit an offence if they perform euthanasia on the basis of ethically consented rules. In the FRG the National Board of Physicians (Bundesärztekammer) still rejects any liberalisation concerning active euthanasia. However, little is known of the attitudes and behaviour of physicians concerning the questions of active and passive euthanasia. Sponsored by Gruner and Jahr publishers for a magazine "Stern" publication we conducted a representative study among physicians working in hospitals and their colleagues in free practices concerning this topic. Beginning with qualitative interviews with 50 physicians we tested the questionnaire developed and looked for the data production method best fitting for this difficult matter resulting in telephone interviews or a self-administered questionnaire. In the main study a representative sample of n = 282 physicians in free practices and n = 191 physicians in hospitals were interviewed. The response rates were 94% and 51% respectively. Analysis of non-responses did not indicate any bias. Half of the physicians think that a broader discussion on euthanasia is necessary, 34% disagree and 17% consider even a discussion already dangerous. 6% of the physicians in hospitals and 11% in free practices have already experienced methods of active euthanasia. Half of the physicians have seen patients who strongly wished euthanasia, a situation which happens once in every two years. The majority of physicians feel a deep understanding but only a minority of 4% comply with the wish. The vast majority of physicians advocate

  15. Agreement between physicians and non-physician clinicians in starting antiretroviral therapy in rural Uganda

    Directory of Open Access Journals (Sweden)

    Vasan Ashwin

    2009-08-01

    Full Text Available Abstract Background The scarcity of physicians in sub-Saharan Africa – particularly in rural clinics staffed only by non-physician health workers – is constraining access to HIV treatment, as only they are legally allowed to start antiretroviral therapy in the HIV-positive patient. Here we present a pilot study from Uganda assessing agreement between non-physician clinicians (nurses and clinical officers and physicians in their decisions as to whether to start therapy. Methods We conducted the study at 12 government antiretroviral therapy sites in three regions of Uganda, all of which had staff trained in delivery of antiretroviral therapy using the WHO Integrated Management of Adult and Adolescent Illness guidelines for chronic HIV care. We collected seven key variables to measure patient assessment and the decision as to whether to start antiretroviral therapy, the primary variable of interest being the Final Antiretroviral Therapy Recommendation. Patients saw either a clinical officer or nurse first, and then were screened identically by a blinded physician during the same clinic visit. We measured inter-rater agreement between the decisions of the non-physician health workers and physicians in the antiretroviral therapy assessment variables using simple and weighted Kappa analysis. Results Two hundred fifty-four patients were seen by a nurse and physician, while 267 were seen by a clinical officer and physician. The majority (> 50% in each arm of the study were in World Health Organization Clinical Stages I and II and therefore not currently eligible for antiretroviral therapy according to national antiretroviral therapy guidelines. Nurses and clinical officers both showed moderate to almost perfect agreement with physicians in their Final Antiretroviral Therapy Recommendation (unweighted κ = 0.59 and κ = 0.91, respectively. Agreement was also substantial for nurses versus physicians for assigning World Health Organization Clinical

  16. Functional foods: health claim-food product compatibility and the impact of health claim framing on consumer evaluation.

    Science.gov (United States)

    van Kleef, Ellen; van Trijp, Hans C M; Luning, Pieternel

    2005-06-01

    Two studies are reported, which aim to strengthen the scientific underpinning of strategic decisions regarding functional food development, as to (1) which health benefits to claim, (2) with which product (category), and (3) in which communication format. The first exploratory study is a secondary analysis of 10 different health claims systematically combined with 10 different food carriers to evaluate their combined suitability for functional food positioning. The results show that consumers tend to prefer functional food concepts that primarily communicate disease-related health benefits in carriers with a healthy image or health positioning history. Study 2 examines health claim format and systematically varies the way in which specific health benefits are being communicated to the consumer. Two physiologically oriented claims (heart disease and osteoporosis) and two psychologically oriented food claims (stress and lack of energy) are expressed in enhanced function format versus disease risk reduction format. Also, it includes the individual difference variable of 'regulatory focus' and the health status of the respondent to explore how these factors impact health claim evaluation. The results show that consumer evaluations primarily differ to the extent that health claims are personally relevant in addressing an experienced disease state. Framing is important, but its effect differs by health benefit. No strong effects for consumers' regulatory focus were found. Underlying mechanisms of these effects and their implications for the development of functional foods are discussed.

  17. Motivational determinants among physicians in Lahore, Pakistan

    Directory of Open Access Journals (Sweden)

    Souares Aurélia

    2010-07-01

    Full Text Available Abstract Introduction Human resource crises in developing countries have been identified as a critical aspect of poor quality and low accessibility in health care. Worker motivation is an important facet of this issue. Specifically, motivation among physicians, who are an important bridge between health systems and patients, should be considered. This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. Methods A stratified random sample of 360 physicians was selected from public primary, public secondary and public and private tertiary health facilities in the Lahore district, Pakistan. Pretested, semi-structured, self-administered questionnaires were used. For the descriptive part of this study, physicians were asked to report their 5 most important work motivators and demotivators within the context of their current jobs and in general. Responses were coded according to emergent themes and frequencies calculated. Of the 30 factors identified, 10 were classified as intrinsic, 16 as organizational and 4 as socio-cultural. Results Intrinsic and socio-cultural factors like serving people, respect and career growth were important motivators. Conversely, demotivators across setups were mostly organizational, especially in current jobs. Among these, less pay was reported the most frequently. Fewer opportunities for higher qualifications was a demotivator among primary and secondary physicians. Less personal safety and poor working conditions were important in the public sector, particularly among female physicians. Among private tertiary physicians financial incentives other than pay and good working conditions were motivators in current jobs. Socio-cultural and intrinsic factors like less personal and social time and the inability to financially support oneself and family were more important among male physicians. Conclusion Motivational determinants differed

  18. Patient Trust in Physicians: Empirical Evidence from Shanghai, China

    Directory of Open Access Journals (Sweden)

    Da-Hai Zhao

    2016-01-01

    Conclusions: Patient trust in physicians in Shanghai, China is higher than previously reported. Furthermore, the most crucial reason for patient distrust in physicians is the information asymmetry between patients and physicians, which is a natural property of the physician–patient relationship, rather than the so-called for-profit characteristic of physicians or patients' excessive expectations.

  19. 19 CFR 10.590 - Right to make post-importation claim and refund duties.

    Science.gov (United States)

    2010-04-01

    ... Republic-Central America-United States Free Trade Agreement Post-Importation Duty Refund Claims § 10.590... no claim for preferential tariff treatment was made, the importer of that good may file a claim for...

  20. Patient attitudes toward emergency physician attire.

    Science.gov (United States)

    Li, Siu Fai; Haber, Marc

    2005-07-01

    Previous studies have suggested that Emergency Department (ED) patient satisfaction is unaffected by physician attire. We conducted a before-and-after trial to test this hypothesis. A convenience sample of ED patients was surveyed during a 2-week period. In the first week, emergency physicians wore white coats and formal attire. In the second week, the same physicians wore scrubs. Patients were asked to indicate on a 100-mm visual analog scale (VAS) their ratings of physician appearance, satisfaction, and professionalism. The primary outcome was the difference in VAS scores between the two dress styles. There were 111 patients surveyed. There were no significant differences between patients' evaluation of appearance (Delta=-.68 mm VAS, 95% confidence interval [CI] -5.5 to 4.1), satisfaction (Delta=.83 mm VAS, 95% CI -3.0 to 4.6), or professionalism (Delta=-.46 mm VAS, 95% CI -3.6 to 2.6) between the two dress styles. Emergency physician attire does not affect patient satisfaction.

  1. Physician-Hospital Alignment in Orthopedic Surgery.

    Science.gov (United States)

    Bushnell, Brandon D

    2015-09-01

    The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have simple, universal steps. Alignment will differ based on individual situational factors and the type of specialty involved. Ultimately, however, there are principles that underlie the concept of alignment and should be a part of any physician-hospital alignment efforts. In orthopedic surgery, alignment involves the clinical, administrative, financial, and even personal aspects of a surgeon's practice. It must be based on the principles of financial interest, clinical authority, administrative participation, transparency, focus on the patient, and mutual necessity. Alignment can take on various forms as well, with popular models consisting of shared governance and comanagement, gainsharing, bundled payments, accountable care organizations, and other methods. As regulatory and financial pressures continue to motivate physicians and hospitals to develop alignment relationships, new and innovative methods of alignment will also appear. Existing models will mature and evolve, with individual variability based on local factors. However, certain trends seem to be appearing as time progresses and alignment relationships deepen, including regional and national collaboration, population management, and changes in the legal system. This article explores the history, principles, and specific methods of physician-hospital alignment and its critical importance for the future of health care delivery.

  2. DIABETIC RETINOPATHY: HOW AWARE ARE THE PHYSICIANS?

    Directory of Open Access Journals (Sweden)

    Narendra P

    2014-05-01

    Full Text Available PURPOSE: The purpose of the study was to assess the awareness of physicians in rural Kolar district towards diabetes and diabetic retinopathy. MATERIALS AND METHODS: A cross sectional survey was conducted in rural Kolar district during May 2013. The study participants were 38 physicians and 2 general practitioners who had special training in diabetes. The data were collected by means of filling up of pre-tested specially designed questionnaires focused on awareness towards Diabetes Mellitus and Diabetic retinopathy. The assessment was done by total score as satisfactory (Diabetic retinopathy awareness index >12, moderately satisfactory (DRAI 9-11 or unsatisfactory if index 12 was attained by only 55% (22/40 practitioners. Nearly 62.5% of physicians refer the diabetics to ophthalmologists only when they develop significant vision problems. CONCLUSION: This survey highlighted some of the lacunae in the knowledge about referral system of the general physicians and identified the need for improvement in awareness regarding the management of the patients with diabetes and diabetic retinopathy. To improve patient compliance, physician needs to educate their diabetic patients about the importance of setting an annual eye examination routinely before the development of vision loss.

  3. The physician in the technological age.

    Science.gov (United States)

    Jaspers, K

    1989-09-01

    Translator's summary and notes: Karl Jaspers (1883-1969) argues that modern advances in the natural sciences and in technology have exerted transforming influence on the art of clinical medicine and on its ancient Hippocratic ideal, even though Plato's classical argument about slave physicians and free physicians retains essential relevance for the physician of today. Medicine should be rooted not only in science and technology, but in the humanity of the physician as well. Jaspers thus shows how, within the mind of every medical person, the researcher contests with the physician and the technician with the humanist. Jaspers therefore opposes all modern tendencies that regard men as abstractions. As a creative existentialist influenced by Kierkegaard, Nietzsche, and Husserl, he reasons that clinical medicine should always treat patients as irreducable individuals, and his thinking on psychotherapy argues for a realm of interiority, freedom, intelligibility, and existential communication that transcends the reach of the causal thinking of natural science. This essay, written in 1959, reflects Jaspers' lifelong preoccupation with the philosophical meaning of medicine (he received his MD degree in 1909) and the totality of the human person. It should significantly enhance our own comprehension of medical power, dangers, reasoning, and accomplishments.

  4. 2012 financial outlook: physicians and podiatrists.

    Science.gov (United States)

    Schaum, Kathleen D

    2012-04-01

    Although the nationally unadjusted average Medicare allowable rates have not increased or decreased significantly, the new codes, the new coding regulations, the NCCI edits, and the Medicare contractors' local coverage determinations (LCDs) will greatly impact physicians' and podiatrists' revenue in 2012. Therefore, every wound care physician and podiatrist should take the time to update their charge sheets and their data entry systems with correct codes, units, and appropriate charges (that account for all the resources needed to perform each service or procedure). They should carefully read the LCDs that are pertinent to the work they perform. If the LCDs contain language that is unclear or incorrect, physicians and podiatrists should contact the Medicare contractor medical director and request a revision through the LCD Reconsideration Process. Medicare has stabilized the MPFS allowable rates for 2012-now physicians and podiatrists must do their part to implement the new coding, payment, and coverage regulations. To be sure that the entire revenue process is working properly, physicians and podiatrists should conduct quarterly, if not monthly, audits of their revenue cycle. Healthcare providers will maintain a healthy revenue cycle by conducting internal audits before outside auditors conduct audits that result in repayments that could have been prevented.

  5. Can price controls induce optimal physician behavior?

    Science.gov (United States)

    Wedig, G; Mitchell, J B; Cromwell, J

    1989-01-01

    Recently, budget-conscious policymakers have shifted their attention to the physician services market and have begun to consider a wide variety of price regulatory schemes for moderating expenditures in this market. In a recent article in this journal, Feldman and Sloan warned that price controls on physician services may cause undesirable declines in service quality, independent of their budgetary ramifications. Our aim in this article is to reconsider the effects of price controls in the broader context of insurance coverage and moral hazard. Our ultimate goal is to assess the benefits of price controls independent of specific assumptions about the controversial issues of demand inducement and income targeting. Using a simple extension of the Feldman/Sloan model, we find that price controls can be and almost certainly are welfare-improving as long as consumers are sufficiently well insured, regardless of where one stands on the inducement issue. The salutary effects of price controls, on the other hand, can be compromised by income-targeting behavior on the part of physicians. We also introduce evidence from Medicare's recent fee freeze to evaluate the possibility of income-targeting behavior empirically. While formal studies of income targeting suggest that its magnitude is small in cross-section, we warn that its effects may be larger over time; this is what our descriptive evidence suggests. We conclude that more dramatic short-term progress on physician fee inflation will require stronger measures, such as putting physicians at risk for consumer expenditures.

  6. [Physician-assisted suicide in dementia?].

    Science.gov (United States)

    Lauter, H

    2011-01-01

    Physician-assisted suicide in Germany is limited by criminal law and disapproved by professional authorities. A physician who is willing to help a demented patient in terminating his life has to be definitely sure that the disease does not interfere with the patient's capacity for decision-making. In cases of early dementia the reason why assisted suicide will usually be requested is not the actual suffering of the patient but his negative expectations for the future. As long as there are sufficient opportunities for palliative care, the progressive course of the dementia process does not imply a state of unbearable suffering which could justify an assisted suicide. Nevertheless there may be certain circumstances--as for instance the value that an individual attributes to his integrity or to the narrative unity of his life--which might possibly provide an ethical justification for the assistance in life termination. A physician who helps a demented person in performing a suicidal act does not necessarily oppose essential principles of medical ethics. Yet, especially with regard to possible societal consequences of physician-assisted suicide in dementia, the rejecting attitude of medical authorities against that activity must be considered as well founded and legitimate. Deviations from these general guidelines ought to be respected as long as they are limited to exceptional situations and correspond to a thorough consideration of a physician's professional duties. They should remain open to public control, but not be ultimately specified by unequivocal normative regulations.

  7. Defense of breast cancer malpractice claims.

    Science.gov (United States)

    Zylstra, S; D'Orsi, C J; Ricci, B A; Halloran, E E; Resseguie, L J; Greenwald, L; Mondor, M C

    2001-01-01

    The goal of this study was to determine whether factors associated with the successful defense and cost of malpractice cases involving the failure to diagnose breast cancer could be identified in medical and legal records. Secondary goals were to develop a multidisciplinary clinical algorithm utilizing National Comprehensive Cancer Network (NCCN) practice guidelines with practitioner risk management strategies. Physician deviations from these guidelines were tracked to identify high-risk areas in the diagnosis of breast cancer. A multidisciplinary clinical algorithm was introduced and practitioner risk management issues were addressed. In this study specific medical, legal, and cost factors were retrospectively abstracted and analyzed to identify associations between medical and legal factors and medicolegal outcome. ProMutual handled 156 malpractice cases involving breast cancer between January 22, 1986, and November 20, 1997. Of the total, 124 cases involving 212 defendants were closed. The closed cases were analyzed, using multivariable stepwise logistic and linear regression, to identify associations between clinical factors and case outcome. Women's health practitioners (WHPs), including obstetrician-gynecologists (OB-GYNs), family medicine, and internal medicine clinicians, were the largest group of defendants (97). Others included radiologists (43), surgeons (33), and pathologists (3). OB-GYNs accounted for 31% of these defendants, with a cost of more than $16 million. The greatest number of specialists represented in the open cases were radiologists, with 38% of the total. The defense model predicts that the probability of successful defense is lessened with inadequate record keeping, a patient that has metastasis and is alive, and a delay in diagnosis of 12 months or more. The overall indemnity model predicts a higher indemnity with the spread of disease at the time of evaluation, a patient who has metastasis and is alive, and a date of occurrence closer

  8. Nurses and Physicians Attitudes toward Nurse-Physician Collaboration: A Survey from Gaza Strip, Palestine

    Directory of Open Access Journals (Sweden)

    Aymen Elsous

    2017-01-01

    Full Text Available Interprofessional collaboration and teamwork between nurses and physicians is essential for improving patient outcomes and quality of health services. This study examined the attitudes of nurses and physicians toward nurse-physician collaboration. A cross-sectional study was conducted among nurses and physicians (n=414 in two main referral public hospitals in the Gaza Strip using the Arabic Jefferson Scale of Attitude toward Physician-Nurse Collaboration. Descriptive statistics and difference of means, proportions, and correlations were examined using Student’s t-test, one-way ANOVA, and Pearson correlation and p<0.05 was considered as statistical significant. Response rate was 42.8% (75.6% for nurses and 24.4% for physicians. Nurses expressed more positives attitudes toward collaboration than physicians (M ± SD on four-point scale: 3.40±0.30 and 3.01±0.35, resp. and experience duration was not proved to have an interesting influence. Teamwork approach in the professional practice should be recognized taking into consideration that the relationship between physicians and nurses is complementary and nurses are partners in patient care.

  9. Family physician perceptions of working with LGBTQ patients: physician training needs.

    Science.gov (United States)

    Beagan, Brenda; Fredericks, Erin; Bryson, Mary

    2015-01-01

    Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ). Understanding physician perceptions of this area of practice may aid in developing improved education. In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Three major themes emerged: 1) Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2) Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3) Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

  10. The Jefferson Scale of Physician Empathy: preliminary psychometrics and group comparisons in Italian physicians.

    Science.gov (United States)

    Di Lillo, Mariangela; Cicchetti, Americo; Lo Scalzo, Alessandra; Taroni, Francesco; Hojat, Mohammadreza

    2009-09-01

    To examine the psychometrics of the Jefferson Scale of Physician Empathy (JSPE) among a sample of Italian physicians. The JSPE was translated into Italian using back-translation procedures to ensure the accuracy of the translation. The translated JSPE was administered to 778 physicians at three hospitals in Rome, Italy in 2002. Individual empathy scores were calculated, as well as descriptive statistics at the item and scale level. Group comparisons of empathy scores were also made among men and women, physicians practicing in medical or surgical specialties, physicians working in different hospitals, and at physicians at various levels of career rank. Results are reported for 289 participants who completed the JSPE. Item-total score correlations were all positive and statistically significant. The prominent component of "perspective taking," which is the most important underlying construct of the scale, emerged in the factor analysis of the JSPE and was similar in both Italian and American samples. However, more factors appeared among Italian physicians, indicating that the underlying construct of empathy may be more complex among Italians. Cronbach coefficient alpha was .85. None of the group differences observed among physicians classified by gender, hospital of practice, specialty, or level of career rank reached statistical significance. Findings generally provide support for the construct validity and reliability of the Italian version of the JSPE. Further research is needed to determine whether the lack of statistically significant differences in empathy by gender and specialty is related to cultural peculiarities, the translation of the scale, or sampling.

  11. Family physician perceptions of working with LGBTQ patients: physician training needs

    Directory of Open Access Journals (Sweden)

    Brenda Beagan

    2015-04-01

    Full Text Available Background: Medical students and physicians report feeling under-prepared for working with patients who identify as lesbian, gay, bisexual, transgender or queer (LGBTQ. Understanding physician perceptions of this area of practice may aid in developing improved education. Method: In-depth interviews with 24 general practice physicians in Halifax and Vancouver, Canada, were used to explore whether, when and how the gender identity and sexual orientation of LGBTQ women were relevant to good care. Inductive thematic analysis was conducted using ATLAS.ti data analysis software. Results: Three major themes emerged: 1 Some physicians perceived that sexual/gender identity makes little or no difference; treating every patient as an individual while avoiding labels optimises care for everyone. 2 Some physicians perceived sexual/gender identity matters primarily for the provision of holistic care, and in order to address the effects of discrimination. 3 Some physicians perceived that sexual/gender identity both matters and does not matter, as they strove to balance the implications of social group membership with recognition of individual differences. Conclusions: Physicians may be ignoring important aspects of social group memberships that affect health and health care. The authors hold that individual and socio-cultural differences are both important to the provision of quality health care. Distinct from stereotypes, generalisations about social group differences can provide valuable starting points, raising useful lines of inquiry. Emphasizing this distinction in medical education may help change physician approaches to the care of LGBTQ women.

  12. Nurses and Physicians Attitudes toward Nurse-Physician Collaboration: A Survey from Gaza Strip, Palestine

    Science.gov (United States)

    Elsous, Aymen

    2017-01-01

    Interprofessional collaboration and teamwork between nurses and physicians is essential for improving patient outcomes and quality of health services. This study examined the attitudes of nurses and physicians toward nurse-physician collaboration. A cross-sectional study was conducted among nurses and physicians (n = 414) in two main referral public hospitals in the Gaza Strip using the Arabic Jefferson Scale of Attitude toward Physician-Nurse Collaboration. Descriptive statistics and difference of means, proportions, and correlations were examined using Student's t-test, one-way ANOVA, and Pearson correlation and p < 0.05 was considered as statistical significant. Response rate was 42.8% (75.6% for nurses and 24.4% for physicians). Nurses expressed more positives attitudes toward collaboration than physicians (M ± SD on four-point scale: 3.40 ± 0.30 and 3.01 ± 0.35, resp.) and experience duration was not proved to have an interesting influence. Teamwork approach in the professional practice should be recognized taking into consideration that the relationship between physicians and nurses is complementary and nurses are partners in patient care. PMID:28326194

  13. Health claims as communication tools that enhance brand loyalty

    DEFF Research Database (Denmark)

    Krystallis, Athanasios; Chrysochou, Polymeros

    2011-01-01

    During the last decade a strong consumer interest has emerged for food products with health protecting or enhancing properties. In this connection, health claims are used as communication tools conveying the health message of a product and further constituting the means of a brand's differentiation...... strategy. Brands carrying a health claim are thus expected to have an advantage over their counterparts. In this study, we aim to investigate whether health claims, with emphasis on the low-fat claims, can act as a means to improve the performance of brands and further enhance their loyalty levels. Based...... on stated preference data using a purchase intention scale (i.e. Juster Scale), a set of Brand Performance Measures (BPMs) are empirically estimated to describe the market structure of two dairy product categories and their respective sub-categories that were defined according to health-related attributes...

  14. The EU health claim regulation in international comparison

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica

    2011-01-01

    Nutrition and health claims are voluntary claims on food indicating favourable nutritional content or health benefits of the food. Nutrition and health claims on food are increasingly regulated in the world market. This process is accompanied by intensive stakeholder discussions on the possible...... impact on consumer protection and food marketing effectiveness. This article reviews literature on regulations in the major food markets in comparison with the EU regulation. The focus is on identifying characteristics of regulations that are expected to have an impact on consumer protection and food...... marketing. The EU regulation is regarded as focusing relatively strongly on precaution and consumer understanding. The extent to which this hampers food innovations is in dispute. It is suggested that using marketing measures in favour of scientifically approved claims as well as stakeholder cooperation...

  15. 33 CFR 25.405 - Claims not payable.

    Science.gov (United States)

    2010-07-01

    ...' Compensation Act, or any other system of compensation where contribution is made or insurance premiums paid... rise to the claim; (i) Is for damage to or loss of a letter or postal matter while in the possession...

  16. Joint Asymptotic Distributions of Smallest and Largest Insurance Claims

    National Research Council Canada - National Science Library

    Albrecher, Hansjörg; Robert, Christian; Teugels, Jef

    2014-01-01

    Assume that claims in a portfolio of insurance contracts are described by independent and identically distributed random variables with regularly varying tails and occur according to a near mixed Poisson process...

  17. Fitting of Finite Mixture Distributions to Motor Insurance Claims

    Directory of Open Access Journals (Sweden)

    P. Sattayatham

    2012-01-01

    Full Text Available Problem statement: The modeling of claims is an important task of actuaries. Our problem is in modelling the actual motor insurance claim data set. In this study, we show that the actual motor insurance claim can be fitted by a finite mixture model. Approach: Firstly, we analyse the actual data set and then we choose the finite mixture Lognormal distributions as our model. The estimated parameters of the model are obtained from the EM algorithm. Then, we use the K-S and A-D test for showing how well the finite mixture Lognormal distributions fit the actual data set. We also mention the bootstrap technique in estimating the parameters. Results: From the tests, we found that the finite mixture lognormal distributions fit the actual data set with significant level 0.10. Conclusion: The finite mixture Lognormal distributions can be fitted to motor insurance claims and this fitting is better when the number of components (k are increase.

  18. Mining claim activity on Federal Land in the United States

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Public Land spatial data sets (shapefile) contains Public Land Survey section polygons that had mining claims recorded in the U.S. Bureau of Land Management's...

  19. The displaced claiming their rights in fragile states

    Directory of Open Access Journals (Sweden)

    Antonia Mulvey

    2013-05-01

    Full Text Available To date, displaced persons in fragile and conflict-affected stateshave had little success in claiming their rights for housing, land andproperty violations. Creative legal thinking and strategic litigation has the potential to change this.

  20. 40 CFR 14.13 - Items fraudulently claimed.

    Science.gov (United States)

    2010-07-01

    ... intentionally misrepresented the cost, condition, cost of repair or a material fact concerning a claim, he/she... Officer determines that the employee intentionally has materially misrepresented the costs, conditions or...

  1. 27 CFR 70.603 - Execution and filing of claim.

    Science.gov (United States)

    2010-04-01

    ... Losses Resulting From Disaster, Vandalism, or Malicious Mischief Claims Procedures § 70.603 Execution and...) resulting from vandalism or malicious mischief, must be filed within 6 months after the date on which the...

  2. The EU health claim regulation in international comparison

    DEFF Research Database (Denmark)

    Aschemann-Witzel, Jessica

    2011-01-01

    Nutrition and health claims are voluntary claims on food indicating favourable nutritional content or health benefits of the food. Nutrition and health claims on food are increasingly regulated in the world market. This process is accompanied by intensive stakeholder discussions on the possible...... impact on consumer protection and food marketing effectiveness. This article reviews literature on regulations in the major food markets in comparison with the EU regulation. The focus is on identifying characteristics of regulations that are expected to have an impact on consumer protection and food...... marketing. The EU regulation is regarded as focusing relatively strongly on precaution and consumer understanding. The extent to which this hampers food innovations is in dispute. It is suggested that using marketing measures in favour of scientifically approved claims as well as stakeholder cooperation...

  3. 27 CFR 70.414 - Preparation and filing of claims.

    Science.gov (United States)

    2010-04-01

    ... States after June 30, 1959. (h) (i) Low wines at vinegar plants. Procedural instructions in respect of claims for remission of tax on low wines (distilled spirits) lost at vinegar plants producing vinegar...

  4. Basic Stand Alone Medicare Claims Public Use Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — CMS is committed to increasing access to its Medicare claims data through the release of de-identified data files available for public use. They contain...

  5. Health claims on foods: challenge for clinical research companies

    Directory of Open Access Journals (Sweden)

    Essi Sarkkinen

    2012-06-01

    Full Text Available Background The Nutrition and Health Claim Regulation 1924/2006/EC, together with EFSA guidances on the scientific requirements for different type of health claims, is setting the basis for health claim substantiation in the EU. Aim The aim of this presentation is to bring up the key challenges that the food industry and clinical research organizations are facing when meeting these requirements. Results and discussion Key issues in clinical research planning to meet the requirements set for the health claim substantiation are: (1 Selection of right outcome markers since the selection of outcome marker defines actually the formulation of the health claim to be used on food or food ingredient. (2 Selection of right target population since that determines the target consumer group for the food with a health claim. (3 Selection of dose regime and food matrices used since these largely determine the conditions set for the use of the health claim. One of the major challenges in health claim substantiation is the deviant approach to risk factors or biomarkers. From the regulation point of view, a single risk factor approach is emphasized, but from the clinical and scientific point of view the pattern of different risk markers or biomarkers could, in some cases, be a more relevant choice to reflect the final health outcome. This is especially the case in the nutrition and health area because we are often dealing with weak but multiple health effects of certain food items or ingredients. Also the lack of validated well-established biomarkers potent to be affected by diet is a challenge in health claim substantiation.The selection of right target population is often a compromise between choosing a more potential target group to obtain efficacy (i.e. risk factors elevated vs. patient groups and choosing a rationale to generalize the results to wider population (target consumer group.The selection of optimal dosing regime and matrices for a clinical study is

  6. Codex recommendations on the scientific basis of health claims.

    Science.gov (United States)

    Grossklaus, Rolf

    2009-12-01

    Within the framework of Codex Alimentarius, attempts are being made at international level to establish guidelines for use of nutrition and health claims. An important issue that has to be addressed is the process of scientific substantiating of claims on foods. To provide an insight into the current step procedure of the proposed draft recommendations on the scientific basis of health claims. These Codex recommendations are intended to facilitate governments' own evaluation of health claims made by the industry. Review of comments of governments, observers and non-governmental organizations (NGOs) and relevant references to the proposed draft recommendations of the last sessions of the Codex Committee on Nutrition and Food for Special Dietary Uses (CCNFSDU). A literature search was performed using the PubMed database. Several proposed draft recommendations on the scientific substantiation of health claims have been considered and amended by the CCNFSDU in recent years but the work is not yet complete. The current work draws on the work of FUFOSE and PASSCLAIM and also on that of WHO and FDA. Given the important role of Codex in food safety, the draft recommendations emphasize circumstances where additional evaluation of safety or nutritional safety needs to be considered. High quality human intervention studies are the prime evidence needed to substantiate claims but there is recognition that, in some cases, only observational studies may be available. Animal and in vitro studies will also be evaluated as part of the totality of the evidence. It has been suggested that the recommendations should include re-evaluation of claims after a certain time period, or if new evidence calls into question the scientific validity underpinning the claims. Setting out a common approach for the substantiation of health claims is an important step in the use of health claims around the world. There is a need to reflect emerging as well as consensus science. The substantiating

  7. Mobile Claims Management : Smartphone Apps in Motor Insurance

    OpenAIRE

    Baecker, Oliver; Ackermann, Lukas; Ackermann, Walter; Fleisch, Elgar

    2010-01-01

    As of April 2010, several Swiss motor insurers offer mobile apps that enable customers to submit a loss report. This article discusses the emergence of mobile apps in the insurance industry and the impact of mobile technology on claims management in motor insurance. We also present a demonstrator that goes beyond existing solutions by integrating a mobile app with a commercial claims management enterprise system. The technical aspects are complemented by results from expert interviews on mobi...

  8. Mobile Claims Management : Smartphone Apps in Motor Insurance

    OpenAIRE

    Baecker, Oliver; Ackermann, Lukas; Ackermann, Walter; Fleisch, Elgar

    2010-01-01

    As of April 2010, several Swiss motor insurers offer mobile apps that enable customers to submit a loss report. This article discusses the emergence of mobile apps in the insurance industry and the impact of mobile technology on claims management in motor insurance. We also present a demonstrator that goes beyond existing solutions by integrating a mobile app with a commercial claims management enterprise system. The technical aspects are complemented by results from expert interviews on mobi...

  9. Health and Stress Management and Mental-health Disability Claims.

    Science.gov (United States)

    Marchand, Alain; Haines, Victor Y; Harvey, Steve; Dextras-Gauthier, Julie; Durand, Pierre

    2016-12-01

    This study examines the associations between health and stress management (HSM) practices and mental-health disability claims. Data from the Salveo study was collected during 2009-2012 within 60 workplaces nested in 37 companies located in Canada (Quebec) and insured by a large insurance company. In each company, 1 h interviews were conducted with human resources managers in order to obtain data on 63 HSM practices. Companies and workplaces were sorted into the low-claims and high-claims groups according to the median rate of the population of the insurer's corporate clients. Logistic regression adjusted for design effect and multidimensional scaling was used to analyse the data. After controlling for company size and economic sector, task design, demands control, gratifications, physical activity and work-family balance were associated with low mental-health disability claims rates. Further analyses revealed three company profiles that were qualified as laissez-faire, integrated and partially integrated approaches to HSM. Of the three, the integrated profile was associated with low mental-health disability claims rates. The results of this study provide evidence-based guidance for a better control of mental-health disability claims. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Performance evaluation of court in construction claims settlement of litigation

    Science.gov (United States)

    Hayati, Kemala; Latief, Yusuf; Rarasati, Ayomi Dita; Siddik, Arief

    2017-06-01

    Claim construction has a major influence on the implementation of projects, such as the cost and time. The success of the construction project is highly dependent on the effective resolution of claims. Although it has been recognized that litigation or court is not the best way because it may reduce or eliminate profits and damage the relationship, it is a method of resolving claims and disputes that is common in the world of construction. The method of resolving claims and disputes through litigation or court may solve the problem in an alternative method, namely the implementation of the judgment which can be enforced effectively against the losing party and the ruling which has the force of law of the country where the claims and disputes are examined. However, litigation or court may take longer time and require high cost. Thus, it is necessary to identify factors affecting the performance of the court and to develop a system capable of improving an existing system in order to run more effectively and efficiently. Resolution in the claims management of construction projects with the method of litigation is a procedure that can be used by the courts in order to shorten the time in order to reduce the cost. The scope of this research is directed to all parties involved in the construction, both the owners and the contractors as implementers and practitioners, as well as experts who are experienced in construction law.

  11. Strategies for selling and consolidating physician practices.

    Science.gov (United States)

    Mancino, D M

    1997-01-01

    The changing dynamics of healthcare service delivery is forcing many physicians to consider selling their practices to hospitals or health plans or consolidating them with other practices. Besides being subject to the corporate and tax requirements that apply to the sale of any business, the sale of physician practices is also subject to Federal fraud and abuse and self-referral laws. Several sale strategies are available to physicians who desire to sell or consolidate their practices, including asset sales, stock sales, forward mergers, drop down consolidations, spinoffs, and statutory mergers. Each strategy has advantages and disadvantages, but whichever strategy is chosen, both sellers and buyers must ensure that tax issues are addressed and that the transaction complies with the requirements of Federal anti-kickback and self-referral laws.

  12. Physician manpower expansionism: a policy review.

    Science.gov (United States)

    Bloom, B S; Peterson, O L

    1979-02-01

    A lack of national health goals has allowed physician manpower policy to be dominated by an expansionist philosophy. Scarce resources have been channeled into the production of specialist physicians trained to provide complex and expensive care for uncommon diseases, using other scare and expensive resources and adding to the steep rise in medical care costs. Society seems to want access to primary care--a lack it views with dismay--and simultaneously fears increasing costs of care. Lack of access plus high cost might lead to rash implementation of other inappropriate policies. Success of policy decisions is pure serendipity if made without reliable and relevant information or based on inappropriate data, such as opinions alone. If information is unavailable, then physician manpower decisions should be delayed or, if made, implemented cautiously.

  13. Physician's acquittal of responsibility in Iranian statutes.

    Science.gov (United States)

    Abbasi, Mahmoud; Pirouz, Amir Samavati

    2011-02-01

    The physician's acquittal has obsessed Iranian legislator's mind to a large extent. This is exclusively observed in Iranian statuses and specifically in Shi'ite school of though. Muslim jurists' opinions play a very important role in enacting legal articles related to it. After reviewing the literature, the authors tried to pick and collect common features of physician's responsibilities and duties to introduce Iranian Acts with respect to the subject. Also, Iranian Acts are analyzed and the challenging medical topics such as emergency situations and infectious diseases are discussed.Iranian legislator didn't specify a kind of physician's acquittal which received from the patient knowingly and is based on his/her free will. There are also some medical and legal gaps. Patients are not often informed of all exact and scientific information and results of their treatments. Furthermore, the forms prepared to receive the patient's consent do not provide what Iranian legislator meant.

  14. Still on physicians' attitude to medical marijuana

    Directory of Open Access Journals (Sweden)

    Olukayode Abayomi

    2014-12-01

    Full Text Available Desai and Patel highlighted in a recent review that and ldquo;there are several issues related to medical marijuana, which concern public health such as its medical use, harmful effects, laws and physicians role. and rdquo; Certainly, physician's perspectives and position on the relative harm and benefits of marijuana contribute to the growing controversy over its legalization in western countries. Interestingly, the seeming resistance of physicians in western countries to marijuana prescription appears to mirror the position of psychiatrists in developing countries. For instance, in a recent survey of psychiatrists in Nigeria, up to 55% of psychiatrists were against the medical use of marijuana. [Int J Basic Clin Pharmacol 2014; 3(6.000: 1098-1098

  15. Physician dual practice: A review of literature

    DEFF Research Database (Denmark)

    Socha, Karolina; Bech, Mickael

    2010-01-01

    of dual practice effects for the public health care. Methods A systematic literature review identified 23 positions on the subject consisting of journal articles, academic working papers, book chapter, and publications of the WHO. Results The subject is short on evidence. Theoretical analyses indicate......Objectives A combination of public and private practice by physicians, referred to as physician dual practice, has been receiving attention in connection with arguments about its negative impact for the public health care. This paper aims to review and critically discuss findings on the subject...... both positive and negative effects of dual practice. Some of the effects depend, however, on assumptions that are undermined in the broader literature. The analyses assume that the dual practitioners’ objective is to maximise income. Yet, while physicians seem to engage in a private practice on top...

  16. Using internal communication as a marketing strategy: gaining physician commitment.

    Science.gov (United States)

    Heine, R P

    1990-01-01

    In the ambulatory care industry, increased competition and promotional costs are pressuring managers to design more creative and effective marketing strategies. One largely overlooked strategy is careful monitoring of the daily communication between physicians and ambulatory care staff providing physician services. Satisfying physician communication needs is the key to increasing physician commitment and referrals. This article outlines the steps necessary to first monitor, then improve the quality of all communication provided to physicians by ambulatory care personnel.

  17. PACS economics and the referring physician

    Science.gov (United States)

    Saarinen, Allan O.; Wilson, M. C.; Iverson, Scott C.; Haynor, David R.; Loop, John W.

    1990-08-01

    One of the touted potential benefits of Picture Archive and Communications Systems (PACS) is that these systems will save referring physicians significant time by eliminating their trips to andfrom the radiology departmentfile room. To date, this potential savings has not been quantified in any hospital setting. Economic modeling of PACS by the University of Washington demonstrates that the cost savings of PACS is extremely sensitive to small productivity changes in referring physician time savings. To provide analytical strength to this argument and supportfor the overall importance of the referring physician in PACS economics, trip distribution data was collected at the University to determine the average time referring physicians spend traveling to andfrom the radiology departmentfile room. This travel time is significant and it corroborates other work by the authors suggesting the benefits of PACS may be, in fact, larger outside the radiology department than inside it. Information for this study was obtained from two sources. In one case, referring physicians were queried about the time they and their support staffspend requesting and retrievingfilmfilesfrom thefile room by using a comprehensive hospital-wide survey. In the second case, the distance between all major clinics in the University medical center and the number offilm files each clinic checks out weekly were entered into a conventional transportation trip distribution model toforecast the time staffspend on this activity. While some differences in the results occurredfrom the two cases, each case generally showed a significant expenditure of effort approaching approximately two-weeks per year per referring physician with a potential recovery value of between 3 to 8 million dollars annually in additional billable revenue, assuming adequate patient demand.

  18. Nutrition labelling, marketing techniques, nutrition claims and health claims on chip and biscuit packages from sixteen countries

    National Research Council Canada - National Science Library

    Mayhew, Alexandra J; Lock, Karen; Kelishadi, Roya; Swaminathan, Sumathi; Marcilio, Claudia S; Iqbal, Romaina; Dehghan, Mahshid; Yusuf, Salim; Chow, Clara K

    2016-01-01

    Food packages were objectively assessed to explore differences in nutrition labelling, selected promotional marketing techniques and health and nutrition claims between countries, in comparison to national regulations. Cross-sectional...

  19. Physicians practicing other occupations, especially literature.

    Science.gov (United States)

    Green, J P

    1993-03-01

    Literature has been the favored nonmedical pursuit of physicians probably because the practice of medicine is suffused with narratives, the patient's history being one. Arthur Conan Doyle regarded medicine as a "grim romance," Somerset Maugham as an opportunity to see "life in the raw," and William Carlos Williams treated "the patient as a work of art." These sentiments may be linked to humanistic medicine. At some medical schools, literature is taught in the context of and integrated with medicine in an attempt to enhance ethics and empathy which were explicitly expressed by some physician-writers.

  20. Automatization of physicians' phone-in hours.

    Science.gov (United States)

    Turunen, J; Loula, P; Soininen, H

    1999-01-01

    In this paper we present a computer-based system that is designed to reduce the number of patient calls in physicians' phone-in hours. Simultaneously it will offer a parallel alternative channel for the patients to listen to their laboratory results. The system requirements were reliability, security and the low costs. The results showed after a two-month test period that the tailored system proved extremely successful. The average time that the physician saved by using this system was over 4 minutes and doctors can leave the messages to the server also outside the phone-in hours.