Tag Archives | physician

Do Physicians Have a Responsibility to Meet the Health Care Needs of Society?

An interesting article appears in the Fall 2012 issue of the The Journal of Law, Medicine & Ethics by Allan S. Brett titled “Physicians Have a Responsibility to Meet the Health Care Needs of Society.” Allan opens the article by addressing a question that was posed to Ron Paul in the 2012 presidential election by Wolf Blizter which I mentioned before on this post http://blog.teethremoval.com/dumb-americans-trust-their-doctors-for-no-valid-reason/. Allan aruged that Ron Paul agreed with the sentiment that “physicians have a responsibility to meet the health care needs of society.” In the article Allan makes the following case. “In the rest of this essay, I first demonstrate that society is already organized— at least in part — to rescue sick people regardless of ability to pay, and that society is not prepared to abandon that general guiding principle. It follows that physicians — society’s principal instrument for provision of health care services — are expected to meet society’s health care needs. I then argue that the current configuration of the U.S. health care system undermines the ability of physicians to fulfill this mandate effectively. And finally, I argue that the medical profession’s responsibility to meet society’s health care needs also carries a responsibility […]

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How to Determine If a Clinical Practice Guideline is Trustworthy

An interesting article titled “How to Decide Whether a Clinical Practice Guideline Is Trustworthy,” written by David F. Ransohoff, MD Michael Pignone, MD, MPH, and Harold C. Sox, MD appears in JAMA, January 9, 2013,Vol 309, No. 2, pp. 139 -140. The article mentions how many controversies have arose recently over cancer screening guidelines. The article mentions how in 2008 Congress gave the Institute of Medicine (IOM) of the National Academies with developing standards for objective, scientifically valid, and consistent approaches to developing practice guidelines. Well as I mentioned in this blog post Tips to Prevent Medical Errors – AHRQ Congress actually gave the Agency for Health Care Policy and Research (AHCPR) in 1989 evidence-based, clinical-practice guidelines. However, the medical device industry and several doctors organizations opposed this as it was threatening to limit their profits and found a sympathetic ear with the Republican Controlled House Majority who crippled the budget of AHCPR and turned it into AHRQ. The authors state “The public should trust practice guidelines only if the recommendations accurately reflect the underlying evidence about benefits and harms to individual patients. Therefore, the first requirement for earning trust is a rigorous process for assembling, evaluating, and summarizing the evidence. […]

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Unsafe Injection Practices Plaque U.S. Outpatient Facilities

In a post last year I discussed how an Oral Surgeon Investigated for Reusing Needles and Syringes. In a recent article in JAMA titled “Unsafe Injection Practices Plague US Outpatient Facilities, Harm Patients,” Bridget M. Kuehn discusses many problems with injection practices (December 26, 2012,Vol 308, No. 24, pp. 2551-2552). She describes how hepatitis C virus was contracted by 2 patients who received an epidural injection from a pain management clinic. “During the visit, they observed the physician who treated both patients withdrawing medication from a multiple-dose vial with a previously used syringe topped with a new needle, a breach of safe injection practices that may have contaminated the vial and exposed subsequent patients to potential blood-borne infections.” This led to 8,000 patients who were treated at the clinic to be tested and 8 additional cases of hepatis C to be found. A few large studies have explored the issue of lapses in infection control and have showed that they happen in more than 40% of all surgery clinics.  The article states “Michael Bell, MD, associate director for infection control in the CDC’s [US Centers for Disease Control and Prevention] division of health care quality promotion, was frank in his […]

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How does the U.S. Health Care System Differ From Other OECD Countries

An interesting article written by Victor R. Fuchs titled “How and Why US Health Care Differs From That in Other OECD Countries” appears in JAMA, January 2, 2013,Vol 309, No. 1, pp. 33-34.  The article attempts to discuss the difference between the U.S. Healthcare system and other countries in the  Organization for Economic Co-operation and Development (OECD). One way they differ is that the healthcare expenditures in the U.S. are twice as high. A second way they differ is that the share of expenditures funded by the U.S. government is lower. Most OECD countries have a tax-supported system healthcare system that is able to have lower administrative costs and is able to negotiate costs more aggressively with drug companies and physicians. Thirdly, there are differences in care with the U.S. being more technology intensive such as with MRIs. The author then argues some reasons for the differences. He says that in the U.S. individuals appear more distrustful of government, and that this has a deeply historic cause. Of course the author points out that Medicare and Medicaid are an exemption to this. I find this argument hard to believe. For example, many Americans put money in a private bank, yet […]

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The Optional Alternative to Medical Injury Claims

Previously on this blog I have discussed some of the issues with medical malpractice in the United States and some potential alternatives. In this post Potential Alternatives to the Current Medico-Legal System in the United States I talk about some possible alternatives such as having some agreement directly with the physician and hence avoiding trial lawyers. In this provocative post How to Improve Your Chances to Win a Dental Malpractice Lawsuit I discuss the 4 elements you need to win a malpractice suit in the U.S. and a possible suggestion to help improve your chances of doing so. Last year, Kevin Pho known as “social media’s leading physician voice” discussed in a post written on July 16, 2012, titled “The New York medical malpractice crisis: Who’s to blame?,” how some financially struggling hospitals are going without medical malpractice insurance and just going bare as they say. He describes how if hospitals don’t have malpractice insurance than lawyers and patients will go after doctors who may have individual policies. Kevin says that conservatives have failed in their effort for tort-reform by focusing only on non-economic damage caps. Physician groups such as the AMA, ADA, and AAOMS have also seemed to focus more […]

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