The Ethics of Keeping Alfie Alive
By SAURABH JHA Of my time arguing with doctors, 30 % is spent convincing British doctors that their American counterparts aren’t idiots, 30 % convincing American doctors that British doctors aren’t idiots, and 40 % convincing both that I’m not an idiot. A British doctor once earnestly asked whether American physicians carry credit card reading machines inside their white coats. Myths about the NHS can be equally comical. British doctors don’t prostate every morning in deference to the NHS, like the citizens of Oceania sang to Big Brother in Orwell’s dystopia. Nor, in their daily rounds, do they calculate opportunity costs for keeping patients alive on ventilators. Conversations such as this are vanishingly rare. Administrator: “It’s costing an arm and leg keeping this sick baby alive – to balance the annual budget we need to stop dialyzing a granny.” ICU doctor: “We’ll have to send poor Ethel to her grave. That’s a shame. She was beginning to grow on me.” Health Ethicist: “Wait, let me check with National Institute of Clinical Excellence, the rationing experts, who should be relieved of intensive care first. Perhaps it should be Winston, not Ethel – because Winston is an alcoholic. We need to make rationing scientific and fair.” For the most parts, doctors in both systems do their best for their patients – the constraints of biology play a greater role in influencing physici...
Publication date: Available online 18 January 2020Source: The American Journal of SurgeryAuthor(s): Asishana A. Osho, Muath M. Bishawi, Elbert E. Heng, Ejiro Orubu, Aaron Amardey-Wellington, Mauricio A. Villavicencio, Masaki FunamotoAbstractBackgroundFailure to Rescue (FTR) is a valuable surgical quality improvement metric. The aim of this study is to assess the relationship between center volume and FTR following lung transplantation.MethodsUsing the database of the United Network for Organ Sharing (UNOS) all adult, primary, isolated lung recipients in the United States between May 2005 and March 2016 were identified. FTR...
ConclusionOverall, these guidelines provide consistent recommendations on who should receive breast reconstruction education, who is a candidate for postmastectomy breast reconstruction, and the appropriate timing of reconstruction and extent of mastectomy. Future updates from all should focus on expanding to include alloplastic and autologous forms of reconstruction and should include a broad scope of relevant questions.
I tried searching but couldn't find a relevant thread. I was wondering if anyone has experience with a hospital employed job that compensates in "collections minus expenses." How exactly does this work in a hospital setting? The hospital is still getting the facility fee for each clinic visit (hospital clinic)/procedure - so I'm not really clear on what "expenses" are typically attributed to the physician. Can anyone share their pay structure with this kind of system?
I've been interviewed for and hired (onboarding to come) for a low volume rural ED to do a few moonlighting shift in the last few months of residency. I'm excited. I asked my PD what questions to ask the medical director for a low volume ED and the answers were as expected No cath lab, yes STEMI cardiologist on call to guide me with respect to tPA/no tPA and where to ship Tele-neurologist to 'share' my liability and decision making for stroke Radiology reads CT's 24/7, but... Low Volume Rural ED Survival Guide?
This study, therefore, aims to investigate the effects of generalised trust and happiness on all-cause and cause-specific mortality. The distinction between different causes of death (i.e. cardiovascular vs. cancer-related mortality) allowed us to assess if psychosocial mechanisms could account for associations between generalised trust, happiness and mortality. The study sample was derived from US General Social Survey data from 1978 to 2010 (response rates ranged from 70 to 82 per cent), and combined with death records from the National Death Index. The analytical sample comprised 23,933 individuals with 5382 validated d...
CONCLUSIONS: The GSDS-26 is a preliminary validated multidimensional scale for better identifying depression in men and may be suitable for routine use after further validation. PMID: 31952089 [PubMed - as supplied by publisher]
CONCLUSION: The positive evaluation and the potential for improvements of the PNP program can support its advancement (e. g. enrolment, billing). PMID: 31952088 [PubMed - as supplied by publisher]
CONCLUSION: Shame needs to be viewed in context of gender roles, status, and their interaction. Future studies should investigate the influence of mental health literacy. PMID: 31952086 [PubMed - as supplied by publisher]
CONCLUSIONS: In the population studied mental illness alone was not a sufficient predictor for suicide. Rather, an interaction between mental illness, psychosocial crisis and other factors may explain and predict suicides. Suicide prevention should better address the needs of relatives and family doctors and offer specific low-threshold services. PMID: 31952085 [PubMed - as supplied by publisher]
CONCLUSIONS: Psychotherapeutic work in rural areas should be better incentivized. Interventions to reduce east-west inequalities in the density of service provision seem to be necessary. PMID: 31952084 [PubMed - as supplied by publisher]
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