This paper presents the results and identifies problems in our experience concerning the development of Medinet sentinel dispensaries network in Romania. Medinet stations network consists in 100 computerized family doctors practices all around the country, where doctors collect primary care data and send it to the project central server through ...

In this article are salutory and awful stories, all based on true cases. They serve to illustrate how terrible the problems can be when travel insurance is not appropriately secured before a traveller becomes sick, or where the patient assumes the risk himself, without insurance, in the absence of a ...

This edition of Tips for Clinicans tackles a common patient complaint: side effects of depot medroxyprogesterone acetate (DMPA). If perception is reality, patient compliance can be greatly enhanced by addressing perception of DMPA side effects proactively. As clinicians, we can educate teens on actual as well as perceived side effects, ...

OBJECTIVE: A patient-centered model of communication has often been advocated in preference to a doctor-centered model. The aim of the present study was to assess in an experimental setting how subjects' general level of anxiety affects their reactions to these two communication styles as measured by emotional reactions and satisfaction ...

In the year of 1805, Goethe almost died of urosepsis. His urological problems were not diseases arising from full health but a new variation in a life accompanied by illnesses. Some sources date the first colics he experienced to the year 1795 and others say 1805. The most dramatic period ...

The papers of Burley and Harris, and Draper and Chadwick, in this issue, raise a problem: what should doctors do when patients request an option which is not the best available? This commentary argues that doctors have a duty to offer that option which will result in the individual affected ...

Under certain circumstances, living wills or advance directives may carry legal force in the UK. This paper traces the development of advance directives, clarifies their current legal position and discusses potential problems with their use. Case histories are used to illustrate some of the common dilemmas which doctors may face.

BACKGROUND: Health-affecting psychosocial problems are inherent in general practice, present among one-third of the patients and constituting between 3 and 13% of reasons for encounter. Such problems are not always presented, and often overlooked by the doctors. OBJECTIVES: We aimed to describe the frequency of psychosocial problems presented to the ...

This article examines the extent to which people with HIV infection change their insurance and employment status over time and investigates the correlates of such changes. Data come from the AIDS Cost and Services Utilization Survey, which followed 1,949 HIV-infected adults over an 18-month period that began March 1, 1991. ...

Previous coding schemes used to assess doctor-patient interaction have been inadequate with respect to the scope of categories used to identify: (a) information exchange and relational communication, and (b) thematic topics of talk. Thirty-two doctor-patient interviews were analyzed with a new coding scheme that includes multiple categories of information exchange ...

OBJECTIVE: To examine current attitudes and knowledge of the community and medical practitioners in Queensland to end-of-life decisions. DESIGN: Cross-sectional survey by postal questionnaire. PARTICIPANTS: 387 general practitioners and medical specialists and 910 community members from the Queensland electoral roll. MAIN OUTCOME MEASURES: Responses to five questions about end-of-life decision-making, ...

BACKGROUND: In the period 1988 to the current, 44 AIDS claims were reviewed in order to assess the policies regarding AIDS testing. RESULTS: The average age of the applicant at time of issue was 30.5 years. 41 percent of the claims were for less than $5000, but this represented less ...

A doctor's personal credibility is the paramount factor in achieving success when testifying, especially as a defendant. Factors that aid credibility include a natural manner, sincerity, confidence, clarity and composure. Being argumentative, defensive, smug, flamboyant, or nervous undermines credibility. The authors offer advice to enhance the ophthalmologist's success in testifying.

Doctors are welcome members on mountaineering expeditions to remote areas, but practical advice on how to prepare and what kit to take can be difficult to find. This article is a ragbag of useful advice on diverse topics. It explains the necessary preparation, provides tips for a healthy expedition, and ...

The process and outcome of clinical tasks in an acute psychiatric unit were compared using four different communication modes: face to face, telephone, hands-free telephone, and a low-cost videoconferencing system. Six doctors and six patients took part in the study. Four assessment measures were used. The videoconferencing system was positively ...

The purpose of this study was to measure unmet needs and changes in insurance status for persons with acquired immunodeficiency syndrome (AIDS). Thirty-six percent of the study's Boston-area respondents (n = 305) had a change in insurance coverage between AIDS diagnosis and interview. Medicaid coverage increased from 14% to 41%. ...

We sought to ascertain general practitioners' (GPs) views on their patients' attendances at genitourinary medicine (GUM) departments regarding methods of referral, record keeping and supplying of information to insurance companies. A questionnaire was sent to 429 local GPs of whom 294 (68%) responded. A written means of referral was less ...

Often employers' problems in complying with the Fair Labor Standards Act salary basis of payment rules arise from their paid time off policies. Although it is possible to write policies that apply to both exempt and nonexempt employees, such policies are complex, and agencies may need to review their compliance ...

Until recently, the content, structure, and function of communication between doctors and patients has received little attention and has been excluded from the realm of scientific inquiry; as a result, most clinicians have had little formal training in communication skills. In this paper leaders in doctor-patient communication present four approaches ...

The Author analyses the technical and ethical choices the doctor who works in the Intensive Care Unit continually has to make when treating patients. Generally the doctor does not accept the concept that the available economic resources are not infinite, in that he sees himself as the patient's advocate. The ...

Insurance and mortgage companies continue to regard melanoma in a rigid and perhaps flawed way, with detrimental effect to patients' financial standing. We questioned 100 consecutive patients coming to our clinic between the ages of 20 and 50, and asked if they had had problems obtaining life insurance, mortgages etc, ...

To examine the relationship between insurance coverage and the diagnostic content of residents' experience in a hospital-based pediatric teaching clinic, we analyzed outpatient problem lists for 6543 patients seen in our clinic over a 15-month period. Problem-list contents were categorized using diagnostic clusters. The frequency distribution of clustered problems was ...

This paper presents data on health insurance coverage among people with AIDS. The data came from interviews with 937 people with AIDS recruited from outpatient HIV clinics and community-based AIDS service organizations in nine communities across the United States. At the time of the interview, 30% had private insurance, 29% ...

An unprecedented wave of immigration of doctors to Israel, mainly from the former Soviet Union, posed for Israeli health leaders the problem of bringing them to a common and accepted Western level of performance. Stemming from the deep commitment which Israel has towards the immigrants, the state offers them a ...

Just a year ago most authorities considered the chances of patients contracting AIDS from doctors and other healthcare workers a virtual impossibility. But last week a Florida woman who got AIDS from her dentist lay near death, and two Minneapolis physicians admitted they had treated hundreds of patients since being ...

In this study we analyze information on self-reported health insurance coverage, HIV screening by insurers, and loss of health insurance. We distributed questionnaires to gay male participants in the Baltimore and Los Angeles sites of the Multicenter AIDS Cohort Study and to leukemia patients and gay AIDS patients seen at ...

This survey of doctors' attitudes took place against the background of professional concern over litigation in the field of benzodiazepine prescribing and the prospect of imposed audit of General Practitioner's (GP's) work. One hundred and thirty-three GPs in the Argyll and Clyde Health Board Area responded to a postal questionnaire ...

The national health burden created by AIDS/HIV disease has had a significant impact on the insurance industry. In an analysis of the MetLife health and life insurance claims from 1986 through 1989, it was found that a total of $323,900,000 has been paid for AIDS/HIV disease. This figure and related ...

Legal problems exist in regard to patent rights for new biotechnologies. Ethical problems arise in connection with the application of the technique to patients and with the possibility to cure embryos. The potentialities of preventive medicine have affected even hiring criteria, in that individuals who present enzymic deficiencies can be ...

A controlled analysis of the attitudes of doctors and homosexual men to male homosexuality is reported. Not surprisingly the homosexual men held the most liberal attitudes which served as a yard-stick against which the doctors' attitudes could be assessed. The implications of these data, collected before the AIDS era, are ...

Dentists around the world have watched with alarm and concern the development of the problems with professional indemnity insurance in the United States. Premiums for general practitioners start at about US$ 4000, with at-risk specialists such as oral surgeons or orthodontists in California paying upwards of $ 30,000. Some Californians ...

"AIDS" is a new clinical entity identified around 1980. There is a marked increase in the incidence of the disease in the USA. Since our country has a lot of interaction around the world, including the areas of occurrence of the disease and also that the risk factors and high ...

Many AIDS-related issues are polarised. At the social level, civil rights or liberties are seen as being in conflict with general utility, and an analogous distinction is often assumed to exist at the one-to-one, individual level at which doctors work. In this paper the latter form of the distinction is ...

Even though federal antidiscrimination laws do not include third-party liability, a number of states now have statutes containing aiding-and-abetting provisions that may provide a basis for causes of action. For instance, in a recent decision, the Colorado Supreme Court held that a third-party insurance company will be held liable along ...

"No longer is the decisive question whether the party sued--the defendant--negligently harmed someone. The question now centers on how much the plaintiff ought to be compensated for injuries". "The underlying problem here is not an epidemic of incompetence among doctors. It is an epidemic of grossly unrealistic expectations of what ...

A stratified random sample of Victorian medical practitioners was surveyed to determine doctors' knowledge of and attitudes to the acquired immunodeficiency syndrome (AIDS). The results of this survey have shown that the knowledge level of a representative sample of medical practitioners in Victoria about AIDS was satisfactory at the beginning ...

The Court of Appeal of Brussels affirmed the decision of the lower court convicting the defendant of illegally performing an abortion. It rejected on three grounds his argument that he performed the abortion in accordance with the sections of a Decree of the Council of the French Community providing that ...

A survey carried out in 17 countries on behalf of the Council of Europe shows how prison doctors and administrations have reacted to the AIDS epidemic in ways that are not always scientifically and ethically sound. The pressing need to control HIV infection in prison, to counsel and support seropositive ...

Malpractice litigation alleging failure to practice responsibly and competently against an increasing number of doctors in America cannot be viewed simply as a legal or insurance problem. It affects the doctor in a highly personal way and in most cases generates emotional and/or physical symptoms for at least a limited ...

This article describes the evaluation of an experimental training in doctor-patient communication for general practitioners. The training was based on Rogerian theory and accommodated to the specific situation of the general practitioner. The main concept of this theory is the notion of 'unconditional positive regard'. It was expected that doctors ...

Chinese university students were asked to indicate their inclination to seek help and the resources for consultation on the 22 problems listed on the Langner Scale. Results showed that the Chinese students were generally not inclined to seek help and when they did, would most often seek help from medical ...

The 1982 Annual Report of the Board of Trustees of the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) Trust Funds indicates sever financial problems in both the short and the long range. The short-range financial status is significantly worse than was estimated last year, after enactment of the ...

Laboratory findings can be used by the police to guide their investigations, to clear the innocent or to indicate guilt in court proceedings. Although called by the prosecution the forensic scientist is in court to tell the whole truth and present impartial evidence to assist the court. His evidence should ...

Nicotine chewing-gum has recently become available to doctors in Britain for use as an aid to giving up smoking. It produces blood nicotine concentrations similar to tobacco smoking and so relieves symptoms of nicotine withdrawal. Owing partly to the slower rate of absorption of nicotine through the buccal mucosa, however, ...

Aid given to patients at the roadside may be divided into three categories, namely first aid, ambulance aid and medical aid. The type of assistance actually rendered by the doctor will depend on how well he is equipped. The main situations with which a doctor may be faced, are dealt ...

Information was received from 61 women doctors who were having difficulty continuing with medical careers. Two main problems were disclosed. Firstly, despite the special arrangements made for women doctors, it is difficult to obtain postgraduate training. The provision of supernumerary posts does not seem to offer a satisfactory solution. Secondly, ...

A problem is defined and its purpose is described. The doctor's personality is analysed in its various aspects, and the patient and his complaints are dealt with. Their relationship reveals their respective needs and the scheme presented is an attempt to find a satisfactory solution to the multiple problems of ...

Problems the Abraxas Foundation encountered in accommodating therapeutic community practices to the justice system in order to develop an alternative for courtstipulated drug offenders are reviewed. First, traditional expectations for prospective clients' motivation proved to be unrealistic. Second, courts' needs for information on their clients' progress appeared to conflict with ...

Even if agreement on "Solutions" is reached, the processes of adjustment will be difficult. More stringent admission standards, quotas, reduced financial support, incentives, or other means of controlling the number of doctorates will challenge established values, frustrate many students and many professors, exacerbate tensions among established and emerging institutions, aggravate ...