The financing, payment and organization of medical services are closely related. Canada's health care system is financed publicly, from tax revenue, and administered in each province by a single government payer. Although the chief method of payment to physicians is fee for service (FFS), the need to control costs and ...

Technical considerations, advantages, and disadvantages of felt and foam contact pads have been presented. Anecdotally, it appears the technique provides a more dynamic, safe, and practical method of ulcer decompression compared with total contact casting. In light of the apparent advantages of felt and foam contact padding, a randomized prospective ...

This paper presents an unusual form of sexual (masturbatory) activity and brings this unusual cause of death to wider medical attention and understanding. All 19 cases of autoerotic asphyxial death that occurred between 1978 and 1989 in the province of Alberta, Canada were reviewed. The fatal victim of autoerotic asphyxia ...

Authors Thomas N. Tavantzis, Ed.D., Carla J. Krasnik, M.B.A., M.S.N., and A. Douglas Bender, Ph.D., try team building as a basis for increasing quality and performance in a medical practices. Through the use of the Myers-Briggs Type Inventory, physicians were better able to understand their interrelationships and build more of ...

Current changes in health care are forcing many physicians to merge their medical practices. Because any successful merger requires careful planning, there are many critical issues that should be reviewed, discussed, and decided by physicians considering merging their medical practices. This article explores some of these issues and provides a ...

A call for change is issued by the author, Susan Cejka, for medical practices to start addressing critical needs for their female physicians. She tackles some of the myths about what women in the practice want and sheds light on the realities. Cejka also offers some suggestions of what medical ...

The ICPs of 10 Southern California medical centers were able to coordinate efforts to standardize the use of glutaraldehyde for high-level disinfection. In implementing "APIC Guidelines for Selection and Use of Disinfectants," variations in practice similar to those recognized nationally were identified. Through coordinated efforts, the regional ICP group researched ...

A small but growing number of reports document the antiaggressive effect of carbamazepine. Although it is supported by a small total number of patients studied with less than ideal rigor, the use of this medication as a means of reducing aggressive behavior is becoming an established clinical practice. The target ...

As this article is being written, in the fall of 1993, we are waiting for the details of the President's plan for extending health insurance coverage of some kind to all members of the population while also containing costs. All observers, including practicing members of the medical profession itself, believe ...

A two-level classifier for medical applications is considered. Such classifiers are expected to yield a more precise result than classical one-level classifiers. The underlying idea for two-level classification is supported by the routine practice of physicians to confirm the diagnosis by several data-driven inferences. An overview of the types of ...

The law and concepts applicable to the employment relationships between and within medical group practices have been evolving over a period of time in response to a number of factors. According to author David Yates, Esq., this evolution has been impacted by a revolution in the law applicable to employment ...

The paper discusses selected methodological aspects of numerators and denominators derived from medical practice observations. The estimation of rates (of incidence or prevalence) on the basis of primary care practice data is apt to be influenced by several methodological factors. These are: morbidity of the local population, physician workload and ...

BACKGROUND AND OBJECTIVES: Senior medical students' interest in family practice as a career choice has declined in recent years. METHODS: A questionnaire about attitudes toward family practice was mailed to the 1990 graduating class at the University of Maryland (N = 143), and 84 completed questionnaires were returned (59% response ...

Physicians practice in a constantly changing environment, exacerbating the need for strategic marketing planning. The evolution of marketing planning within the medical industry parallels that of other industries in some respects, yet, in most instances it has not reached the level of sophistication necessary to be an effective tool. There ...

An important recent development in American medicine has been the strong push in the last few years toward the formal creation, dissemination, and enforcement of explicit clinical practice guidelines or parameters relating to the quality and efficacy of various medical interventions, parameters that would guide the decisions and actions of ...

On 1 April 1974 New Zealand's no-fault accident compensation scheme commenced. Since then doctors in New Zealand have been protected from civil claims for damages which arise directly or indirectly from medical misadventure. During this period disciplinary complaints against doctors have risen substantially but there is no empirical evidence that ...

Current knowledges about time-dependent variations in onset of several acute medical diseases are briefly reviewed. Moreover, temporal variation in relative risk factors are also discussed. Any clue to the increased likelihood of a given event can heighten suspicion and shorten time of effective action. The predictability of a certain event, ...

A post-marketing surveillance survey of dipotassium clorazepate usage was carried out in the Philippines between July 1990 and April 1991. Data were analyzed on 562 patients suffering from conditions in which anxiety was a major component. The results suggest that the medication was prescribed in accordance with the generally accepted ...

Dealing with infections is an integral part of clinical practice. The vast number of antimicrobial agents available, with new ones being introduced constantly, behooves practitioners to keep abreast of the properties, antimicrobial activities, clinical uses and possible adverse effects of these agents. This article attempts to present an overview on ...

A retrospective review of hysterosalpingography (HSG) in a major gynaecological centre was carried out. 324 patients attended (95%) for HSG out of 341 patients referred for this investigation. 189 examinations (58.3%) were abnormal. The requests and radiological findings were reviewed and the results compared with laparoscopy. HSG remains an integral ...

Spirituality is an important aspect of health care that is not often addressed in modern day primary medical practice. Controversy surrounds the role of spiritual issues in medical practice. Some of this stems from confusing spirituality with religion. This paper distinguishes between spiritual and religious issues and reviews the history ...

In response to growing concerns about the quality of medical care, physicians and physician organizations are increasingly turning to practice parameters as a possible solution. This article describes recent efforts by the American Medical Association and others to develop, evaluate, and implement medical practice parameters, and provides an overview of ...

The purpose of this study is to remind the contemporary readers of the role and contribution of Croatian medical heritage in the development of medicine in Europe and the World, as well as of the development of medical concepts and medical practice on the territory of what is Croatia today. ...

The Doctrine of Double Effect and the Principle of Do No Harm raise important theoretical and practical issues, some of which are discussed by Boyle, Donagan, and Quinn. I argue that neither principle is correct, and some revisionist, and probably nonabsolutist, analysis of constraints on action and omission is necessary. ...

With progress in medical knowledge and in the technology of medical care, the contents of medical practice have become increasingly complicated year by year. The protocol practice (clinical algorithms or scheduled care) has been experimentally employed as one of medical-practice systems aimed at providing better medical care and maintaining its ...

A survey of the practice styles and preferences of 1990 ASCRS members with a U.S. zip code was performed in September 1990. Approximately 3,620 questionnaires were sent and 45% (1,625) were returned prior to the cut-off date. Three main profile questions were used to cross-analyze the results: the age of ...

This paper reports the results of a survey conducted among members of the American Association of Equine Practitioners, concerning medical problems of adult horses. A one-page questionnaire listing 36 medical problems grouped by body system was completed by 1,149 veterinarians. The top-ranked disease was colic, followed by viral respiratory tract ...

The practice of euthanasia in the Netherlands is often cited as an example of progressive social reform. While the Dutch penal code outlaws active euthanasia, the courts have interpreted the law in such a way as to allow doctors to kill their patients under certain conditions, chiefly when the patient ...

In January 1986, West German legislators enacted the Medical Equipment Ordinance (MedGV) to define specific regulations for both manufacturers and operators of medical equipment and to offer a measure of safety to patients. We describe the history of MedGV, its regulations, and the mechanisms developed to enforce those regulations. We ...

Concern exists about perceived overuse of gastrointestinal endoscopic procedures. To determine the portion of the current practice of gastroenterology that is procedure related or purely cognitive, we compared 303 consultations from two practices. One-hundred and eighty-seven patients were in a Veterans Affairs Medical Center and 116 in a private group ...

Standard and straight forward practice guidelines for administration of home oxygen therapy have been long established and widely accepted. Medical records for 418 patients prescribed home oxygen through hospital-based programs at seven Veterans Administration medical centers (VAMCs) were reviewed to determine compliance with practice guidelines at the time of initial ...

This article describes one method of professional performance review which relies heavily on confidentiality and comparability. For the Newark Information Sharing Project, an association of five practices collected data for two years on registrations, workload, prevention, referrals, prescribing, and disease prevalence. After central collation, the averages and ranges were returned ...

The author analyzes the practice of James Miles Langstaff, a physician who practised in the town of Richmond Hill, Ont, during the 1800s. As one of the first Ontario-born and Ontario-trained physicians, Dr Langstaff employed the medical innovations provided during a period of exciting change in medicine. Perhaps his greatest ...

Fifty percent of the American Association of Oral and Maxillofacial Surgeons membership in the United States was polled in an effort to evaluate the influence a medical degree might have on privileges and referral patterns, and its role in the office, hospital, and academic settings. Biographical data were collected and ...

Combat stress reaction occurs when a soldier's ability to function effectively is impaired by overwhelming stressors in a combat environment. During recent wars, Combat stress reaction has accounted for 30% to 40% of all casualties. Army Family Physicians can expect to be assigned to frontline medical units in time of ...

Over a 15 month period, all the scripts written by doctors in the Episkopi Garrison Medical Centre, Cyprus, were analysed. A formulary was produced by using the most popular items in that 15 month period and tested in a one month trial period. The idea was to find a practical ...

Pediatrics is a constantly evolving medical specialty. As our knowledge grows through scientific research and careful observation, common pediatric concepts and practices are modified or sometimes even abandoned. Yet, for many reasons, clinicians tend to resist rapid changes and perpetuate antiquated practices, diagnostic strategies, and clinical policies. A number of ...

The recognition that much current medical practice is based on incomplete scientific evidence has led to calls for the generation of guidelines for optimal patterns of practice. These guidelines must be developed from a synthesis of existing scientific data ideally obtained from randomized clinical trials. However, at present we may ...

Pressure for national standards of medical practice is increasing from cost control initiatives, medical malpractice liability, and the desire to simplify complex practice problems. Good standards need to be academically sound, focused enough to be clinically useful, yet flexible enough to allow for the realities of practice. Standards have already ...

Practicing physicians need to have practical techniques to help patients who want to stop using benzodiazepines. I have developed three approaches that usually work. The first, and most widely applicable, is gradually reducing the dose without adding any other medicine. Failing this, use one of the following two approaches, occasionally ...

Physical methods for the management of unwanted hair are critically reviewed. Electrolysis and thermolysis are popular and medically proven electrochemical and electrosurgical techniques for permanent hair removal. Many patients seek consultation with their physician prior to having this elective procedure performed. Clinical guidelines are presented for a successful consultation with ...

Many health care providers practicing near the border between the United States and Mexico have serious concerns about their patients' using medications obtained in Mexico. Despite these concerns, the extent of this problem is not known. A survey administered in a publicly funded rural clinic and an urban private practice ...

Many recent studies have clearly documented the development of tolerance, dependence, and addiction to benzodiazepines. In spite of these studies and reviews of the literature, confusion remains regarding the risk and benefits of the use of benzodiazepines in medical practice. The source of the confusion arises in part from the ...

This paper reports the results of a national survey of anaesthetists which was undertaken to determine the effect of liability concerns on the practice of anaesthesia. Four hundred seventy-six anaesthetists from four regions (East, Quebec, Ontario and the West) (overall usable response rate of 73.3 per cent) responded to a ...

The randomized clinical trial (RCT) is the most powerful tool available to assess the effectiveness of a medical procedure. It complies with the fundamentals of scientific human experimentation and it is accepted, as such, by the researchers as the yardstick of medical progress. Therefore RCTs should have had a major ...

Dr. William O. Coffee was an ophthalmologist who conducted an office and mail-order practice in the Midwest from the 1880s until 1927. His main stock in trade was a self-discovered absorption cure for a variety of ocular diseases, with particular emphasis on the medical cure of cataracts. Dr. Coffee's career ...

Breast cancer, screening and mammography have caused considerable debate in several countries. This article explores the concept of best medical practice in the context of mammographic screening for breast cancer. Maximizing the use of technology, ignores the risks intrinsic to technological intervention. To do no harm in modern medical practice ...

In reality, the present climate for the sale of your practice is probably not quite as good as reported in many practice management articles. That is, contrary to the accounts of some authors, relatively few practices receive net selling prices that equal or exceed one year's revenue. However, the future ...

Physicians seem to prefer to practice in communities where there is already an adequate number of physicians, rather than in underserved rural areas. Virtually all studies examining this problem base their data on subjects who are already within or beyond the medical education process. Thus, such studies may obscure the ...

A case is presented for the durability of anatomy including dissection of the cadaver and of morbid anatomy as elements in medical education and practice. It is these subjects, as consistently relevant over the centuries for medical practice as are communication skills, that are our hallmark as doctors. It is ...