Recently the medical profession has faced increase outside pressure to reform postgraduate medical training programs to better equip young doctors for changing health care needs and public expectations. In this article we explore the impact of reform on professional self-governance by conducting a comparative historical-institutional analysis of postgraduate medical training ...

Survey data suggest that many people fear genetic discrimination by health insurers or employers. In fact, such discrimination has not yet been a significant problem. This article examines the fear and reality of genetic discrimination in the United States, describes how Congress sought to prohibit such discrimination by passing the ...

Objective: The present article reports on the discovery and translation of a chapter in a 1775 medical textbook by the German physician, Melchior Adam Weikard, which describes attention disorders. This article is believed to be the earliest reference to the syndrome that today is known as attention deficit hyperactivity disorder, ...

Throughout history, medical advances have been adopted first and preferentially by the well educated and economically advantaged groups. The development of personalized therapeutics holds promise to fundamentally alter the practice of clinical medicine, but if it also is used preferentially by economically advantaged groups, this advance will likely worsen socioeconomic ...

BackgroundWhile it is generally acknowledged that self-prescribing among physicians poses some risk, research finds such behaviour to be common and in certain cases accepted by the medical community. Largely absent from the literature is knowledge about other activities doctors perform for their own medical care or for the informal treatment ...

This article gives an overview of anticoagulative medication accompanying neurointerventional procedures. The basic pharmacology of prevalent medication is outlined and the thrombogenicity of standard procedures is described. A brief overview of the literature on risks and benefits of standard medications and their monitoring is provided. A customized regime of care ...

Attempts to define professionalism and humanism suggest that qualities such as compliance to values, patient access, doctor-patient relationship, demeanor, professional management, personal awareness, and motivation are prominent thematic components. In this communication, we present a method for instruction in the values of humanism that may help to overcome the "curricular ...

PURPOSE: The purpose of this study was to assess (1) medication adherence in individuals with diabetes, (2) barriers to adherence, and (3) what factors were related to medication nonadherence.METHODS: A self-administered anonymous survey was provided to adults with diabetes (N = 59) who used a grocery store chain pharmacy or ...

BACKGROUND: Previous reports have confirmed that comprehensive tort reform in Texas (enacted in 2003) was associated with fewer lawsuits and less litigation-associated cost. We hypothesized that complaints to the Texas Medical Board (TMB) increased after tort reform. STUDY DESIGN: To test this hypothesis, we compared complaints, investigations, disciplinary actions, and ...

The formula for reform works, but is the next review already overdue?

INTRODUCTION: Green oncology is a new conceptual and operational paradigm of oncology, which compared to the traditional biomedical model focused on the interest of a single patient and on its exclusive relationship with the doctor, represents a complex evolutionary step towards clinical activities that have to be eco-responsible of the ...

The educational environment has been increasingly acknowledged as vital for high-quality medical education. As a result, several instruments have been developed to measure medical educational environment quality. However, there appears to be no consensus about which concepts should be measured. The absence of a theoretical framework may explain this lack ...

BACKGROUND: The Internet has become the largest, most up-to-date source for medical information. Besides enhancing patients' knowledge, the freely accessible audio-visual files have an impact on medical education. However little is known about their characteristics. In this manuscript the quality of lumbar puncture (LP) and spinal anaesthesia (SA) videos available ...

This is a review of the literature on the role of symptoms in family practice, with a focus on the diagnostic approach in family medicine (FM). We found two, contrasting, approaches to reducing symptoms presented by patients in primary care, especially those which do not immediately allow the definition of ...

OBJECTIVE: To develop the hypothesis that reductionism in medical anthropology, professional education and health care influences empathy development, communication and patient satisfaction. METHOD: We identified relevant literature and reviewed the material in a structured essay. We reflected our hypothesis by applying it to Anthroposophic Medicine (AM), an example of holistic ...

IntroductionC-reactive protein (CRP) levels rise during inflammatory processes and have been ordered for rheumatic disease follow-up since the 1950s. The number of tests ordered in the emergency setting has increased, but without evident improvement in medical care quality.ObjectiveTo determine the pattern of CRP determinations in the emergency department (ED) of ...

Background  Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children's role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents' perspectives. Objective  To ...

Introduction:  The decade has seen developments in non-medical prescribing with the introduction of prescribing rights for healthcare professionals. In this article, we focus on the education, training and practice of non-medical prescribers in the UK. There are around 20,000 nurse independent prescribers, 2,400 pharmacist supplementary/independent prescribers, several hundred allied health ...

Following dramatic reductions between the early 1900s and the early 1980s, the maternal mortality ratio began to rise, reaching a peak of almost 17 maternal deaths per 100,000 live births. Although this number pales in comparison with that found in sub-Saharan Africa and India, the troubling rise in the United ...

ACCESSIBLE SUMMARY: •  In many countries staff are allowed to inject psychiatric inpatients against their will with psychotropic medication. •  This study, conducted in England, found such injections were given to 9% of patients, usually in response to aggressive behaviour or medication refusal. •  In most cases the forced injections ...

For 5 millennia, Cannabis sativa has been used throughout the world medically, recreationally, and spiritually. From the mid-19th century to the 1930s, American physicians prescribed it for a plethora of indications, until the federal government started imposing restrictions on its use, culminating in 1970 with the US Congress classifying it ...

Abstract Objective: Medication abortion with mifepristone and misoprostol has been available in the United States since 2000. The authors reviewed the first 46 medication abortion cases conducted at a university-based student health care clinic to determine the safety and feasibility of medication abortion in this type of clinical setting. Participants: ...

In 2003, the World Health Organization reported that 50% of patients are adherent to long-term therapies. Frequently, the reason for a patient's nonadherence is the cost of medications. Even with prescription insurance coverage, patients may not be able to afford their medications. To assess prescriber knowledge of the cost of ...

The aim of this study was to develop an educational website (www.enttheatre.com) that showed common ENT operations and emergencies, in order to help improve the basic surgical ENT knowledge of medical students and junior doctors. A two-round Delphi survey was conducted to establish the contents of the website. 'Experts' who ...

Prescribing is one of the commonest tasks expected of new doctors and is a complex process involving a mixture of knowledge, judgement and skills. Preparing graduates to be prescribers is one of the greatest challenges of modern undergraduate medical education and there is some evidence to suggest that training could ...

Although most health care services can and should be provided by their medical home, children will be referred or require visits to the emergency department (ED) for emergent clinical conditions or injuries. Continuation of medical care after discharge from an ED is dependent on parents or caregivers' understanding of and ...

PURPOSE: Few studies have examined prescribers' interactions with medication alerts at the point of prescribing. We conducted an in situ, human factors investigation of outpatient prescribing to uncover factors that influence the prescriber-alert interaction and identify strategies to improve alert design. METHODS: Field observations and interviews were conducted with outpatient ...

Allergic rhinitis is a major medical and socioeconomic problem due to its troublesome local symptoms, negative impact on quality of life, association with reduced productivity and increased absenteeism, its widespread nature, and the rapidly rising medical costs associated with the disease. Its handling depends on improved understanding of genetic, biological, ...

BackgroundThe medical regulator in the UK, the General Medical Council, requires curricula and assessments for postgraduate training to be blueprinted to its regulatory statement, Good Medical Practice. A similar document, Tomorrow's Doctors (2009), covers undergraduate education and training. Good Medical Practice, originally designed to regulate medical practice, is not optimally ...

Electronic medical record (EMR) systems have enabled healthcare providers to collect detailed patient information from the primary care domain. At the same time, longitudinal data from EMRs are increasingly combined with biorepositories to generate personalized clinical decision support protocols. Emerging policies encourage investigators to disseminate such data in a de-identified ...

BACKGROUND: Despite federal guidelines calling for the reduction of obesity and elimination of health disparities, black-white differences in obesity prevalence and in medical expenditures and utilization of health care services persist. OBJECTIVES: To examine black-white differences in medical expenditures and utilization of health care services (office-based visits, hospital outpatient visits, ...

In this review, we discuss the treatment of anorexia nervosa (AN) in children and adolescents, highlighting inpatient and outpatient psychiatric treatment. AN is an illness that involves medical and psychological issues; hence, treatment often requires the seamless integration of several medical professionals. It is important that the treatment model be ...

BACKGROUND: Medication error reporting systems in hospitals are faced with the challenge of processing vast numbers of reports which identify a myriad of safety issues. With such large volumes of data and limited resources it makes sense to adopt a prioritisation approach. Several published studies have focused solely on the ...

Purpose:In-service exams are a commonly used educational tool in postgraduate medical education. Although most specialties utilize such an exam, medical genetics did not. It was decided in the spring of 2009 at the inaugural Medical Genetics Residency Program Directors (PDs) Group meeting to develop and implement such a test.Methods:Using questions ...

With the attendant rise of the number of medical colleges in India over past few decades, the demand for cadavers used in medical education and research is growing. However, there is an insufficient supply of donated cadavers available for dissection. This study was undertaken to assess the general population's awareness ...

BackgroundThis study aims to evaluate the attending surgeons' and residents' attitudes towards error disclosure and factors that can potentially affect these tendencies in major academic hospitals affiliated with Tehran University of Medical Sciences (TUMS).Methods and materialIn a cross-sectional study, self-administered questionnaires were delivered to all attending surgeons and second to ...

Among the growing number of works of graphic fiction, a number of titles dealing directly with the patient experience of illness or caring for others with an illness are to be found. Thanks in part to the Medical Humanities movement, many medical schools now encourage the reading of classic literature ...

The use of cinema in medical education has the potential to teach students about a variety of subjects, for instance by illustrating a lecture on communication skills with a clip of Sir Lancelot Spratt (Doctor In The House, 1954) demonstrating a paternalistic, doctor-centred approach to medicine or nurturing an ethical ...

The year 2010 marked the centenary of the birth of Akira Kurosawa (1910-1998), whose works have been reassessed favourably in the last couple of years in Japan. During his lifetime, Kurosawa directed and produced three films whose chief characters are medical doctors: Drunken Angel (1948), The Quiet Duel (1949) and ...

BACKGROUND: The quality of pharmacologic care provided to older adults is less than optimal. Medication therapy management (MTM) programs delivered to older adults in the ambulatory care setting may improve the quality of medication use for these individuals. OBJECTIVES: We conducted focus groups with older adults and primary care physicians ...

This essay presents an analytic approach to understanding patients' responsibilities. Prompted by arguments in Margaret Brazier's article 'Do No Harm-Do Patients Have Responsibilities Too?', the paper demonstrates how medical lawyers can attempt to answer the questions Brazier raises, particularly regarding the translation of ethical responsibilities into legal ones. It suggests ...

This article details a systematic review of medical evaluation forms in support of licensing decisions for medically at-risk drivers. Comparisons were made between all-inclusive forms utilized by 52 State and Provincial Departments of Motor Vehicles (DMVs) in the US and Canada. Comparisons focused on length, format, content, instructional quality, medical ...

This paper draws on two conceptual frameworks, therapeutic landscapes and postcolonial theory, to discuss aspects of medical tourism not addressed in extant literature. Building on the intersection between postcolonial and therapeutic landscapes scholarship, it highlights inequalities related to the production of national therapeutic landscapes located in postcolonial regions as well ...

We describe and analyze the statistics of general physics and laboratory courses in the medical schools of Taiwan. We explore the development of the general physics curriculum for medical students of Taiwan. Also, an approach to designing a general physics course in combination with its application to medical sciences is ...

Medical professionalism is reflected in attitudes, behaviors, character, and standards of practice. It is embodied by physicians who fulfill their duties to patients and uphold societies' trust in medicine. Professionalism requires familiarity with the ethical codes and standards established by international, governmental, institutional, or professional organizations. It also requires becoming ...

Background In the United Kingdom, the General Medical Council aims to introduce revalidation for all medical doctors from 2012, in response to public and government pressure. Doctors will submit evidence to support their fitness to practise medicine every 5 years in relation to the four domains and 12 attributes of ...

Glaucoma is an insidious "thief of vision" that affects millions of Americans and is a leading cause of blindness worldwide. The signs of the most common form of glaucoma are incremental and are often not noticed until the vision loss is acute. Nurses, in any practice arena, who are aware ...

In today's medical market, marketing philosophy is being rapidly transformed from customer searching to patient satisfaction and service improvement. The principal objective of this study was to contribute to the establishment of a desirable medical marketing strategy, through the factors of customer satisfaction and the positioning of patients' perceptions by ...

This article reports on the results of an exploratory survey to determine if librarians actively participate in medical school student recruiting programs. It looks specifically at what librarians are doing to assist with recruitment and what biomedical career resources their libraries offer. The survey link was e-mailed to all U.S. ...

The Chemical Hazards Emergency Medical Management (CHEMM) website from the National Library of Medicine is designed for first responders and medical providers who are planning for and responding to chemical hazards events. It includes pages tailored to the individual interests of specific groups, including first responders, health care providers, mental ...