The Role of Outcome-Based Standards in Yoga Therapy

2010 ◽  
Vol 20 (1) ◽  
pp. 42-51
Author(s):  
Scott Laurence
Keyword(s):  
Medical Model ◽  
Third Party ◽  
Yoga Therapy ◽  
Middle Way ◽  
Measurement Tools ◽  
Third Party Reimbursement ◽  
Sample Measurement ◽  
Community Outcome ◽  
Model Approach

This article introduces a powerful and effective approach to facilitating and documenting positive change that may be new to many in the Yoga therapy community: outcome-based standards and practices. Outcome-based methods are efficient, effective, and conform to both modern medical practices and to third-party reimbursement requirements. At the same time, outcome-based approaches maintain the spirit and identity of the Yogic approach to change and are thus superior to strictly evidence-based therapies. Outcome-based therapy is a middle way between a reductionist, allopathic medical model approach and a free-wheeling, forever spontaneous philosophy that eschews research and evidence. Sample measurement tools are provided.

Treatment Choices and Informed Consent in Psychiatry: Implications of the Osheroff Case for the Profession

1986 ◽  
Vol 14 (1-2) ◽  
pp. 9-107 ◽  
Author(s):  
John Gulton Malcolm
Keyword(s):  
Decision Making ◽  
Informed Consent ◽  
Alternative Treatment ◽  
Third Party ◽  
Treatment Modalities ◽  
Decision Making Process ◽  
Psychiatric Facility ◽  
Third Party Reimbursement ◽  
The Impact

In a case that is presently pending, a patient sued a private psychiatric facility alleging that the hospital committed malpractice by treating his disorder through psychodynamic rather than biological techniques. In this article, the author discusses the potential implications this suit may have for psychiatrists faced with making decisions about alternative treatment modalities. The article also discusses the role of the informed consent doctrine in this decision-making process. The impact of third-party reimbursement and the erosion of the so-called “respectable minority” rule are also discussed.

Health Care

2018 ◽  
Author(s):  
Pierre Pestieau ◽  
Mathieu Lefebvre
Keyword(s):  
Health Care ◽  
Technological Progress ◽  
Health Care Systems ◽  
Third Party ◽  
Medical Expenditure ◽  
Public Health Care ◽  
The Public ◽  
Common Features ◽  
Care Systems

This chapter reviews the public health care systems as well as their challenges. It first shows how expenditure on health care has evolved in previous decades and deals with the reasons for the growth observed in almost every European country. It emphasizes the role of technological progress as a main explanatory factor of the increase in medical expenditure but also points to the challenges facing cost-containment policies. Especially, the main common features of health care systems in Europe, such as third-party payment, single provider approach and cost-based reimbursement are discussed. Finally the chapter shows that although inequalities in health exist in the population, health care systems are redistributive. Reforms are thus needed but the trade-off between budgetary efficiency and equity is difficult.

scholarly journals Impact of tumor-parenchyma biomechanics on liver metastatic progression: a multi-model approach

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yafei Wang ◽  
Erik Brodin ◽  
Kenichiro Nishii ◽  
Hermann B. Frieboes ◽  
Shannon M. Mumenthaler ◽  
...  
Keyword(s):  
Time Scales ◽  
Constitutive Relations ◽  
Elastic Tissue ◽  
Metastatic Progression ◽  
Patient Death ◽  
Metastatic Growth ◽  
Tumor Parenchyma ◽  
Short Time ◽  
Model Approach

AbstractColorectal cancer and other cancers often metastasize to the liver in later stages of the disease, contributing significantly to patient death. While the biomechanical properties of the liver parenchyma (normal liver tissue) are known to affect tumor cell behavior in primary and metastatic tumors, the role of these properties in driving or inhibiting metastatic inception remains poorly understood, as are the longer-term multicellular dynamics. This study adopts a multi-model approach to study the dynamics of tumor-parenchyma biomechanical interactions during metastatic seeding and growth. We employ a detailed poroviscoelastic model of a liver lobule to study how micrometastases disrupt flow and pressure on short time scales. Results from short-time simulations in detailed single hepatic lobules motivate constitutive relations and biological hypotheses for a minimal agent-based model of metastatic growth in centimeter-scale tissue over months-long time scales. After a parameter space investigation, we find that the balance of basic tumor-parenchyma biomechanical interactions on shorter time scales (adhesion, repulsion, and elastic tissue deformation over minutes) and longer time scales (plastic tissue relaxation over hours) can explain a broad range of behaviors of micrometastases, without the need for complex molecular-scale signaling. These interactions may arrest the growth of micrometastases in a dormant state and prevent newly arriving cancer cells from establishing successful metastatic foci. Moreover, the simulations indicate ways in which dormant tumors could “reawaken” after changes in parenchymal tissue mechanical properties, as may arise during aging or following acute liver illness or injury. We conclude that the proposed modeling approach yields insight into the role of tumor-parenchyma biomechanics in promoting liver metastatic growth, and advances the longer term goal of identifying conditions to clinically arrest and reverse the course of late-stage cancer.

Death, taxes and uncertainty: Economic motivations in end-of-life decision making

2021 ◽  
pp. 147775092110114
Author(s):  
George Slade Mellgard ◽  
Jacob M Appel
Keyword(s):  
End Of Life ◽  
Ethical Issues ◽  
Conflicts Of Interest ◽  
Clinical Care ◽  
Third Party ◽  
Ethical Conflicts ◽  
Financial Interests ◽  
End Of Life Decision ◽  
Death Taxes

Economic motivations are key drivers of human behavior. Unfortunately, they are largely overlooked in literature related to medical decisionmaking, particularly with regard to end-of-life care. It is widely understood that the directions of a proxy acting in bad faith can be overridden. But what of cases in which the proxy or surrogate appears to be acting in good faith to effectuate the patient’s values, yet doing so directly serves the decision-maker’s financial interests? Such situations are not uncommon. Many patients care as deeply about economic wellbeing of their families as they do for their own lives and health. This brief work examines three scenarios that raise ethical issues regarding the role of pecuniary motives in making critical medical decisions. Each scenario presents a potential financial conflict of interest between an incapacitated patient and a third-party decision-maker and offers a framework for integrating ethical and legal concerns into clinical care. It is our hope that this work prepares physicians for unexpected ethical conflicts of interest and enables them to further the interests of his or her patients.

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