scholarly journals Does a Pandemic Preempt Participatory Medicine?

10.2196/23860 ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. e23860
Author(s):  
Michael Louis Millenson
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Shared Control ◽  
Jewish Tradition ◽  
Medical Professionals ◽  
Mutual Trust ◽  
Care Providers ◽  
Collaborative Relationship ◽  
Participatory Medicine

For those of us who believe deeply in a collaborative relationship between patients and doctors, the chaos created by the COVID-19 pandemic has brought an uncomfortable question to the fore: Is participatory medicine still relevant during a pandemic? Drawing liberally upon the Jewish tradition of Talmudic reasoning, I would like to offer 3 considered replies: “Yes,” “no,” and “it depends.” Sometimes, patients may have no choice but to cede control to medical professionals, even though patients are still the experts on their own lives. Other times, the shared control of participatory medicine is both an ethical and clinical imperative. However, as the worldwide toll exacted by COVID-19 has made us grimly aware, no one is really in control. That is why, in these uncertain times, the path forward requires maintaining mutual trust between health care providers and patients, whatever the circumstances. After all, it is our bodies and our selves at stake.

scholarly journals Does a Pandemic Preempt Participatory Medicine? (Preprint)

2020 ◽  
Author(s):  
Michael Louis Millenson
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Shared Control ◽  
Jewish Tradition ◽  
Medical Professionals ◽  
Mutual Trust ◽  
Care Providers ◽  
Collaborative Relationship ◽  
Participatory Medicine

UNSTRUCTURED For those of us who believe deeply in a collaborative relationship between patients and doctors, the chaos created by the COVID-19 pandemic has brought an uncomfortable question to the fore: Is participatory medicine still relevant during a pandemic? Drawing liberally upon the Jewish tradition of Talmudic reasoning, I would like to offer 3 considered replies: “Yes,” “no,” and “it depends.” Sometimes, patients may have no choice but to cede control to medical professionals, even though patients are still the experts on their own lives. Other times, the shared control of participatory medicine is both an ethical and clinical imperative. However, as the worldwide toll exacted by COVID-19 has made us grimly aware, no one is really in control. That is why, in these uncertain times, the path forward requires maintaining mutual trust between health care providers and patients, whatever the circumstances. After all, it is our bodies and our selves at stake.

scholarly journals Plain Talk About Health: Linguistic Aspects of Mediation between Amish and Mennonites and Health Care Professionals

2020 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Mark L. Louden
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Language Use ◽  
Medical Professionals ◽  
Care Providers ◽  
Public Spheres ◽  
Pennsylvania Dutch ◽  
Old Order ◽  
Cultural Mediator

As the population of Amish and Old Order Mennonites grows exponentially, so are the contacts between Plain people and medical professionals increasing. All Plain adults are bilingual; however, the fact that the primary everyday language for most is Pennsylvania Dutch is important for understanding how they navigate the health care system. In this article I give an overview of language-related questions involved in communication between Plain people and health care providers with a focus on three areas: translation, interpretation, and patterns of language use. Much of the information I present in this article is drawn from my experience as an interpreter and cultural mediator for Plain people in a number of different public spheres, mainly health care.

scholarly journals Medical Ethics in Clinical Practice in Nepal: Challenges and Way Forward

2018 ◽  
Vol 6 (2) ◽  
pp. 69-72
Author(s):  
Shristi Raut ◽  
Anand Kumar
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Medical Ethics ◽  
Health Care Providers ◽  
Undergraduate Curriculum ◽  
Medical Professionals ◽  
Care Providers ◽  
Treatment Providers ◽  
Level Of Knowledge ◽  
Hospital Ethics

Ethics for health care professional have many components. Among them, medical ethics is one of the important but neglected component which deals with issues related to confidentiality, beneficence and non-maleficence between health care providers and stake holders. Four basic principles of medical ethics are autonomy, justice, beneficence and non- maleficence which form the foundation of ethical clinical practice. The level of knowledge on medical ethics that medical students receive during the training is meagre and inadequate. In recent years, clinical practice has become more challenging. This is primarily due to increased opposition, aggression and violence against medical professionals at health care settings. As a result, the gap between clinicians and patients is increasing leading to diminishing trust and real/perceived allegations. In addition, the widening gap between doctors and patients has provided a space for middle men/broker to meddle, oppose and flare up the violence against treatment providers. Doctors and other medical professionals have been increasingly facing such challenges leading to circumspection in their practice, despondence, psychosocial trauma and depression. There is an urgent need of incorporation of medical ethics in undergraduate curriculum and independent hospital ethics committee consisting of experts from the hospital and outside to monitor and provide rational reasons to minimize such challenges.

scholarly journals Telemedicine in Germany During the COVID-19 Pandemic: Multi-Professional National Survey (Preprint)

2020 ◽  
Author(s):  
Arne Peine ◽  
Pia Paffenholz ◽  
Lukas Martin ◽  
Sandra Dohmen ◽  
Gernot Marx ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Online Survey ◽  
Information Quality ◽  
Health Care Systems ◽  
Public Information ◽  
Current Status ◽  
Medical Professionals ◽  
Care Providers ◽  
University Hospitals

BACKGROUND In an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user’s acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear. OBJECTIVE The aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels. METHODS A national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language. RESULTS A total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (<i>P</i>=.01) as well as between the stationary sector compared to the ambulatory sector (<i>P</i>&lt;.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (<i>P</i>&lt;.001). Participant’s age negatively correlated with the perception of telemedicine’s significance (ρ=–0.23; <i>P</i>&lt;.001). CONCLUSIONS Telemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome.

scholarly journals Accessibility, reliability, and usability of neurosurgical resources

2017 ◽  
Vol 126 (4) ◽  
pp. 1263-1268 ◽  
Author(s):  
Nitin Agarwal ◽  
Sumana S. Kommana ◽  
David R. Hansberry ◽  
Ahmed I. Kashkoush ◽  
Robert M. Friedlander ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Education ◽  
Health Care Providers ◽  
Assessment Tool ◽  
Easy Access ◽  
Medical Professionals ◽  
Care Providers ◽  
Neurosurgical Patient ◽  
Neurological Surgery ◽  
User Friendly

OBJECTIVE Closing the knowledge gap that exists between patients and health care providers is essential and is facilitated by easy access to patient education materials. Although such information has the potential to be an effective resource, it must be written in a user-friendly and understandable manner, especially when such material pertains to specialized and highly technical fields such as neurological surgery. The authors evaluated the accessibility, usability, and reliability of current educational resources provided by the American Association of Neurological Surgeons (AANS), Healthwise, and the National Institute for Neurological Disorders and Stroke (NINDS). METHODS Online neurosurgical patient education information provided by AANS, Healthwise, and NINDS was evaluated using the LIDA scale, a website quality assessment tool, by medical professionals and nonmedical professionals. A high achieving score is regarded as 90% or greater using the LIDA scale. RESULTS Accessibility scores were 76.7% (AANS), 83.3% (Healthwise), and 75.0% (NINDS). Average usability scores for the AANS, Healthwise, and NINDS were 73.3%, 82.6%, and 82.9%, respectively, when evaluated by medical professionals and 78.5%, 80.7%, and 75.9%, respectively, for nonmedical professionals, respectively. Average reliability scores were 58.5%, 53.3%, 72.6%, respectively, for medical professionals and 70.4%, 66.7%, and 78.5%, respectively, for nonmedical professionals when evaluating the AANS, Healthwise, and NINDS websites. CONCLUSIONS Although organizations like AANS, Healthwise, and NINDS should be commended for their ongoing commitment to provide health care–oriented materials, modification of this material is suggested to improve the patient education value.

scholarly journals The Importance of Health Values Among Health Care Providers

2021 ◽  
pp. 155982762199227
Author(s):  
Aliye B. Cepni ◽  
Cherine Hatem ◽  
Tracey A. Ledoux ◽  
Craig A. Johnston
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Medical Professionals ◽  
Behavior Changes ◽  
Lifestyle Behaviors ◽  
Care Providers ◽  
Diet And Physical Activity ◽  
Improve Health

Medical professionals’ healthy eating and physical activity behaviors are likely to wane as other life events and everyday pressures increase. This is vital because as health behaviors decrease, the likelihood that this topic is addressed with patients also decreases. Increased training to improve health care providers’ knowledge about lifestyle behaviors may be inadequate to actually bring about a healthier lifestyle. The area of personal identity and value formation may shed light on a significant barrier in this area. Developing health care professionals who have values consistent with a healthy diet and physical activity, instead of just being informed about it, would increase the likelihood that healthy behavior changes are discussed with patients. Strategies to encourage value formation around healthy lifestyles among medical professionals are discussed.

Hurricane Maria and La Crisis Boricua on Health-Care Supply in Puerto Rico

2021 ◽  
Vol 111 ◽  
pp. 598-601
Author(s):  
Jose M. Fernandez
Keyword(s):  
Health Care ◽  
Puerto Rico ◽  
Financial Crisis ◽  
Health Care Providers ◽  
Family Physicians ◽  
Medical Professionals ◽  
Care Providers ◽  
Difference In Difference ◽  
Difference Model ◽  
Health Care Supply

Many medical professionals left Puerto Rico due to the financial crisis. Puerto Rico passed Act 14 in April 2017 to mitigate the exodus of physicians, reducing the flat tax on medical services to 4 percent. The same year, Puerto Rico was devastated by a Category 4 hurricane, leaving the is land without power for several months. A difference-in-difference model is used to estimate the net effects of the hurricane and Act 14 on the number of health-care providers. The number of health-care providers decreased by 6.5 percent, family physicians by 17.5 percent, and specialists by 8 percent.

scholarly journals Telemedicine in Germany During the COVID-19 Pandemic: Multi-Professional National Survey

10.2196/19745 ◽  
2020 ◽  
Vol 22 (8) ◽  
pp. e19745 ◽  
Author(s):  
Arne Peine ◽  
Pia Paffenholz ◽  
Lukas Martin ◽  
Sandra Dohmen ◽  
Gernot Marx ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Online Survey ◽  
Information Quality ◽  
Health Care Systems ◽  
Public Information ◽  
Current Status ◽  
Medical Professionals ◽  
Care Providers ◽  
University Hospitals

Background In an effort to contain the effects of the coronavirus disease (COVID-19) pandemic, health care systems worldwide implemented telemedical solutions to overcome staffing, technical, and infrastructural limitations. In Germany, a multitude of telemedical systems are already being used, while new approaches are rapidly being developed in response to the crisis. However, the extent of the current implementation within different health care settings, the user’s acceptance and perception, as well as the hindering technical and regulatory obstacles remain unclear. Objective The aim of this paper is to assess the current status quo of the availability and routine use of telemedical solutions, user acceptance, and the subjectively perceived burdens on telemedical approaches. Furthermore, we seek to assess the perception of public information quality among professional groups and their preferred communication channels. Methods A national online survey was conducted on 14 consecutive days in March and April 2020, and distributed to doctors, nurses, and other medical professionals in the German language. Results A total of 2827 medical professionals participated in the study. Doctors accounted for 65.6% (n=1855) of the professionals, 29.5% (n=833) were nursing staff, and 4.9% (n=139) were identified as others such as therapeutic staff. A majority of participants rated the significance of telemedicine within the crisis as high (1065/2730, 39%) or neutral (n=720, 26.4%); however, there were significant differences between doctors and nurses (P=.01) as well as between the stationary sector compared to the ambulatory sector (P<.001). Telemedicine was already in routine use for 19.6% (532/2711) of German health care providers and in partial use for 40.2% (n=1090). Participants working in private practices (239/594, 40.2%) or private clinics (23/59, 39.0%) experienced less regulatory or technical obstacles compared to university hospitals (586/1190, 49.2%). A majority of doctors rated the public information quality on COVID-19 as good (942/1855, 50.8%) or very good (213/1855, 11.5%); nurses rated the quality of public information significantly lower (P<.001). Participant’s age negatively correlated with the perception of telemedicine’s significance (ρ=–0.23; P<.001). Conclusions Telemedicine has a broad acceptance among German medical professionals. However, to establish telemedical structures within routine care, technical and regulatory burdens must be overcome.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

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