scholarly journals The Validity of Online Patient Ratings of Physicians: Analysis of Physician Peer Reviews and Patient Ratings (Preprint)

2017 ◽  
Author(s):  
Robert J McGrath ◽  
Jennifer Lewis Priestley ◽  
Yiyun Zhou ◽  
Patrick J Culligan
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Health Care ◽  
Family Medicine ◽  
Peer Review ◽  
Large Scale ◽  
The United States ◽  
Medical Specialization ◽  
Peer Reviews ◽  
Selection Of

BACKGROUND Information from ratings sites are increasingly informing patient decisions related to health care and the selection of physicians. OBJECTIVE The current study sought to determine the validity of online patient ratings of physicians through comparison with physician peer review. METHODS We extracted 223,715 reviews of 41,104 physicians from 10 of the largest cities in the United States, including 1142 physicians listed as “America’s Top Doctors” through physician peer review. Differences in mean online patient ratings were tested for physicians who were listed and those who were not. RESULTS Overall, no differences were found between the online patient ratings based upon physician peer review status. However, statistical differences were found for four specialties (family medicine, allergists, internal medicine, and pediatrics), with online patient ratings significantly higher for those physicians listed as a peer-reviewed “Top Doctor” versus those who were not. CONCLUSIONS The results of this large-scale study indicate that while online patient ratings are consistent with physician peer review for four nonsurgical, primarily in-office specializations, patient ratings were not consistent with physician peer review for specializations like anesthesiology. This result indicates that the validity of patient ratings varies by medical specialization.

Rationalization of Health Services: Political and Social Assumptions

1972 ◽  
Vol 2 (3) ◽  
pp. 331-348 ◽  
Author(s):  
R. M. Battistella
Keyword(s):  
United States ◽  
Health Care ◽  
Health Services ◽  
Large Scale ◽  
Economies Of Scale ◽  
Cost Savings ◽  
The United States ◽  
Health Economy ◽  
Market Values ◽  
Efficiency And Effectiveness

Confronted with deep—seated problems of spiralling health care costs, the United States is actively considering rationalization as a means for improving efficiency and effectiveness in the operation of health services. The application of managerial and organizational principles characteristic of large—scale business and industry, i.e. quantification of decision—making, consolidation of production, money rewards for cost savings, and economies of scale, is increasingly seen as the key to successful control of the health economy. The drive for rationalization is assessed in terms of its probable impact on the following issues: (a) the scope of health—field boundaries and program responsibilities; (b) the influence of health professionals in policy and planning; (c) the role of altruistic ideals as compared to market values in conditioning provider behavior; and (d) the relationship of health services to larger social and philosophic aims. Because of the tendency toward convergence in the problems governments face in the financing and delivery of health care, it is suggested that developments in the United States may be relevant to other countries in similarly advanced stages of economic growth.

Challenge of Hospital Emergency Preparedness: Analysis and Recommendations

2009 ◽  
Vol 3 (S1) ◽  
pp. S74-S82 ◽  
Author(s):  
Joseph A. Barbera ◽  
Dale J. Yeatts ◽  
Anthony G. Macintyre
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Natural Disasters ◽  
Emergency Response ◽  
Emergency Preparedness ◽  
Large Scale ◽  
The United States ◽  
Public Health Care ◽  
Medical Emergency

ABSTRACTIn the United States, recent large-scale emergencies and disasters display some element of organized medical emergency response, and hospitals have played prominent roles in many of these incidents. These and other well-publicized incidents have captured the attention of government authorities, regulators, and the public. Health care has assumed a more prominent role as an integral component of any community emergency response. This has resulted in increased funding for hospital preparedness, along with a plethora of new preparedness guidance.Methods to objectively measure the results of these initiatives are only now being developed. It is clear that hospital readiness remains uneven across the United States. Without significant disaster experience, many hospitals remain unprepared for natural disasters. They may be even less ready to accept and care for patient surge from chemical or biological attacks, conventional or nuclear explosive detonations, unusual natural disasters, or novel infectious disease outbreaks.This article explores potential reasons for inconsistent emergency preparedness across the hospital industry. It identifies and discusses potential motivational factors that encourage effective emergency management and the obstacles that may impede it. Strategies are proposed to promote consistent, reproducible, and objectively measured preparedness across the US health care industry. The article also identifies issues requiring research. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S74–S82)

scholarly journals The future of internal medicine in the United States and Poland

2014 ◽  
Vol 124 (1) ◽  
pp. 49-54
Author(s):  
Candace M. Wilson ◽  
Olusegun Taylor ◽  
Andrzej Prystupa ◽  
Wojciech Załuska
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Health Care ◽  
Cost Savings ◽  
The United States ◽  
The Body ◽  
Policy Makers ◽  
The Future ◽  
Holistic Manner

Abstract Internal medicine physicians are critical to the health of the population. Internal medicine doctors also bring cost savings in health care because they treat many systems in the body and treat the patients in a holistic manner. However, the popularity of the specialty of internal medicine is declining. This is due to the decreased compensation that internal medicine doctors obtain when compared to their colleagues who specialize in other fields. The decline in number of physicians specializing in internal medicine causes a decrease in the health of the population. Governments and policy makers must look for ways to reverse the trend of doctors not specializing in internal medicine

Science and Medicine in the United States of America

2012 ◽  
Author(s):  
Edmund Ramsden
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
United States Of America ◽  
Rapid Growth ◽  
Large Scale ◽  
Medical Science ◽  
The United States ◽  
Biomedical Sciences ◽  
Democratic State

This article begins with great optimism expressed by Tocqueville for America's future as the embodiment of the democratic state. It discusses the opportunity to express the liberal political ideals, arguing that its success was based on a community of common sensibility. An understanding of society and politics endowed the historian with the power to help remake health care. This article explores and compares the ways in which medicine is developed and applied in a number of different social, cultural, and physical contexts. It shows rapid growth, from a period in which European ideas, methods, and structures were adapted to the American context, to one in which the United States is at the forefront of large-scale initiatives in public health, disease control, and innovation in the biomedical sciences. Finally, it mentions the contradiction, most notably between profound faith in the technical capacities of medical science and equally profound dissatisfaction with the provision of health care.

scholarly journals Declines, and Pronounced Regional Disparities, in Meperidine Use in the United States

2020 ◽  
Author(s):  
John M. Boyle ◽  
Kenneth L. McCall ◽  
Stephanie D. Nichols ◽  
Brian J. Piper
Keyword(s):  
Internal Medicine ◽  
United States ◽  
Pain Management ◽  
Family Medicine ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Medicare Part D ◽  
The United States ◽  
Part D ◽  
Interventional Pain Management

AbstractPurposeThere have been increasing concerns about adverse effects and drug interactions with meperidine including removal from the World Health Organization’s list of essential medications. The goal of this study was to characterize pharmacoepidemiological patterns in meperidine use in the United States.MethodsMeperidine distribution data was obtained from the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS). Medicare Part D Prescriber Public Use Files (PUF) were utilized to capture overall trends in national meperidine prescriptions.ResultsNational meperidine distribution decreased from 2001 to 2019 by 94.6%. In 2019 Arkansas, Alabama, Oklahoma, and Mississippi saw significantly greater distribution per person when compared to the average state (9.27, SD = 6.82). Meperidine per ten persons showed an eighteen-fold difference between the highest (Arkansas = 36.8 mg) and lowest (Minnesota = 2.1 mg) states. Five of the six lowest states were in the northeast. Meperidine distribution per state was significantly correlated with the prevalence of adult obesity (r(47) = +0.47, p < 0.001).Family medicine and internal medicine physicians accounted for 28.9% and 20.5% of Medicare Part D total daily supply (TDS) of meperidine in 2017. However, interventional pain management (5.66) and pain management (3.48) physicians accounted for the longest while family medicine (0.69) and internal medicine (0.40) accounted for the shortest TDS per provider.ConclusionUse of meperidine has been declining over the last two-decades. Meperidine distribution varied on a geographical level with south/south-central, and more obese, states showing appreciably greater distribution per person. Primary care doctors continue to account for the majority of meperidine daily supply, but specialists like interventional pain management were the most likely to prescribe meperidine to Medicare patients. Increasing knowledge of meperidine’s undesirable adverse effects (e.g. seizures) and serious drug-drug interactions likely are responsible for these pronounced reductions.

Review Article: Dismantling the Health Care State? Political Institutions, Public Policies and the Comparative Politics of Health Reform

2004 ◽  
Vol 34 (4) ◽  
pp. 693-724 ◽  
Author(s):  
JACOB S. HACKER
Keyword(s):  
United States ◽  
Health Care ◽  
Comparative Politics ◽  
Political Institutions ◽  
Large Scale ◽  
The United States ◽  
Policy Outcomes ◽  
Main Task ◽  
Medical Systems ◽  
Cross National

This article examines the recent pattern and progress of health care reform in affluent democracies, focusing in particular on Britain, Canada, Germany, the Netherlands and the United States. Its main contention is that efforts to reform health care in advanced industrial states have been marked by a paradoxical pattern of ‘reform without change and change without reform’, in which large-scale structural reforms have had surprisingly modest effects yet major ground-level shifts have, nonetheless, frequently occurred as a result of decentralized adjustments to cost control. The main task of the article is to investigate the reasons for and effects of this puzzling pattern by plumbing the largely unexplored theoretical territory between comparative health policy analysis and cross-national research on the welfare state. Along the way, the article develops a simple model of the politics of reform that helps explain cross-national variation in legislative and policy outcomes – particularly outcomes that occur through decentralized processes of internal policy ‘conversion’ and policy ‘drift’, rather than through formal legislative reform. It also takes up a number of other intriguing issues raised by recent trends: why, for example, market reforms are clustered in centralized political and medical frameworks; why these reforms have generally enhanced state authority rather than market autonomy; why, despite fragmentation, decentralized political and medical systems shifted towards an expanded government role; and why significant retrenchment of the public-private structure of health benefits occurred in the United States.

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