Predicting Patients' Satisfaction With Doctors in Online Medical Communities

Online medical communities have revolutionized the way patients obtain medical-related information and services. Investigating what factors might influence patients’ satisfaction with doctors and predicting their satisfaction can help patients narrow down their choices and increase their loyalty towards online medical communities. Considering the imbalanced feature of dataset collected from Good Doctor, we integrated XGBoost and SMOTE algorithm to examine what factors and these factors can be used to predict patient satisfaction. SMOTE algorithm addresses the imbalanced issue by oversampling imbalanced classification datasets. And XGBoost algorithm is an ensemble of decision trees algorithm where new trees fix errors of existing trees. The experimental results demonstrate that SMOTE and XGBoost algorithm can achieve better performance. We further analyzed the role of features played in satisfaction prediction from two levels: individual feature level and feature combination level.

Communication in Healthcare: Global challenges in the 21st Century

This article explores the communication challenges brought about by the digital revolution in the 21st century for healthcare professionals internationally. It particularly focuses on the use of content-generating and sharing platforms like social media. Globally, healthcare has been irrevocably altered by digital innovation and health professionals deploy an extensive range of social media and web-based tools on a daily basis. However, many healthcare professionals use these platforms in a regulatory vacuum—where there may not be specific legal or ethical guidance—and without an appreciation of the associated risks. Given the special protections afforded to the practitioner–patient relationship, and the importance of a health practitioners' reputation, it is vital that we understand how to traverse the many ethical and legal challenges of the digital interaction. A comprehensive set of recommendations (see “Guidelines for Good Digital Citizenship in the Health Professions” on page 5 ff.) to keep practitioners out of trouble is provided. These hinge on the notion of being a “good person and a good doctor” as a formative maxim for ethical and legal safety. The constituents of publication, and the consequences of falling foul of acceptable publication standards on social media, are specifically discussed. “Publication” involves sharing content with a third party, or a group of people, and social media refers to platforms on which content can be shared with more than one person. Hence, most information that we post on social media can be considered as “published,” and as such may attach liability for health professionals who do not use these platforms with requisite care and sufficient forethought.

Perceptions of Practicing Physicians and Members of the Public on the Attributes of a “Good Doctor”

Since physician–patient relationships are a central part of the medical practice, it is essential to understand whether physicians and the general public share the same perspective on traits defining a “good doctor”. Our study compared the perceptions of physicians and members of the public on the essential traits of a “good doctor.” We conducted parallel surveys of 1000 practicing specialist-physicians, and 500 members of the public in Israel. Respondents were asked about the two most important attributes of a “good doctor” and whether they thought the physicians’ role was to reduce health disparities. Many physicians (56%) and members of the public (48%) reported that the role of physicians includes helping to reduce health disparities. Physicians emphasized the importance of non-technical skills such as humaneness and concern for patients as important traits of a “good doctor,” while the public emphasized professional and technical skills. Internal medicine physicians were more likely than surgeons to emphasize humaneness, empathy, and professionalism. Future research should focus on actionable approaches to bridge the gap in the perceptions between the groups, and that may support the formation of caring physicians embedded in a complex array of relationships within clinical and community contexts.

Moral Distress Trajectories of Physicians 1 Year after the COVID-19 Outbreak: A Grounded Theory Study

The COVID-19 pandemic has confronted emergency and critical care physicians with unprecedented ethically challenging situations. The aim of this paper was to explore physicians’ experience of moral distress during the pandemic. A qualitative multicenter study was conducted using grounded theory. We recruited 15 emergency and critical care physicians who worked in six hospitals from the Lombardy region of Italy. Semi-structured interviews about their professional experience of moral distress were conducted from November 2020–February 2021 (1 year after the pandemic outbreak). The transcripts were qualitatively analyzed following open, axial, and selective coding. A model of moral distress was generated around the core category of Being a Good Doctor. Several Pandemic Stressors threatened the sense of Being a Good Doctor, causing moral distress. Pandemic Stressors included limited healthcare resources, intensified patient triage, changeable selection criteria, limited therapeutic/clinical knowledge, and patient isolation. Emotions of Moral Distress included powerlessness, frustration/anger, and sadness. Physicians presented different Individual Responses to cope with moral distress, such as avoidance, acquiescence, reinterpretation, and resistance. These Individual Responses generated different Moral Outcomes, such as moral residue, disengagement, or moral integrity. The Working Environment, especially the team and organizational culture, was instrumental in restoring or disrupting moral integrity. In order for physicians to manage moral distress successfully, it was important to use reinterpretation, that is, to find new ways of enacting their own values by reframing morally distressing situations, and to perceive a cooperative and supportive Working Environment.

"Moving things forward": Birthing Suite culture and labour augmentation for healthy first-time mothers.

<p>In Aotearoa New Zealand, healthy women giving birth for the first time may plan to give birth in range of settings - from home to a tertiary hospital where surgical and anaesthetic services are available. Each birth location has its own culture, and the extent to which this culture influences the birth experience lies at the heart of this research. Just twenty-three percent of first-time mothers experience a normal birth with no obstetric interventions, and the chosen place of birth is implicated in this statistical outcome. Tertiary maternity settings report the highest rates of birth interventions, even for healthy women who can anticipate straightforward labour experiences. Among the most frequently used birth interventions are labour augmentation procedures - artificial rupture of membranes and administration of synthetic oxytocin infusions. My critical realist ethnography aims to explore the cultural landscape within one tertiary birthing suite and in doing so to identify the generative mechanisms that influence the likelihood of labour augmentation for well first-time mothers. I begin with a retrospective chart review to uncover the magnitude of the use of augmentation procedures for a sample of healthy women presenting in labour to the birthing suite over one calendar year. Interviews with women who experienced long labours yield insights about their decision-making with respect to augmentation. Focus groups and interviews with midwives and obstetric doctors contribute an understanding of factors associated with their use of augmentation, and a period of non-participant observation in the birthing suite illuminates the nuanced ways the unit culture contributes to the permissive use of augmentation procedures in this birthing environment. Findings reveal that sixty percent of women experienced labour augmentation procedures and for one third of them, the augmentation was not indicated according to the clinical guideline in use at the time. Pressure to be “moving things forward” characterises the birthing suite culture. The identified generative mechanisms that combine to influence the likelihood of augmentation include a lack of belief in birth, not valuing midwives, the education and socialisation of midwives and doctors, and the industrialisation of birth - all underpinned by available social discourses about being a good mother, a good midwife or a good doctor. Ironically, the very attributes that make the tertiary hospital the ideal place to be when birth is complex or the unexpected happens (‘poised-ness’ for action, being a ‘well-oiled machine’ for emergency care, surveillance and control) are the same attributes that create a dis-abling environment for physiological first birth to unfold at its own pace. The ‘perfect system’ is in place; a well-embedded midwifery-led continuity of care model incorporating seamless and integrated secondary referral processes. But despite this potentially enabling model of maternity care, once ‘nested’ within the tertiary hospital setting the impact of social, professional and industrial discourses overwhelms the salutogenic factors that should protect normal birth. A re-focussed commitment to providing continuity of care across the labour continuum, home visiting in early labour, enhancing physiological birth support in both the relational and environmental realms, averting the obstetric gaze and prioritising women’s needs over institutional needs represent the best way forward as strategies to resist the inexorable rise of obstetric intervention. Midwives are well-positioned to respond to this call. Reclaiming their expertise in support of physiological first birth by driving the practice and research agenda presents the optimal way to “move things forward” for women.</p>

"Moving things forward": Birthing Suite culture and labour augmentation for healthy first-time mothers.

<p>In Aotearoa New Zealand, healthy women giving birth for the first time may plan to give birth in range of settings - from home to a tertiary hospital where surgical and anaesthetic services are available. Each birth location has its own culture, and the extent to which this culture influences the birth experience lies at the heart of this research. Just twenty-three percent of first-time mothers experience a normal birth with no obstetric interventions, and the chosen place of birth is implicated in this statistical outcome. Tertiary maternity settings report the highest rates of birth interventions, even for healthy women who can anticipate straightforward labour experiences. Among the most frequently used birth interventions are labour augmentation procedures - artificial rupture of membranes and administration of synthetic oxytocin infusions. My critical realist ethnography aims to explore the cultural landscape within one tertiary birthing suite and in doing so to identify the generative mechanisms that influence the likelihood of labour augmentation for well first-time mothers. I begin with a retrospective chart review to uncover the magnitude of the use of augmentation procedures for a sample of healthy women presenting in labour to the birthing suite over one calendar year. Interviews with women who experienced long labours yield insights about their decision-making with respect to augmentation. Focus groups and interviews with midwives and obstetric doctors contribute an understanding of factors associated with their use of augmentation, and a period of non-participant observation in the birthing suite illuminates the nuanced ways the unit culture contributes to the permissive use of augmentation procedures in this birthing environment. Findings reveal that sixty percent of women experienced labour augmentation procedures and for one third of them, the augmentation was not indicated according to the clinical guideline in use at the time. Pressure to be “moving things forward” characterises the birthing suite culture. The identified generative mechanisms that combine to influence the likelihood of augmentation include a lack of belief in birth, not valuing midwives, the education and socialisation of midwives and doctors, and the industrialisation of birth - all underpinned by available social discourses about being a good mother, a good midwife or a good doctor. Ironically, the very attributes that make the tertiary hospital the ideal place to be when birth is complex or the unexpected happens (‘poised-ness’ for action, being a ‘well-oiled machine’ for emergency care, surveillance and control) are the same attributes that create a dis-abling environment for physiological first birth to unfold at its own pace. The ‘perfect system’ is in place; a well-embedded midwifery-led continuity of care model incorporating seamless and integrated secondary referral processes. But despite this potentially enabling model of maternity care, once ‘nested’ within the tertiary hospital setting the impact of social, professional and industrial discourses overwhelms the salutogenic factors that should protect normal birth. A re-focussed commitment to providing continuity of care across the labour continuum, home visiting in early labour, enhancing physiological birth support in both the relational and environmental realms, averting the obstetric gaze and prioritising women’s needs over institutional needs represent the best way forward as strategies to resist the inexorable rise of obstetric intervention. Midwives are well-positioned to respond to this call. Reclaiming their expertise in support of physiological first birth by driving the practice and research agenda presents the optimal way to “move things forward” for women.</p>

Knowledge about Prescription of the Antibiotic for Endodontic’s Treatment among Final Year Students.

Background: Since antibiotic’s discovery, they have been widely utilized for treatment of the odontogenic infections. Writing a prescription is a vital determining factor of the good doctor/clinician. Drug Prescription is a dynamic and personalized clinical process, which is established as a result of necessities of the patient & acquaintance of practitioner & is also the component of curriculum of graduation. Aim: To evaluate and assess knowledge about prescription of the antibiotic during the endodontics’s treatment and the errors made by final year students at the dental hospital. Setting: Multan Medical & Dental College Multan Methodology: This survey-based research was led among 48 students of Multan Dental College Multan. A form was designed, regarding pattern of the antibiotic’s prescription & conditions/situations for which the drugs were recommended by students of final year. Results: The medication of choice was mostly Amoxicillin alone (75%) and Amoxicillin + clavulanic acid (55%). Most of antibiotic prescriptions were written for Perio-endo lesion (85%), acute apical abscess (80%). Chronic apical abscess with sinus tract (80%), Ch. apical abscess with periodontitis (65%), Patients with swelling & difficulty in swallowing (62%). In this study the greatest numbers of antibiotics prescribed were prophylactically for congenital cardiac sicknesses 69.7%, and uncontrolled diabetes mellitus 60%. Prosthetic joint in past 2 years 40% & Chemo/radio therapy 30%. Conclusion: There is a dearth of knowledge as well as information concerning the suitable indication, kind, & dose of the antibiotics in practice of dentistry. The curriculum should propose great accent on prescription, and decent prescription practices should also be taught in clinical rotation’s, using actual or imaginary cases. Keywords: Antibiotics, Endodontics, Prescription writing, prophylaxis, Root canal treatment (RCT)

Exploring Important Aspects of Service Quality While Choosing a Good Doctor

Online reviews generated by patients on physician rating Websites (PRWs) have recently received much attention from physicians and their patients. In these reviews, patients exchange opinions as a diverse set of topics regarding different aspects of healthcare quality. This study aimed to propose a novel service quality-based text analytics (SQTA) model with other qualitative methods to mine different aspects of physicians and their clinical relevance in choosing a good doctor. Data included 45,560 online reviews that the authors scraped from a U.S.-based PRW (Healthgrades.com). The resulting topics demonstrate excellent classification results across different disease ranks, with overall accuracy and recall of 98%. The proposed classifier’s performance was 3% better than the existing topic classification methods applied in previous studies. The resulting clinically informative topics could help patients and physicians to maximize the usefulness of online reviews for efficient clinical decisions and improving the quality of care.

CORPORATE SOCIAL RESPONSIBILITY (CSR) PT. GRAB INDONESIA DI ERA NEW NORMAL MASA PANDEMI COVID-19

Today, the social responsibility of a company or better known as CSR has become the subject of discussion among the public and business people. PT. Grab Indonesia, as an Indonesian online transportation application, together with the government, carried out a covid 19 vaccination as an implementation of CSR in the New Normal era of the Covid-19 pandemic in several regions in Indonesia for the elderly and online transportation drivers. This study aims to determine the implementation of Grab Indonesia's "vaccine for the country" Corporate Social Responsibility (CSR) during the new normal period of the covid-19 pandemic. The study uses the CSR concept from John Elkington which reveals the triple bottom line concept, namely profit, people, and planet. This research uses a case study approach. The results showed PT Grab Indonesia in the new normal era carried out CSR by holding a covid-19 vaccination together with the Ministry of Health and the Ministry of Tourism and Creative Economy and several other companies such as Fatigon, Good Doctor, Teh Pucuk as vaccine centers in Bali, Palembang, Banten, West Java and other areas.