physicians view the health care system of the United States in terms of cost, quality and access. The purpose of this research plan is to develop a survey that will present a conceptual model for measuring health plan quality from the perspective of physicians and nurses.
The survey will be conducted through telephone interviews and emailed surveys to a national random sample of 30 physicians and 20 nurses nationwide between February and March 2003.

Due to the fact that fewer Medicare beneficiaries are in managed health care plans, the survey asks doctors and nurses only about their experiences with patients under 65 years of age. The physician sample will be drawn from the American Medical Association's physician list and will target physicians who care for patients 20 or more hours per week.

This survey will gather quantitative information about physicians' and nurses' experiences with and attitudes towards health plans, particularly as related…...

physicians agree that managed care is not doing the job it was originally created to do. Although reform efforts have not worked in the past, many doctors believe now is the time to revisit reform to combat the lack of health care access to a growing number of Americans, escalating costs, and deteriorating quality. This paper explores the evolution of managed care, and its problems and possible solutions from the viewpoint of two organizations representing the interests of physicians.
In 1993, President Clinton introduced a plan for regulated health care reform in response to escalating costs and the growing ranks of the uninsured. From 1970 until the time of the reform proposal, health care spending had increased from $74.4 billion to $752 billion annually. The Clinton proposal was met with huge opposition from the "medical industrial complex" comprised of insurance firms, pharmaceutical companies, hospital suppliers and medical device companies and…...

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Bibliography better-quality alterantive; single-payer national health system reform. Retrieved on February

3, 2003 Physicians For A National Health Program Web Site:   national health program for the United States: a physician's proposal. Retrieved on February 3, 2003 Physicians For A National Health Program Web Site:  http://www.pnhp.org/publications/archives/000016.php http://www.pnhp.org/publications/archives/000015.php 

Caplan, A. (2000, December 21, 2000) In 2000, managed care our no. 1 health crisis, Retrieved on February 3, 2003 from MSNBC News Web Site:  http://www.msnbc.com/news/671464.asp 

Healthcare crisis: managed care. Retrieved February 3, 2002 from PBS Web site:  http://www.pbs.org/healthcarecrisis/managedcare.html 

Position paper on universal access to health care and health system reform. Retrieved on February 3, 2003 from American Medical Women's Association Web Site:  http://www.amwa-doc.org/publications/Position_Papers/univesal_access.htm

Independent Physicians
The Dying Profession of Independent Physicians

In the past, it has always been the case that physicians were, for the most part, independent contractors who had working agreements with certain hospitals in their region. However, that is not the case anymore. Physicians are increasingly joining healthcare organizations because the costs of remaining autonomous are too strenuous. It does not matter that independent physicians, on average still make more than their group counterparts because there are too many advantages to joining a healthcare group. The primary advantage being the fact that the individual is no longer solely responsible for such tasks as billing and scheduling. Although joining a group may be advantageous in some ways, it is troubling in others. Patient care is sometimes lessened because, as with the government sponsored socialized medical practices that exist in other countries, the patient may have to wait longer for care and care is…...

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Works Cited

Berman, Micah. "The 'Quality Health Care Coalition Act': Can Antitrust Law Improve Patient Care?" Stanford Law Review 53.3 (2003): 695-717. Print.

Biz Times. "Independent Physicians are a Vanishing Breed." Biz Times: Milwaukee Business News, 8 August 2008. Web.

Chufo, Veronica. "Independent Docs Vanishing: As Healthcare Costs Rise, Many Physicians are Joining Healthcare Systems to Pool Resources, but is That Trend Best for Patients?" Daily Press, 15 June 2009. Web.

Figliuolo, Michael L., Paul D. Mango and David H. McCormick. "Hospital, Heal Thyself." The McKinsey Quarterly (2000): 91-95.

(Easterbrook, et al., 1999)
ourke goes on to discuss his recommendations for increasing the number of rural sourced students to medical training programs, the most important of which is changing the admissions one that more adequately recruits rural candidates:

Changes to admissions process

Objective

• to admit a fair and equitable number of students of rural original to medical school

ecommended strategies

• Include rural physicians and rural community members on admissions policy and process committees

• Include rural physicians and rural community members as interviewers

• Ensure that students of rural origin are not disadvantaged by the admissions process

• Apply a rural adjustment factor to grade point averages and MCAT scores

• Set targets for rural enrolment (ourke, 2005)

All of these strategies to increase enrollment of rural candidates in medical training programs seem logical as the need to recruit people that have ties to rural communities and are presumably committed to returning to their rural roots is…...

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Resources

Curran, V., & Rourke, J. (2004). The role of medical education in the recruitment and retention of rural physicians. Medical Teacher, 26 (3), 265-272.

Easterbrook, M., Godwin, M., Wilson, R., Hodgetts, G., Brown, G., Pong, R., et al. (1999). Rural background and clinical rural rotations during medical training: effect on practice location. Canadian Medical Association Journal, 160 (8), 1159-1163.

Grumbach, K., Vranizan, K., & Bindman, a.B. (1997). Physician Supply AndAccess to Care in Urban Communities. Health Affairs, 16 (1), 71-86.

Hutchison, B., Abelson, J., & Lavis, J. (2001). Primary Care in Canada: So Much Innovation, So Little Change. Primary Care, 20 (3), 116-131.

Introduction to Situation
This paper is based on a fictional case study in which a young woman is considering becoming a physician. Prior to fully committing to this decision, she desires to attain prudent financial information about its repercussions. Specifically, she is seeking to identify the return on investment that her decision could potentially generate. This involves both qualitative and quantitative factors, the former of which pertains to personal gain derived from aiding people in a much needed professional setting. The latter relates to the finances she can generate from practicing medicine.

This financial data is stratified into a number of different categories corresponding to the market for doctors in terms of supply and demand, elasticity, production costs, pricing, and normal profit. These factors will help her to decide in which state it is beneficial to practice. The focus of this paper, then, is to identify how these factors relate to this…...

shortage of physicians overall, or only in key areas? If the latter, what policies might encourage more physicians to enter important fields like primary care and geriatrics?
The answer to both questions is 'yes.' While overall there is a shortage of physicians, there are clearly areas of greater need than others. In total, "at current graduation and training rates, the nation could face a shortage of as many as 150,000 doctors in the next 15 years, according to the Association of American Medical Colleges" (Sataline & Wang 2010). However, there are critical areas that are suffering much more acute deficits, such as primary care. "The U.S. has 352,908 primary-care doctors now, and the college association estimates that 45,000 more will be needed by 2020. But the number of medical-school students entering family medicine fell more than a quarter between 2002 and 2007" (Sataline & Wang 2010). Only about half of…...

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References

Halsey, Ashley. (2009). Primary-care doctor shortage may undermine health reform efforts.

The Washington Post. Retrieved October 16, 2011 at  http://www.washingtonpost.com/wp-dyn/content/article/2009/06/19/AR2009061903583.html 

Kavilanz, P. (2010). Why the U.S. faces a shortage of rural physicians.CNN.

Retrieved October 16, 2011 at  http://money.cnn.com/2010/03/26/news/economy/health_care_rural_care_country_doctors/index.htm

Medicare payments to physicians have come under some serious controversial debate lately due to erroneous calculations by CMS. This issue is raised in a recent article published in Ophthalmology Times where author, Neal Freeman, explains the variables used to calculate sustainable growth rate in Medicare payments systems which directly affects physicians' payout. The author first focuses on the estimates used to calculate sustainable growth rate in Medicare. These factors include "estimates in changes in physicians' fees, changes in the average number of Medicare beneficiaries, changes in expenditures due to regulatory changes, and growth in per capita gross domestic product." Once this has been determined, the government establishes an index of target and actual expenditure. A fee schedule for physicians is then determined with resource-based relative value system. There is a general resentment against this method for calculate of physicians' payments under Medicare. It is believed that this method of…...

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Reference

1. Freeman, L. Neal, Physician payments hinge on sustainable growth rate factor: system can be confusing, but does bear a crucial role in physician compensation.(Medicare reimbursement) Ophthalmology Times; 10/15/2004

specialization by physicians contributed to inefficiency in healthcare?
Research conducted by Dartmouth economics instructors Katherine Baicker and Amitabh Chandra indicates that areas of the United States that have "…relatively more medical specialists" tend to have "higher spending per Medicare beneficiary" and yet those areas do not produce "higher quality care," or more satisfaction, or even "lower mortality" (Baicker, et al., 2004).

The initial pertinent question raised by the researchers: a) is a higher density of doctor specialization in healthcare markets linked to "higher-quality healthcare?" The first part of the answer is that when there is increased specialization in a healthcare area it is linked to the fact that patients see more doctors (Baicker, 359). In areas where there are say, eight more medical specialists per 100,000 people -- and 8 fewer family practitioners -- those areas have "…50% more beneficiaries seeing more than 10 doctors in the last six months of…...

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Works Cited

Baicker, K., and Chandra, A. (2004). The Productivity of Physician Specialization: Evidence

From the Medicare Program. Harvard University. Retrieved February 26, 2014, from  http://www.hks.harvard.edu .

Feldman, D.S., Novack, DH, and Gracely, E. (1998). Effects of managed care on physician-patient relationships, quality of care, and the ethical practice of medicine: a physician survey. PubMed. Retrieved February 26, 2014, from  http://www.ncbi.nlm.nih.gov .

Jecker, N.S. (1998). Managed Care. Ethics in Medicine. Retrieved February 26, 2014, from  http://depts.washington.edu .

Euthanasia: "Should physicians be allowed to assist in patient suicide?" (No)
Euthanasia is, quite literally, a "life and death" issue. It is no surprise, therefore, that it evokes heated debate among doctors, lawyers, philosophers, academicians as well as the general public all over the world. Although, recent developments in modern medicine have given it a new dimension, euthanasia is by no means an exclusively modern-day concern. Even the ancient Greeks had pondered over the issue centuries ago, albeit without reaching a definite conclusion about its merits or otherwise. In more recent times, euthanasia has been the subject of discussion in various forums including the Supreme Court of the United States with similar inconclusive results. Despite considerable debate and weighty arguments by either side, several key euthanasia questions remain unresolved such as "Should physicians be allowed to assist in patient suicide?" which is the subject of this paper. In the following paragraphs,…...

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References

Angell, Marcia. "The Supreme Court and Physician-Assisted Suicide -- The Ultimate Right," Article reproduced in "Taking Sides: Clashing Views on Controversial Bioethical Issues," pp. 80-87

Evans, Hilary M.D. "Pitfalls of physician-assisted suicide" (September 1997) Physician News Digest. Retrieved on October 28, 2003 at  http://www.physiciansnews.com/commentary/997wp.html 

Foley, Kathleen M. "Competent care for the Dying Instead of Physician-Assisted Suicide." Article reproduced in Taking Sides: Clashing Views on Controversial Bioethical Issues," pp. 88-95

Hendin, Herbert "Physician-Assisted Suicide and Euthanasia in the Netherlands: Lessons from the Dutch," 277 Journal of the American Medical Association, (June 4, 1997), p. 1720-1722

Stark II rules, physicians are presumed to have "financial relationships" by virtue of any direct rather than indirect compensation arrangement with any clinic, hospital, or other entity furnishing or delivering healthcare services that are within the Stark designation. In principle, the applicability of Stark prohibitions to the entities detailed depend substantially on whether there is an intervening entity between the physician and the facility or entity in which he owns a financial interest. In that regard, the owning physician is deemed to "stand in the shoes" of the healthcare entity in that the payment or compensation format of one is presumptively and automatically, ipso facto, imputed to the other.
The Modern Evolution of Stark II and Applicability to Hospitals and Physicians

Previous version of Stark rules excepted various indirect compensation mechanisms, such as where the physician was technically employed by a clinic or other facility that was, in turn, owned by…...

ight to Die
Physician-Assisted Suicide

The case of Mildred D: The right to die

The core dilemma of 'the right to die' of Mildred D. revolves around Mildred's alleged statement to her children that she wanted no heroic means to continue her life. There is also the question of whether intravenous feeding is 'heroic' means, since removing the NG will effectively 'starve' her and ending her life before it would naturally terminate were the NG tube not removed. Food is usually not considered 'additional' means of life support, although it is debatable whether food not administered by mouth constitutes heroic means. Mildred had no living will clarifying her wishes and is now not competent to make the decision herself.

Legally, in the U.S. Supreme Court case of Cruzan v. Director, Missouri Department of Health, "the Court considered whether Missouri could insist on proof by 'clear and convincing evidence' of a comatose patient's desire to…...

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References

Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261 (1990). Retrieved:

 http://biotech.law.lsu.edu/cases/consent/Cruzan_SC.htm 

The right to die. (2012). Exploring Constitutional Conflicts. Retrieved:

 http://law2.umkc.edu/faculty/projects/ftrials/conlaw/righttodie.htm

physician-assisted suicide. Specifically, it will show why I disagree with physician-assisted suicide. Physician-assisted suicide is too much like playing God. When people die should be up to their bodies and God, not a doctor who is not involved with them or their families.
In many religions, suicide is a sin, and if you commit suicide, you will go to Hell. This refers to any kind of suicide, even physician-assisted suicide. "As unrepentant simmer, suicides were denied burial in consecrated ground and expected to end in Hell" (Van Den Haag 136).

Even if it is not a sin, it is not normal. Normal people do not commit suicide; they have something wrong with them mentally or physically, and cannot deal with it, or deal with the pressures of life. People who commit suicide with the help of a physician because of a terminal disease are no different from anyone else. They will…...

Is physician-assisted suicide ethical if the patient requests medical assistance in terminating his or her own life?
Introduction

In the U.S., the Supreme Court ruled in Washington v. Glucksberg (1997) that physician-assisted suicide is not protected by the Constitution. However, in other parts of the world, physician-assisted suicide is accepted socially and legally; and in the U.S., a patient who is terminally ill may engage in assisted-dying procedures, which are legal in six states and are legally differentiated from suicide (Buiting, Dieden et al., 2009). If one sets aside the legalistic parameters differentiating physician-assisted dying from physician-assisted suicide, can one say that the former is more ethical than the latter?
In other words, is physician-assisted suicide ethical if the patient requests medical assistance in terminating his or her own life?

Position Statement

In spite of what is permitted under the auspices of physician-assisted dying procedures, this paper will argue that physician-assisted suicide is, ultimately, unethical…...

Assignment 1: Is physician-assisted suicide morally acceptable when a person is suffering from a painful, incurable, terminal condition? 
Premise 1: Physician-assisted suicide is not morally acceptable under any circumstances.

According to the American Medical Association (2018), “permitting physicians to engage in assisted suicide would ultimately cause more harm than good,” (p. 1). The reasoning behind the AMA’s position is threefold. First, the AMA (2018) claims that physician-assisted suicide is “incompatible with the physician’s role as healer,” (p. 1). Second, the AMA points out that there are too many ways the process can be abused. As alternatives to physician-assisted suicide, the AMA recommends improving access to pain relief and emotional support to patients with terminal illnesses.

Another reason for opposing physician-assisted suicide is the rapid pace at which medicine advances. If a person has been diagnosed with a terminal illness, there is still a possibility—however slim—that either a cure or an ameliorative process might…...

List current core clinical vendor, product, as well as version or. That your are aware of as well as the application types (a/D/T, adiology, Laboratory, Pharmacy, Nursing Documentation, Order Communication).
2. Is there a need for IS Department to anticipate the need for a third-party consulting

Assistance beyond what the is provided by the vendors for handling of any aspect of the CPOE design, implementation, as well as training

3. How can the CPOE be implemented at the laboratory? >What are its advantages in this setting?

4. How can the CPOE be implemented at the ICU? >What are its advantages in this setting?

5. How can the CPOE be implemented at the patient registry? >What are its advantages in this setting?

6. How can the CPOE be implemented at the outpatient pharmacy? >What are its advantages in this setting?

7. What certification standards are needed to operate a CPOE?

8. Can a single CPOE application be used…...

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References

Al-Dorzi, HM., Cherfan, a et al. (2011).Impact of computerized physician order entry (CPOE) system on the outcome of critically ill adult patients: a before-after study. BMC Medical Informatics and Decision Making 2011, 11:71 doi:10.1186/1472-6947-11-71

Collins S, Currie L, Bakken S, Cimino JJ: Interruptions during the use of a CPOE system for MICU rounds.

AMIA Annu Symp Proc 2006, 895.

Eslami S, de Keizer NF, Abu-Hanna a: The impact of computerized physician medication order entry in hospitalized patients -- a systematic review.

In order to determine whether there should be more financial support given to physicians who practice primary care, we have to first determine some facts about primary care physicians, their costs, their salaries, and other financial factors.  While the average annual salary of a primary care physician varies by state, the average appears to be from $130k a year to around $220k a year.  This breaks down to around $75 to $120 an hour. 

At first glance, that salary seem very comfortable and may leave people wondering if financial support for the position is warranted.  However, in reality....

There are so many interesting topics to discuss surrounding the opioid epidemic,  There are debatable discussions about its root causes and questions of whether public response has been different given the impacted demographics.  Therefore, looking at any of the questions can provide opportunities for debate.  Before debating the topic, it is important to understand some of the facts about the epidemic.  In 2019, over 70,000 people died from drug overdose, 1.6 million people had an opioid disorder, 745,000 used heroin, 1.6 million misused prescription pain relievers for the first time, and 0.1....

1. The Ethical Imperative of Universal Healthcare

Explore the moral obligation to provide healthcare to all citizens, regardless of their financial status or social background.
Discuss the consequences of denying healthcare to vulnerable populations and the impact it has on society as a whole.
Examine the ethical principles that should guide the design and implementation of universal healthcare systems.

2. The Economic Benefits of Universal Healthcare

Analyze the potential economic advantages of universal healthcare, such as reduced healthcare costs, increased productivity, and reduced poverty.
Consider the impact of universal healthcare on businesses and the economy at large.
Evaluate the long-term economic....

1. The Ethics of Physician-Assisted Suicide

2. The Controversy Surrounding Physician-Assisted Suicide

3. Exploring the Legality of Physician-Assisted Suicide

4. The Role of Physicians in Assisted Suicide

5. The Impact of Physician-Assisted Suicide on Medical Ethics

6. Religious Perspectives on Physician-Assisted Suicide

7. The Right to Die: Understanding Physician-Assisted Suicide

8. Physician-Assisted Suicide: A Patient's Right to Choose

9. Physician-Assisted Suicide and End-of-Life Care

10. The Debate Over Physician-Assisted Suicide: Balancing Autonomy and Medical Ethics
11. Examining the Psychological Impact of Physician-Assisted Suicide

12. The Global Perspective on Physician-Assisted Suicide

13. Physician-Assisted Suicide: A Healthcare Provider's Dilemma

14. The Evolution of Physician-Assisted Suicide Laws

15. Ethical Considerations in Physician-Assisted Suicide

16. Physician-Assisted Suicide: Personal Choice....