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When a friend or acquaintance asks for informal medical advice, Steven Brown, MD, a clinical associate professor at Texas Tech University in Lubbock, gives this standard reply: "I would be doing you a great disservice by pretending that I could give you good medical advice outside the context of a thorough review of your full medical history and an appropriate physical examination."
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Does a psychiatrist offer diagnostic neuroimaging to their patients and claim to diagnose and treat psychiatric disorders using the results?
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There are several ethical questions surrounding the American Medical Association's policy prohibiting physicians from giving substances they believe are placebos to their patients unless the patient is informed of and agrees to use of the substance, according to a 2012 report from the Hastings Center.
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The goal of proposed reforms in regulations governing human research subjects is to enhance protections for research subjects while reducing burden, delay, and ambiguity for investigators, according to the National Institutes of Health (NIH) Office of Science Policy, which received more than 1,000 public comments on the proposed changes.
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The most important ethical implication of the Supreme Court's ruling upholding the Affordable Care Act is "the recognized national responsibility to provide medical care for all citizens," according to Neil S. Wenger, MD, MPH, director of the University of California--Los Angeles (UCLA) Health System Ethics Center and professor at UCLA's Division of General Internal Medicine.
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In the past, if a member of Capital District Physicians' Health Plan (CDPHP) in Albany, NY, was hospitalized for a suicide attempt and ended up in the intensive care unit, or was hospitalized with a medical problem and diagnosed with a behavioral health issue as well, the medical case manager would give him or her a referral to a toll-free number for an out-of-state vendor that provided behavioral health management for the health plan.
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Recognizing that medical problems and behavioral health issues are often intertwined, payers and providers are coordinating behavioral health and medical health case management.
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As the National Committee for Quality Assurance hopes that all-cause readmission rate reporting by health plans will assist in creating more consideration of patient care across the continuum, the National Quality Forum (NQF) hopes a new measurement framework for multiple chronic conditions will likewise help improve care in and out of the hospital.
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A collaborative approach in which primary care physicians and nurse case managers work with patients with depression has resulted in a 50% improvement of scores on a depression questionnaire among patients who were part of a pilot project at UC Davis Family Medicine in Sacramento.
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To keep a lid on costs, health care policy experts recognize that hospitals need to find more effective ways to manage transitions. The care coordination piece can be particularly problematic in the fast-paced ED setting, and yet it can make a big difference in determining whether a patient receives appropriate follow-up after an acute event and whether he or she is back in the ED within days or weeks with another acute exacerbation of the same issue.
