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The history of cardiac arrest as an indication for resuscitation is "loaded with implications for current standards of care," says Daniel Brauner, MD, associate professor of medicine at the University of Chicago. At one point in time, resuscitation was used only in very limited instances, he explains.
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When upfront collections first became a focus several years ago at Portland, OR-based Legacy Health’s six hospitals, “we started with the basics,” says Lindsay Hayward, director of patient access and health information management.
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It's a "tremendous victory to have something approaching universal access" as a result of the Patient Protection and Affordable Care Act, but the resulting increase in underinsured patients will pose ethical challenges for providers, according to Joseph J. Fins, MD, MACP, chief of the Division of Medical Ethics at Weill Cornell Medical College and director of medical ethics at New York Presbyterian Hospital-Weill Cornell Center in New York City.
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Prescribing potentially addictive medications "is often a very challenging situation for physicians," says David A. Fleming, MD, MA, FACP, professor and chairman of the Department of Internal Medicine and director of the Center for Health Ethics at University of Missouri in Columbia.
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Linking payment to patient satisfaction could have a profound impact on the doctor-patient relationship, argues James N. Kirkpatrick, MD, an assistant professor of medicine at the Hospital of the University of Pennsylvania who is affiliated with the University of Pennsylvania Department of Medical Ethics and Health Policy.
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Approximately one in five (22%) out of 608 critical care physicians surveyed reported always providing surrogates of critically ill adult patients with a recommendation about limiting life support, while one in 10 (11%) reported rarely or never doing so, according to a just-published study.1 Surrogates' desires for recommendations and physicians' agreements with surrogates' likely decisions may influence whether recommendations are provided.
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While the Centers for Disease Control and Prevention (CDC) in Atlanta has been calling on EDs to routinely test patients for HIV since 2006, the practice is hardly widespread.
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Northwestern Memorial Physicians Group in Chicago is partnering with Walgreens to counsel patients with chronic illnesses on their disease and medication and to support them in following their medication regimen. So far, patients in the pilot have increased their medication adherence on five different drugs by 5%.
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Based on the positive outcomes of a health coaching pilot for its employees with diabetes, Advocate Health Care, an integrated healthcare system based in Oak Brook, IL, now offers health coaching to its patients, employees, spouses, and employer groups as part of its comprehensive wellness solution.
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Providers and insurers are starting to add lifestyle coaching to the range of interventions they provide to help motivate people to take charge of their own health and make changes in the way they live that help them live healthier, more productive lives.
