Biomedical subjects
Publications and source records attributed to M A Kleiman.
JONA's Healthcare Law, Ethics, and Regulation interviewed Attorney Mark Allen Kleiman regarding the False Claims Act. Mr. Kleiman has had much experience with this Act in both prosecution and consulting. In this interview, he provides great insight into the details and interpretations of the Act, as well as implications for healthcare providers.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Although HMOs have been reluctant to capitate hospital services, capitated payments allow hospitals greater control over their strategic and economic position. Healthcare financial managers have a role to play in demonstrating to HMOs that capitating hospital services can create a win/win situation.
Explore the source record for details and available documents.
The PO model, in which a PO and hospitals "peacefully coexist" without some level of integration, may not be sustainable in the long term, as managed care and healthcare reform initiatives pressure providers to integrate delivery and align their economic incentives (either on a fee-for-service or capitated basis). Therefore, while integrating physicians and hospitals within a PHO may not be attractive to physicians initially, opting for an approach that does not integrate physician and hospital services and align their economic incentives can eventually invite a significant level of competition between the two.
This article provides both a conceptual overview of pricing health care services and two pricing strategy examples. The overview addresses the underlying concepts of pricing, the factors that influence it, and the risk continuum of pricing approaches. The pricing strategy examples highlight some of the issues and considerations involved in pricing services in a changing health care market. Because the payors of health care will continue to shift economic risk to the providers of health care, the examples emphasize the importance of managing risk.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A random-sample, anonymous survey of the members of the American Society of Clinical Oncology (ASCO) was conducted in spring 1990 measuring the attitudes and experiences of American oncologists concerning the antiemetic use of marijuana in cancer chemotherapy patients. The survey was mailed to about one third (N = 2,430) of all United States-based ASCO members and yielded a response rate of 43% (1,035). More than 44% of the respondents report recommending the (illegal) use of marijuana for the control of emesis to at least one cancer chemotherapy patient. Almost one half (48%) would prescribe marijuana to some of their patients if it were legal. As a group, respondents considered smoked marijuana to be somewhat more effective than the legally available oral synthetic dronabinol ([THC] Marinol; Unimed, Somerville, NJ) and roughly as safe. Of the respondents who expressed an opinion, a majority (54%) thought marijuana should be available by prescription. These results bear on the question of whether marijuana has a "currently accepted medical use," at issue in an ongoing administrative and legal dispute concerning whether marijuana in smoked form should be available by prescription along with synthetic THC in oral form. This survey demonstrates that oncologists' experience with the medical use of marijuana is more extensive, and their opinions of it are more favorable, than the regulatory authorities appear to have believed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Use of neurologic criteria to pronounce death, although accepted by many, has caused controversy among physicians, lawyers, legislators, philosophers, and theologians. The present work attempts to resolve this by accomplishing four objectives. (1) It summarizes scientific information that establishes the ability to determine the state of brain death with certainty on the basis of presently available clinical and laboratory criteria. (2) It shows that the concept of brain death is in accord with secular philosophy and the three major Western religions. (3) It documents the need for legislative recognition that death may be pronounced on the basis of neurologic criteria. (4) It reviews the present status of judicial and statutory law relating to the determination of death in the United States.
Cancer patients frequently encounter psychological problems distinct from those with other serious illnesses. Cancer's deadly nature and its drastic treatment often alienate patients from relatives and caregivers. The CanCervive program trained cancer patients to counsel other patients. They functioned as role models and provided opportunities for catharsis. Yet their own unresolved conflicts often led them to overidentify with patients. Volunteers lacked insight into their own feelings of stress at seeing dying patients and their own guilt over their relatively advantaged medical status. Despite this, they helped patients cope with their insecurities and dependency needs, and assisted with professional education.
Explore the source record for details and available documents.