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PubMed1996

History of the Secretariats of the American Academy of Ophthalmology.

The American Academy of Ophthalmology and Otolaryngology grew steadily during its 82-year existence, and since 1979, the American Academy of Ophthalmology has had an accelerated increase in membership and activity. In 1995, as the Academy approached its centennial, the AAO had more than 20,000 members and an annual budget of more than +26 million. Total registration for the 1994 Annual meeting was slightly more than 27,000, an all-time high. Instruction Courses numbered 450,300 scientific papers were presented, and 130 posters were displayed. The original postgraduate course in 1921 served as the predecessor to the more than 700 hours of instruction presented at the 1994 Annual Meeting. The original committee of four was the predecessor of what has become the Secretariats of the Academy. The popular Home Study Courses were the forerunners of the Academy's programs, formulated and supervised by the Education Secretaries. The Clinical Education Programs include the Basic and Clinical Science Courses, Focal Points, Continuing Ophthalmic Video Education, Manuels, Regional Update Courses, Special Focus/Skills Courses, Monographs, PROvision, slide scripts, and other programs produced for allied health personnel, medical students, and other physicians. The Secretaries originate, produce, and oversee all the important functions of the Academy. The individuals who have served the Academy as Secretaries through the years have been dedicated volunteers. Their contributions have been incalculable. In recent years, the various Secretaries have been ably assisted by Associate Secretaries, Advisory Committees, and Subcommittees, spreading the workload of each Secretary. Credit for the success of the Academy's endeavors, while under the guidance of the Secretaries, also must be given to the Academy's many committee chairs and committee members who have diligently worked to achieve their goals and objectives. In 1995, the Executive Vice President, the 11 Secretaries, and the Editor were aided and assisted by 46 committees. The Secretaries, through the years, and the Academy are further indebted to a wonderful, dedicated staff who willingly and conscientiously contribute to the many Academy programs. When you stand back and look at this history of active, participating Academy members who have contributed so many hours in travel, meeting, and homework within the Secretariats, you marvel at the dedication and forces at work in the American Academy of Ophthalmology. Is it any wonder that, through the years, so many Secretaries, because of their proven ability, talents, and contributions to ophthalmology, have been selected by the membership to serve as President of the American Academy of Ophthalmology.

History, 19th Century↗

PubMed1991

Vision research in departments of ophthalmology. An Association of University Professors of Ophthalmology perspective.

A research committee of the Association of University Professors of Ophthalmology disseminated a survey questionnaire to determine the state of research in departments of ophthalmology across the United States. The questionnaire contained 71 questions that were designed to assess attitudes and trends within members' departments and to solicit suggestions from the membership. Of the 145 members and affiliates queried, 140 responded. While the results of the survey indicate significant diversity among departments, departmental chairpersons view research as a major priority in the goals of their departments, and they envision maintenance or expansion of research over the next decade. The survey results have been collated and serve now as the basis for this Association of University Professors position article.

Humans↗

PubMed2003

[Dr. Elisabeth Hecker (1895-1986): career in child and adolescent psychiatry on the one hand--involvement in elimination of the handicapped on the other hand].

During the period of national socialism in Loben/Lublinitz (Silesia) existed a children's special department, where many disabled and mentally retarded children were killed. This was happened under participation of the physician Elisabeth Hecker, who was one of the pioneer's of child and adolescent psychiatry in Germany. During the Second World War she was director of the Loben's clinic for adolescent psychiatry--one of the first of its sort and situated directly in the neighbourhood of the children's special department. Hecker announced children with negative ratings to the "Reich Committee for the Scientific Registration of Severe Genetically and Constitutionally Determined Diseases" in Berlin and transferred them to the children's special department in Loben. In 1979 the German Association of Child and Adolescent Psychiatry appointed Hecker as a honorary member for her commitment after the war. This honorary membership has been discussed critically because of her activities during the period of national socialism. The following paper analyses Hecker's involvement to the child "euthanasia" program based on unnoticed archival sources.

Adolescent↗

PubMed1994

[Norwegian psychiatry and Nazism. A historical project of current interest].

In 1945 the Ministry of Justice appointed a committee to conduct a psychiatric examination of Norwegian Nazis. This was done after a proposal from the Norwegian Psychiatric Association on the initiative of Professor Langfeldt, who at that time was head of the Department of Psychiatry at the University of Oslo. An investigation based on a crosscheck between membership of the Nazi party and the Norwegian case register for psychoses for the period 1926-1940 showed 30% more psychoses among the Nazis than in the population as a whole. Other studies tended to support the view that there was a high prevalence of deviant personalities among the Nazis. A study of 340 "front combatants" (not representative of the whole group of 8,000) showed no increase in psychopathology. They had a higher level of intelligence and education than the mean of young Norwegian males. Many of them belonged to strong pro-Nazi families. The studies of pro-Nazi women, especially the very young who had been involved in sexual relationships with German soldiers, are not representative. The findings seem to indicate that many of them lacked family support and had social problems. The studies are discussed in a historical perspective, with some comments about their relevance today.

Female↗

PubMed1996

Attitudes of Florida Academic Physicians toward the Florida Medical Association.

An Ad Hoc Committee on Academic Physicians was given the charge in 1992 of studying Florida academic physician's participation in the Florida Medical Association. It was postulated that academic physicians may participate less in organized medicine than community physicians and, therefore, may be a group that should be selectively targeted during membership campaigns. Data was obtained from the American Medical Association Masterfiles about Florida academic and community physician membership in the FMA and AMA. Academic physicians at the four academic medical centers in Florida were surveyed about their attitudes toward organized medicine, especially the Florida Medical Association. Unlike any other state in the Federation, more academic physicians than community physicians were members of the state society (46.9% v 43.5%) p < 0.05, which was accounted for mainly women academic physicians. There were substantial differences across the academic medical centers with the University of Florida at Gainesville and Jacksonville being overrepresented, the University of South Florida having average membership, and the University of Miami being underrepresented. Florida academic and community physician membership in the AMA was 34.6% and 38.5% respectively, which was consistent with national trends. Academic physicians at the University of Florida campuses rated their relationship and communication with the FMA as being better than academic physicians at the University of South Florida and Miami. Academic physicians at all four medical centers rated membership dues as being too high relative to the benefits derived, but there was indirect evidence to suggest that this was an apparent and not real barrier. Also, academic physicians thought that the FMA represented community physicians more effectively than academic physicians. The state of Florida is unique in that more academic physicians than community physicians are members of the state medical society. The differences by academic medical centers may be accounted for by variations in leadership at the different medical centers. Decreasing the membership dues for academic physicians probably will not have a significant effect on membership of academic physicians. The FMA should direct efforts at informing academic physicians about how the FMA is representing their interest in forums such as governmental and other regulatory agencies, and third party payers like the insurance industry.

Academic Medical Centers↗

PubMed2002

European convergence towards higher standards in dental education: the DentEd Thematic Network Project.

INTRODUCTION: This paper describes a Thematic Network Project (TNP) funded by the European Union's Directorate for Education and Culture. It focused on convergence towards higher standards in dental education in the European Union and included those 'Associate Countries' seeking membership of an expanding EU. The DentEd Project sought to use peer influence in promoting convergence towards higher standards in European dental education and training. There is evidence of serious differences in standards despite the European Union's Dental Directives and the series of guidelines and recommendations of their Advisory Committee on the Training of Dental Practitioners. METHODS: The DentEd TNP sought to improve communication, better understanding of different systems and to pool intellectual resources. A central objective of the network was to promote outcome analysis and the implementation of evidence-based treatments. DentEd sought to identify and disseminate innovations and best practices in European dental schools and stomatological institutions. This was achieved by instigating 30 self-assessments of dental schools throughout Europe. Self-assessment was followed by a visit from a team of international peers. Each assessment comprised 19 sections and was placed on the DentEd web site (www.dented.org) after it was jointly approved by the visitors and host school. The 30 self-assessment reports together with the visitors comments and recommendations were then divided into their component sections and analysed. Responsibility for each section was allocated to one of 19 different international working groups of between 8 and 12 people. Preliminary analyses from these working groups were presented and debated on the DentEd interactive web site. They finalised their findings in the DentEd Report at a Plenary meeting in the Nobel Forum in the Karolinska Institute in Stockholm. The meeting was organised in such a way that each working group finalised their report. This was followed by the rotation of the working groups to listen and respond to the presentation of another group on the basis of a series interactive meetings. At the end of the meeting the original groups reassembled and revised their analysis on the basis of the additional input from the other 200 individuals involved and then finalised their group's report on the web site. These reports are available on the web site and were also published in hard copy.1 The three-year DentEd Project achieved its stated objectives. CONCLUSION: The DentEd Thematic Network Project employed a process of schools visits, plenary meetings and the use of an interactive web site to help reach consensus on innovations, best practices and significant divergence in standards in dental education in Europe. This process has proven an effective method of improving communication and of increasing the understanding of diversity in a wide range of educational methods. It also emphasised the importance of continuing quality improvement and outcome analysis of the clinical competence of graduates from European dental schools. It is important to emphasise that schools visited are likely to reflect those with an open and flexible attitude to educational reform and development and perhaps they were not representative of those schools that would benefit most from a self-assessment followed by peer review. On completion of the DentEd Thematic Network Project (TNP) the European Union's Directorate for Education and Culture approved a new three-year DentEdEvolves TNP and the consortium has recently submitted a major proposal in the EU's eLearning initiative on the basis of the success of this collaboration. This has extended to include 75% of dental schools from North America and plans for extension to South-east Asia will bring a major meeting to Singapore in April 2002.

Communications Media↗

PubMed2000

Orthopaedics, ethics, and industry. Appropriateness of gifts, grants, and awards.

At the Academic Orthopaedic Society meeting in San Francisco on November 8 and 9, 1996, the membership addressed the issue of ethics and industry in an academic setting. Using a Delphi panel technique, they arrived at a definition of conflict of interest, and 41 separate points of acceptable and unacceptable behavior related to gifts, research awards, and funding of various activities. The Academic Orthopaedic Society Delphi Committee also mailed 191 questionnaires (157 department chairpersons and 34 program directors) to 157 training programs. The respective department chairpersons and program directors were asked to copy and distribute the questionnaires to staff (faculty) and house officers (residents and fellows) to complete anonymously and return them for collation. Ninety-one programs (58%) responded. Three hundred and fifty-two questionnaires were returned (237 from staff, 115 from house officers), each of which expressed agreement or lack of agreement with the Delphi panel report using a Likert scale technique. With only modest (and usually predictable) disagreement on certain items, the final statements by the Delphi panel were supported strongly by the survive results. The Academic Orthopaedic Society believes that the major points arrived at by the panelists should serve as the basis for ethical guidelines in the relation between academic orthopaedic institutions and industry.

Awards and Prizes↗

PubMed1997

Competencies for Part II of the examination for membership of the Faculty of Public Health Medicine.

BACKGROUND: The assessment of competence is of growing importance in modern educational theory. This paper reports the results of a study to investigate the views of Part II examiners and public health trainees about whether an agreed list of competencies for the practice of public health medicine could be determined. METHODS: A postal questionnaire was sent to Part II examiners and representatives of the Trainee Members Committee of the Faculty of Public Health Medicine. RESULT: A total of 90 questionnaires were sent. Seventy per cent of Part II examiners and 70 per cent of the Trainee Members Committee returned questionnaires. There was a high degree of consensus amongst respondents that most of the skills listed in the Faculty Handbook as being necessary for the completion of training should form core competencies for the Part II examination. Sections of the syllabus dealing with epidemiology and disease prevention were also seen as core competencies. There was less support for the assessment of attitudes or other sections of the Handbook syllabus. The written reports and oral examination were seen as being complementary, with respondents listing different competencies as being appropriately assessed by the two methods. There was little support for the introduction of a standardized skills examination. CONCLUSIONS: This is the first study to assess the face validity of possible components for the Part II examination using the views of both trainees and Part II examiners. This could form the first step to the introduction of an agreed set of competency areas into the examination.

Attitude of Health Personnel↗

PubMed2002

2001 American Urological Association Gallup Survey: changes in physician practice patterns, satisfaction with urology, and treatment of prostate cancer and erectile dysfunction.

PURPOSE: The Health Policy Survey and Research Committee of the American Urological Association and the Gallup organization have performed 9 surveys of American urologists since 1992 for the purpose of assessing demographics and practice patterns. The results of the 2001 survey are presented. MATERIALS AND METHODS: A random sample of 507 urologists was interviewed in February and March 2001. Major content areas were physician practice patterns, cryosurgery/brachytherapy, prostate specific antigen, erectile dysfunction, Medicare and the Internet. RESULTS: Membership in the American Urological Association continues to increase among American urologists. The number of patients seen weekly in the office also continues to increase. While age at retirement has not changed significantly, most urologists are satisfied with the specialty and increasing numbers are using the Internet. CONCLUSIONS: Minimally invasive procedures such as brachytherapy for prostate cancer continue to proliferate and there is evidence that the specialty of urology is continuing to become more office based. The demand for urological services appears to be continuing to increase.

Adult↗

PubMed2003

Perspectives on the value of American Society of Clinical Oncology clinical guidelines as reported by oncologists and health maintenance organizations.

PURPOSE: Although the American Society of Clinical Onoclogy's (ASCO) Health Services Research (HSR) committee activities have primarily focused on clinical guideline development, little is known about the value placed on these guidelines by the desired end users. ASCO members and Health Maintenance Organizations (HMOs) were surveyed on the value and implementation of ASCO guidelines. In this article, we summarize our findings. METHODS: ASCO members (n = 1500) were queried about whether they had read ASCO's first four clinical guidelines and technology assessment; whether they agreed with the recommendations; whether they used guidelines in clinical practice; and how guidelines had affected reimbursement. HMOs (n = 131) were queried on how they identify, implement, and value the first four ASCO clinical guidelines. RESULTS: The membership survey indicated that ASCO guidelines were read more often by physicians in private healthcare settings compared with physicians in academic practices (P <.02). Disagreement rates were low for all guidelines (range, 1% to 7%). One quarter of respondents reported that the guidelines were difficult to find and difficult to apply to the practice setting, and approximately one tenth of respondents indicated that the guidelines were difficult to evaluate, interpret, or read. The HMO survey indicated that one third of HMOs reported use of ASCO guidelines, with higher rates of usage by larger HMOs and by those with higher National Committee on Quality Assurance (NCQA) ratings. Respondent HMOs valued guidelines for various purposes and used multiple methods of guideline identification and implementation. CONCLUSION: ASCO guidelines are generally highly supported by physicians and HMOs. Additional studies are needed to identify implementation barriers and to see whether guidelines have resulted in improvements in healthcare.

Attitude of Health Personnel↗

PubMed1995

The Delaware School Health Advisory Committee.

For nearly 40 years, the Delaware School Health Advisory Committee (SHAC) has been improving school health education and school health services in the state. The SHAC has recommended policies to the Delaware Board of Education and the state legislature, conducted conferences and workshops, and published brochures, studies, resource guides, curricula, and pamphlets. The key to SHAC success has been its diverse membership and the cooperation it engendered in the state.

Adolescent↗

PubMed1995

Quality improvement guidelines for the treatment of acute pain and cancer pain. American Pain Society Quality of Care Committee.

OBJECTIVE: To develop quality improvement (QI) guidelines and programs to improve treatment outcomes for patients with acute pain and cancer pain. PARTICIPANTS: Twenty-four members of the American Pain Society (APS) participated in preparing the statement, including 15 nurses (oncology, general medical-surgical nursing, pediatrics, and QI research), seven physicians (clinical pharmacology, neurology, anesthesiology, radiation oncology, and physiatry), one psychologist, and one statistician. Participants were self-selected from the 3000 members of the APS, which supported the process and held annual open committee meetings and scientific symposia beginning in 1988. EVIDENCE: MEDLINE was searched (1980 to 1995) to identify all articles on pain assessment, treatment of acute pain or cancer pain, and QI or education related to pain. CONSENSUS PROCESS: Following panel discussions, one member (M.B.M.) prepared successive drafts and circulated them to the panel and APS membership for comments. After publication of a prototype version in 1991, 14 panelists carried out formal studies of implementation of the guidelines at three medical centers. This article was prepared based on this research, a new literature review, and suggestions from 50 pain clinicians and researchers. CONCLUSIONS: Quality improvement programs to improve treatment of acute pain and cancer pain should include five key elements: (1) Assuring that a report of unrelieved pain raises a "red flag" that attracts clinicians' attention; (2) making information about analgesics convenient where orders are written; (3) promising patients responsive analgesic care and urging them to communicate pain; (4) implementing policies and safeguards for the use of modern analgesic technologies; and (5) coordinating and assessing implementation of these measures. Several short-term studies suggest that this QI approach may improve patient satisfaction and facilitate recognition of institutional obstacles to optimal pain treatment, but it is not a panacea for undertreated pain. By making the magnitude of the problem apparent and committing the institution to change, pain treatment QI programs can provide a foundation for a multifaceted approach that includes education of clinicians and patients, design of informational tools to minimize errors in prescribing, and improved coordination of the process of assessing and treating pain.

Humans↗

PubMedDate not supplied

Implementation of the electronic medical record: the team approach.

The implementation of the electronic medical record (EMR) is a process that involves knowledge and skills of technology and group dynamics. The literature was reviewed to identify the most effective methodology for EMR implementation. Integral to the success of any EMR implementation is the 'buy-in' of the organization. To facilitate the implementation the use of a tiered team approach is advantageous. There must be an executive steering team whose role is to provide the vision, the approval, and the money for the project. The project steering team makes major policy decisions based on user needs and requirements, organization infrastructure, and general implementation strategies. The project work team has the responsibility of ensuring the implementation is satisfactory to the organization. This article discusses the membership, roles, and functions of the three EMR implementation teams.

Decision Making, Organizational↗

PubMed1984

Brief and appendix for amicus curiae: the American Geriatrics Society.

In February 1984, the following "friend of the court" (amicus curiae) brief was submitted to the New Jersey Supreme Court by the American Geriatrics Society to assist in the Court's deliberation in the case known as In re Claire C. Conroy. The Board of Directors of the AGS had decided to undertake this endeaver because the reasoning adopted by the Appellate Division in this case would, if affirmed by the Supreme Court, greatly diminish the capacity of physicians to serve their patients, especially their older patients. The brief was prepared by AGS member Joanne Lynn, MD, and was critiqued, revised, and finally approved by all of the members of the Executive Committee of the Board of Directors. A New Jersey attorney, Mr. Charles Deubel, III, filed the brief and the necessary associated papers on behalf of the AGS and without charge. Expenditures by the AGS in this endeavor totalled less than $300. The Editors of the Journal and the Board of Directors of the AGS would welcome comments from the membership and other concerned persons concerning the content of the brief and the process of developing and submitting it.

Aged↗

PubMedDate not supplied

New standard for medical equipment management programs.

This article is based on the current draft of a new AAMI equipment management standard (AAMI EQ56). Until now, no documentation has clearly specified the requirements for an equipment management program. At the time of the writing of this article, a February 1996 Committee Draft of the new standard was out for ballot and public review. Comments will be reviewed at a meeting of the AAMI Patient-Care Equipment Management Committee in June 1996, in conjunction with the AAMI Annual Meeting, and the standard could be formalized as early as October 1996. Readers should keep in mind that, while the final standard may differ somewhat from the material presented here, the author of this article and BI&T's staff felt that the interest of a very large portion of the AAMI membership warranted an advance article describing the content and general direction of the document.

Biomedical Engineering↗

PubMed1975

Quality, quantity and distribution of medical education and care: regulation by the private sector or mandate by government?

The public, the federal government and most state governments have become increasingly concerned with the lack of access to primary care as well as the specialty and geographic maldistribution problems. Currently, there is a race in progress between the private sector and the federal government to devise solutions to these problems. In the federal sector, varying pieces of legislation are under active consideration to mandate the correction of specialty and geographic maldistribution; proposals include: 1) setting up federal machinery to regulate the numbers and types of residencies; 2) make obligatory the creation of Departments of Family Practice in each medical school; 3) withdraw current education support from medical schools causing tuition levels to increase substantially--federal student loans would then provide the necessary leverage to obligate the borrower to two years of service in an under-served area in exchange for loan forgiveness. In the private sector, for the first time in the history of the United States, the five major organizations involved in medical care have organized to form the Coordinating Council on Medical Education (CCME) and the Liaison Committee on Graduate Medical Education (LCGME). One of the initial major endeavors of the CCME has been to address itself to the problem of specialty maldistribution. The LCGME has been tooling up to become the accrediting group for residency training thus providing an overview of the quality and quantity of specialty training. It will be the intent of this presentation to bring the membership of the Southern Surgical Association an up-to-date report on these parallel efforts. The author's personal hope is that the private sector can move sufficiently rapidly to set up its own regulatory mechanisms and avert another federally controlled bureaucracy that will forever change the character of the medical profession in the United States.

Allied Health Personnel↗

PubMed1989

[Opinion survey on the bioethical views of Catholic physicians in Japan. I. Contraception and induced abortion].

This opinion survey on sex and bioethics was carried out in March and April of 1988 by the special committee for family planning and sex related problems which the JMCA (President Dr. Yasuro Anno) had drawn up. This study deals with the analysis of 229 responses to the 3 questions concerning contraception, natural family planning and induced abortion respectively. The background factors of the respondents, sex, age, baptismal age, region (by archdiocese), specialty (clinical, fundamental and social medicine), and payment of the membership fees during the past 3 years were investigated by means of the multiple regression analysis. In addition to the age factor which clearly influenced the responses of each question, the regional factor showed significant influences on the responses to the contraception as well as natural family planning questions. The author proposes five operational hypotheses (A-E) to explain these phenomena, and concludes that it is important to undertake interdisciplinary research as well as to conduct continuous education programs concerning biomedical ethics among the catholic physicians in Japan.

Abortion, Induced↗

PubMed2002

Medical staff appointment and delineation of pediatric privileges in hospitals.

The review and verification of credentials and the granting of clinical privileges are required of every hospital to ensure that members of the medical staff are competent and qualified to provide specified levels of patient care. The credentialing process involves the following: 1) assessment of the professional and personal background of each practitioner seeking privileges; 2) assignment of privileges appropriate for the clinician's training and experience; 3) ongoing monitoring of the professional activities of each staff member; and 4) periodic reappointment to the medical staff on the basis of objectively measured performance. This statement examines the essential elements of a credentials review for initial and renewed medical staff appointments along with suggested criteria for the delineation of clinical privileges. Sample forms for the delineation of privileges can be found on the American Academy of Pediatrics Web site (http://www.aap.org/visit/cmte19.htm). Because of the differences in individual hospitals, no one method for credentialing is universally applicable. The medical staff of each hospital must, therefore, establish its own process based on the general principles reviewed in this statement. The issues of medical staff membership and credentialing have become very complex, and institutions and medical staffs are vulnerable to legal action. Consequently, it is advisable for hospitals and medical staffs to obtain expert legal advice when medical staff bylaws are constructed or revised.

Child↗