The legal environment and dentistry.
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AIM: to obtain a more in-depth understanding of some of the key factors influencing medical error reporting behaviours of doctors in New Zealand. METHODS: A cross-sectional anonymous survey of 292 doctors in North Island was conducted over a period of 4 months. RESULTS: 128 doctors completed the survey (45% response rate). The results of the study suggest that (overall) most doctors feel they should report the occurrence of medical errors to both the patient and the hospital when they are anticipating major adverse events (long term/serious complications or mortality). However, when they are anticipating minor complications, not every doctor feels that they should report the error(s). This study also shows that doctors feel more comfortable to report errors to the patient than to report to the hospital (79% vs 21%). Furthermore, doctors selected the fear of losing patient's trust and the threat of public outcry most frequently as the most important reasons for their reluctance to report. Lastly, 86% of surveyed doctors felt that reporting the occurrence of errors to patients will decrease the likelihood of complaints being filed against them. CONCLUSIONS: The study suggests that to learn from most of the mistakes, we need to have a system that not only facilitates the reporting of major errors but also encourages the reporting of minor ones. To mitigate the effects of key factors that prevent error reporting, we may benefit from making changes to how doctors are trained and how media reacts to the occurrence of errors in New Zealand hospitals.
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Physician behavioral issues take a toll on medical groups, and practice leaders often lack the basic tools to address them. All too often, medical practice leaders and administrators look the other way when physicians are disruptive or behave inappropriately. They delay dealing with negative conduct for a variety of reasons and allow physicians to continue to act out in ways that would never be tolerated in a staff member. Much has been written about how to deal with serious issues in physician behavior, such as impairment and addiction. This article addresses how to recognize and manage less extreme and more chronic disruptive behaviors. It provldes the reader with comprehensive tools to identify and address these issues, including a "do and don't" list and a simple five-question test to assess in an unbiased way what steps should be taken.
This paper addresses bullying of United Kingdom (UK) nursing students whilst on work placement as a specific issue of inter-group difficulty that currently affects nurses and students working in the UK National Health Service. The authors begin by discussing the concept of bullying and sharing the types of bullying reported in two recent studies involving UK nursing students. Both studies illustrate the effects that negative workplace experiences can have on new entrants to the profession. After reviewing various individual solutions which have been recommended for reducing bullying, they suggest that the most effective solution is for health care organisations offering placement training to become much more proactive in creating a culture that will not tolerate bullying behaviour by staff at any level. The literature suggests bullying is a phenomenon affecting workplaces in many countries. Thus the issues described in this article, and the solutions offered have relevance to a variety of health care settings.
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A difficult task for the new nurse manager is to learn how to counsel staff that are not meeting job expectations. This article discusses why it is important not to avoid this responsibility and some tips to help them become more effective counselors.
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