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At least 793 records · Page 44Linked to original sources
PubMed2000

Mapping "region" in Canadian medical history: the case of British Columbia.

The notion of "region" can be a valuable analytical tool in the writing of Canadian medical history. This article explores themes in the history of British Columbia that link medicine and regional development. Employing a historiographical sweep from the colonial period to the 1970s, the author considers doctors and imperialism, medical practice and the economy, and the relationship between metropolis and periphery in shaping medical institutions and medical culture in the western province. The intent of the piece is to stimulate thought about the potential of introducing the sense of place into regional medical history in Canada.

Canada↗
PubMed2006

[Synptons of outpatients as data for syndromic surveillance].

OBJECTIVE: To review complaints (such as fever, respiratory symptoms, diarrhea, vomiting, and rashes) in the medical records of outpatients as potential sources of data for syndromic surveillance, and to examine the possibility of practical application from a statistical view point. MATERIALS AND METHODS: Using data obtained from a certain internal and pediatric clinic, we count the number of patients each day who suffered from one of the above five symptoms from January 1st, 2003 to June 30th, 2005. In order to detect outbreaks prospectively after January 1st, 2005, we at first estimate the baseline using the data from January 1st, 2003 to the day before any given day. We then predict the number of patients there ought to be in any given day and judge whether or not an outbreak has occurred. So as to evaluate the system, we check the sensitivity and specificity in its ability to detect outbreaks other than those seen in previous patterns. RESULTS: The total number of cases in which each of the above symptoms occurred were respectively: 11,896 cases of fever, 16,273 cases of respiratory symptoms, 3,672 cases of diarrhea, 3,485 cases of vomiting, and 542 cases of rash. We found prolonged outbreaks of fever and respiratory symptoms in February and March and shorter outbreaks of vomiting and diarrhea in January. The sensitivity and specificity of this system' s ability to detect outbreaks was very high and thus we can confirm that it showed satisfactory performance. DISCUSSION: We found large-scale outbreaks of influenza late in the 2004/2005 season, and small outbreaks of GI that seemed to be particularly related to the Noro virus. In both cases, these outbreaks seemed to be natural phenomena, not artificial, human induced phenomena such as outbreaks caused by bioterrorism attacks. However, since this system was able to detect these outbreaks, we would also be able to use it to detect an outbreak caused by a bioterrorism attack if the size of the outbreak was similar to these cases. CONCLUSION: In order to use this system to detect outbreaks in the community on a smaller level we would have to increase the number of medical institutions cooperating in this study. Moreover, we would need to find a way to handle the different electronic medical record systems and different writing styles used by different medical institutions in order to move toward the practical use of Syndromic Surveillance.

Child↗
PubMed2001

A little bit of medicine, a lot of hope.

After nearly a week of treating patients in Nicaragua, this physician realized that curing isn't everything. Her story was runner-up for the Young Doctor Award in the Medical Economics Doctors' Writing Contest for 2000.

Family Practice↗
PubMed1994

[Teaching sociology in medical school].

As early as in 1994 medical education was criticised by the Royal College of Physician in London. Nevertheless until 1978 D. C. Maddision was still asking the question: "What's wrong with medical education?", and Abrahamson writing a paper called "Disease of the (medical) curriculum". Since the 1950s social and behavioural sciences have been gradually brought into the curriculum in order to pursue better medical care. In the 1970s critics of medicine went beyond its economical and political aspects, ie. its maldistribution etc., to its cultural side. Not only the efficacy of modern medicine but its moral neutrality and benevolence were called into question. This paper is mainly based on the writer's personal experience of teaching sociology and medical sociology in a medical school in Taiwan. The debate on relevance, the difficulties and problems in teaching and suggestions for the future are covered.

Education, Medical↗
PubMed1983

Style in medical journals.

A study of medical journals from 1962 showed a constant preoccupation with style. Editors and contributors on both sides of the Atlantic revile unnecessary obscurity and complexity and the use of jargon, barbarisms, vogue words, and weak impersonal constructions. They bewail the pompous use of verbiage and the "medspeak" typified by acronyms and neologisms created by affixation. Suggestions for possible causes of poor medical style range from editorial demands for compression and a general ignorance of the principles of good writing to faulty logic and the subordination of communication to status seeking. The consequences of bad writing may include the fragmentation of knowledge, an increase in the importance of abstracting services, a trend towards free glossy medical newspapers, and, as remedial measures, workshops and courses in medical writing. Some implications for English language teachers working with foreign medical graduates and preclinical students are discussed.

Language↗
PubMed2000

General principles of forensic report writing.

OBJECTIVE: The aim of this paper is to provide an update of principles of forensic report writing, to guide and assist registrars, junior consultants and psychiatrists considering working within the forensic arena. METHOD: The literature was reviewed for information on principles of report writing from a variety of jurisdictions. Additionally, literature on medical ethics was examined. RESULT: Writing reports is a professional activity that most psychiatrists undertake at some point in their careers. The report represents the psychiatrist's professional opinion. It is important that information is accurate, relevant and ethical. In writing medico-legal reports, psychiatry deviates from traditional medical ethics. CONCLUSION: It is important that psychiatrists who write reports have a good understanding of the process and behave ethically and competently.

Australia↗
PubMed2006

Teaming up for medical necessity compliance.

Healthcare finance professionals and other employees from departments involved with a hospital's revenue cycle can work together in many ways to minimize denials, delays, and write-offs: Verifying medical necessity when a patient is first seen, rather than when the patient arrives for service, so that an advance beneficiary notice can be issued and signed at the time of service. Ensuring that the proper codes and modifiers are assigned before a claim is submitted. Augmenting software compliance tools with human expertise in compliance and internal education programs to reduce errors over time before they reach the billing department.

Cooperative Behavior↗
PubMed1987

Internal medicine house officers' performance as assessed by experts and standardized patients.

Three chronically ill patients were trained to evaluate the performance of 31 second-year internal medicine house officers based upon: a checklist for the medical data elicited during the medical interview; the process of the interview (that is, the house officer's interviewing style); and the physical examination technique. Four standardized rating scales were completed by the patients for the evaluations. Expert evaluations of the same house officers were conducted by a trained evaluator who reviewed videotapes of the interview and a faculty member who reviewed the adequacy of the medical history write-ups. Results of the study indicate a high correlation between the patients' and the experts' evaluations of the adequacy of the medical history data collected; less agreement was found in evaluations of the adequacy of the psychosocial data collected. These findings suggest that, if carefully selected and trained, patients with chronic medical conditions can provide reliable and standardized evaluations of house officers' performance at a level consistent with but less expensive than faculty members' evaluations.

Aged↗
PubMed1988

Reduction in order turnaround time, telephone calls, and trips to the pharmacy by means of facsimile transceivers.

The facsimile transceiver (FAX) was trialed at Beverly Hospital, Beverly Massachusetts, on the Intensive Care Unit and the Pediatric Floor from March 13 to April 27, 1987. Beverly Hospital is a 233 bed non profit community hospital. The facsimile unit was used to transmit medication orders to the pharmacy over existing telephone lines. The purpose of the trial was to determine the time saved between the writing of the medication order and the arrival of the medication on the nursing unit. This time was considered as medication turnaround time. During the trial period, a total of 1767 medication order sheets were processed via the FAX machine. The results of the trial showed that medication turnaround time has improved by an average of 90 minutes for each order placed. In addition, it was found that a total of 60 phone calls and 14 trips to the pharmacy, per day, were eliminated from both trial units combined. This resulted in an estimated time savings of 6.5 staff hours per day on these two units alone. On a hospital-wide basis, this would result in considerable labor savings for nursing staff on the floors. In addition, supply costs of medication order sheets will be reduced by approximately $3200 per year if the FAX units were used throughout the hospital. As a result of the trial, Beverly Hospital purchased 9 units, at a cost of $17,325 and implemented a hospital-wide policy of sending medication orders to the pharmacy using this equipment. This will result in improved ability of the pharmacy to respond to new orders in a more timely manner, supply cost reductions and improved use of staff.

Costs and Cost Analysis↗
PubMed1980

The medical director in the nursing home.

The place of the medical director in the acute care general hospital is discussed. The federal legislation mandating medical directors for nursing homes is summarized, and is criticized for being too closely based on acute care general hospital models. Descriptive writing about the medical director's role are reviewed, and also quantified surveys. It is suggested that an educational and consultative role is most suitable. There is doubt about the ability of the medical director to control and supervise medical staff. His/her ability to control quality of care is also dubious.

Humans↗
PubMed1995

Clinical practice and medical research: bridging the divide between the two cultures.

The failure of the results of many research studies to be integrated into everyday clinical practice is both well documented and much decried. In the writings on why medical research and clinical practice have remained separate cultures, two issues have not been sufficiently debated. First, are medical researchers addressing the problems that cause clinicians the most concern in their consultations with patients, and secondly, are the results of research studies being presented in a manner that clinicians can both understand and use? This discussion paper highlights primary care clinicians' urgent need for information on the predictive value of the symptoms and signs seen in everyday clinical practice. Medical research has still to provide this information, often leaving general practitioners with inadequate predictive information on which to make early diagnoses, for example, on whether a patient with chest pain has a pulmonary embolus, or a child with pyrexia and rash has meningococcal septicaemia. The format in which research information is commonly presented is discussed; it has been shown that epidemiological terms used in studies are impenetrable to most clinicians. Additional ways of framing research information need to be devised that present such research information in a narrative format and numerical format, emphasizing the effects of management decisions as well as diagnostic categories, and for use in individual consultations as well as describing populations. Only then will clinicians be able to integrate into their everyday clinical practice the potentially valuable information provided by medical research.

Communication↗