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Individual advocacy as a governing principle.

Many case managers have two roles, that of gatekeeper and that of advocate, that often conflict. A true advocate adopts the client's perspective as the guide for activity. Many advocacy models exist, notably those of physician/patient and lawyer/client. The client's rights to an informed choice and to strict confidentiality are fundamental to these advocacy models and must be incorporated into any advocacy model of case management.

Cost Control↗

In re LePage.

Explore the source record for details and available documents.

Child↗

Optical identification and traceability potentials.

This brief outline of optical identification potentials alerts law enforcement agencies to the early developments in the field. The present elective system of I.D. classification may become a mandatory program for universal traceability in the future.

Classification↗

Health of the public: The private-sector challenge.

The rapid growth of managed care poses challenges and opportunities for the health of the public. The fundamental risk is that both mission and accountability will be defined too narrowly; the opportunity lies in broadening both. What would a socially responsible managed care system look like? Such a system would provide excellent individual care to its enrollees, yet it would also include programs and activities that address broader populations and policies. We propose 8 attributes of such a system that can be used as a guide by managed care systems and to judge whether a managed care system is a responsible, accountable, and responsive contributor to the health of its community. As the role of the public sector shrinks, the private sector must expand its responsibility. It is both prudent and reasonable for managed care systems to seize their unique opportunity to improve the health of the public.

Delivery of Health Care↗

Attitudes of family practice residency program directors toward mandatory preemployment drug testing.

BACKGROUND AND OBJECTIVES: As health care institutions adopt policies on substance use and abuse and mandatory substance abuse testing in the workplace, applicants for house staff positions may become the subjects of testing as a requirement for acceptance into a residency program. This study attempted to learn what directors of family practice residency programs feel about mandatory preemployment drug testing and its effect on house staff recruitment. METHODS: We surveyed the directors of 420 US family practice residency programs, as listed by the American Academy of Family Physicians, in November 1994. All programs (community based, university affiliated, university based, and military) were included in the survey. RESULTS: A total of 308 (73%) program directors responded. Of these, almost half disagreed with mandatory substance abuse testing and felt it should not be a condition of acceptance for a house staff position. Eighty-eight percent believed that the existence of a policy did not hinder recruitment. None felt it was an enhancement. CONCLUSIONS: Preemployment drug testing for potential house staff remains a controversial issue, and it is unlikely that it will be universally implemented in the near future.

Attitude of Health Personnel↗