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PubMed1981

Medico-legal opinion: radiology and vicarious liability.

Vicarious liability in Canadian law implies additional responsibilities which parallel the benefits of a partnership, and the benefits of employer--employee relationships. It promotes optimum patient care, together with avenues for loss distribution in situations where negligence occurs. Radiologists, as persons in charge, are expected to exercise due care and skill in maintaining the quality of care which patients receive during all phases of the professional relationship. They are expected to provide the patient with a reasonable standard of care and skill, irrespective of whether the radiologist chooses to deal with the patient directly, or through a partner or employee. This is the same common sense requirement which all of us expect when we contract with a builder or mechanic who employs others to do part of the work. It is not reasonable to expect a patient to entrust his or her health on any other basis.

Canada↗
PubMed1980

Under the golden psi: the franchising of mental health.

M. Brewster-Smith (1968) divided the history of psychiatry into three revolutionary periods. The first was the unshackling of the lunatics and the conception of mental illness. The second revolution was the spread of the dynamic theory of Freud with its emphasis on the one-to-one therapeutic relationship. The third revolution was the community mental health movement with its emphasis on bringing treatment into the community. We are now on the verge of yet another revolution. The new revolution is quiet and its leaders come from within the psychiatric profession. The major feature of this revolution is the binding together of medical authority and social treatment models within a corporate structure. The new movement takes the individually oriented private practitioners and shows them that in union there is profit.

Delivery of Health Care↗
PubMed1980

Anticipatory guidance in pediatric practice.

Physicians, by their collective positions in society and their individual interaction with patients, can be facilitators in helping families adopt more healthful ways of living. This study addresses the issue of the amount of time pediatricians in private practice spend with patients during well-child visits and the proportion of that time they devote to discussing potential health problems. The study population consisted of a random sample of pediatricians in the metropolitan Pittsburgh area. Observation of physician-patient interactions were made during one day in each of 23 pediatricians' offices. During the days of observation there were 305 well-child visits. The time spent with each patient averaged 10.3 minutes. Anticipatory guidance constituted 8.4% of total visit time. Pediatricians in group practice or partnerships and those recently trained spent more time with patients and a greater part of their time in anticipatory guidance. The amount of time during the well-child visit spent in anticipatory guidance varied with the age of the patient. The most time discussing potential future problems was spent with parents of infants less than 5 months of age (1 minute 37 seconds), with only an average of seven seconds being spent with adolescents. Of particular note was the lack of time spent discussing issues of safety, sex, behavior and growth. Because pediatricians spend more than 60% of their in-office time seeing patients for well-child care, they have an excellent opportunity to motivate parents and patients to change to more healthful ways of living. This opportunity will be lost however unless pediatricians reorient their priorities by addressing currently unmet health problems.

Adolescent↗