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PubMed2002

Developing a strategic plan for school health services in Massachusetts.

School health service programs underwent rapid changes to meet the health needs of today's students. These needs stem largely from: a) increased number of students with special health care needs attending school, b) increased stress and time pressure on families, c) rapid restructuring of the health care system serving children, and d) recognition that schools provide opportunities to identify students with health risks. This paper describes seven components of a statewide Massachusetts plan to develop school health services by: a) setting standards, b) reviewing and revising statutes and regulations, c) promoting credentialing of school health personnel, d) providing continuing education on subjects pertinent to school health, e) exploring reimbursement systems and new funding sources, including funds from the tobacco settlement, f) exploring new models of care, and g) implementing data systems. The plan focuses on developing school nurse-managed school health services within a public health model.

Credentialing↗
PubMed1998

Residency training in dental public health: assessment of status, needs, and issues.

The opportunities for public health training have declined over the years while the need for public health skills is likely to increase. This paper reports the results of a project, sponsored by the Health Resources and Services Administration, which answers the question of "how best to invest in the dental public health education system so as to fulfill the profession's responsibilities to protect and improve the oral health of individuals and society." An information base on dental public health education, practice, and specialization was developed from an extensive review of the literature and a survey of dentists concerning employment and practice requirements for public health dentists. An advisory group considered this information, met to discuss the issues involved in dental public health training, and provided advice to the project staff. Based on the information gathered as part of the project, recommendations were made to: (1) develop a grant program to support advanced education in dental public health; (2) increase the competencies of dentists who are working in public health positions and not eligible for board certification via off-site residencies; (3) develop model programs in areas of great need, such as general public health, management, policy, prevention, environmental health and research, that in conjunction with a basic public health core, could satisfy the eligibility requirements of the American Board of Dental Public Health; (4) develop student loan forgiveness programs for dentists and dental hygienists working in public health; and (5) develop additional credential recognition programs for dental public health workers.

Certification↗
PubMedDate not supplied

Professional development during a career break: building your own program.

Professional organizations offer healthcare quality management professionals a myriad of opportunities for professional development. Healthcare professionals taking a break from their careers can take advantage of these and other opportunities to build a program for professional development that is not job-specific, with a focus on reentry into the workforce. Options include continuing education via certificate, credentialing, and fellowship programs, writing, networking, doing volunteer work, and providing résumé or marketing services.

Career Mobility↗
PubMed1994

Opportunities for psychiatrists in managed care organizations.

Managed care organizations have used psychiatrists primarily for their patient care skills, and their potential for performing administrative and managerial services for managed care organizations has not been fully appreciated. However, the role of physician managers is likely to expand with or without federal action on health care reform. Areas of opportunity for psychiatrists include utilization and quality management, network development, provider profiling, and credentialing. In addition, psychiatrists may serve as ombudsmen for managed care organizations and support internal operations. Although formal training beyond medical school and residency is not necessary for psychiatrists to become effective managers, various educational programs are available and are highly recommended.

Career Choice↗
PubMed1976

Muriel Driver Memorial Lecture.

The paper attempts to explore the implications of maintenance of competence for Canadian Occupational Therapists. It reviews the concepts of accountability, credentialing, peer review, self-evaluation and continuing education. Reference is made to other Health Care professions and their progress in maintenance of competence. Suggestions for some solutions are offered and a challenge is put to the educators to encourage the forthcoming graduates to recognize the need for life long learning.

Canada↗
PubMed2000

Ethical issues in addiction counseling.

Although all counselors face ethical challenges, addictions counselors encounter ethical issues that are, in many respects, unique to their discipline. This article provides an overview of these issues, which include but are not limited to (a) the lack of communication and continuity between research and clinical practice, (b) lack of agreement over the necessary professional credentials, (c) the questionable propensity of group work in the addictions field, (d) special issues of confidentiality and privileged communication, (e) boundaries of professional practice in making treatment decisions, and (f) unusual circumstances of informed consent. In addressing these issues, addictions counselors must not only uphold the ethical standards of their profession, they must also be cognizant of any federal statutes that may supersede their state regulations and act in accordance with them.

Communication↗
PubMed2002

Training and certifying behavior analysts.

Proper professional certification and training of behavior analysts who work with individuals with autism is critical in ensuring that those individuals receive the highest quality behavior analytic services. This article discusses the current issues surrounding certification of behavior analysts and describes the important features of the Behavior Analyst Certification Board and its credentials. The article also reviews approaches to the training of professional behavior analyst practitioners and discusses appropriate training content for behavior analysts who work with persons with autism. The interrelationship between training and certification is explored.

Autistic Disorder↗
PubMed1990

Assessing peer review in the quest for improved medical services: Part III.

Part I of this article explored flaws in the operation of peer review in the selection of articles for journal publication and decision-making in the award of research grants, and Part II described medical peer review, its practitioners, and the distinctions between medical peer review and other activities and processes aimed at improving the quality of medical performance in hospitals. This part of the article directs attention to how the courts respond when a physician, aggrieved by an adverse determination with regard to appointment, reappointment, or clinical privileges (credentialing) by the hospital based on medical peer review, seeks redress in the courts.

Clinical Competence↗
PubMed2006

Insurers' contracting policies on nurse practitioners as primary care providers: the current landscape and what needs to change.

A national survey showed that most insurance companies refuse to credential nurse practitioners as primary care providers in nurse-managed health centers. These prohibitive policies, along with weak federal and state laws, threaten the long-term sustainability of nurse-managed health centers as safety-net health care providers and limit the ability for nurse practitioners to become an accepted primary health care source in the United States. Interviews with national managed care organizations revealed that these companies' current business practice and policies are unlikely to change without regulatory change at state and/or federal levels.

Contract Services↗
PubMed2006

Training residents in endovascular neurosurgery.

Neurosurgeons have a long history of treating cerebrovascular disease. Understanding the vascular anatomy and physiology of the nervous system and management of patients with abnormalities of theses vascular structures are vitally important aspects of neurosurgery resident training. Over the past decade, the treatment of cerebrovascular disease has been evolving toward endovascular strategies for many patients. Interventional neuroradiologists were the pioneers in developing this area of therapy, but the number of neurosurgical trainees in neuroendovascular treatment is increasing, and other specialties, including neurology, vascular surgery, and cardiology, are now entering the field of neuroendovascular treatment. The purpose of this article is to review the current credentialing guidelines for neurosurgeons to use endovascular techniques in the treatment of cerebrovascular disease and to consider options for resident training in the rapidly evolving field of endovascular neurosurgery.

Credentialing↗
PubMed1995

Four years experience of a hospital's impaired physician committee.

Physician impairment contributes to patient morbidity, malpractice claims, physician license loss and suicide. This paper describes four years of experience of the University of Maryland's Professional Assistance Committee. The committee is composed of medical staff members. Its mission is to help impaired physicians obtain assessment, treatment and monitoring, and to protect patients from harm. The committee has evaluated 23 cases over the past four years. Ten were credential checks, and 13 investigations of active problems. Eight of the 23 cases were for alcohol, eight for drug, and seven for behavioral problems. Only one person lost medical staff privileges. The committee has been well accepted by the medical staff and hospital administration and can be easily reproduced in other hospitals.

Credentialing↗
PubMed2007

State of the art: interventional pulmonology.

Interventional pulmonology (IP) provides comprehensive care to patients with structural airway disorders and pleural diseases. A growing armamentarium of diagnostic and therapeutic tools has expanded the interventional pulmonologist's ability to care for pulmonary patients with complex abnormalities, often in concert and close collaboration with physicians in other specialties, such as thoracic surgery. Innovative technologies promise to have an impact on diseases and clinical entities not traditionally treated by invasive pulmonary interventions, such as asthma, COPD, and the solitary pulmonary nodule. Training, credentialing, reimbursement, and scientific validation remain key necessities for the continued growth of IP, and require a concerted effort by chest physicians and their professional organizations.

Bronchoscopy↗
PubMed1999

How the licensure process will evolve.

BACKGROUND AND OVERVIEW: All aspects of dental licensure are continuing to evolve. This article describes the changes that are occurring in the licensure process and projects the direction and magnitude of future changes. CONCLUSIONS: The author predicts that national board examinations will continue to move away from recall of facts and toward assessment of basic science and clinical principles as they apply to clinical decision making and delivery of care. Clinical examinations will continue their evolution to become even more reliable and valid. Licensure by credentials will be adopted by more states, thus addressing concerns about mobility that are expressed by many practitioners. PRACTICE IMPLICATIONS: Despite all of this projected progress, the dental profession should expect elevated public pressure for greater accountability unless it takes a proactive position to ensure the continued competency of all practitioners.

Clinical Competence↗
PubMed1996

Medical-legal issues in teleradiology.

With the advent of high-speed, high-resolution digital imaging and network transmission, teleradiology promises to dramatically change the mechanism for interpreting radiologic images and the traditional relationships between radiologists and patients and referring physicians. We discuss the current status of medical-legal issues pertaining to privacy, licensing, credentialing, liability, and fraud for teleradiology. Special emphasis is placed on the technical factors that may result in differences in image properties, consequently affect radiologic diagnosis, and bring the potential for liability.

Confidentiality↗
PubMed1994

Laser safety programs in general surgery.

General surgery represents a speciality where, while any procedure can be performed with lasers, there are no procedures for which the laser is the sine quo non. The general surgeon may perform a variety of procedures with a multitude of laser wavelengths and technologies. Laser safety in general surgery requires a multidisciplinary approach. Effective laser safety requires the oversight of the hospital's "laser usage committee" and "laser safety officer" while providing a workable framework for daily laser use in a variety of clinical scenarios simultaneously. This framework must be user-friendly rather than oppressive. This presentation will describe laser safety at the Rochester General Hospital, a tertiary care, community-based teaching hospital. The safety program incorporates the following components: input to physician credentialing and training, education and in-servicing of nursing and technical personnel, equipment purchase and maintenance, quality assurance, and safety monitoring. The University of Rochester general surgery residency training program mandates laser training during the PGY-2 year. This program stresses the safe use of lasers and provides the basis for graded hands-on experience during the surgical residency. The greatest challenge for laser safety in general surgery centers on the burgeoning field of minimally invasive surgery. Safety assurance must be balanced so as to maintain a safe operating-room environment while ensuring patient safety and the ability to permit the surgery to proceed efficiently. Safety measures for laparoscopic procedures must be sensitive to the needs of the surgical team while not providing confusing signals for the "gallery" observers. This task is critical for the safe operation of lasers in general surgery. Effective laser safety in general surgery requires constant vigilance tempered with sensitivity to the needs of the surgeon and the patient as laser technology and its applications continue to evolve.

Credentialing↗
PubMed1999

Degree-granting institutions and characteristics of psychologists with both diplomate and fellow status in counseling psychology.

Psychologists (44 men, 6 women) were identified as individuals who received both Fellow status from Division 17 of the APA and ABPP Diplomate status in Counseling Psychology. Years of postdoctoral experience acquired prior to gaining the credentials averaged 13.1 (SD = 6.1) for the Division 17 Fellow and 9.8 (SD = 4.7) for the ABPP Diplomate. 25 different degree-granting institutions provided training for the 50 whose careers exemplify the scientist-practitioner approach to their work. Columbia graduated 9 of these psychologists, whereas Ohio State and Minnesota graduated 5 each. In regard to degree specialty, 37 (74%) gained their degrees from counseling or counseling psychology programs, whereas 11 (22%) gained their degrees from other types of psychology programs. These psychologists tended to work in academic institutions and to publish an average of 57 journal articles per year.

Adult↗
PubMedDate not supplied

Laparoscopic surgery for cancer patients.

Laparoscopy is an effective tool for diagnosis and staging of malignancies. Laparoscopic resection of abdominal tumors has been performed rarely, with two exceptions: laparoscopic adrenalectomy and laparoscopic resection of colorectal cancer. One of the best applications of minimally invasive surgery is the use of laparoscopic techniques for palliation of abdominal cancer. Requiring thorough training and preparation of surgeons and mandating their strict credentialing will reduce the risk of complications from laparoscopic surgery.

Abdominal Neoplasms↗
PubMed2006

Evolution of surgical skills training.

Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients. Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced, virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations. The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent. Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery. An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training, ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

Clinical Competence↗