Practicing in an Integrated-Managed Care Organization.

Traditionally a small number of clinical specialties, such as obstetrics and gynaecology, have been regarded as particularly high-risk areas of medical practice in terms of medical negligence litigation. Increasing evidence is emerging to substantiate the view that clinical negligence litigation is becoming prevalent in primary and ambulatory care settings.1–3 In common with other specialist areas of clinical practice, travel medicine presents medico-legal risks. The potential for unrecognised medico-legal risk and a lack of risk management practices in travel medicine merit consideration. In order for an allegation of negligence to be proven, four principle facts must be individually established.4 In the first instance, the travel health professional must have a duty of care to the patient. Second, that professional must have failed to reach an accepted standard of practice in the course of providing that care. Third, the patient must have suffered physical, financial, psychological and/or another form of loss. Finally, the loss must have been legally caused by the failure to provide an accepted standard of care. The onus is upon the plaintiff (i.e. the patient) to prove that negligence has occurred, and unless evidence of all four aspects is accepted by the court, the allegation of negligence will not be upheld. Travel health professionals owe a duty of care to any patient who consults them. Within that duty of care, there is an obligation to provide a standard of care that must be approved by a reputable body of opinion within the specialist area of practice. In this way, variation in clinical practice and differences in opinion between practitioners are taken into account. If there is a reasonable body of opinion to support the course of action taken, then the professional will likely be considered to have provided an appropriate standard of care. Duty of care begins …

Commentaries on health services research

Volume 100: clinical investigations: where next?

The challenges of academic physician-scientists in gastroenterology and hepatology: From managing indebtedness, securing grants, to managing conflicts

Patient-oriented research and the shiny object syndrome.

Role Ambiguity and Speech-Language Pathology

Although team-based care can improve coronary heart disease (CHD) risk factors and is considered cost-effective from a healthcare system perspective, little is known about the financial impact of team-based primary care for secondary prevention of CHD. The purpose of this study was to define the impact of team-based care for CHD on utilization, costs, and revenue of a private primary care practice. Interrupted time series analysis. Between March 1, 2010, and March 31, 2013, we assisted a private medical practice, comprising 5 primary care clinic sites, to organize and deliver team-based care for patients with CHD. We used billing records and the registered nurse care manager's diary to calculate the cost of team-based care, differences in the average number of visits per patient, and revenue per patient before and after the implementation of team-based care. The net cost of team-based primary care was $291 per patient over the 1-year period of observation. The findings from this study are consistent with other economic analyses of team-based care and suggest that payment for care must be restructured if patients are expected to enjoy the benefits of team-based primary care.

Same-Day Consent for Regional Anesthesia Clinical Research Trials: It's About Time.

Keeping clinicians in clinical research: the Clinical Research/Reproductive Scientist Training Program

The state of the medical geneticist workforce: Findings of the 2003 survey of American Board of Medical Genetics certified geneticists

David O. Warner, M.D., Recipient of the 2022 Excellence in Research Award

Navigating Primary Care

The United States 2020 Census data: implications for precision medicine and theresearch landscape.

The faces of pharmacy: Students and pharmacists stepping forward

Infinite cornucopia: The future of education and training in oral and maxillofacial surgery