Board Of Registration In Medicine Research Articles

Bariatric surgeon perceptions of the safety of same-day sleeve gastrectomy in the state of Massachusetts.

During the past 2.5 years, select bariatric surgeons in the Commonwealth of Massachusetts have been implementing same-day sleeve gastrectomy (SDSG). Key reasons for this change have been to reduce risks associated with hospitalization in the context of the COVID-19 pandemic and to comply with third-party payer preference to reduce costs. We aimed to evaluate bariatric surgeons' attitudes about outcomes and morbidity between patients who are hospitalized after sleeve gastrectomy and patients who undergo SDSG. Beth Israel Deaconess Medical Center in Boston, Massachusetts (teaching hospital of Harvard Medical School). This prospective cohort study was conducted among bariatric surgeons practicing in the Commonwealth of Massachusetts. An anonymous web-based questionnaire was distributed using the Research Electronic Data Capture software. A total of 58 bariatric surgeons in Massachusetts were identified and successfully contacted based on registration with the Massachusetts Board of Registration in Medicine, membership in the American Society for Metabolic and Bariatric Surgery, and internet search. A total of 33 bariatric surgeons in Massachusetts completed the survey, yielding a response rate of 56.9%. Among the respondents, 75.76% have not performed SDSG, reporting patient safety as the major concern, and 24.24% had performed SDSG in the past. Survey responses showed no significant differences in surgeon perception between SDSG and hospitalization after surgery. Optimal patient selection was an important factor influencing surgeons' decisions with regard to performing SDSG. However, bariatric surgeons in Massachusetts are reluctant to perform SDSG.

The effect of provider characteristics on the responses to medication-related decision support alerts

BackgroundImproving the quality of prescribing and appropriate handling of alerts remains a challenge for design and implementation of clinical decision support (CDS) and comparatively little is known about the effects that provider characteristics have on how providers respond to medication alerts. ObjectivesTo investigate the relationship between provider characteristics and their response to medication alerts in the outpatient setting. Design and participantsRetrospective observational study using a prescription log from the automated electronic outpatient system for each of 478 providers using the system at primary care practices affiliated with 2 teaching hospitals, from 2009 to 2011 for six types of alerts. Provider characteristics were obtained from the hospital credentialing system and the Massachusetts Board of Registration in Medicine. Main measuresOverride rates per 100 prescriptions and 100 alerts. ResultsThe providers’ mean override rates per 100 prescriptions and per 100 alerts were 0.52 (95% confidence interval (CI), 0.46–0.58) and 0.42 (95% CI, 0.38–0.44) respectively. The physicians (n=422) on average overrode drug alerts with rates of 0.48 per 100 drugs and 0.44 per 100 warnings. Univariate analysis revealed that six physician characteristics (physician type, age, number of encounters, medical school ranking, residency hospital ranking, and acceptance of Medicaid) were significantly related to the override rate. Multiple regression showed that house staff were more likely to override than staff physicians (p<0.001), physicians with fewer than 13 average daily encounters were more likely to override than others with more than 13 encounters (p (range), <0.001–0.05), and graduates of the top 5 medical schools were more likely to override than the others (p=0.04). All six predictors together explained 30% and 50% of the variance in override rates, respectively. ConclusionsConsideration of six specific physician characteristics may help inform interventions to improve prescriber decision-making.

The Availability and Nature of Physician Information on the Internet

Although patients are commonly using the Internet to find healthcare information, the amount of personal and professional physician information and patient-generated ratings freely accessible online is unknown. To characterize the nature of online professional and personal information available to the average patient searching for physician information through a standardized web search. We studied 250 randomly selected internal medicine physicians registered with the Massachusetts Board of Registration in Medicine in 2008. For each physician, standardized searches via the Google search engine were performed using a sequential search strategy. The top 20 search results were analyzed, and websites that referred to the study subject were recorded and categorized. Physician rating sites were further investigated to determine the number of patient-entered reviews. Number and content of websites attributable to specific physicians. Websites containing personal or professional information were identified for 93.6% of physicians. Among those with any web sites identified, 92.8% had professional information and 32.4% had personal information available online. Female physicians were more likely to have professional information available on the Internet than male physicians (97.5% vs. 91.7%, p=0.03), but had similar rates of available personal information (32.5% vs. 32.5%, p=ns). Among personal sites, the most common categories included social networking sites such as Facebook (10.8% of physicians), hobbies (10.0%), charitable or political donations (9.6%), and family information (8.8%). Physician rating sites were identified for 86.4% of providers, but only three physicians had more than five reviews on any given rating site. Personal and professional physician information is widely available on the Internet, and often not under direct control of the individual physician. The availability of such information has implications for physician-patient relationships and suggests that physicians should monitor their online information.

The Nexus Necessity: Disciplining Physicians for Non-Clinical Misconduct

The Nexus Necessity: Disciplining Physicians for Non-Clinical Misconduct

Associations Between Physician Characteristics and Quality of Care

Information on physicians' performance on measures of clinical quality is rarely available to patients. Instead, patients are encouraged to select physicians on the basis of characteristics such as education, board certification, and malpractice history. In a large sample of Massachusetts physicians, we examined the relationship between physician characteristics and performance on a broad range of quality measures. We calculated overall performance scores on 124 quality measures from RAND's Quality Assessment Tools for each of 10,408 Massachusetts physicians using claims generated by 1.13 million adult patients. The patients were continuously enrolled in 1 of 4 Massachusetts commercial health plans from 2004 to 2005. Physician characteristics were obtained from the Massachusetts Board of Registration in Medicine. Associations between physician characteristics and overall performance scores were assessed using multivariate linear regression. The mean overall performance score was 62.5% (5th to 95th percentile range, 48.2%-74.9%). Three physician characteristics were independently associated with significantly higher overall performance: female sex (1.6 percentage points higher than male sex; P < .001), board certification (3.3 percentage points higher than noncertified; P < .001), and graduation from a domestic medical school (1.0 percentage points higher than international; P < .001). There was no significant association between performance and malpractice claims (P = .26). Few characteristics of individual physicians were associated with higher performance on measures of quality, and observed associations were small in magnitude. Publicly available characteristics of individual physicians are poor proxies for performance on clinical quality measures.

Oral Cancer Knowledge, Attitudes and Practices: A Survey of Dentists and Primary Care Physicians in Massachusetts

The authors conducted a study to assess dentists' and primary care physicians' oral cancer knowledge, attitudes and practices in the Commonwealth of Massachusetts. The authors mailed a 38-item, pretested questionnaire to a stratified sample of dentists and primary care physicians in Massachusetts. The sample population included all general medicine, internal medicine and family practice physicians listed with the Massachusetts Board of Registration in Medicine and all Massachusetts Dental Society members. The authors invited a random sample of more than 1,000 clinicians to participate in the survey. They assessed knowledge, attitudes and practices of respondents and performed a bivariate analysis of responses to questions by using statistical software. Forty-nine percent of physicians reported performing an oral cancer examination in patients aged 40 to 55 years, compared with 92 percent of dentists (P < .001). For patients 56 years or older, 54 percent of physicians reported performing oral cancer examinations, compared with 93 percent of dentists (P < .001). More than 96 percent of physicians reported that they asked patients about smoking and alcohol use. However, only 9 percent of physicians and 39 percent of dentists were able to identify the two most common sites on which oral cancer develops (P < .001). Fifty-seven percent of dentists and 24 percent of physicians correctly identified the most common symptom of early oral cancer. This survey identified an existing gap in knowledge and practices among physicians and dentists and underscores the need to enhance oral cancer education among both professional groups.

Electronic Health Records and Malpractice Claims in Office Practice

Electronic health records (EHRs) may improve patient safety and health care quality, but the relationship between EHR adoption and settled malpractice claims is unknown. Between June 1, 2005, and November 30, 2005, we surveyed a random sample of 1884 physicians in Massachusetts to assess availability and use of EHR functions, predictors of use, and perceptions of medical practice. Information on paid malpractice claims was accessed on the Massachusetts Board of Registration in Medicine (BRM) Web site in April 2007. We used logistic regression to assess the relationship between the adoption and use of EHRs and paid malpractice claims. The survey response rate was 71.4% (1345 of 1884). Among 1140 respondents with data on the presence of EHR and available BRM records, 379 (33.2%) had EHRs. A total of 6.1% of physicians with an EHR had a history of a paid malpractice claim compared with 10.8% of physicians without EHRs (unadjusted odds ratio, 0.54; 95% confidence interval, 0.33-0.86; P = .01). In logistic regression analysis controlling for sex, race, year of medical school graduation, specialty, and practice size, the relationship between EHR adoption and paid malpractice settlements was of smaller magnitude and no longer statistically significant (adjusted odds ratio, 0.69; 95% confidence interval, 0.40-1.20; P = .18). Among EHR adopters, 5.7% of physicians identified as "high users" of EHR had paid malpractice claims compared with 12.1% of "low users" (P = .14). Although the results of this study are inconclusive, physicians with EHRs appear less likely to have paid malpractice claims. Confirmatory studies are needed before these results can have policy implications.

Personal Accounts: Rodolph H. Turcotte, M.D.: Another Perspective

Personal Accounts: Rodolph H. Turcotte, M.D.: Another Perspective

Personal Accounts: Rodolph H. Turcotte, M.D.: Another Perspective

Personal Accounts: Rodolph H. Turcotte, M.D.: Another Perspective

Professional Liability Payments in Obstetrics and Gynecology

The purpose of this study was to test the hypothesis that the percentage of subspecialists in obstetrics and gynecology who made payments on professional liability claims was less than the percentage of general obstetrician-gynecologists who made payments. Professional liability payment data from the Massachusetts Board of Registration in Medicine was used. During the 10 years preceding August 2005, 38.6% of obstetrician-gynecologists and 32.2% of gynecologists made at least 1 professional liability payment. During the same time period, the percentage of subspecialists who made a payment was significantly less than obstetrician-gynecologists: gynecologic oncologists 10.0% (P = .012), maternal-fetal medicine 3.7% (P = .002), and reproductive endocrinologists 11.9% (P = .016). Using aggregate payment data for the period 1994-2003, the average payment per claim for specialists in maternal-fetal medicine ($1,950,000) and gynecologic oncology ($1,014,006) were above the average payment per claim for obstetrician-gynecologists ($447,983) or gynecologists ($400,338). Reproductive endocrinologists had an average payment per claim of $454,047. All specialists in the field of obstetrics and gynecology have major professional liability risks. Among subspecialists in obstetrics and gynecology, the favorable trend toward fewer physicians making payments is counterbalanced by greater payments per lost claim. II-2.

Career Satisfaction and Retention of a Sample of Women Physicians Who Work Reduced Hours

To better understand the career satisfaction and factors related to retention of women physicians who work reduced hours and are in dual-earner couples in comparison to their full-time counterparts. Survey of a random sample of female physicians between 25 and 50 years of age working within 25 miles of Boston, whose names were obtained from the Board of Registration in Medicine in Massachusetts. Interviewers conducted a 60-minute face-to-face closed-ended interview after interviewees completed a 20-minute mailed questionnaire. Fifty-one full-time physicians and 47 reduced hours physicians completed the study; the completion rate was 49.5%. The two groups were similar in age, years as a physician, mean household income, number of children, and presence of an infant in the home. Reduced hours physicians in this sample had a different relationship to experiences in the family than full-time physicians. (1) When reduced hours physicians had low marital role quality, there was an associated lower career satisfaction; full-time physicians report high career satisfaction regardless of their marital role quality. (2) When reduced hours physicians had low marital role or parental role quality, there was an associated higher intention to leave their jobs than for full-time physicians; when marital role or parental role quality was high, there was an associated lower intention to leave their jobs than for full-time physicians. (3) When reduced hours physicians perceived that work interfering with family was high, there was an associated greater intention to leave their jobs that was not apparent for full-time physicians. Women physicians in this sample who worked reduced hours had stronger relationships between family experiences (marital and parental role quality and work interference with family) and professional outcomes than had their full-time counterparts. Both career satisfaction and intention to leave their employment are correlated with the quality of home life for reduced hours physicians.

Correction: Error in Medicine

Corrections20 February 2001Correction: Error in MedicineFREESearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-4-200102200-00032 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The article on error in medicine (1) contained two errors. First, Bogner's book, Human Error in Medicine, is actually in print (publisher, Lawrence Erlbaum). Second, the Massachusetts error reporting and feedback system is sponsored and run by the Massachusetts Board of Registration in Medicine, not by the Massachusetts Medical Society.Reference1. Bates DW, Gawande AA. Error in medicine: what have we learned? Ann Intern Med. 2000;132:763-7. [PMID: 0010787381] LinkGoogle Scholar Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoError in Medicine: What Have We Learned? David W. Bates and Atul A. Gawande Metrics 20 February 2001Volume 134, Issue 4Page: 347 ePublished: 20 February 2001 Issue Published: 20 February 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Designing a Conscious Sedation Program: A Collaborative Approach

St. Elizabeth's Medical Center identified a need to change its guidelines for the administration of IVCS. A task force consisting of physicians, nurses, pharmacists, and administrators was formed for this purpose. Goals for the guidelines were identified utilizing resources provided from the Board of Registration in Nursing and the Board of Registration in Medicine, as well as other professional organizations and local hospitals. A consensus was reached and a document generated that received approval by the Medical Center. Implementation went smoothly because of widespread support for the goals of the policy. Quality improvement studies have been performed and the results have been used to change practice. The process is currently ongoing.

Developing Issues Under the Massachusetts ‘Physician Profile’ Act

Massachusetts recently became the first state in the United States to publish physician malpractice histories and hospital disciplinary records. On August 9, 1996, Governor William F. Weld signed the Physician Profile Act (Profile Act or Act) into law, making “profiles” of the Commonwealth’s approximately twentyseven thousand doctors available to the public. Under the Act, the Massachusetts Board of Registration in Medicine (Board) provides information on physicians’ insurance plans, specialties, training, honors, and malpractice histories over a toll-free telephone number, through the Internet and on CD-ROM.The Act developed partially as a legislative response to a series of Boston Globe articles appearing in late 1994 which savaged the Board. Spotlighting a number of high-profile iatrogenic incidents, this highly charged series of articles, accompanied by a blistering editorial, alleged that some patients suffered substandard medical care at the hands of physicians who had been sued repeatedly for malpractice but never disciplined by the Board.

Professional Boundaries in the Physician-Patient Relationship

THE SUBJECT of professional boundaries (and boundary violations) has received a great deal of recent attention in the psychiatric literature. 1-5 The emphasis on defining guidelines for professional conduct has expanded beyond the confines of ethics committees and has worked its way into licensing boards charged with disciplining physicians whose behavior jeopardizes the well-being of patients. The Massachusetts Board of Registration in Medicine, 6 for example, has recently issued detailed guidelines on such matters as self-disclosure, dual relationships, sexual relationships with patients, and other professional boundaries to help define for the public and for the profession the parameters of professional conduct in the practice of psychotherapy by physicians. While specialists in psychiatry have been debating the pros and cons of issuing such guidelines, nonpsychiatric physicians have yet to involve themselves so extensively in similar discussions. In this article, we will provide a conceptual framework for discussion of professional boundaries in

Problems in Medical Licensure

To the Editor.— Vasilios G. Letsou, MD ( 210: 1764, 1969), a member of the Massachusetts Board of Registration in Medicine, focuses attention on that perennial problem of licensure, universal reciprocity, and endorsement between the states, when he says: Difficulties arise when one attempts to evaluate the significance of a license given by state authorities after their own examinations. Examinations given by most states vary and even when the same examination is given by various states the accepted passing mark varies from state to state, and, as a matter of fact, may vary from year to year in the same state. In the less than two-year period that I have served on the State Board of Registration in Medicine in Massachusetts, the accepted passing mark has been altered on two separate occasions, so that during that period, three sets of standards have applied to the same examination. In quoting Letsou, there

Officers of Board of Registration in Medicine

Officers of Board of Registration in Medicine

New Policies of Board of Registration in Medicine

New Policies of Board of Registration in Medicine

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Board of Registration in Medicine

Board of Registration in Medicine

Board of Registration in Medicine