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Currently, there are more than 60, 000 practicing hospitalists in the United States. This represents a steady and slight exponential growth over the past 25 years. No specialty has grown as fast and has had a greater impact on the delivery of healthcare than hospital medicine. Certainly, the COVID-19 pandemic has given the hospitalist a time to shine. During the COVID-19 pandemic, the specialty demonstrated its value by its flexibility and adaptability. One trend remains constant in this time of uncertainty - hospitalist have undisputed value. This chapter reviews current compensation trends and career satisfaction. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
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The Supreme Court's decision on Dobbs vJackson will have an impact on reproductive health care provision for years to come, not only where abortion care is now restricted but across the country. As of January 2023,14 states have outlawed or severely restricted abortion.1 Morbidity and mortality around the time of labor is already on the rise nationally, from 658 in 2018 to 861 in 20202-particularly in places where abortion is restricted and labor care is increasingly sparse because of loss of the workforce after the COVID-19 pandemic.3 It is important to understand how the criminalization of abortion providers will affect all other forms of reproductive health care moving forward.In states where abortion care is currently severely limited, clinicians who provide abortion care face criminalization that can include insurmountable legal fees, loss of their medical license, and even imprisonment. Abortion restrictions create a duality in which providers feel they must serve as agents of the state-reporting any suspicious pregnancy-related issues-or have their license called into question, all while trying to best help their patients. Since these laws took effect, we are already seeing delays in health care services for patients needing early pregnancy care management-for abortion as well as miscarriage management and ectopic pregnancies.4 Health care providers may be called on to increase surveillance and report signs of abortion that can violate their protection of HIPAA (the Health Insurance Portability and Accountability Act) rights, while also facing malpractice claims if they, by delaying or denying early pregnancy care management, are providing what medical evidence shows to be substandard care.
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The use of communication technologies to provide psychiatric services is broadly termed telepsychiatry. While telehealth is not new and has been in existence for over 50 years, the COVID-19 pandemic accelerated the use of this modality and demonstrated its advantages in healthcare delivery. Although on the surface telepsychiatry may simply appear to be the practice of psychiatry through videoconference, like any innovation it presents nuanced regulatory, liability, and practice considerations. Familiarity with relevant rules regarding licensure, prescribing, credentialing, malpractice coverage, and privacy and security is important prior to getting involved with providing virtual services. Clinical issues such as informed consent, establishing a physician-patient relationship, documentation, and standard of care must also be considered. In this chapter, we will review these key issues through the lens of enhancing clinical practices and reducing the risk of medical malpractice and licensure violation when providing these services. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Improving the protection of the right to health of ethnic Roma people is one of the most pressing public health challenges in contemporary Europe, as their life expectancy and health status remain significantly lower than their non-Roma counterparts. This paper analyzes Roma-led accountability initiatives that embrace social accountability and legal empowerment approaches to advocate for equitable fulfillment of the right to health. While these initiatives have led to the elimination of some harmful health practices (such as illegal cash bribes and violent and abusive treatment by medical professionals) and to improvements in health care, and some Roma communities have become driving forces for local and national health system reforms for advancing the fulfillment of health rights, the health inequalities affecting Roma communities remain significant. This issue also remains largely overlooked by European health research and policy experts, who are mostly reluctant to incorporate analyses of ethnicity and racialization into their research on health inequalities in Europe. The COVID-19 pandemic has further exacerbated these health inequalities.
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COVID-19 is a new disease that results in a worldwide pandemic. A rapid increasing of studies regarding occurs within a few period after its first emergence. The infodemic of COVID-19 data occurs. On the one hand, it can bring useful new knowledge. On the other hand, the negative impact such as misconduct and exaggeration off data occurs. In addition, since this new disease occurs in the IT era, the public health communication through social media regarding COVID-19 is also an interesting public health phenomenon. In this brief report, the authors summarize and discuss on infodemic and its unwanted effect on COVID-19.Copyright © 2023 Journal of Medical Society.
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Introduction: Medical errors are a serious public health problem. The COVID-19 pandemic has caused further stress to doctors with the increase in patient mortality, the lack of definite guideline and growing work demands. In this scenario, the patient is not the only victim of the medical error. The "second victim" (SV) is defined as a health worker who was involved in an unforeseen and negative event for the patient, who suffers physically and psychologically, because he was traumatized by his own mistake and/or by the injuries caused to the patient. The SV phenomenon prevalence varies from 10.4% up to 43.3%. Objective(s): The aim of this study is to evaluate the second victim phenomenon during the COVID-19 pandemic among medical doctors of the Catanzaro University Hospital (Italy). Method(s): A cross-sectional study will be conducted by administering an anonymous questionnaire to the Catanzaro University Hospital medical doctors using SurveyMonkey software. Descriptive analysis will be performed. Result(s): The data collection is ongoing. Currently, 300 subjects are included in the sample. Conclusion(s): The second victim phenomenon has a negative impact on doctors, colleagues and patients. It is important to aid health workers involved in an adverse event by activating support networks and adopting appropriate strategies in order that the event is a source of learning and not of demotivation.
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The use of communication technologies to provide psychiatric services is broadly termed telepsychiatry. While telehealth is not new and has been in existence for over 50 years, the COVID-19 pandemic accelerated the use of this modality and demonstrated its advantages in healthcare delivery. Although on the surface telepsychiatry may simply appear to be the practice of psychiatry through videoconference, like any innovation it presents nuanced regulatory, liability, and practice considerations. Familiarity with relevant rules regarding licensure, prescribing, credentialing, malpractice coverage, and privacy and security is important prior to getting involved with providing virtual services. Clinical issues such as informed consent, establishing a physician-patient relationship, documentation, and standard of care must also be considered. In this chapter, we will review these key issues through the lens of enhancing clinical practices and reducing the risk of medical malpractice and licensure violation when providing these services. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Recent data on number of claims, final judgement of claims and their costs are scarce. This study analyzes 15 years of malpractice claims in the Netherlands. All claims filed, and all claims closed by two insurance companies (which insure approximately 95% of all hospitals in the Netherlands) between 2007-2021 are included. Trends in number of claims, medical specialties involved, final judgements and costs from malpractice claims are analyzed, as well as the impact of COVID-19 on malpractice claims. In total, 20,726 claims were filed and 21,826 claims were closed. Since 2013, the number of claims filed decreased. Of all claims filed, 64% were aimed at surgical specialties and 18% at contemplative specialties. Of all claims closed, 24.49% were accepted, 19.26% were settled and 48.94% got rejected. The financial burden of all claims closed quadrupled between 2007 and 2021; this increase was caused by rare cases with excessively high costs. Since the COVID-19 pandemic, we observed a decrease in the number of claims filed, and the number of incidents reported. This study provides valuable insights into trends and developments in the number and costs of liability claims, which is the first step towards improving patient safety and preventing incidents and malpractice claims.
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Respecting the consent and confidentiality of a patient is an underlying element in establishing the patient's trust in the physician and, implicitly, obtaining the patient's compliance. In particular, cases of inmate patients require increased attention in order to fulfill this goal against a background of institutional interferences, which, in certain situations, may endanger the autonomy of the physician and their respect for the inmate's dignity. The purpose of this article is to depict the characteristics of consent and confidentiality in a prison environment, in special cases, such as hunger strikes, violent acts, HIV testing, COVID-19 measures, and drug use, bringing into focus the physician and the inmate in the context of the particular situation where the target is disciplining someone in order for them to conform to social and juridical norms. Respecting the dignity of the inmate patient requires an adequate approach of informed consent and confidentiality, depending on each case, considering the potential unspoken aspects of the inmate's account, which can be key elements in obtaining their compliance and avoiding malpractice claims.
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By law, doctors and pharmacists may be held liable for professional misconduct. The pharmacist’s roles and responsibilities have been expanding in patient care, particularly in times of COVID-19 pandemic and now they may perform a diverse range of professional activities as attested by the newly adopted legislation, Minister of Health’s Order no. 2382/2021. However, pharmacist malpractice is different than medical malpractice because pharmacists’ responsibility is based on pharmacist professional standards and legal duties. Despite the existence of overlaps, there are differences between the doctors’ and the pharmacists’ professional duties. Our study identified ten main legal professional duties of pharmacists and provided examples of negligence. The results could be used as a tool for malpractice risk assessment and management. We also argue that the Romanian legal framework allows malpractice claims to be filed by both the patient and/or the doctors when shared accountability is involved and this increases the pharmacists’ risk of being sued. Moreover, the chief pharmacist is responsible for the pharmacy’s overall activity, including liability for tasks entrusted to subordinated personnel.
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Blood transfusion is a vital service within modern healthcare. Patients expect to receive safe and quality assured blood as part of their clinical management. Globally, demand for blood has shown varying patterns, depending on the morbidity patterns, availability and access to healthcare with its determinants. In developed countries, an increasing emphasis on patient blood management, improved access to testing and technology assisted bloodless procedures, has gradually reduced the demand for blood. In the short term, the converse is expected in Low and middle income countries, with improving access to healthcare. The COVID19 pandemic has highlighted the vulnerabilities of blood transfusion services across the globe. Although much attention has been made to ensure safety of blood from the testing and processing aspects, there is a lack of focus on the source. According to the WHO Global Status Report on Blood Safety and Availability 2021 (in preparation), 86.7% of donations over the last decade has been from voluntary donations. Although most nations have stated policies that support voluntary blood donors, in many, there is no programmatic approach to promote awareness, motivate and retain the safe pool of donors, leaving it to fragmented local efforts. A clear understanding of baseline demographic profile, health status, prevalent morbidities, socio-cultural beliefs and practices is necessary to identify target groups and plan social marketing campaigns. Lack of reliable donor information can be overcome by creation of secure federated donor registries with authenticated donor identity management to enable systematic data collection. It will also help to plan donor engagement and recognition. Registries accessed and updated locally, with confidential sharing of information will also dissuade potential malpractice among blood donors. There is a need to normalize the conversation about blood donation in our communities. Increasing the availability of reliable information about the science of donation, safety and the use of blood is essential to overcome a lack of awareness. Public authorities can mandate display of information, in local languages, in public spaces and media. Individuals are motivated by a variety of reasons. Identifying and sustaining these can only be through careful systematic engagement. Though modern technologies such as social media, messaging platforms and apps have increasingly become popular, the actual extent of the impact of these have not been clearly documented. Direct interaction with individuals has shown good results. Facilities at blood donor drives, fixed donor centres and blood centres need to be carefully structured to enhance a pleasant donor experience while being regulated to ensure donor safety and quality. Donor health interventions including counselling and medical consults for deferred donors will help sustain the bond between the potential donor and the blood centre. Non-financial incentives such as weightage for voluntary donations during employment may be worth exploring. Retaining repeat voluntary donors from a low-risk population remains a challenge, which can be met only through sustained and systematic public investment and engagement with the community to change attitudes and participate in ensuring blood security and safe blood for all.
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The development of communication technologies has a dramatic influence on culture. The internet, cell phones and e-mail are different domains, and if health care professionals want to join this space, they will be careful to do so. Telemedicine has medical-legal implications for aspects of identification, licensing, insurance, protection, privacy and confidentiality, as well as other risks related to online healthcare communication. The International Advisory Group of the World Health Organization (WHO), which met in Geneva in 1997, identified telemedicine as providing healthcare services, where distance is a critical factor, to health care providers, who use the information and communications technologies to exchange relevant information for the diagnosis, treatment and prevention of diseases and injuries, and to continue to do so. In the context of the COVID-19 Pandemic Lockdown, the Indian Government has authorized telemedicine legal status. The Governing board, established by the Government at a meeting of the Indian Medical Council with the Ministry of Health and Family Welfare’s approval, published a notice dated 25 March 2020 (‘Amendment’) modifying Guidelines of the Indian Medical Council 2002 on telemedicine in India. The amendment introduced ‘Telemedicine consultation’ to the law. A basic knowledge of how medical negligence compensation is calculated and adjudicated in the judicial courts of India. The paper concludes with an assessment of the rules. This paper will seek to determine whether binding arbitration is the best possible solution to resolving malpractice disputes, or whether traditional litigation, while costly, is the safest choice. To do this, the paper will examine both the advantages and the disadvantages associated with using arbitration as opposed to litigation.
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The article reports that the U.S. Government Accountability Office (GAO) has criticized the U.S. Department of Health and Human Services (HHS) for persistent deficiencies in its response to the coronavirus pandemic and past public health emergencies.
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Introduction: Physicians and other healthcare personnel have an important role during epidemic of public health crises such as COVID-19 pandemic . It has been observed that this pandemic has increased the stress of different communities, hnology;especially medical staff. Since the widespread of this disease, no research has been conducted on the effects of this pandemic on the stress and resilience of pediatric and emergency assistants of Iran. The present research aims to evaluate the association between resilience and stress of coronavirus (COVID-19) in pediatric and emergency assistants of Iran University of Medical Sciences in 2021. Method: The present research is a cross-sectional study. The statistical population included 52 pediatric and emergency assistants of Ali Asghar and Rasoul Akram hospitals in Tehran , 2021. The census sampling method was implemented for selecting the samples. For deliberating content validity and reliability, 30 questionnaires were initially examined and after confirmation , other samples were examined. In the present study, 2 questionnaires were used and 52 people responded to them, and then the two components of content validity ratio and content validity index (CVI and CVR) were evaluated. For determining the reliability , the Cronbach's alpha coefficient formula was implemented, after calculating Conor and Davidson resilience alpha, (CD-RIS) the score 0.90 and for the anxiety scale of coronavirus in pediatric and emergency assistants, digit 0.89 was obtained, and considering that both of them are greater than. 0.7 , appropriate reliability was obtained. Considering the normality of the data, Pearson correlation coefficient was used for analyzing the association between resilience and stress in pediatric and emergency assistants . Results: Since sig was higher than 0.05 (0.1), the null hypothesis was confirmed and the opposite hypothesis was rejected, and no significant association was found among these two variables (P = 0.6). The results also demonstrated that there was no association between resilience and stress in assistants and residents. Since there was no association among the two variables, the intensity and directions were not assessed. The findings showed that most pediatric assistants and residents were stressed about the new coronavirus disease and the health of individuals that are close to them. According to the chi-square test and probability value, it was found that there was no significant association among the demographic characteristics and stress of coronavirus in pediatric and emergency assistants and their resilience scale.
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COVID-19 continues to be both a major medical problem and a real ethical and forensic issue, profoundly affecting both patients and health services around the world. This pandemic has produced major changes in the provision of healthcare, especially in patients with chronic conditions. The consequence has been the deviation in some medical situations from the medical guidelines and protocols in force with forensic risks for clinicians. When the criteria of professional competence are met, the civil liability ensures a protection of the health workers. Disputes can arise when there are doubts about how the medical activity was performed in safe conditions for patients, when local care decisions were made or when there are no nationally validated guidelines. In conclusion, clarifying legal concepts on the public health crisis, developing a legislative framework and appropriate means to combat it, are important desideratum on more judicious management of a crisis situation.
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Telemedicine allows for the effective delivery of health care to patients at a distance through the application of information technology to the field of medicine. This is optimal during the COVID-19 pandemic to reduce interpersonal contact to mitigate contagion. Among the possible Telemedicine applications, there is Telesurgery, which involves more and more surgical specialties thanks to the numerous benefits in quality and cost containment. In the growing field of Telesurgery, its technical and legal implications must be considered. In this study, a traditional review of the scientific literature was carried out to identify the most relevant issues of interest in Telesurgery. The problematic legal aspects identified are mainly related to the difference in legislation between different geographical areas, which is critical in the case of malpractice. In addition, there is the possibility of a malicious hacker attack on the transmitted data stream either to steal sensitive data or to harm the patient. Finally, there are inherent difficulties with the technology used, such as latency issues in data transmission. All these critical issues are currently not adequately addressed by current legislation. Therefore, one can only hope for a legislative action to allow Telesurgery to be used safely.
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COVID-19 , Telemedicine , Delivery of Health Care , Humans , Pandemics , SARS-CoV-2ABSTRACT
Background: Italy is one of the few countries globally where physicians can be criminally prosecuted. Results: The total of pending civil sector files in 2020 is rather stable however, it has suffered a net increase in the Supreme Court (+12%), an increase in the Court (+3.1%) and in the Court of Appeal (+1.1%) mainly due to CoViD-19 (C19) restrictions. Many patients or patients' families have sued physician because of the deaths due to C19. ISTAT has published the information reported by physicians in 4,942 death cards of subjects diagnosed with a positive C19 test (15.6% of the total deaths reported to the ISS Integrated Surveillance System). In the cards of deaths are certified, in addition to C19, those conditions and diseases that have played a role in determining death. Conclusions: Law No. 24/2017 states that an HP who commits an avoidable technical error can be considered not guilty if full compliance with proper national guidelines/protocols is proven and it is not a case of gross negligence (a term that is not explicitly defined by any law). In 2020 C19 pandemic no national effective guidelines/protocols were given so HPs have no official documents to refer to in order to properly treat the patients and this has led to a significant increase in cases evolving into criminal and civil proceedings for medical malpractice. A proper defensive strategy is essential both for the HP and the Hospital/Clinic to avid final conviction and, in case of evident malpractice, make recurs to the help of a mediator is highly recommendable rather than taking legal action or trying to win a trial.
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In forensic pathology, apparently straightforward cases can often hide rarities that, if not correctly interpreted, can alter the results of the entire investigation, leading to misinterpretations. This occurs when the investigation is conducted to assess medical malpractice. An unexpected death, with no known apparent cause, is often linked to an underlying disease process of unclear etiological origin whose nature can, unfortunately, be properly investigated only post-mortem. This presentation shows a case study, in which it was possible to reconduct the death of a patient to a natural pathology and not to medical treatment. Here, the authors illustrate a case with a hamartoma developed in chronic inflammatory conditions (bronchiectasis) that was difficult to differentiate from lung cancer due to the inability to perform specific instrumental examinations. The hamartoma, usually benign and identifiable by standard instrumental investigations, in this case, led to the patient's death precisely during the execution of a bronchoscopy. However, in the absence of a certain cause of death, public opinion unanimously attributes a patient's disease to medical error. Indeed, a routine practice such as bronchoscopy should not cause death and consequently, the doctor must have made a mistake. Fortunately, the autopsy not only demonstrated the origin of the bleeding but also unveiled the reason for this, as rare congenital lung disease. Fate, one might say.