BACKGROUND Many physicians believe that advanced practice clinicians (APCs [nurse practitioners and physician assistants]) provide care of relatively lower value. OBJECTIVE To compare use of low-value services among U.S. APCs and physicians. DESIGN Service use after primary care visits was evaluated for 3 conditions after adjustment for patient and provider characteristics and year. Patient...

Many physicians and health care leaders express concern about the amount of time available for clinical practice. While debates rage on about how much time is truly available, the perception that time is inadequate is now pervasive. This perception has ethical significance, because it may cause clinicians to forego activities and behaviors that promote important aspects of the patient-physician...

OBJECTIVE: To support collaboration and clinician-targeted decision support, electronic health records (EHRs) must contain accurate information about patients' care providers. The objective of this study was to evaluate two approaches for care provider identification employed within a commercial EHR at a large academic medical center. METHODS: We performed a retrospective review of EHR data fo...

 Background and Objectives: Hospital bed utilization is influenced by various factors, which may be categorized into patient-related, physician-related, and administration-related issues. It could be argued that the causes of inappropriate hospital bed utilization would be perceived differently by the clinicians and the patients. Given the unique role of clinical practitioners in quality of car...

OBJECTIVE Psychosocial problems cause much of the morbidity among children, and their frequency of presentation in primary care is growing. How is primary care treatment of children's psychosocial problems affected by child symptoms, physician training, practice structure, insurance, physician/patient relationship, and family demographics? DESIGN Questionnaire study of treatment of psychosoci...

BACKGROUND Metoclopramide use is associated with serious and potentially irreversible neurologic side effects. However, it is often used for questionable or unclear indications in clinical practice. OBJECTIVES To (1) determine whether an intervention targeted at the prescribing physician would increase the rate of metoclopramide discontinuation among patients prescribed the medication for que...

Photo by National Cancer Institute on Unsplash
 “An expert is someone who knows some of the worst mistakes that can be made in his subject, and how to avoid them.”
 ― Werner Heisenberg
 INTRODUCTION
 Bioethicists have long debated question expertise clinical ethics gets a say bedside consults.[1] From Seattle’s famous God Committee decided allocation kidneys, ethicists at su...

In recent years, there has been an increase in the number of nonphysician pediatric clinicians and an expansion in their respective scopes of practice. This raises critical public policy and child health advocacy concerns. The American Academy of Pediatrics (AAP) believes that optimal pediatric health care depends on a team-based approach with coordination by a physician leader, preferably a pe...

background and objectives: hospital bed utilization is influenced by various factors, which may be categorized into patient-related, physician-related, and administration-related issues. it could be argued that the causes of inappropriate hospital bed utilization would be perceived differently by the clinicians and the patients. given the unique role of clinical practitioners in quality of care...