BACKGROUND Patient-clinician communication is thought to be central to care outcomes, but when and how communication affects patient outcomes is not well understood. OBJECTIVE We propose a conceptual model and classification framework upon which the empirical evidence base for the impact of patient-clinician communication can be summarized and further built. DESIGN We use the proposed model...

Background: Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. Method: We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998–99 policies of 38 organisations—18 medical associations (associations), nine physician group practices (groups...

BACKGROUND Variability in processes of care and outcomes has been reported widely in high-income settings (at geographic, hospital, physician group and individual physician levels); however, such variability and the factors driving it are rarely examined in low-income settings. METHODS Using data from a cross-sectional survey undertaken in 22 hospitals (60 case records from each hospital) acr...

BACKGROUND Serum immunoglobulin A antibodies against Epstein-Barr virus (EBV), viral capsid antigen (VCA-IgA) and early antigen (EA-IgA), are used to screen for nasopharyngeal carcinoma (NPC) in endemic areas. However, their routine use has been questioned because of a lack of specificity. This study aimed to determine the distributions of different subtypes of antibody and to illustrate how th...

BACKGROUND Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. METHOD We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998-99 policies of 38 organisations-18 medical associations (associations), nine physician group practices (groups...

Evaluating clinician satisfaction with an electronic medical record (EMR) system is an important dimension to overall acceptance and use, yet project managers often lack the time and resources to formally assess user satisfaction and solicit feedback. This article describes the methods used to assess clinician satisfaction with an EMR and identify opportunities for improving its use at a 300-ph...

CMS is investigating techniques that might help identify costly physician practice patterns. One method presently under evaluation is to compare resource use for certain episodes of care using commercially available episode grouping software. Although this software has been used by the private sector to classify insured individuals' medical claims into episodes of care, it has never been used w...

STUDY OBJECTIVE Hydronephrosis is readily visible on ultrasonography and is a strong predictor of ureteral stones, but ultrasonography is a user-dependent technology and the test characteristics of clinician-performed ultrasonography for hydronephrosis are incompletely characterized, as is the effect of ultrasound fellowship training on predictive accuracy. We seek to determine the test charact...

Shared decision-making (SDM) promotes family and clinician collaboration, with ultimate goals of improved health and satisfaction. This clinical report provides a basis for a systematic approach to the implementation of SDM by clinicians for children with disabilities. Often in the discussion of treatment plans, there are gaps between the child's/family's values, priorities, and understanding o...

As clinicians, physician leaders place great value on preserving their professional identity and autonomy (sec Box, p. 28, bottom). What they determine to be the best interests of the patient drives their decision making. Physician leaders, as administrators, on the other hand, serve as participative agents of the organization through active planning and the delegation of tasks. These two proto...