The Opinion Pages
The New York Times
Originally published Ocotber 17, 2012
The Florida Supreme Court decided on Wednesday that the state can proceed with the execution next week of a 64-year-old inmate named John Ferguson. His lawyers immediately said that they will ask the United States Supreme Court to stay the execution and to review the case on grounds that Mr. Ferguson is mentally incompetent and that executing him would violate his constitutional rights as defined by the court in two earlier decisions.
The court must review the case. At issue are not only Mr. Ferguson’s life but also two differing interpretations of what constitutes competence: one Florida’s, the other the Supreme Court’s.
The entire story is here.
Wednesday, October 24, 2012
Tuesday, October 23, 2012
American Therapeutics' program director Abreu gets 108 months
by Kevin Gale
South Florida Business Journal
Originally published October 15, 2012
Vanja Abreu, former program director at the mental health care company American Therapeutic Corporation (ATC), was sentenced Thursday to 108 months in prison for participating in the $205 million Medicare fraud scheme, a press release from the U.S. Attorney's office said.
Abreu, 49, of Pembroke Pines, worked at ATC centers in Boca Raton and Miami. In addition to her prison term, U.S. District Judge Patricia A. Seitz sentenced Abreu to three years of supervised release following her prison term and ordered her to pay $72.7 million in restitution, jointly and severally with co-defendants.
On June 1, after a seven-week trial, a federal jury in the Southern District of Florida found Abreu, who holds a doctorate degree, guilty of one count of conspiracy to commit health care fraud.
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Evidence at trial revealed that program directors, including Abreu, helped doctors at ATC sign patient files without reading the files or seeing the patients. Evidence further revealed that Abreu and others would assist the owners of ATC in fabricating doctor notes, therapist notes and other documents to make it falsely appear in ATC’s patient files that patients were qualified for this highly specialized treatment and that the patients were receiving the intensive, individualized treatment PHP is supposed to be.
The entire story is here.
South Florida Business Journal
Originally published October 15, 2012
Vanja Abreu, former program director at the mental health care company American Therapeutic Corporation (ATC), was sentenced Thursday to 108 months in prison for participating in the $205 million Medicare fraud scheme, a press release from the U.S. Attorney's office said.
Abreu, 49, of Pembroke Pines, worked at ATC centers in Boca Raton and Miami. In addition to her prison term, U.S. District Judge Patricia A. Seitz sentenced Abreu to three years of supervised release following her prison term and ordered her to pay $72.7 million in restitution, jointly and severally with co-defendants.
On June 1, after a seven-week trial, a federal jury in the Southern District of Florida found Abreu, who holds a doctorate degree, guilty of one count of conspiracy to commit health care fraud.
(cut)
Evidence at trial revealed that program directors, including Abreu, helped doctors at ATC sign patient files without reading the files or seeing the patients. Evidence further revealed that Abreu and others would assist the owners of ATC in fabricating doctor notes, therapist notes and other documents to make it falsely appear in ATC’s patient files that patients were qualified for this highly specialized treatment and that the patients were receiving the intensive, individualized treatment PHP is supposed to be.
The entire story is here.
Monday, October 22, 2012
Self-Reflection in Ethical Choice Making
Balancing Values Through the Looking Glass
By Allison Bashe
The Ethical Professor Blog
Originally published October 21, 2012
Self-reflection may be the most critical ingredient to making good ethical choices. As professors, we need to highlight the importance of self-reflection in our undergraduate and graduate ethics courses. We can do this through assignments that encourage self-reflection and emphasize to students the importance of self-reflection throughout their professional careers. More importantly, we can highlight the importance of self-reflection by engaging in it on a regular basis and modeling this practice to our students.
At the 17th Annual Ethics Educators Conference in Harrisburg, PA, professionals reflected on their core values and then discussed how these values might be compatible with or might conflict with the profession of psychology. Although generally the professionals in the room could appreciate the value of self-reflection, one person acknowledged that he initially felt oppositional toward an exercise that required him to consider how his values might conflict with our profession. He commented that if our values conflict with our profession, it might indicate that we have not worked hard enough yet. And that’s exactly the point: Self-reflection helps us sharpen our focus to make better decisions.
The entire blog post is here.
The video can be found here.
By Allison Bashe
The Ethical Professor Blog
Originally published October 21, 2012
Self-reflection may be the most critical ingredient to making good ethical choices. As professors, we need to highlight the importance of self-reflection in our undergraduate and graduate ethics courses. We can do this through assignments that encourage self-reflection and emphasize to students the importance of self-reflection throughout their professional careers. More importantly, we can highlight the importance of self-reflection by engaging in it on a regular basis and modeling this practice to our students.
At the 17th Annual Ethics Educators Conference in Harrisburg, PA, professionals reflected on their core values and then discussed how these values might be compatible with or might conflict with the profession of psychology. Although generally the professionals in the room could appreciate the value of self-reflection, one person acknowledged that he initially felt oppositional toward an exercise that required him to consider how his values might conflict with our profession. He commented that if our values conflict with our profession, it might indicate that we have not worked hard enough yet. And that’s exactly the point: Self-reflection helps us sharpen our focus to make better decisions.
The entire blog post is here.
The video can be found here.
Pa. Supreme Court rules general practitioners not held to sex prohibitions
Prohibitions stands for mental health care providers
By Zack Needles
The Legal Intelligencer
Originally published October 15, 2012
In a case of first impression, the state Supreme Court has ruled that general practitioner doctors are not barred from having consensual sex with a patient, even if they are also providing "incidental mental health treatment" to the patient.
In so doing, the court has refused to extend the prohibition that prevents mental health physicians from having consensual sex with their patients -- and makes those who do susceptible to medical malpractice suit -- to general practitioners and family doctors.
In Thierfelder v. Wolfert, the high court ruled 5-1 -- suspended Justice Joan Orie Melvin did not participate in the decision -- to reverse a divided May 2009 Superior Court ruling that both general practitioners and psychiatrists "need to maintain the same trust when rendering psychological care."
Chief Justice Ronald D. Castille, writing for the majority, said that even what might constitute an ethical violation does not necessarily amount to a legal violation.
"The question is not whether this court condones appellant's actions, nor even whether his actions amounted to a violation of medical ethics," Justice Castille said. "We hold here only that, as a general practitioner, appellant was under no specific or 'heightened' duty in tort to refrain from sexual relations with his patient under these circumstances."
Sunday, October 21, 2012
Guilt Proneness and Moral Character
By Taya R. Cohen, A. T. Panter and Nazli Turan
Current Directions in Psychological Science
October 2012 21: 355-359
Abstract
Guilt proneness is a personality trait indicative of a predisposition to experience negative feelings about personal wrongdoing, even when the wrongdoing is private. It is characterized by the anticipation of feeling bad about committing transgressions rather than by guilty feelings in a particular moment or generalized guilty feelings that occur without an eliciting event. Our research has revealed that guilt proneness is an important character trait because knowing a person’s level of guilt proneness helps us to predict the likelihood that person will behave unethically. Web-based studies of adults across the United States have shown that people who score high on measures of guilt proneness (compared to low scorers) make fewer unethical business decisions, commit fewer delinquent behaviors, and behave more honestly when making economic decisions. In the workplace, guilt-prone employees are less likely to engage in counterproductive behaviors that harm their organization.
The entire article is here.
A review of the research article is here.
Saturday, October 20, 2012
Sports in the Board Room
By Allie Grasgreen
Inside Higher Ed
Originally published October 10, 2012
The very morning that the man whose actions brought down top administrators at Pennsylvania State University was being condemned to at least 30 years in prison for child abuse, critics of big-time collegiate athletics gathered here were discussing the role -- or lack thereof -- of university governing boards in sports programs.
In documenting the many failings revealed by the abuse scandal at Penn State, the report by Louis J. Freeh documented the faults of the university's former president, Graham Spanier -- among them, neglecting to adequately alert the 32-member Board of Trustees about red flags regarding former assistant football coach Jerry Sandusky.
But equally or even more so at fault, the report said, was the board itself, whose trustees failed to ask questions of Spanier or themselves, such as whether they should conduct an internal investigation. They lacked the necessary structures even to make sure they got the information they needed to properly assess and address potential risks, the report said.
And so officials from the Association of Governing Boards of Universities and Colleges recognized the “crisis” at Penn State and role the board played in it, as they presented the findings of a new survey and report on board responsibilities for intercollegiate athletics here Wednesday at a meeting of the Knight Commission on Intercollegiate Athletics.
The entire story is here.
Inside Higher Ed
Originally published October 10, 2012
The very morning that the man whose actions brought down top administrators at Pennsylvania State University was being condemned to at least 30 years in prison for child abuse, critics of big-time collegiate athletics gathered here were discussing the role -- or lack thereof -- of university governing boards in sports programs.
In documenting the many failings revealed by the abuse scandal at Penn State, the report by Louis J. Freeh documented the faults of the university's former president, Graham Spanier -- among them, neglecting to adequately alert the 32-member Board of Trustees about red flags regarding former assistant football coach Jerry Sandusky.
But equally or even more so at fault, the report said, was the board itself, whose trustees failed to ask questions of Spanier or themselves, such as whether they should conduct an internal investigation. They lacked the necessary structures even to make sure they got the information they needed to properly assess and address potential risks, the report said.
And so officials from the Association of Governing Boards of Universities and Colleges recognized the “crisis” at Penn State and role the board played in it, as they presented the findings of a new survey and report on board responsibilities for intercollegiate athletics here Wednesday at a meeting of the Knight Commission on Intercollegiate Athletics.
The entire story is here.
Friday, October 19, 2012
To Encrypt Email or Not to Encrypt Email? Practical Answers to a Question That Is Surprisingly Complex
by Elizabeth H. Johnson
Poyner Spruill LLP
Originally posted on October 5, 2012
Health care providers frequently ask us whether they have to encrypt emails, particularly those sent to patients who have asked for an emailed copy of their health records. Since patients have a right to receive electronic copies of their health records, emailing them a copy when they ask for it seems like the right thing to do.
Unfortunately, the decision actually is more complicated. HIPAA requires that all electronic transmissions of protected health information (PHI) be encrypted. That means ALL of them … fax, email, web-based and otherwise. The requirement applies regardless of the identity of the recipient or patient, and the recipient cannot “undo” or waive the requirement by consenting to the receipt of unencrypted emails.
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One more time in English? Health care providers are allowed to send PHI in unencrypted emails but only after they engage in the analysis described above and document their determination. It is a violation of the HIPAA Security Rule to send unencrypted emails containing PHI without first having performed and documented that analysis. A single violation can carry a penalty as high as $50,000, a useful figure to contemplate if you think encryption is too expensive to implement. Encryption also carries the benefit of qualifying for a “safe harbor” under HIPAA’s breach notification requirements. A security incident that would otherwise require notification is not considered a breach if the PHI affected were encrypted and the encryption key has not been compromised.
The entire article is here.
Thanks to Marlene Maheu for this article via LinkedIn.
Poyner Spruill LLP
Originally posted on October 5, 2012
Health care providers frequently ask us whether they have to encrypt emails, particularly those sent to patients who have asked for an emailed copy of their health records. Since patients have a right to receive electronic copies of their health records, emailing them a copy when they ask for it seems like the right thing to do.
Unfortunately, the decision actually is more complicated. HIPAA requires that all electronic transmissions of protected health information (PHI) be encrypted. That means ALL of them … fax, email, web-based and otherwise. The requirement applies regardless of the identity of the recipient or patient, and the recipient cannot “undo” or waive the requirement by consenting to the receipt of unencrypted emails.
(cut)
One more time in English? Health care providers are allowed to send PHI in unencrypted emails but only after they engage in the analysis described above and document their determination. It is a violation of the HIPAA Security Rule to send unencrypted emails containing PHI without first having performed and documented that analysis. A single violation can carry a penalty as high as $50,000, a useful figure to contemplate if you think encryption is too expensive to implement. Encryption also carries the benefit of qualifying for a “safe harbor” under HIPAA’s breach notification requirements. A security incident that would otherwise require notification is not considered a breach if the PHI affected were encrypted and the encryption key has not been compromised.
The entire article is here.
Thanks to Marlene Maheu for this article via LinkedIn.
Thursday, October 18, 2012
Phone Therapy Is Effective, Increases Access And Potentially Decreases Costs
Medical News Today
Originally published October 2, 2012
A new study reveals that cognitive therapy over the phone is just as effective as meeting face-to-face. The research was published in the journal PLoS ONE.
Researchers at the University of Cambridge together with the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care (NIHR CLAHRC) and NHS Midlands & East also found that providing talking therapy over the phone increases access to psychological therapies for people with common mental disorders and potentially saves the NHS money.
For the study, data from 39,000 patients in seven established Improving Access to Psychological Therapies (IAPT) services (an initiative which aims to expand the availability of psychological therapies) in the East of England were used to compare Cognitive Behavioural Therapy (CBT) delivered face-to-face versus over the phone. For all but an infrequent, identifiable clinical group with more severe illness, therapy over the phone was as effective as face to face, and the cost per session was 36.2% lower.
Originally published October 2, 2012
A new study reveals that cognitive therapy over the phone is just as effective as meeting face-to-face. The research was published in the journal PLoS ONE.
Researchers at the University of Cambridge together with the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care (NIHR CLAHRC) and NHS Midlands & East also found that providing talking therapy over the phone increases access to psychological therapies for people with common mental disorders and potentially saves the NHS money.
For the study, data from 39,000 patients in seven established Improving Access to Psychological Therapies (IAPT) services (an initiative which aims to expand the availability of psychological therapies) in the East of England were used to compare Cognitive Behavioural Therapy (CBT) delivered face-to-face versus over the phone. For all but an infrequent, identifiable clinical group with more severe illness, therapy over the phone was as effective as face to face, and the cost per session was 36.2% lower.
Wednesday, October 17, 2012
Attention Disorder or Not, Pills to Help in School
By ALAN SCHWARZ
The New York Times
Originally published October 9, 2012
Here is an excerpt:
Dr. Anderson is one of the more outspoken proponents of an idea that is gaining interest among some physicians. They are prescribing stimulants to struggling students in schools starved of extra money — not to treat A.D.H.D., necessarily, but to boost their academic performance.
It is not yet clear whether Dr. Anderson is representative of a widening trend. But some experts note that as wealthy students abuse stimulants to raise already-good grades in colleges and high schools, the medications are being used on low-income elementary school children with faltering grades and parents eager to see them succeed.
“We as a society have been unwilling to invest in very effective nonpharmaceutical interventions for these children and their families,” said Dr. Ramesh Raghavan, a child mental-health services researcher at Washington University in St. Louis and an expert in prescription drug use among low-income children. “We are effectively forcing local community psychiatrists to use the only tool at their disposal, which is psychotropic medications.”
Dr. Nancy Rappaport, a child psychiatrist in Cambridge, Mass., who works primarily with lower-income children and their schools, added: “We are seeing this more and more. We are using a chemical straitjacket instead of doing things that are just as important to also do, sometimes more.”
Dr. Anderson’s instinct, he said, is that of a “social justice thinker” who is “evening the scales a little bit.” He said that the children he sees with academic problems are essentially “mismatched with their environment” — square pegs chafing the round holes of public education. Because their families can rarely afford behavior-based therapies like tutoring and family counseling, he said, medication becomes the most reliable and pragmatic way to redirect the student toward success.
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