Civil rights, press freedom and party's mistakes among subjects banned from teaching in order described by an academic as back-pedaling
By Raymond Li
South China Morning Post
Originally published May 11, 2013
Mainland universities have been ordered to steer clear of seven topics in their teaching, including universal values, press freedom and civil rights, two university staff said, offering an insight into ideological control under the new Communist Party leaders.
A law professor with a Shanghai-based university who requested anonymity because he feared persecution said yesterday that teaching staff at his university had been briefed about the seven taboo subjects, which also include judicial independence and the past mistakes of the Communist Party.
"Are we still a university if we are not allowed to talk about even civil rights and press freedom?" he asked.
He said he had no idea which party department had given the order, saying they were simply told that it came from the party's Central Committee.
A Beijing-based industrial relations professor said yesterday the order, in the form of a classified document, had come from the General Office of the party's Central Committee, and only a select group of teaching and administrative staff at his university had been briefed about it.
The Beijing professor, who also declined to be named, said he had not personally seen the document but had been briefed on it because he had been outspoken.
"It's apparent back-pedaling if we cannot talk about what the Communist Party did wrong in the past," he said.
The entire story is here.
Monday, May 27, 2013
Sunday, May 26, 2013
Medical ethics language doesn’t stick with students
A study finds a gap between learning ethical terms and using them in a clinical setting, which can lead to a lack of shared understanding.
By MARCIA FRELLICK
amednews correspondent — Posted May 15, 2013
Do medical school students remember ethical principles when they start practicing medicine?
Because physicians need shared language and universal terms when they discuss ethical issues with each other and with patients, researchers at the University of Iowa Carver College of Medicine examined how well terms and concepts taught in school were recalled and incorporated in the clinical years. The study asked 109 third-year medical students at the University of Iowa to recall ethics terms learned in the first two years of school.
Results were mixed, according to the study posted online April 14 in AJOB Primary Research. The students were much more likely to name the four ethical principles (beneficence, nonmaleficence, respect for patient autonomy and justice) than the six sources of ethical value or categories for justifying an ethical decision (ethical principles, rights, consequences, comparable cases, professional guidelines and conscientious practice).
Overall, 59.6% of the students remembered all four principles, but the highest number of sources of ethical value recalled was four of the six. Only 10% of students could name three or four of the six sources.
The entire article is here.
Here is the original research abstract.
Background:
Ethics education is an established part of the medical school curriculum and typically involves preclinical instruction that includes formal ethical terminology. However, it is not clear whether the language of ethics taught in preclinical settings is applied by students during the clinical years of training.
Methods:
We used a survey and a content analysis of written reflections to determine whether third-year (clinical) medical students were able to recall and apply ethical principles and other sources of ethical value they were taught as second-year (preclinical) students.
Results:
The majority of clinical students were able to recall the four ethical principles, appreciated the relevance of preclinical ethics education, and had positive self-assessments of their clinical-ethical reasoning abilities. However, they were less able to recall other (nonprinciple) sources of ethical value and infrequently used ethical terms spontaneously in written reflections about ethically or professionally challenging issues.
Conclusions:
Ethics educators should consider the extent to which preclinical ethics education depends on a formal language of ethics and should develop ways to reinforce that language meaningfully through experience-based learning opportunities during the clinical years of training, with special emphasis on the way clear ethical reasoning and communication demonstrate respect for other persons.
By MARCIA FRELLICK
amednews correspondent — Posted May 15, 2013
Do medical school students remember ethical principles when they start practicing medicine?
Because physicians need shared language and universal terms when they discuss ethical issues with each other and with patients, researchers at the University of Iowa Carver College of Medicine examined how well terms and concepts taught in school were recalled and incorporated in the clinical years. The study asked 109 third-year medical students at the University of Iowa to recall ethics terms learned in the first two years of school.
Results were mixed, according to the study posted online April 14 in AJOB Primary Research. The students were much more likely to name the four ethical principles (beneficence, nonmaleficence, respect for patient autonomy and justice) than the six sources of ethical value or categories for justifying an ethical decision (ethical principles, rights, consequences, comparable cases, professional guidelines and conscientious practice).
Overall, 59.6% of the students remembered all four principles, but the highest number of sources of ethical value recalled was four of the six. Only 10% of students could name three or four of the six sources.
The entire article is here.
Here is the original research abstract.
Background:
Ethics education is an established part of the medical school curriculum and typically involves preclinical instruction that includes formal ethical terminology. However, it is not clear whether the language of ethics taught in preclinical settings is applied by students during the clinical years of training.
Methods:
We used a survey and a content analysis of written reflections to determine whether third-year (clinical) medical students were able to recall and apply ethical principles and other sources of ethical value they were taught as second-year (preclinical) students.
Results:
The majority of clinical students were able to recall the four ethical principles, appreciated the relevance of preclinical ethics education, and had positive self-assessments of their clinical-ethical reasoning abilities. However, they were less able to recall other (nonprinciple) sources of ethical value and infrequently used ethical terms spontaneously in written reflections about ethically or professionally challenging issues.
Conclusions:
Ethics educators should consider the extent to which preclinical ethics education depends on a formal language of ethics and should develop ways to reinforce that language meaningfully through experience-based learning opportunities during the clinical years of training, with special emphasis on the way clear ethical reasoning and communication demonstrate respect for other persons.
Owning Our Mistakes
By Nate Kreuter
Inside Higher Ed - Career Advice
Originally published May 15, 2013
Some of the columns that I write here at Inside Higher Ed arise from a really basic formula. It goes something like this: I make a mistake at work. I realize my error, or am compelled by another party to realize it, and I take corrective action. Then I write a column addressing the mistake in general terms, in hopes of perhaps removing a little of the trial and error from this whole higher education gig for a reader or two. Somewhat less frequently I simply observe the mistake of another and then write a column. I probably couldn’t keep up with this column without the steady stream of mistakes I make myself. Maybe my mistakes are job security of a strange sort.
I probably could even use this venue to make a public promise regarding my mistakes to my colleagues in my department, college, university, and across my discipline. Here goes: I promise you all that I’ll screw up again one day. I don’t know exactly how and I don’t know exactly when, but I promise to bungle something. Maybe just in a small way. Maybe in a big way. Who knows?
But here’s what I also promise: I promise to own up to whatever mistakes I make as soon as I recognize them, to do everything in my power to correct them, and to do my damnedest not to repeat them. This is, I think and I hope, what it means to be a good colleague. I certainly would not ask a colleague for more, but I also expect no less.
If to err is human, then 'fessing up is humane. Humane for ourselves and humane for our fellows.
The entire post is here.
Inside Higher Ed - Career Advice
Originally published May 15, 2013
Some of the columns that I write here at Inside Higher Ed arise from a really basic formula. It goes something like this: I make a mistake at work. I realize my error, or am compelled by another party to realize it, and I take corrective action. Then I write a column addressing the mistake in general terms, in hopes of perhaps removing a little of the trial and error from this whole higher education gig for a reader or two. Somewhat less frequently I simply observe the mistake of another and then write a column. I probably couldn’t keep up with this column without the steady stream of mistakes I make myself. Maybe my mistakes are job security of a strange sort.
I probably could even use this venue to make a public promise regarding my mistakes to my colleagues in my department, college, university, and across my discipline. Here goes: I promise you all that I’ll screw up again one day. I don’t know exactly how and I don’t know exactly when, but I promise to bungle something. Maybe just in a small way. Maybe in a big way. Who knows?
But here’s what I also promise: I promise to own up to whatever mistakes I make as soon as I recognize them, to do everything in my power to correct them, and to do my damnedest not to repeat them. This is, I think and I hope, what it means to be a good colleague. I certainly would not ask a colleague for more, but I also expect no less.
If to err is human, then 'fessing up is humane. Humane for ourselves and humane for our fellows.
The entire post is here.
Saturday, May 25, 2013
VETS Act Expands Veterans Access to Care, Protects Patient Safety
The American Telemedicine Association strongly supports the proposed Veterans E-Health and Telemedicine Support Act (H.R. 2001,) lauding it as a key step in improving healthcare quality by minimizing regulatory barriers for interstate telemedicine.
Press Release
The American Telemedicine Association
Originally published May 16, 2013
The American Telemedicine Association voices its strong support for the new Veterans E-Health and Telemedicine Support Act (H.R. 2001) as one key step in lowering regulatory barriers to 21st century healthcare. The bi-partisan bill, introduced by Representatives Charles Rangel (D-NY) and Glenn Thompson (R-PA) and cosponsored by 21 Members of Congress, would permit U.S. Department of Veterans Affairs health professionals to treat veterans nationwide with a single state license.
This bill, known as the VETS Act, builds on the unanimous congressional enactment of the 2011 STEP Act (Servicemembers' Telemedicine and E-Health Portability Act,) which provides a similar provision for healthcare providers in the U.S. Department of Defense. A similar licensing rule for patients and providers of Medicare, Medicaid and other major federal health programs was included in a comprehensive telemedicine bill submitted by Rep. Mike Thompson (D-CA) in December 2012.
“These bills are a simple way, while preserving the states’ role to license, to address shortages of medical specialists, to improve patient access to the best qualified physicians, and to accommodate mobile Americans and multi-state health plans,” said Jonathan Linkous, Chief Executive Officer of the American Telemedicine Association. “They accommodate both patient choice and patient safety. We would like to see a similar act for all federal patients and providers.”
Presently, most providers who practice interstate telemedicine must be licensed both where the patient and provider are physically located. Such regulation increases the cost of healthcare and is an artificial barrier, favoring the business interests of local physicians over patient choice. Some state medical boards are even imposing stricter licensing requirements for telehealth providers than they do for in-person care, such as requiring a prior face-to-face examination for each and every case.
“Access to quality healthcare is, ultimately, the foremost safety issue for the patient,” concluded Linkous. “It’s time that we allow patients to make an appointment and see a qualified licensed health provider regardless of where the patient or provider is located."
About the American Telemedicine Association
The American Telemedicine Association is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and its diverse membership, works to fully integrate telemedicine into transformed healthcare systems to improve quality, equity and affordability of healthcare throughout the world. Established in 1993, ATA is headquartered in Washington, DC.
For more information visit http://www.americantelemed.org.
Press Release
The American Telemedicine Association
Originally published May 16, 2013
The American Telemedicine Association voices its strong support for the new Veterans E-Health and Telemedicine Support Act (H.R. 2001) as one key step in lowering regulatory barriers to 21st century healthcare. The bi-partisan bill, introduced by Representatives Charles Rangel (D-NY) and Glenn Thompson (R-PA) and cosponsored by 21 Members of Congress, would permit U.S. Department of Veterans Affairs health professionals to treat veterans nationwide with a single state license.
This bill, known as the VETS Act, builds on the unanimous congressional enactment of the 2011 STEP Act (Servicemembers' Telemedicine and E-Health Portability Act,) which provides a similar provision for healthcare providers in the U.S. Department of Defense. A similar licensing rule for patients and providers of Medicare, Medicaid and other major federal health programs was included in a comprehensive telemedicine bill submitted by Rep. Mike Thompson (D-CA) in December 2012.
“These bills are a simple way, while preserving the states’ role to license, to address shortages of medical specialists, to improve patient access to the best qualified physicians, and to accommodate mobile Americans and multi-state health plans,” said Jonathan Linkous, Chief Executive Officer of the American Telemedicine Association. “They accommodate both patient choice and patient safety. We would like to see a similar act for all federal patients and providers.”
Presently, most providers who practice interstate telemedicine must be licensed both where the patient and provider are physically located. Such regulation increases the cost of healthcare and is an artificial barrier, favoring the business interests of local physicians over patient choice. Some state medical boards are even imposing stricter licensing requirements for telehealth providers than they do for in-person care, such as requiring a prior face-to-face examination for each and every case.
“Access to quality healthcare is, ultimately, the foremost safety issue for the patient,” concluded Linkous. “It’s time that we allow patients to make an appointment and see a qualified licensed health provider regardless of where the patient or provider is located."
About the American Telemedicine Association
The American Telemedicine Association is the leading international resource and advocate promoting the use of advanced remote medical technologies. ATA and its diverse membership, works to fully integrate telemedicine into transformed healthcare systems to improve quality, equity and affordability of healthcare throughout the world. Established in 1993, ATA is headquartered in Washington, DC.
For more information visit http://www.americantelemed.org.
Vermont Legalizes Assisted Suicide
By Wilson Ring
The Associated Press
Originally published May 20, 2013
After years of debate, Vermont became the fourth state in the country Monday to allow doctors to prescribe lethal doses of medicine to terminally ill patients seeking to end their lives.
Gov. Peter Shumlin signed the bill into law at a Statehouse ceremony even as opponents vowed to push for its repeal.
The End of Life Choices law was effective immediately, although it could be weeks before the state Health Department develops regulations in accordance with the new measure.
Vermont Health Commissioner Dr. Harry Chen said he expects doctors to write between 10 and 20 lethal prescriptions a year, with a smaller number of patients actually using the drugs.
He based his figures on the experience in Oregon, the first state to legalize assisted suicide in 1997. Washington state and Montana followed later, with Montana's coming by way of a court order.
The entire story is here.
The Associated Press
Originally published May 20, 2013
After years of debate, Vermont became the fourth state in the country Monday to allow doctors to prescribe lethal doses of medicine to terminally ill patients seeking to end their lives.
Gov. Peter Shumlin signed the bill into law at a Statehouse ceremony even as opponents vowed to push for its repeal.
The End of Life Choices law was effective immediately, although it could be weeks before the state Health Department develops regulations in accordance with the new measure.
Vermont Health Commissioner Dr. Harry Chen said he expects doctors to write between 10 and 20 lethal prescriptions a year, with a smaller number of patients actually using the drugs.
He based his figures on the experience in Oregon, the first state to legalize assisted suicide in 1997. Washington state and Montana followed later, with Montana's coming by way of a court order.
The entire story is here.
Friday, May 24, 2013
Doctors’ Lucrative Industry Ties
By Roni Caryn Rabin
The New York Times - The Consumer Blog
Originally published May 13, 2013
Dr. Alfred J. Tria is the chief of orthopedic surgery at St. Peter’s University Hospital, a 478-bed facility in New Brunswick, N.J., and to the medical technology company Smith & Nephew, his good word is worth a million bucks. Well, $940,857, to be precise.
That’s how much the company paid Dr. Tria in fees for promoting its products and training doctors in Asia to use them from 2009 to 2011, according to disclosures required by the state of Massachusetts, where Dr. Tria is licensed. In 2010, Dr. Tria earned $421,905 from private industry — more than any other Massachusetts-licensed physician that year.
Dr. Tria may be an outlier, but gifts and payments to physicians from drug and medical device companies have been rampant in medicine for decades. Over a two-and-a-half-year period, device and drug companies shelled out over $76 million just to physicians licensed in Massachusetts, according to a study published online this month in The New England Journal of Medicine. That amount does not include outlays of less than $50, which are exempt from disclosure.
The entire story is here.
The New York Times - The Consumer Blog
Originally published May 13, 2013
Dr. Alfred J. Tria is the chief of orthopedic surgery at St. Peter’s University Hospital, a 478-bed facility in New Brunswick, N.J., and to the medical technology company Smith & Nephew, his good word is worth a million bucks. Well, $940,857, to be precise.
That’s how much the company paid Dr. Tria in fees for promoting its products and training doctors in Asia to use them from 2009 to 2011, according to disclosures required by the state of Massachusetts, where Dr. Tria is licensed. In 2010, Dr. Tria earned $421,905 from private industry — more than any other Massachusetts-licensed physician that year.
Dr. Tria may be an outlier, but gifts and payments to physicians from drug and medical device companies have been rampant in medicine for decades. Over a two-and-a-half-year period, device and drug companies shelled out over $76 million just to physicians licensed in Massachusetts, according to a study published online this month in The New England Journal of Medicine. That amount does not include outlays of less than $50, which are exempt from disclosure.
The entire story is here.
Why Groupon and other social coupons are unethical in healthcare
By Deniza Gertzberg
www.kevinmd.com
Originally published on May 16, 2013
In addition to the possible legal pitfalls of advertising on Groupon-type websites, there are also ethical and practice management concerns to be weighed by healthcare practitioners before agreeing to such arrangements. Even with the recent announcement that companies such as Groupon and LivingSocial may be offering contracts to healthcare providers that take into consideration the prohibition against fee splitting, practitioners should nonetheless proceed with caution.
The concerns about social coupons in the healthcare context extend further than what is strictly legal as doctors also face the more basic question of whether such advertising practices are appropriate. It is not surprising that we find an increasing number of professional organizations speaking out about the ethical implications of providing social discounts to consumers. Several past presidents of the British Association of Aesthetic Plastic Surgeons, for example, in 2011 spoke out strongly against the practice of advertising discounts for plastic surgeries online.
Similarly, in the United States, we are seeing professional societies discussing the legality and ethical implications of such arrangements. The American Dental Association (ADA) last year, for example, issued an advisory opinion prohibiting the use of social coupons if such an arrangement would constitute fee splitting.
The entire blog post is here.
Thanks to Ed Zuckerman for this lead.
www.kevinmd.com
Originally published on May 16, 2013
In addition to the possible legal pitfalls of advertising on Groupon-type websites, there are also ethical and practice management concerns to be weighed by healthcare practitioners before agreeing to such arrangements. Even with the recent announcement that companies such as Groupon and LivingSocial may be offering contracts to healthcare providers that take into consideration the prohibition against fee splitting, practitioners should nonetheless proceed with caution.
The concerns about social coupons in the healthcare context extend further than what is strictly legal as doctors also face the more basic question of whether such advertising practices are appropriate. It is not surprising that we find an increasing number of professional organizations speaking out about the ethical implications of providing social discounts to consumers. Several past presidents of the British Association of Aesthetic Plastic Surgeons, for example, in 2011 spoke out strongly against the practice of advertising discounts for plastic surgeries online.
Similarly, in the United States, we are seeing professional societies discussing the legality and ethical implications of such arrangements. The American Dental Association (ADA) last year, for example, issued an advisory opinion prohibiting the use of social coupons if such an arrangement would constitute fee splitting.
The entire blog post is here.
Thanks to Ed Zuckerman for this lead.
Thursday, May 23, 2013
New Mental-Health Manual Likely to Impact HR
Making accommodations for employees with mental disabilities has never been easy, and it's about to get more difficult with the release of the American Psychiatric Association's new manual of mental disorders.
By James J. McDonald, Jr.
Human Resource Executive Online
Originally published May 22, 2013
By James J. McDonald, Jr.
Human Resource Executive Online
Originally published May 22, 2013
In psychiatry, unlike other branches of medicine, there is no laboratory test that can confirm the existence of a particular mental disorder. Psychiatrists and other mental health professionals rely on the Diagnostic and Statistical Manual of Mental Disorders, known as "DSM-5" to diagnose patients. The American Psychiatric Association has just released a new fifth edition of the manual and human resources executives should take note. It contains new diagnostic categories not listed in its predecessor and loosens the criteria for some diagnoses which will likely result in more people qualifying for these diagnoses. DSM-5 is likely to impact HR by expanding the number of employees who will qualify as disabled under the Americans with Disabilities Act and be entitled to reasonable accommodation.
(cut)
New Diagnoses
DSM-5 adds several new diagnoses that employers are likely to find vexing. One is "Social (Pragmatic) Communication Disorder," which describes persons whose communication skills are impaired but who do not qualify for an autism diagnosis. It applies to persons with "persistent difficulties in the social use of verbal and nonverbal communications" that limit social relationships or occupational performance. While typically diagnosed in childhood it can continue into adulthood. Employees previously thought to be merely shy or socially awkward may qualify for this new diagnosis.
Another new diagnosis is "Binge Eating Disorder," a condition characterized primarily by eating a large amount of food in a short time at least once per week for three months. DSM-5 notes that while most overweight persons do not engage in recurrent binge-eating, Binge Eating Disorder is "reliably associated with overweight and obesity." Thus, this diagnosis makes it more likely that obesity (at least when precipitated by binge-eating) might finally qualify as a disability under the ADA.
Largest US Hospice Company Sued for Medicare Fraud
By Kelli Kennedy
The Associated Press/ABC News
Originally posted May 9, 2013
The Department of Justice is suing the hospice company founded by Florida's Senate president, accusing it of submitting tens of millions of dollars in fraudulent Medicare claims for more than a decade, including while Don Gaetz was vice chairman of the board.
Vitas Hospice and Vitas Healthcare submitted claims for emergency services for patients that weren't needed, weren't provided, or were provided to patients who weren't eligible under Medicare requirements, according to the DOJ. The companies set goals for the number of crisis-care days to be billed and pressured their employees to submit more claims so it would get more revenue, the lawsuit said. The agency said Medicare payments for crisis care can be hundreds of dollars greater than typical hospice care payments.
Vitas is the largest U.S. hospice care chain, and its parent company Chemed Corp. said the claims go back to 2002, two years before it acquired the company.
The entire article is here.
The Associated Press/ABC News
Originally posted May 9, 2013
The Department of Justice is suing the hospice company founded by Florida's Senate president, accusing it of submitting tens of millions of dollars in fraudulent Medicare claims for more than a decade, including while Don Gaetz was vice chairman of the board.
Vitas Hospice and Vitas Healthcare submitted claims for emergency services for patients that weren't needed, weren't provided, or were provided to patients who weren't eligible under Medicare requirements, according to the DOJ. The companies set goals for the number of crisis-care days to be billed and pressured their employees to submit more claims so it would get more revenue, the lawsuit said. The agency said Medicare payments for crisis care can be hundreds of dollars greater than typical hospice care payments.
Vitas is the largest U.S. hospice care chain, and its parent company Chemed Corp. said the claims go back to 2002, two years before it acquired the company.
The entire article is here.
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