By Holly Moore
CBC News
Originally posted January 29, 2016
Nearly 8,000 Canadians filed a complaint about a physician last year, but on average only about 54 doctors were formally disciplined in each of the past 15 years. Of those complaints, just over half were determined to require no further action.
Historical data examined by CBC News found cases of 817 physicians that resulted in formal discipline, which is the only part of the disciplinary process for colleges of physicians and surgeons that is consistently made public across Canada.
"That number's not anywhere near what's actually happening. Those are the ones you could get to," said Ann Van Regan, a volunteer responder with TELL (Therapy Exploitation Link Line), a network of survivors of sex abuse by physicians and psychotherapists. "They say they're taking it seriously, but their actions show that they are not."
The article is here.
Wednesday, February 17, 2016
Prevalence and Characteristics of Physicians Prone to Malpractice Claims
D. M. Studdert, M. M. Bismark, M. M. Mello, H. Singh, and M. J. Spittal
N Engl J Med 2016; 374:354-362
January 28, 2016
Background
The distribution of malpractice claims among physicians is not well understood. If claim-prone physicians account for a substantial share of all claims, the ability to reliably identify them at an early stage could guide efforts to improve care.
Methods
Using data from the National Practitioner Data Bank, we analyzed 66,426 claims paid against 54,099 physicians from 2005 through 2014. We calculated concentrations of claims among physicians. We used multivariable recurrent-event survival analysis to identify characteristics of physicians at high risk for recurrent claims and to quantify risk levels over time.
Results
Approximately 1% of all physicians accounted for 32% of paid claims. Among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims), 16% had at least two paid claims (accounting for 32% of the claims), and 4% had at least three paid claims (accounting for 12% of the claims). In adjusted analyses, the risk of recurrence increased with the number of previous paid claims. For example, as compared with physicians who had one previous paid claim, the 2160 physicians who had three paid claims had three times the risk of incurring another (hazard ratio, 3.11; 95% confidence interval [CI], 2.84 to 3.41); this corresponded in absolute terms to a 24% chance (95% CI, 22 to 26) of another paid claim within 2 years. Risks of recurrence also varied widely according to specialty — for example, the risk among neurosurgeons was four
times as great as the risk among psychiatrists.
Conclusions
Over a recent 10-year period, a small number of physicians with distinctive characteristics accounted for a disproportionately large number of paid malpractice claims.
The article is here.
N Engl J Med 2016; 374:354-362
January 28, 2016
Background
The distribution of malpractice claims among physicians is not well understood. If claim-prone physicians account for a substantial share of all claims, the ability to reliably identify them at an early stage could guide efforts to improve care.
Methods
Using data from the National Practitioner Data Bank, we analyzed 66,426 claims paid against 54,099 physicians from 2005 through 2014. We calculated concentrations of claims among physicians. We used multivariable recurrent-event survival analysis to identify characteristics of physicians at high risk for recurrent claims and to quantify risk levels over time.
Results
Approximately 1% of all physicians accounted for 32% of paid claims. Among physicians with paid claims, 84% incurred only one during the study period (accounting for 68% of all paid claims), 16% had at least two paid claims (accounting for 32% of the claims), and 4% had at least three paid claims (accounting for 12% of the claims). In adjusted analyses, the risk of recurrence increased with the number of previous paid claims. For example, as compared with physicians who had one previous paid claim, the 2160 physicians who had three paid claims had three times the risk of incurring another (hazard ratio, 3.11; 95% confidence interval [CI], 2.84 to 3.41); this corresponded in absolute terms to a 24% chance (95% CI, 22 to 26) of another paid claim within 2 years. Risks of recurrence also varied widely according to specialty — for example, the risk among neurosurgeons was four
times as great as the risk among psychiatrists.
Conclusions
Over a recent 10-year period, a small number of physicians with distinctive characteristics accounted for a disproportionately large number of paid malpractice claims.
The article is here.
Tuesday, February 16, 2016
Why You Should Stop Using the Phrase ‘the Mentally Ill’
By Tanya Basu
New York Magazine
Originally published February 2, 2016
Here is an excerpt:
What’s most surprising is the reaction that counselors have when the phrase “the mentally ill” is used: They’re more likely to believe that those suffering from mental illness should be controlled and isolated from the rest of the community. That's pretty surprising, given that these counselors are perhaps the ones most likely to be aware of the special needs and varying differences in diagnoses of the group.
Counselors also showed the largest differences in how intolerant they were based on the language, which boosted the researchers’ belief that simply changing language is important in not only understanding people who suffer from mental illness but also helping them adjust and cope. “Even counselors who work every day with people who have mental illness can be affected by language,” Granello said in a press release. “They need to be aware of how language might influence their decision-making when they work with clients.”
The entire article is here.
New York Magazine
Originally published February 2, 2016
Here is an excerpt:
What’s most surprising is the reaction that counselors have when the phrase “the mentally ill” is used: They’re more likely to believe that those suffering from mental illness should be controlled and isolated from the rest of the community. That's pretty surprising, given that these counselors are perhaps the ones most likely to be aware of the special needs and varying differences in diagnoses of the group.
Counselors also showed the largest differences in how intolerant they were based on the language, which boosted the researchers’ belief that simply changing language is important in not only understanding people who suffer from mental illness but also helping them adjust and cope. “Even counselors who work every day with people who have mental illness can be affected by language,” Granello said in a press release. “They need to be aware of how language might influence their decision-making when they work with clients.”
The entire article is here.
From Good Institutions to Good Norms: Top-Down Incentives to Cooperate Foster Prosociality But Not Norm Enforcement
Michael N Stagnaro, Antonio A. Arechar, & David G. Rand
Social Science Research Network
Abstract:
What makes people willing to pay costs to help others, and to punish others’ selfishness? And why does the extent of such behaviors vary markedly across cultures? To shed light on these questions, we explore the role of formal institutions in shaping individuals’ prosociality and punishment. In Study 1 (N=707), we found that the quality of the institutions that participants were exposed to in daily life was positively associated with giving in a Dictator Game, but had little relationship with punishment in a Third-Party Punishment Game. In Study 2 (N=516), we investigated causality by experimentally manipulating institutional quality using a centralized punishment institution applied to a repeated Public Goods Game. Consistent with Study 1’s correlational results, we found that high institutional quality led to significantly more prosociality in a subsequent Dictator Game, but did not have a significant overall effect on subsequent punishment. Thus we present convergent evidence that the quality of institutions one is exposed to “spills over” to affect subsequent prosociality, but not punishment. These findings support a theory of social heuristics, suggest boundary conditions on spillover effects of cooperation, and demonstrate the power of effective institutions for instilling habits of virtue and creating cultures of cooperation.
The article is here.
Social Science Research Network
Abstract:
What makes people willing to pay costs to help others, and to punish others’ selfishness? And why does the extent of such behaviors vary markedly across cultures? To shed light on these questions, we explore the role of formal institutions in shaping individuals’ prosociality and punishment. In Study 1 (N=707), we found that the quality of the institutions that participants were exposed to in daily life was positively associated with giving in a Dictator Game, but had little relationship with punishment in a Third-Party Punishment Game. In Study 2 (N=516), we investigated causality by experimentally manipulating institutional quality using a centralized punishment institution applied to a repeated Public Goods Game. Consistent with Study 1’s correlational results, we found that high institutional quality led to significantly more prosociality in a subsequent Dictator Game, but did not have a significant overall effect on subsequent punishment. Thus we present convergent evidence that the quality of institutions one is exposed to “spills over” to affect subsequent prosociality, but not punishment. These findings support a theory of social heuristics, suggest boundary conditions on spillover effects of cooperation, and demonstrate the power of effective institutions for instilling habits of virtue and creating cultures of cooperation.
The article is here.
Monday, February 15, 2016
If You’re Loyal to a Group, Does It Compromise Your Ethics?
By Francesca Gino
Harvard Business Review
Originally posted January 06, 2016
Here are two excerpts:
Most of us feel loyalty, whether to our clan, our comrades, an organization, or a cause. These loyalties are often important aspects of our social identity. Once a necessity for survival and propagation of the species, loyalty to one’s in-group is deeply rooted in human evolution.
But the incidents of wrongdoing that capture the headlines make it seem like loyalty is all too often a bad thing, corrupting many aspects of our personal and professional lives. My recent research, conducted in collaboration with Angus Hildreth of the University of California, Berkeley and Max Bazerman of Harvard Business School, suggests that this concern about loyalty is largely misplaced. In fact, we found loyalty to a group can increase, rather than decrease, honest behavior.
(cut)
As our research shows, loyalty can be a driver of good behavior, but when competition among groups is high, it can lead us to behave unethically. When we are part of a group of loyal members, traits associated with loyalty — such as honor, honesty, and integrity — are very salient in our minds. But when loyalty seems to demand a different type of goal, such as competing with other groups and winning at any cost, behaving ethically becomes a less important goal.
The article is here.
Harvard Business Review
Originally posted January 06, 2016
Here are two excerpts:
Most of us feel loyalty, whether to our clan, our comrades, an organization, or a cause. These loyalties are often important aspects of our social identity. Once a necessity for survival and propagation of the species, loyalty to one’s in-group is deeply rooted in human evolution.
But the incidents of wrongdoing that capture the headlines make it seem like loyalty is all too often a bad thing, corrupting many aspects of our personal and professional lives. My recent research, conducted in collaboration with Angus Hildreth of the University of California, Berkeley and Max Bazerman of Harvard Business School, suggests that this concern about loyalty is largely misplaced. In fact, we found loyalty to a group can increase, rather than decrease, honest behavior.
(cut)
As our research shows, loyalty can be a driver of good behavior, but when competition among groups is high, it can lead us to behave unethically. When we are part of a group of loyal members, traits associated with loyalty — such as honor, honesty, and integrity — are very salient in our minds. But when loyalty seems to demand a different type of goal, such as competing with other groups and winning at any cost, behaving ethically becomes a less important goal.
The article is here.
When Deliberation Isn’t Smart
By Adam Bear and David Rand
Evonomics
Originally published January 25, 2016
Cooperation is essential for successful organizations. But cooperating often requires people to put others’ welfare ahead of their own. In this post, we discuss recent research on cooperation that applies the “Thinking, fast and slow” logic of intuition versus deliberation. We explain why people sometimes (but not always) cooperate in situations where it’s not in their self-interest to do so, and show how properly designed policies can build “habits of virtue” that create a culture of cooperation. TL;DR summary: intuition favors behaviors that are typically optimal, so institutions that make cooperation typically advantageous lead people to adopt cooperation as their intuitive default; this default then “spills over” into settings where it’s not actually individually advantageous to cooperate.
Life is full of opportunities to make personal sacrifices on behalf others, and we often rise to the occasion. We do favors for co-workers and friends, give money to charity, donate blood, and engage in a host of other cooperative endeavors. Sometimes, these nice deeds are reciprocated (like when we help out a friend, and she helps us with something in return). Other times, however, we pay a cost and get little in return (like when we give money to a homeless person whom we’ll never encounter again).
Although you might not realize it, nowhere is the importance of cooperation more apparent than in the workplace. If your boss is watching you, you’d probably be wise to be a team player and cooperate with your co-workers, since doing so will enhance your reputation and might even get you a promotion down the road. In other instances, though, you might get no recognition from, say, helping out a fellow employee who needs assistance meeting a deadline, or who calls out sick.
The article is here.
Evonomics
Originally published January 25, 2016
Cooperation is essential for successful organizations. But cooperating often requires people to put others’ welfare ahead of their own. In this post, we discuss recent research on cooperation that applies the “Thinking, fast and slow” logic of intuition versus deliberation. We explain why people sometimes (but not always) cooperate in situations where it’s not in their self-interest to do so, and show how properly designed policies can build “habits of virtue” that create a culture of cooperation. TL;DR summary: intuition favors behaviors that are typically optimal, so institutions that make cooperation typically advantageous lead people to adopt cooperation as their intuitive default; this default then “spills over” into settings where it’s not actually individually advantageous to cooperate.
Life is full of opportunities to make personal sacrifices on behalf others, and we often rise to the occasion. We do favors for co-workers and friends, give money to charity, donate blood, and engage in a host of other cooperative endeavors. Sometimes, these nice deeds are reciprocated (like when we help out a friend, and she helps us with something in return). Other times, however, we pay a cost and get little in return (like when we give money to a homeless person whom we’ll never encounter again).
Although you might not realize it, nowhere is the importance of cooperation more apparent than in the workplace. If your boss is watching you, you’d probably be wise to be a team player and cooperate with your co-workers, since doing so will enhance your reputation and might even get you a promotion down the road. In other instances, though, you might get no recognition from, say, helping out a fellow employee who needs assistance meeting a deadline, or who calls out sick.
The article is here.
Sunday, February 14, 2016
Why people fall for pseudoscience
By Sian Townson
The Guardian
Originally published January 26, 2016
Pseudoscience is everywhere – on the back of your shampoo bottle, on the ads that pop up in your Facebook feed, and most of all in the Daily Mail. Bold statements in multi-syllabic scientific jargon give the false impression that they’re supported by laboratory research and hard facts.
Magnetic wristbands improve your sporting performance, carbs make you fat, and just about everything gives you cancer.
Of course, we scientists accept that sometimes people believe things we don’t agree with. That’s fine. Science is full of people who disagree with one another . If we all thought exactly the same way, we could retire and call the status quo truth.
But when people think snake oil is backed up by science, we have to challenge that. So why is it so hard?
The article is here.
The Guardian
Originally published January 26, 2016
Pseudoscience is everywhere – on the back of your shampoo bottle, on the ads that pop up in your Facebook feed, and most of all in the Daily Mail. Bold statements in multi-syllabic scientific jargon give the false impression that they’re supported by laboratory research and hard facts.
Magnetic wristbands improve your sporting performance, carbs make you fat, and just about everything gives you cancer.
Of course, we scientists accept that sometimes people believe things we don’t agree with. That’s fine. Science is full of people who disagree with one another . If we all thought exactly the same way, we could retire and call the status quo truth.
But when people think snake oil is backed up by science, we have to challenge that. So why is it so hard?
The article is here.
Saturday, February 13, 2016
Pentagon Wants Psychologists to End Ban on Interrogation Role
By James Risen
The New York Times
Originally posted on January 24, 2016
The Pentagon has asked the American Psychological Association to reconsider its ban on the involvement of psychologists in national security interrogations at the Guantánamo Bay prison and other facilities.
The Defense Department reduced its use of psychologists at Guantánamo in late 2015 in response to the policy approved by the association last summer.
But in a letter and accompanying memo to association officials this month, Brad Carson, the acting principal deputy secretary of defense for personnel and readiness, asked that the group, the nation’s largest professional organization for psychologists, revisit its “blanket prohibition.”
Although “the Department of Defense understands the desire of the American psychology profession to make a strong statement regarding reports about the role of former military psychologists more than a dozen years ago, the issue now is to apply the lessons learned to guide future conduct,” Mr. Carson wrote.
The article is here.
The New York Times
Originally posted on January 24, 2016
The Pentagon has asked the American Psychological Association to reconsider its ban on the involvement of psychologists in national security interrogations at the Guantánamo Bay prison and other facilities.
The Defense Department reduced its use of psychologists at Guantánamo in late 2015 in response to the policy approved by the association last summer.
But in a letter and accompanying memo to association officials this month, Brad Carson, the acting principal deputy secretary of defense for personnel and readiness, asked that the group, the nation’s largest professional organization for psychologists, revisit its “blanket prohibition.”
Although “the Department of Defense understands the desire of the American psychology profession to make a strong statement regarding reports about the role of former military psychologists more than a dozen years ago, the issue now is to apply the lessons learned to guide future conduct,” Mr. Carson wrote.
The article is here.
Friday, February 12, 2016
Harm is all you need? Best interests and disputes about parental decision-making
by Giles Birchley
J Med Ethics 2016;42:111-115
doi:10.1136/medethics-2015-102893
Abstract
A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema's seminal paper as an example, this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests.
The article is here.
J Med Ethics 2016;42:111-115
doi:10.1136/medethics-2015-102893
Abstract
A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema's seminal paper as an example, this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests.
The article is here.
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