House officer responses to impaired physicians

Article Abstract:

It is commonly thought that physicians fail to act when confronted with an impaired colleague. Seventy-six house officers at a Rhode Island teaching hospital were surveyed on their responses when confronted with an alcohol-impaired attending physician, an incompetent attending physician, a depressed house officer, an alcohol-impaired house officer, and an incompetent house officer. Possible courses of action included confronting the physician personally, telling a senior faculty member, reporting the incident to the Rhode Island Medical Society Impaired Physician Committee, deciding to take no action, or taking another course of action specified by the respondent. The house officer responses differed depending on whether the impaired individual was an attending physician or a house officer. Seventy-two percent of house officers would report the incident to the chief resident if the alcohol-impaired individual was an attending physician, whereas 96 percent of those surveyed would directly confront an alcohol-impaired house officer. The most common response to an incompetent attending physician (67 percent) or house officer (49 percent) was to tell the chief resident; only 25 percent of respondents would directly confront an incompetent house officer. Seventy-one percent of house officers would directly confront a depressed house officer. Thus, house officers tend to help each other through personal confrontation, but they refer to senior physicians when dealing with incompetent attending physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Evaluation, Telecommunications systems, Surveys, Medical personnel, Residents (Medicine), Physician impairment

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Physicians and family caregivers: a model for partnership

Article Abstract:

Primary care physicians need to establish a model for their relationship with family caregivers. Family caregivers are important in the provision and management of health care for the frail elderly and individuals with other chronic diseases. The number of frail elderly living in the community is increasing, and family caregivers play an important role in providing home care to these individuals. Family caregivers often suffer from emotional, psychological, physical and social stresses that may be difficult to cope with. An intervention strategy needs to be developed to provide family caregivers with the support to deal with these stresses. An effective model would be to develop a partnership between the primary care physician and the caregiver. The caregiver as well as the patient would undergo periodic assessments by a primary care physician.

Social aspects, Caregivers, Physicians (General practice), General practitioners

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Fraud by physicians against Medicaid

Article Abstract:

Physicians may have several reasons for committing Medicaid fraud by overcharging or charging for services not provided. The Medicaid fee-for-service reimbursement system makes it easy to charge for extra services without being caught. Physicians find it easier to overcharge a government program than an individual. A survey of 138 physicians sanctioned for Medicaid fraud between 1977 and 1982 found that a large percentage were psychiatrists, older physicians, foreign medical school graduates and minorities. Medicaid violators blame their actions on their employees, patients or the bureaucracy of the Medicaid system. They do not claim financial motivation. Medicaid officials believe that greed and selfishness are the primary causes of Medicaid fraud.

Causes of, Crime, Medicaid fraud

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