Browsing by Subject "Physicians"
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Item Defining professionalism in the digital age: barriers and opportunities(2014-05-13) Farnan, JeanneThe overwhelming popularity of Web 2.0 technologies, such as social networking sites, media sharing sites and blogging, has significantly changed the manner in which trainees interact with educators, colleagues, and the lay public. Individual and institutional representation, the absence of existing policies and the perception of the lay public are some of the salient issues that arise when considering the "digital images" displayed by trainees and faculty alike. Little guidance exists for medical educators on preventing misuse of digital media and ensuring standards for professional conduct. Similarly, the positive potential of these media, within medical education, are only beginning to be realized. While many of these issues are also faced by colleagues in other areas of higher education, medical educators and their institutions are faced with the additional challenge of ensuring that graduates exemplify the ideals of medical professionalism. This lecture will address educators' understanding of the currently available technology, the threats that they pose to trainee professionalism and strategies to protect the trainees' and the program or institutions' digital image.Item The "difficult patient" reconceived: an expanded moral mandate for clinical ethics(2020-10-13) Fiester, Autumn M.Between 15%-60% of patients are considered "difficult" by their treating physicians. Patient psychiatric pathology is the conventional explanation for why patients are deemed "difficult." But the prevalence of the problem suggests the possibility of a less pathological cause. I argue that the phenomenon can be better explained as responses to problematic interactions related to healthcare delivery. If there are grounds to reconceive the "difficult" patient as reacting to the perception of ill treatment, then there is an ethical obligation to address this perception of harm. Resolution of such conflicts currently lies with the provider and patient. But the ethical stakes place these conflicts into the province of the ethics consult service. As the resource for addressing ethical dilemmas, there is a moral mandate to offer assistance in the resolution of these ethically charged conflicts that is no less pressing than the more familiar terrain of clinical ethics consultation.Item Donald W. Seldin, M.D., Research Symposium finalist presentations(2022-04-29) Almonte, Matthew; Duvalyan, Angela; McAdams, Meredith; Onyirioha, Kristeen; Saez-Calveras, Nil; Triana, TaylorThis edition of the UT Southwestern Internal Medicine Grand Rounds features presentations by the six Foster Fellows selected as finalists from the Seventh Annual Donald W. Seldin, M.D. Research Symposium, which was held on April 21, 2022. These Foster Fellows presented work that spanned the breadth and depth of scholarly activity across the department, and at the close of Grand Rounds, one will be selected as the 2022 Seldin Scholar, in honor of Dr. Donald W. Seldin. The Grand Rounds presentation includes additional award presentations recognizing Clinical Vignettes, as well as the Award for Research in Quality and Education at Parkland Hospital and the Social Impact Award.Item Ethical implications of public disclosure of Medicare payments to individual physicians(2015-03-10) Steinbrook, RobertIn the spring of 2014, the Centers for Medicare & Medicaid Services, in response to a court decision and the requirements of the Freedom of Information Act, began to publicly disclose the amounts and reasons for Medicare payments to individual physicians. The disclosures have attracted broad interest in the news media and shone a bright light on patterns of physician billing and utilization that were previously hidden from public view. The disclosures, however, have also raised questions about what the data means, how useful they will be to patients, and how the data can best be used to improve the quality and values of medical care. This grand rounds will discuss salient examples from the first year of the new policy that highlight the ethical implications of the public disclosure of physician payment data.Item Ethics of smart pills and the dawn of surveillance medicine(2019-10-08) Klugman, Craig M.This presentation will explore the ethics of digital medicine--technology represented by pills that alter our bodily functions alongside sensors that not only collect data about our bodies, but share it with our physicians, family and friends. With FDA approval of the Abilify MyCite system in November 2017, pills now interact with cell phones to track medication adherence, but at what cost? Surveillance medicine stands to redefine the physician patient relationships and raises a host of new ethical issues such as redefining notions of privacy, confidentiality, vulnerability, trust, autonomy, consent, data and device management, dependability, physician autonomy, and equity in access to treatment. This presentation introduces attendees to these technologies and explores the ethical and professional challenges raised as they become more ubiquitous.Item Family Practice part 1--the need(1980-12-03) Harrell, AnnItem Family Practice part II--the solution(1980-12-03) Harrell, AnnItem Family Practice part III--the problems(1980-12-03) Harrell, AnnItem Future crises in manpower for medicine: increasing the number of minority physicians(1987-06-04) Haley, Robert W.Item Grit & resilience in learners(2017-06-09) Barker, Blake R.Item Impact of a Physician Dashboard on Episiotomy Utilization at William P. Clements Jr. University Hospital(2016-01-19) Xiong, Katherine; Horsager-Boehrer, RobynOBJECTIVE: Third and fourth degree vaginal lacerations following delivery are associated with long-term pelvic floor complications including pain and incontinence. Routine performance of episiotomy in a spontaneous vaginal delivery increases the likelihood of a severe perineal laceration and routine utilization of episiotomy is discouraged. High provider variation in adherence to this recommendation is known. The objective of this study was to determine if the adoption of a physician dashboard that reported individual and group rates of episiotomy utilization could reduce both institutional and individual rates to below the national benchmark of 5.5%. STUDY DESIGN: Baseline data extracted from records of patients delivering between January 1, 2015 and July 15, 2015 were entered into a green-yellow-red dashboard that listed all generalist obstetricians performing deliveries at Clements University Hospital (CUH). Physician identities were blinded on the dashboard; individual physicians were provided their code in written and email communications. Data on episiotomy utilization were collected prospectively following distribution of the dashboard. RESULTS: The baseline rate for episiotomy performance was 9.5% at CUH prior to the development of the physician dashboard, with individual rates ranging from 0.0% to 55.6%. Following implementation of the dashboard there was a significant reduction in the institutional rate of episiotomy (9.5% pre-intervention vs. 0.52% post-intervention, p<0.001) and all providers met the target rate of <5.5%. Our analysis of data also validated the increased risk of severe perineal lacerations with the performance of episiotomy at CUH (Table below). Pre-Intervention No episiotomy Episiotomy Total deliveries 458 52 3rd/4th degree laceration 9 (1.97%) 4 (7.69%) p=0.01; Odds ratio 4.1 (1.2, 14.0) Despite the reduction in episiotomy utilization we were unable to demonstrate a reduction in the frequency of severe perineal lacerations (2.42% pre-intervention vs. 1.55% post-intervention, p=0.48), suggesting that multiple factors contribute to these events. CONCLUSION: When variation in physician performance exists, utilization of a physician dashboard comparing individual provider behavior to peers can result in a significant improvement in provider and institutional performance on specific metrics.Item Impaired physicians(2005-10-20) Cook, Patricia A.Item Is transhumanism a helpful answer to contemporary bioethical challenges?(2014-03-11) Vicini, AndreaTranshumanism is proposed by its advocates as the ultimate solution to struggles and limitations that affect personal and social health and well-being. Such a proposal could appear merely a philosophical exercise. Three current developments, however, make the transhumanist aspirations more realistic: first, the influence of transhumanist ideas and projects in successful leading global companies like Google; second, the rapidly developing robotic technologies and their implementation; third, the forthcoming studies on brain functioning. Both medicine and bioethics have addressed personal and social challenges, locally and globally, by aiming at further humanization, i.e., by focusing on the "human," not on the "transhuman." Should physicians and bioethicists revise their human-centered focus by replacing it with the proposed "transhuman"? Does "transhumanism" promote health and address health-related bioethical challenges?Item Medical decision making, ethics, and behavioral economics(2022-04-12) Blumenthal-Barby, Jennifer S.Bioethicists have long argued for rational persuasion to help patients with their medical decisions. But the findings of behavioral economics – popularized in Thaler and Sunstein's Nudge and other books – show that arguments depending on rational thinking are unlikely to be successful, and even that the idea of purely rational persuasion may be a fiction. In this talk based on her recent book, "Good Ethics and Bad Choices: The Relevance of Behavioral Economics for Medical Ethics", Dr. Blumenthal-Barby examines how behavioral economics challenges some of the most fundamental tenets of medical ethics. She integrates some of the latest research from both fields and provides examples of how physicians might apply concepts of behavioral economics in practice.Item A Need for Education in Healthcare Politics for Medical Professionals(2011-10-25) Spence, Kelly; Weber, Mary EllenI worked in Congressman Michael Burgess’s office in Washington, D.C. through the University of Texas Southwestern Medical School Congressional Fellowship program from May 2007 until May 2008. During this time, I worked as his health legislative assistant and performed many of the same tasks as the other legislative assistants, including meeting with constituents, attending briefings, preparing the Congressman for hearings, and answering constituent correspondence. My work on several healthcare bills as a legislative assistant taught me the importance of an education in health policy for physicians if we are to successfully influence the future of healthcare legislation.Item [News Item](1953-04-14) Aagaard, George N.Item [News Item](1954-01-20) Aagaard, George N.Item [News Item](1954-01-12) Aagaard, George N.Item [News Item](1953-12-01) Aagaard, George N.Item [News Items](1952-12-06) Aagaard, George N.