- Our intellectuals have failed us - System of a Down. [Editorial]
- IHIndian Heart J 2017 Mar - Apr; 69(2):133-135
- Medical profession is at cross-roads. On one hand are issues like medical mal-practice and negligence but on the other are loss of respect, low re-imbursement, lawsuits against medical professionals,…
Medical profession is at cross-roads. On one hand are issues like medical mal-practice and negligence but on the other are loss of respect, low re-imbursement, lawsuits against medical professionals, violence against physicians all contributing to a lot of stress as also a high suicide rate among medical practitioners. While some of the problems seem related to changing societal norms, most of them seem to stem from a failure, active or passive on the part of medical intellectual, moving away from altruism, justice and self regulation to pursuance of self interest with a consequent loss of trust in doctor-patient relationship. The solution lies not only in regaining this trust by following a path of community welfare, change in medical curriculum but also recognition by society, the problems faced by medical fraternity; long hours, low re-imbursement for mental and physical effort but most importantly loss of prestige. Urgent steps to reverse this malady should be undertaken, otherwise a full-fledged commercial and profit making medical field is the only alternative.
- Fee Splitting among General Practitioners: A Cross-Sectional Study in Iran. [Journal Article]
- AIArch Iran Med 2016; 19(12):861-865
- CONCLUSIONS: Fee splitting is an unethical act, contradicts the goals of the medical profession, and undermines patient's best interest. In Iran, there is no code of ethics on fee splitting, but in this study, it was found that the majority of GPs considered it unethical. However, among those who had negative attitudes toward fee splitting, there were physicians who did practice fee splitting. The results of the study showed that physicians who had a positive attitude toward fee splitting practiced it more than others. Therefore, if physicians consider fee splitting unethical, its rate will certainly decrease. The study claims that to decrease such practice, the healthcare system has to revise the tariffs.
- Growth and splitting of neural sequences in songbird vocal development. [Journal Article]
- NatNature 2015 Dec 17; 528(7582):352-7
- Neural sequences are a fundamental feature of brain dynamics underlying diverse behaviours, but the mechanisms by which they develop during learning remain unknown. Songbirds learn vocalizations comp…
Neural sequences are a fundamental feature of brain dynamics underlying diverse behaviours, but the mechanisms by which they develop during learning remain unknown. Songbirds learn vocalizations composed of syllables; in adult birds, each syllable is produced by a different sequence of action potential bursts in the premotor cortical area HVC. Here we carried out recordings of large populations of HVC neurons in singing juvenile birds throughout learning to examine the emergence of neural sequences. Early in vocal development, HVC neurons begin producing rhythmic bursts, temporally locked to a 'prototype' syllable. Different neurons are active at different latencies relative to syllable onset to form a continuous sequence. Through development, as new syllables emerge from the prototype syllable, initially highly overlapping burst sequences become increasingly distinct. We propose a mechanistic model in which multiple neural sequences can emerge from the growth and splitting of a common precursor sequence.
- History and evolution of surgical ethics: John Gregory to the twenty-first century. [Historical Article]
- WJWorld J Surg 2014; 38(7):1568-73
- As surgery grew to become a respected medical profession in the eighteenth century, medical ethics emerged as a response to the growing need to protect patients and maintain the public's trust in phy…
As surgery grew to become a respected medical profession in the eighteenth century, medical ethics emerged as a response to the growing need to protect patients and maintain the public's trust in physicians. The early influences of John Gregory and Thomas Percival were instrumental in the formulation of patient-centered medical ethics. In the late nineteenth century, the modern surgical advances of anesthesia and antisepsis created the need for a discipline of ethics specific to surgery in order to confront new and evolving ethical issues. One of the founding initiatives of the American College of Surgeons in 1913 was to eliminate unethical practices such as fee-splitting and itinerant surgery. As surgery continued to advance in the era of solid organ transplantation and minimally invasive surgery in the latter half of the twentieth century, surgical innovation and conflict of interest have emerged as important ethical issues moving forward into the twenty-first century. Surgical ethics has evolved into a distinct branch of medical ethics, and the core of surgical ethics is the surgeon-patient relationship and the surgeon's responsibility to advance and protect the well-being of the patient.
- Centennial reprint: 1952 Supreme Court decision prompts college action on fee splitting. 1952. [Classical Article]
- BABull Am Coll Surg 2013; 98(5):36-40
- Online coupons may give rise to fee splitting concerns. [Journal Article]
- JOJ Okla Dent Assoc 2012; 103(7):40
- Online coupons may give rise to fee splitting concerns. [Journal Article]
- JOJ Okla Dent Assoc 2012 Mar-Apr; 103(3):33
- [Diagnosis-related groups as an instrument to develop suitable case-based lump sums in hematology and oncology]. [Journal Article]
- OOnkologie 2011; 34 Suppl 1:11-5
- In 2003 a new reimbursement system was established for German hospitals. The approximately 17 million inpatient cases per year are now reimbursed based on a per-case payment regarding diagnoses and p…
In 2003 a new reimbursement system was established for German hospitals. The approximately 17 million inpatient cases per year are now reimbursed based on a per-case payment regarding diagnoses and procedures, which was developed from an internationally approved system. The aim was a better conformity of costs and efforts in in-patient cases. In the first 2 years after implementation, the German diagnosis-related group (DRG) system was not able to adequately represent the complex structures of treatment in hematological and oncological in-patients. By creating new diagnoses and procedures (International Classification of Diseases 10 (ICD-10) and Surgical Operations and Procedures Classification System (OPS) catalogues), generating new DRGs and better splitting of existing ones, the hematology and oncology field could be much better described in the following years. The implementation of about 70 'co-payment structures' for new and expensive drugs and procedures in oncology was also crucial. To reimburse innovations, an additional system of co-payments for innovations was established to bridge the time until innovations are represented within the DRG system itself. In summary, hematological and oncological in-patients, including cases with extraordinary costs, are meanwhile well mapped in the German reimbursement system. Any tendencies to rationing could thereby be avoided, as most of the established procedures and costly drugs are adequately represented in the DRG system.
- Fee splitting in ophthalmology. [Review]
- CJCan J Ophthalmol 2011; 46(1):21-7
- Fee splitting and co-management are common practices in ophthalmology. These arrangements may conflict with the ethical principles governing the doctor-patient relationship, may constitute profession…
Fee splitting and co-management are common practices in ophthalmology. These arrangements may conflict with the ethical principles governing the doctor-patient relationship, may constitute professional misconduct, and at times, may be illegal. Implications and perceptions of these practices may vary between different cultures. Full disclosure to the patient may minimize the adverse effects of conflicts of interest that arise from these practices, and may thereby allow these practices to be deemed acceptable by some cultural morays, professional guidelines, or by law. Disclosure does not necessarily relieve the physician from a potential ethical compromise. This review examines the practice of fee splitting in ophthalmology, its legal implications, the policies or guidelines governing such arrangements, and the possible ethical ramifications. A comparative view between 3 countries, Canada, the United States, and Oman, was conducted; illustrating that even in disparate cultures, there may be some universality to the application of ethical principles.
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- Corporate practice, fee splitting and referral fees. [Journal Article]
- NYN Y State Dent J 2008 Aug-Sep; 74(5):6-8