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A brief review of the Physician Quality Reporting System (PQRS) is presented highlighting the program's legislative history, eligibility requirements and incentive payment plan. Specifically, PQRS measures applicable to neuroradiology practice are discussed. Several steps are suggested for individual physicians or group practices to start participation in the program. Resources are also provided for further information on the program requirements and PQRS measures.

Physician reimbursement and the coding to support it are critically important to the sustained health of any physician's practice. This article reviews the recent history of physician reimbursement from the government and third-party payers and physician coding to support reimbursement. Explanations of terminology and documentation requirements are included.

• Movie "Fit to Fight" shown at close of the 13th annual meeting of Medical Association of Southwest, about influenza's effect in the military. • Major John O. McReynolds of United States Medical Reserve Corps: "We can't hope to stamp out this as we would other diseases. You may as well make up your mind that it is going to last for some time. The important thin is for people not to get panicky." • It's decided that closing schools will have little effect on stopping epidemic, though military quarantines are thought effective, as the influenza is so dangerous to young adults ; Newspaper article ; 8

Intro -- Preface -- Contents -- Contributors -- Part I: Advancing Professional Calling and the Culture of Wellbeing in Medicine -- Chapter 1: Calling, Compassionate Self, and Cultural Norms in Medicine -- Medical Cultural Norms -- Deferring Personal Needs to Serve Others -- Shaming Intolerance of Error -- Compassion in Addressing Personal Well-Being and Health-Care Quality Improvement -- Compassion in Addressing Personal Wellbeing -- Compassion in Health-Care Quality Improvement -- References -- Chapter 2: Creating a Culture of Wellness -- Barriers to a Culture of Wellness Common in Medical Training and Practice -- Belief that Deferring Self-Care Equals Dedication to Patients -- Belief that Shaming and Punishment in Response to Errors Promote Safety in Health Care -- Stigma Suggesting that Physicians Who Seek Mental Health Help Are Less Fit for Duty -- Promoting Specific Culture of Wellness Factors for Physician WellBeing -- Psychological Safety -- Inclusive Leadership Style -- Leadership Support -- Values Alignment -- Appreciation and Gratitude -- Fairness/Equity -- Flexibility and Work-Life Integration -- Peer Support -- Community/Collegiality -- Conclusion -- A Culture of Wellness Is Achievable -- References -- Chapter 3: Compassion Cultivation -- Introduction -- How Is Compassion Cultivated -- Compassion Training Programs -- Cognitively-Based Compassion Training -- Compassion Cultivation Training -- Mindful Self-Compassion (MSC) -- Being with Dying (BWD) -- Brief Compassion Training for Physician Well-Being: A Case Study in Program Design -- Conclusion -- References -- Part II: Recognizing Threats to Physician Wellbeing -- Chapter 4: Mistreatment -- Introduction -- History and Prevalence -- Types of Mistreatment -- Sources of Mistreatment -- The Interplay of Wellness and Mistreatment -- Impact on Learners -- Impact on Mistreater -- Solutions.

A letter report issued by the General Accounting Office with an abstract that begins "Through a variety of programs, the federal government supports the training of physicians and encourages physicians to work in underserved areas or pursue primary care specialties. GAO was asked to provide information on the physician supply and the generalist and specialist mix of that supply in the United States and the changes in and geographic distribution of physician supply in metropolitan and nonmetropolitan areas. To address these objectives, GAO analyzed data on physician supply and geographic distribution from 1991 and 2001."

Written by PAs for PAs, Orthopaedics for Physician Assistants, 2nd Edition, is the first and only orthopaedics text specifically designed for physician assistant practitioners and students. This comprehensive yet portable guide helps you master the essential knowledge that directly affects your patient care. Coauthors and physician assistants Sara Rynders and Jennifer Hart clearly present everything you need to know to manage orthopaedic issues in either a general practice or orthopaedic practice setting. Provides precisely the diagnostic and procedural information physician assistants need, covering orthopaedic physical examination and history taking, imaging interpretation and diagnosis, and treatment strategies for orthopaedic problems. Features brief, bulleted text, consistent headings in each chapter, an easy-to-follow outline format, and clear diagrams and images throughout. Demonstrates how to perform 14 key joint injections with online videos of elbow joint injection, knee joint injection, medial epicondyle injection, subacromial injection, digital block, and more. NEW to the 2nd Edition: ICD-10 codes to facilitate accurate coding and billing "Clinical Alert boxes that highlight key information Quick-reference guide inside the front cover listing content by disorder name Concise review of common Orthopedic PANCE/PANRE topics Streamlined surgery content that focuses on need-to-know material A clearer, more direct writing style and updated content throughout, reflecting the most current research evidence and national and international guidelines Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices

The purpose of this collective case study was to understand and describe the experience of physicians who use health information technology in medical practice. There are numerous factors applying pressure to the practice of medicine with limited support to physicians practicing medicine. With recent health insurers and both state and federal governments mandating health information technology, physicians are required to implement an electronic health record (EHR) with measurable outcomes and benefits to the delivery of healthcare. This study is significant in that it offers a view into the experience of physicians who use health information technology in medical practice. To gain insight into the experience of physicians and their use of health information technology, I interviewed four physicians practicing in a medical clinic setting. Analysis of the interview transcripts revealed four themes: (a) the change process within the work was the challenge with the EHR implementation; (b) physicians learn best from other physicians; (c) implementation of the EHR impacted the entire team of care providers, not just the physicians; and (d) EHR optimization was reinforced with follow- up training after implementation.

Physicians are increasingly expected to assume responsibility for the management of human and financial resources in health care, particularly in hospitals. Juggling their new management responsibilities with clinical care, teaching and research can lead to conflicting roles. However, their presence in management is crucial to shaping the future health care system. They bring to management positions important skills and values such as observation, problem-solving, analysis and ethical judgement. To improve their management skills physicians can benefit from management education programs such as those offered by the Physician-Manager Institute and several Canadian universities. To manage in the future environment they must increase their knowledge and skills in policy and political processes, financial strategies and management, human resources management, systems and program quality improvement and organizational design.

Purpose. This study explores two possible mechanisms through which occupational stress is linked to absenteeism. The extent to which physician-excused absenteeism and absenteeism not excused by a physician are related to employee reports of perceived stress is assessed. Design. A plantwide survey was conducted in January 1990. Employee reports of occupational stress gained from this survey were linked with 1990 absenteeism data from the employees' records. Setting. A mid-sized manufacturing plant. Sample. Complete data were available for 998 of the 1534 (65%) unionized employees in the plant. Measures. Measures of both physician-excused absences and absences not excused by a physician were created. Stressors included role ambiguity, lack of control over work pace, and being paid on a piece-rate basis. Perceived stresses included role conflict, physical environment stresses, and overall work stress. Results. For physician-excused absenteeism, role conflict (OR, 1.54, p <.01), overall work stress (OR 1.24, p <.05), and physical environment stress (OR 1.34, p <.05) had significantly elevated odds ratios, even after adjusting for demographics. For absences not excused by a physician, none of the stressors or stresses had significant odds ratios after controlling for demographic characteristics. Conclusions. Employees in this plant were not using short-term voluntary absenteeism as a way of coping with work stress. However, high levels of perceived work stress were associated with subsequent physician-excused absences.

La theorie du localisme‐cosmopolitanisme est appliquee a l'identification des types de medecin. L'analyse factorielle, le coefficient de concordance de Kendall ainsi que les gamma et chi‐carres sont utilises selon diverses combinaisons pour identifier des constellations de variables. On identifie deux types de medecins qui sont statistiquement bien differencies: le professionnel de la medecine (cosmopolitain) et le politicien de la medecine (local). Une demonstration empirique s'ensuit laquelle etablit que les cosmopolitains ont une attitude plus liberate que les locaux vis‐a‐vis les problemes sociaux et medicaux et une attitude plus critique vis‐a‐vis les regimes d'assurance maladie.The theory of localism‐cosmopolitanism is applied to the identification of physician‐types. Factor analysis, Kendall's coefficient of concordance, gamma and chi‐square are used in combination to identify variable clusters. Two statistically distinct types were found, the professional (cosmopolitan) and the medical politician (local). Empirical evidence is presented which indicates that cosmopolitans tend to be more liberal than locals in attitudes toward certain medical‐social issues, and more critical of health insurance plans.

Intro -- Contents -- Introduction -- What Do We Need to Know About Existing Physician Trends? -- What Is Our Current Market Position and State of Physician Relations? -- Which Engagement Options Should We Consider? -- How Do We Develop a Successful Strategy? -- Bibliography -- About the Author -- Acknowledgments.

Physician Staffing for the VA -- Preface -- Acknowledgments -- Contents -- Executive Summary -- OVERVIEW OF THE STUDY -- Purpose and Scope -- Organization and Conduct of the Study -- Some Undergirding Assumptions -- DEFINING, BUILDING, AND RECONCILING ALTERNATIVE APPROACHES TO PHYSICIAN STAFFING -- Three General Approaches to Determining Physician Requirements -- The Empirically Based Physician Staffing Models -- Expert Judgment Models -- Reconciling the Approaches -- Using the Reconciliation Strategy to Calculate Physician FTEE -- External Norms -- OVERALL ADEQUACY OF PHYSICIAN STAFFING IN THE VA: COMMITTEE PERSPECTIVE -- VA CENTRAL OFFICE AND THE VAMC: PROMOTING A DIALOGUE -- AFFILIATIONS WITH MEDICAL SCHOOLS -- NONPHYSICIAN PRACTITIONERS -- FURTHER DEVELOPMENT OF THE METHODOLOGY -- CONCLUDING REMARKS -- 1 Overview of the Study -- PURPOSE AND SCOPE -- ORGANIZATION AND CONDUCT OF THE STUDY -- THE COMMITTEE PERSPECTIVE -- REFERENCES -- 2 Background -- CURRENT ALLOCATION OF PHYSICIANS IN THE VA -- Total Physicians, By Specialty -- How Physician FTEE Levels Currently Are Determined -- SOME UNDERGIRDING ASSUMPTIONS -- The Methodology Focuses on Physician FTEE for VAMCs -- This Is Not a Needs-Based Approach -- Assuring the Quality of Care -- The Methodology Must Be Relevant to the Present, Flexible for the Future -- REFERENCES -- 3 Overview of the Analysis -- A CENTRAL PROBLEM: DETERMINING PHYSICIAN FTEE REQUIRED FOR PATIENT CARE AND RESIDENT EDUCATION -- DETERMINING PHYSICIAN REQUIREMENTS FOR OTHER MISSION-RELATED ACTIVITIES -- RECONCILING THE APPROACHES -- MANAGEMENT USES OF PHYSICIAN STAFFING MODELS -- PROJECTING FUTURE VA PATIENT WORKLOAD -- THE VAMC-MEDICAL SCHOOL AFFILIATION RELATIONSHIP -- NONPHYSICIAN PRACTITIONERS AND VA PHYSICIAN REQUIREMENTS -- COMMITTEE CONCLUSIONS AND RECOMMENDATIONS -- REFERENCE.

Abstract. Background: There is a bias for natural versus synthetic drugs in general populations. Aims: We investigated whether physicians who have advanced medical and scientific training and routinely prescribe drugs exhibit this bias. Methods: Physicians and non-physicians were presented with a hypothetical medical situation in which pharmacological therapy was required. Participants were asked if they would prefer a natural or synthetic drug for treatment. Physicians were also asked which drug they would prescribe to a patient. Results: In a forced-choice paradigm, non-physicians (87.5%) and physicians (79.2%) had an equally strong bias for the natural drug, with physicians (74.3%) also preferring the natural drug for patients. When a 9-point drug choice scale was used, including a "no preference" choice (5), non-physicians ( M = 6.91) and physicians ( M = 5.41) again showed a preference for the natural drug compared to the mid-point of the scale, but the non-physicians' bias was stronger. Physicians no longer preferred the natural drug for patients ( M = 5.15). Limitations: The participants do not represent a random sample and therefore may not represent physicians/non-physicians in general. Additionally, the responses were hypothetical and may not represent behavior in actual medical contexts. Conclusion: These data indicate that physicians and non-physicians exhibit a bias for natural drugs, with physicians also demonstrating a bias for prescribing natural drugs. However, the bias is reduced in physicians compared to non-physicians when a "no preference" option is available, suggesting that advanced medical and/or scientific training may be beneficial in minimizing this bias.