Physician Quality and Health Care for the Poor and Uninsured

Many studies have documented adverse health outcomes for uninsured patients in U.S. hospitals. These poor outcomes have been attributed to their health status and limited access to healthcare. A measure of treatment that remains unexplored is the quality of the physicians treating uninsured patients. We examine whether uninsured and poor patients are treated by lower quality physicians with four measures of physician quality. Using a hospital fixed-effects model, we find that cardiac patients are matched to physician quality based on their ability to pay. Even after controlling for average physician quality within a hospital and patient characteristics, we find that uninsured and Medicaid patients are generally treated by lower quality physicians. We also find that while for-profit and not-for-profit hospitals treat the uninsured with lower quality physicians, government hospitals do not. However, there is evidence that hospitals of all ownership types treat Medicaid patients with lower quality physicians.Uninsured, Medicaid, Physician Quality, Hospital Ownership

Physician Self-Referral and Physician-Owned Specialty Facilities

Outlines issues of self-referral -- physicians referring patients to a group or facility in which they have a financial interest -- and the prevalence of physician-owned facilities, as well as the effects on healthcare quality, cost, and access

Physician assisted suicide : an unbiased review

Medical ethics has become a highly discussed topic in the United States. Physician assisted suicide is one of the most commonly discussed ethical issues in the medical field. Physician assisted suicide dates back to the ancient Greek and Roman empires but has only become a heavily talked about subject in the past century. An unbiased analysis of the ethics behind physician assisted suicide along with the physicians' perspective is challenging and, therefore, rare to find. I attempt to give an unbiased look into the history, pros and cons, current issues, ethics, physician perspective and future of physician assisted suicide with a focus on terminally ill senior patients. This will allow readers to form their own opinions about physician assisted suicide before I reveal my personal opinion on the subject.Honors CollegeThesis (B.?.

Relationships between scores on the Jefferson Scale of physician empathy, patient perceptions of physician empathy, and humanistic approaches to patient care: a validity study.

BACKGROUND: Empathy is the backbone of a positive physician-patient relationship. Physician empathy and the patient\u27s awareness of the physician\u27s empathic concern can lead to a more positive clinical outcome. MATERIAL/METHODS: The Jefferson Scale of Physician Empathy (JSPE) was completed by 36 physicians in the Family Medicine residency program at Thomas Jefferson University Hospital, and 90 patients evaluated these physicians by completing the Jefferson Scale of Patient Perceptions of Physician Empathy (JSPPPE), and a survey about physicians\u27 humanistic approaches to patient care. RESULTS: A statistically significant correlation was found between scores of the JSPE and JSPPPE (r=0.48, p CONCLUSIONS: These findings provide further support for the validity of the JSPE. Implications for the assessments of empathy in the physician-patient relationship as related to clinical outcomes are discussed

Study Protocol for Investigating Physician Communication Behaviours that Link Physician Implicit Racial Bias and Patient Outcomes in Black Patients with Type 2 Diabetes Using an Exploratory Sequential Mixed Methods Design

Introduction Patient-physician racial discordance is associated with Black patient reports of dissatisfaction and mistrust, which in turn are associated with poor adherence to treatment recommendations and underutilisation of healthcare. Research further has shown that patient dissatisfaction and mistrust are magnified particularly when physicians hold high levels of implicit racial bias. This suggests that physician implicit racial bias manifests in their communication behaviours during medical interactions. The overall goal of this research is to identify physician communication behaviours that link physician implicit racial bias and Black patient immediate (patient-reported satisfaction and trust) and long-term outcomes (eg, medication adherence, self-management and healthcare utilisation) as well as clinical indicators of diabetes control (eg, blood pressure, HbA1c and history of diabetes complication). Methods and analysis Using an exploratory sequential mixed methods research design, we will collect data from approximately 30 family medicine physicians and 300 Black patients with type 2 diabetes mellitus. The data sources will include one physician survey, three patient surveys, medical interaction videos, video elicitation interviews and medical chart reviews. Physician implicit racial bias will be assessed with the physician survey, and patient outcomes will be assessed with the patient surveys and medical chart reviews. In video elicitation interviews, a subset of patients (approximately 20–40) will watch their own interactions while being monitored physiologically to identify evocative physician behaviours. Information from the interview will determine which physician communication behaviours will be coded from medical interactions videos. Coding will be done independently by two trained coders. A series of statistical analyses (zero-order correlations, partial correlations, regressions) will be conducted to identify physician behaviours that are associated significantly with both physician implicit racial bias and patient outcomes

Communication Patterns Between Physicians and Physician Assistants

Communication is imperative to the success of any team-based organization. In healthcare, it is common for patient outcomes to be affected by variables including but not limited to the quality of extraprofessional communication. Physicians and physician assistants are two meaningful and valued members of the medical care team, and the need for collaboration amongst each other is irrefutable. Physicians are the trusted leaders of any medical team, having completed the most amount of schooling and training. Physician assistants are versatile, economically advantageous, and skill-proficient mid-level practitioners that are required by law to be supervised by a collaborating physician. The working partnership of physicians and their physician assistants requires a consistent, adept communication structure in order to function in a successful capacity. Based on research, it is concluded that insufficient communication patterns between physicians and physician assistants are commonly seen in the healthcare setting, indicating that immediate reform is necessary. Recommendations for reform in physician- physician assistant communication include pursuing extraprofessional education, placing emphasis on the medical team as its own entity rather than a team of individuals, and establishing a culture of extraprofessional trust