Aggressive medical care at the end of life: does capitated reimbursement encourage the right care for the wrong reason?

Article Abstract:

Managed care organizations appear to provide fewer end-of-life procedures, but they may do so for economic rather than health reasons. A 1997 study found that Medicare patients in managed care received fewer end-of-life procedures than those in fee-for-service plans. However, Medicare patients can choose their plans, and those who want aggressive end-of-life care may have chosen a fee-for-service plan. Also, less end-of-life care is not necessarily better end-of-life care. Many patients may want aggressive end-of-life care while others may not. Physicians should ask patients what procedures they want, and do their best to comply.

Health aspects, Analysis, Terminal care, Managed care plans (Medical care), Critically ill

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Changes in marketplace demand for physicians: a study of medical journal recruitment advertisements

Article Abstract:

The demand for many general practitioners and specialists appears to have peaked in the early 1990's and is now declining. Researchers came to this conclusion after studying advertisements for physician openings in the classified ad section of 7 medical journals. In a journal that covers all specialties, the number of specialist positions has declined 55% since 1990 and the specialist-to-generalist ratio dropped from 4 to 1.8. In a journal that covers internal medicine, specialist positions dropped 75% since 1990 and the ratio fell from 2 to 0.3. Only the number of positions for family physicians grew during this time.

Medicine, Physicians, Medical professions, Advertising, Employment, Medical specialties, Professions

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Is SARS just ARDS?

Article Abstract:

Severe acute respiratory syndrome (SARS) can cause acute respiratory distress syndrome (ARDS), as reported by doctors from Singapore and Toronto. In this case, the cause of ARDS is a virus. But the lessons learned from treating critically ill SARS patients will benefit patients whose ARDS is caused by some other factor.

Causes of, Complications and side effects, Acute respiratory distress syndrome, Adult respiratory distress syndrome, Severe acute respiratory syndrome

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