The national practitioners data bank

Article Abstract:

September 1, 1991 is the date set for the initiation of the National Practitioner Data Bank. This confidential data base will be available to licensing borders, hospital appointment committees, specialty boards, and other professional groups needing information on the professional conduct of medical practitioners. However, the general public will not have access to the reports. Specific actions against the clinician taken by insurers, hospitals, professional societies, state medical and dental boards, such as withdrawal of privileges must be reported. Payment of any malpractice settlement by the physician will also be reported. The data base will be administered by the Health Resources and Services Administration, to which all adverse reports will be made. Every practitioner will start with a clean slate; no adverse reports of actions taken before the start-up date will be included in the data base. Although settlement payments for malpractice claims must be provided by law, it is important to note that claims are often settled for economic reasons or for reasons other than clinical culpability. Such statements must not be construed to indicate professional misconduct. One aspect of the law is the immunity of professional review boards from civil suit for providing information on the competence or professional conduct of the clinician. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physicians, Medical professions, Medical personnel, Information services, Malpractice, Medical malpractice

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What should be done now that national health system reform is dead?

Article Abstract:

Health professionals and politicians may need to assume a leadership stance in order to achieve modest health care reforms. Because national health care reform was not enacted in 1994, current problems in the health care system will extend into the future. Many Americans will lack health insurance, federal cost-containment measures will not be implemented, the gap between public and private sector payments for medical care will widen, managed care will grow unrestrained, and the aged population will increase without adequate financing for long-term care. Elements of health care reform that are backed by strong public support include broadened, portable health insurance coverage, consumer protection, choice of insurance plans, and medical malpractice reform. Laws regulating these issues may be enacted if they are brought to legislators by health care, business, and union leaders. Health care issues that lack public support may be more difficult to resolve. These contested issues include financing long-term care, paying for universal health care coverage, subsidizing teaching hospitals, and cost-containment in the private sector.

Political aspects, Health care reform

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Variations in methadone treatment practices: results from a national study

Article Abstract:

A 1988 survey of 172 methadone maintenance treatment clinics in the US found large variations in treatment practices. Many clinics used methods that have been shown to be ineffective. Research has shown that the longer drug users remain in treatment, the less likely they are to return to drug use. And drug users have been shown to remain in treatment longer if they are given a relatively high dose of methadone and are encouraged to participate in their treatment. But 34% of the clinics tell their patients little or nothing about their treatment and 50% encourage their patients to finish treatment in six months or less. Twenty-five percent use methadone doses of 20 to 60 milligrams per day, a dose many experts consider too low to be effective. Clinics that reported they were influenced by government regulation were more likely to give higher doses. Methadone treatment clinics should be monitored to ensure that effective methods are used.

Evaluation, Methadone maintenance

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