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Examines trust, its definition, value, and decline from the perspective of a physician and a medical ethicist.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Investigates trust and honesty in medicine and the doctor-patient relationship, raising questions of patients' autonomy and self-determination. Of interest to those working in medical ethics and applied philosophy, and for medical practitioners.
Does trust still matter in health care and who does it matter to? Have trust relations changed in the 'New' NHS? What does trust mean to patients, clinicians and managers? In the NHS trust has traditionally played an important part in the relationships between its three key actors: the state, health care practitioners and patients. However, in recent years the environments in which these relationships operate have been subject to considerable change as the NHS has been modernised. Patients are now expected to play a more active role, both in self-managing their illness and in choice of care provider and clinicians are expected to work in teams and in partnership with managers. This unique book explores the importance of trust, how it is lost and won and the extent to which trust relationships in health care may have changed. The book combines theoretical and empirical analysis, while also examining the role of policy. Calnan and Rowe analyse data collected from interviews with patients, health care professionals and managers in primary care and acute care settings. Among the issues covered are: The importance of trust to their relationships What constitutes high and low trust behaviour The changing nature of trust relations between patients, clinicians and managers How trust can be built and sustained How interpersonal trust affects institutional trust Trust Matters in Health Care is key reading for policy makers, health care professionals and managers in the public and private sector, and a useful resource for educators and students within health and social care and management studies.
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Medicine machine, exposing its glitches and recommending a much-needed overhaul to make it hum.
In this "meticulously researched" account (New York Times Book Review), a Pulitzer Prize-winning author examines the dangers of a failing public health system unequipped to handle large-scale global risks like a coronavirus pandemic. The New York Times bestselling author of The Coming Plague, Laurie Garrett takes on perhaps the most crucial global issue of our time in this eye-opening book. She asks: is our collective health in a state of decline? If so, how dire is this crisis and has the public health system itself contributed to it? Using riveting detail and finely-honed storytelling, exploring outbreaks around the world, Garrett exposes the underbelly of the world's globalization to find out if it can still be assumed that government can and will protect the people's health, or if that trust has been irrevocably broken. "A frightening vision of the future and a deeply unsettling one . . . a sober, scary book that not only limns the dangers posed by emerging diseases but also raises serious questions about two centuries' worth of Enlightenment beliefs in science and technology and progress." -- Michiko Kakutani, The New York Times
Collaborations of physicians and researchers with industry can provide valuable benefits to society, particularly in the translation of basic scientific discoveries to new therapies and products. Recent reports and news stories have, however, documented disturbing examples of relationships and practices that put at risk the integrity of medical research, the objectivity of professional education, the quality of patient care, the soundness of clinical practice guidelines, and the public's trust in medicine. Conflict of Interest in Medical Research, Education, and Practice provides a comprehensive look at conflict of interest in medicine. It offers principles to inform the design of policies to identify, limit, and manage conflicts of interest without damaging constructive collaboration with industry. It calls for both short-term actions and long-term commitments by institutions and individuals, including leaders of academic medical centers, professional societies, patient advocacy groups, government agencies, and drug, device, and pharmaceutical companies. Failure of the medical community to take convincing action on conflicts of interest invites additional legislative or regulatory measures that may be overly broad or unduly burdensome. Conflict of Interest in Medical Research, Education, and Practice makes several recommendations for strengthening conflict of interest policies and curbing relationships that create risks with little benefit. The book will serve as an invaluable resource for individuals and organizations committed to high ethical standards in all realms of medicine.
A groundbreaking text on how to deliver the highest quality patient care through professionalism in daily medical practice Five Star Doody’s Review: “This is an outstanding book for all clinicians and professors, indeed for everyone in medicine to help mentor and self-police the medical profession.” "Understanding Medical Professionalism is a 'must-have' for all involved in the healing arts. The book demystifies professionalism, bringing it from a philosophical, mystical concept to a practical everyday set of behaviors. The twelve chapters, in a uniform way, provide wonderful, real-life stories that illustrate the challenges faced by practitioners, describe ways to deal with those challenges, and help develop the personal and institutional skills necessary to provide excellent and compassionate care." -- Carlos A. Pellegrini, MD, FACS, FRCSI (Hon.), The Henry N. Harkins Professor and Chair, Department of Surgery, University of Washington "Insightful, practical, and authoritative. Building on their own research and that of others, Levinson et al. offer a comprehensive discussion of medical professionalism from the refreshing perspective of behavioral skills and an enabling healthcare system. Understanding Medical Professionalism has fundamentally reframed the professionalism debate and will likely remain the definitive work in this field for quite some time." -- David G. Nichols, MD, President and CEO, The American Board of Pediatrics "The authors' ambitious goal of providing a framework for the continuum of physician development of professional behaviors, from student through expert senior clinician, has been met. Students will find the text modular and instructive; residents will benefit from the reinforcement of positive professional behaviors and explication of strategies to excel in this competency; educational program directors will find the framework and tools for assessment and strategies for remediation enriching; and the expert professional will find subtle opportunities to grow to mastership of this most important physician competency." -- Thomas J. Nasca, MD, MACP, Chief Executive Officer, Accreditation Council for Graduate Medical Education, Professor of Medicine, Jefferson Medical College "The authors offer a framework and an approach to medical professionalism that enable us to understand it, teach it, and incorporate it into our day-to-day lives as health professionals. It is a much needed addition to our armamentarium as we work to align the education of health professionals with the needs and expectations of the society we serve." -- George E. Thibault, MD, President, Josiah Macy Jr. Foundation
"[This book is] the most authoritative assessment of the advantages and disadvantages of recent trends toward the commercialization of health care," says Robert Pear of The New York Times. This major study by the Institute of Medicine examines virtually all aspects of for-profit health care in the United States, including the quality and availability of health care, the cost of medical care, access to financial capital, implications for education and research, and the fiduciary role of the physician. In addition to the report, the book contains 15 papers by experts in the field of for-profit health care covering a broad range of topicsâ€"from trends in the growth of major investor-owned hospital companies to the ethical issues in for-profit health care. "The report makes a lasting contribution to the health policy literature." â€"Journal of Health Politics, Policy and Law.