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Health, The Medical Profession, and Regulation presents new evidence concerning health and the environment, inequality of health in many countries, and the compatibility of different quality of life measurements, along with new solutions to problems of health policy. The book is grouped into three sections. Section I, comprising six papers, looks into the determinants of people's health. Section II consists of three papers and deals with the supply side of the market for health care services. Finally, Section III contains three contributions devoted to health regulation. The intended market for this volume includes, but is not limited to, health economists, policy makers, insurers, and governmental advisors who need to stay abreast of the latest developments in health services research worldwide.
Regulation shapes all aspects of America's fragmented health care industry, from the flow of dollars to the communication between physicians and patients. It is the engine that translates public policy into action. While the health and lives of patients, as well as almost one-sixth of the national economy depend on its effectiveness, health care regulation in America is bewilderingly complex. Government agencies at the federal, state, and local levels direct portions of the industry, but hundreds of private organizations do so as well. Some of these overseers compete with one another, some conflict, and others collaborate. Their interaction is as important to the provision of health care as are the laws and rules they implement. Health Care Regulation in America is a guide to this regulatory maze. It succinctly recaps the past and present conflicts that have guided the oversight of each industry segment over the past hundred years and explains the structure of regulation today. To make the system comprehensible, this book also presents the sweep of regulatory policy in the context of the interests, values, goals, and issues that guide it. Chapters cover the process of regulation and each key area of regulatory focus - professionals, institutions, financing arrangements, drugs and devices, public health, business relationships, and research. In a uniquely American way, the system thrives on confrontation between competing interests but survives by engendering compromise. Robert Field shows that health care regulation is an inexorable force that nurtures as well as restricts the enterprise of American health care. For the student, practitioner, executive, policy analyst, or concerned citizen, this book is an invaluable guide to the policy, politics, and practice of an industry that directly touches us all.
This book explores the pressing issue of regulating & certifying a healthcare provider's qualifications & skills. It examines the issues & challenges in professional regulation today as a result of managed care, cost containment, & outcomes measurement. The impact of emerging healthcare markets & increased consumer empowerment on the future role of professional regulation is also discussed. "[This book] distills the relevant & interesting aspects of professional regulation into [a] remarkably readable & informative text. It reduces the confusing aspects of administrative law into understandable terms for the non-attorney."-The Journal of Medical Licensure & Discipline.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
How did American doctors come to be licensed on the terms we now take for granted? Licensed to Practice begins with an 1891 shooting in Wheeling, West Virginia, that left one doctor dead and another on trial for his life. Formerly close friends, the doctors had fallen out over the issue of medical licensing. Historian James C. Mohr calls the murder “a sorry personal consequence of the far larger and historically significant battle among West Virginia’s physicians over the future of their profession.” Through most of the nineteenth century, anyone could call themselves a doctor and could practice medicine on whatever basis they wished. But an 1889 U.S. Supreme Court case, Dent v. West Virginia, effectively transformed medical practice from an unregulated occupation to a legally recognized profession. The political and legal battles that led up to the decision were unusually bitter—especially among physicians themselves—and the outcome was far from a foregone conclusion. So-called Regular physicians wanted to impose their own standards on the wide-open medical marketplace in which they and such non-Regulars as Thomsonians, Botanics, Hydropaths, Homeopaths, and Eclectics competed. The Regulars achieved their goal by persuading the state legislature to make it a crime for anyone to practice without a license from the Board of Health, which they controlled. When the high court approved that arrangement—despite constitutional challenges—the licensing precedents established in West Virginia became the bedrock on which the modern American medical structure was built. And those precedents would have profound implications. Thus does Dent, a little-known Supreme Court case, influence how Americans receive health care more than a hundred years after the fact.
A part of the Duke Medical Center Library History of Medicine Ephemera Collection.
`It has particular appeal for health-care professionals and managers with an interest in corporate and clinical governance′ - British Journal of Perioperative Nursing In recent years the health professions have been subject to unprecedented regulatory changes. Exposure of poor practice provoked widespread criticism of self-regulation and calls for a system in which the interests of health care consumers and employers are more fully recognized. Examining the historical and contemporary context, Regulating the Health Professions provides an in-depth analysis of professional self-regulation and the implications of regulatory change for the future of health care. Part One sets out general regulatory issues in the healthcare arena with chapters covering the impact of globalization on the professions, the purpose of professional regulation, the legal context of regulation and the significance of professional codes of ethics. In Part Two, issues specific to the different professions are explored through chapters on medicine, nursing, dentistry, the professions allied to medicine, clinical psychology and alternative medicine. This extremely topical book will be of interest to students, educators and researchers in a wide range of disciplines including sociology, social policy, politics and health studies, and to healthcare professionals and their managers.
Topical and controversial The Tyranny of Health exposes the dangers of the explosion of health awareness for both patients and doctors, using straightforward language to explain the latest health statistics and research findings. Michael Fitzpatrick, a full-time inner-city GP, argues from his day-to-day experience in the surgery that health propaganda is having a very unhealthy effect on the nation. Patients are made unnecessarily anxious as a result of health scares which have greatly exaggerated the risks of everyday activities such as eating beef, sunbathing and having sex. Doctors no longer seem content with treating disease but are encouraged by the government to tell people how to live more and more aspects of their lives. Michael Fitzpatrick concludes that doctors should stop trying to make people virtuous. He argues that we need to establish a clear boundary between the worlds of medicine and politics, so that doctors can concentrate on treating the sick - and leave the well alone.
At the center of this book is the complex and perplexing question of how to design professional preparation programs, organizational management practices, public policy systems and robust professional associations committed to and capable of, maintaining confidence, trust and the other hallmarks of responsible professionalism. To do this, we need to rebuild our understanding of professional responsibility from the ground up. We describe how individuals might be prepared to engage in responsible professional service delivery, examine promising options for the reform of professional service systems and finally, outline a reform strategy for improving practice in education and medicine – two essential public services. The nexus of the reform problem in professionalism is establishing a more robust and effective working relationship between teachers and their students; between health care professionals and their patients and between educators and health professionals. Professionalism means acceptance of professional responsibility for student and patient outcomes — not just acceptance of responsibility for technical expertise, but commitment to the social norms of the profession, including trustworthiness and responsibility for client wellbeing. In the past, it may have been sufficient to assume that adequate knowledge can be shaped into standards of professional practice. Today, it is clear that we must take careful account of the ways in which practicing professionals develop, internalize and sustain professionalism during their training, along with the ways in which this commitment to professionalism may be undermined by the regulatory, fiscal, technological, political and emotional incentive systems that impinge on professional workplaces and professional employment systems.