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2.
J Leg Med ; 39(3): 235-246, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31626578

RESUMEN

We surveyed New York physicians to study their perceptions of reporting requirements related to their own mental health care on professional applications, including whether they were experiencing symptoms of burnout. Over half of the responding physicians reported experiencing symptoms of burnout and these physicians were at increased odds of perceiving a barrier to seeking mental health care if they had to report such care on professional applications and renewals for medical licensure, malpractice, and hospital privileges and credentialing compared to physicians not experiencing symptoms of burnout. As state medical boards, hospitals, and insurers seek information to help assess risks posed by physicians, it is essential to strike an appropriate balance between their duty to protect the public and the physician's right to confidentiality. This balance can be assessed based on the questions that are asked on various professional applications and how information gleaned through physician responses is used. Overly intrusive questions, though well intentioned to protect the public, may run counter to current interpretations of federal law and may inhibit care-seeking among physicians, which is critical to both patient safety and physician health.


Asunto(s)
Actitud del Personal de Salud , Agotamiento Profesional/psicología , Notificación Obligatoria , Salud Mental , Médicos/psicología , Habilitación Profesional , Encuestas de Atención de la Salud , Humanos , Solicitud de Empleo , Licencia Médica , New York/epidemiología , Sociedades Médicas
3.
Tech Vasc Interv Radiol ; 22(3): 162-164, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31623757

RESUMEN

A sound understanding of billing and coding is essential to start a successful interventional radiology endoscopy practice. While the codes utilized are similar to gastrointestinal and genitourinary endoscopy codes, physicians and institutional coders need to be familiar with the codes used for these types of procedures in the interventional radiology setting. The following manuscript gives a brief overview of aspects relating to credentialing, billing, and coding in interventional radiology endoscopy.


Asunto(s)
Habilitación Profesional , Current Procedural Terminology , Endoscopía , Honorarios y Precios , Costos de la Atención en Salud , Radiografía Intervencional , Mecanismo de Reembolso , Competencia Clínica , Habilitación Profesional/normas , Endoscopía/clasificación , Endoscopía/economía , Endoscopía/normas , Honorarios y Precios/normas , Costos de la Atención en Salud/normas , Humanos , Radiografía Intervencional/clasificación , Radiografía Intervencional/economía , Radiografía Intervencional/normas , Mecanismo de Reembolso/economía , Mecanismo de Reembolso/normas
6.
World J Gastroenterol ; 25(27): 3468-3483, 2019 Jul 21.
Artículo en Inglés | MEDLINE | ID: mdl-31367151

RESUMEN

Endoscopic-retrograde-cholangiopancreatography (ERCP) is now a vital modality with primarily therapeutic and occasionally solely diagnostic utility for numerous biliary/pancreatic disorders. It has a significantly steeper learning curve than that for other standard gastrointestinal (GI) endoscopies, such as esophagogastroduodenoscopy or colonoscopy, due to greater technical difficulty and higher risk of complications. Yet, GI fellows have limited exposure to ERCP during standard-three-year-GI-fellowships because ERCP is much less frequently performed than esophagogastroduodenoscopy/colonoscopy. This led to adding an optional year of training in therapeutic endoscopy. Yet many graduates from standard three-year-fellowships without advanced training intensely pursue independent/unsupervised ERCP privileges despite inadequate numbers of performed ERCPs and unacceptably low rates of successful selective cannulation of desired (biliary or pancreatic) duct. Hospital credentialing committees have traditionally performed ERCP credentialing, but this practice has led to widespread flouting of recommended guidelines (e.g., planned privileging of applicant with 20% successful cannulation rate, or after performing only 7 ERCPs); and intense politicking of committee members by applicants, their practice groups, and potential competitors. Consequently, some gastroenterologists upon completing standard fellowships train and learn ERCP "on the job" during independent/unsupervised practice, which can result in bad outcomes: high rates of failed bile duct cannulation. This severe clinical problem is indicated by publication of ≥ 12 ERCP competency studies/guidelines during last 5 years. However, lack of mandatory, quantitative, ERCP credentialing criteria has permitted neglect of recommended guidelines. This work comprehensively reviews literature on ERCP credentialing; reviews rationales for proposed guidelines; reports problems with current system; and proposes novel criteria for competency. This work advocates for mandatory, national, written, minimum, quantitative, standards, including cognitive skills (possibly assessed by a nationwide examination), and technical skills, assessed by number performed (≥ 200-250 ERCPs), types of ERCPs, success rate (approximately ≥ 90% cannulation of desired duct), and letters of recommendation by program director/ERCP mentor. Mandatory criteria should ideally not be monitored by a hospital committee subjected to intense politicking by applicants, their employers, and sometimes even competitors, but an independent national entity, like the National Board of Medical Examiners/American Board of Internal Medicine.


Asunto(s)
Colangiopancreatografia Retrógrada Endoscópica/normas , Competencia Clínica/normas , Habilitación Profesional/normas , Gastroenterólogos/normas , Gastroenterología/normas , Enfermedades de las Vías Biliares/diagnóstico por imagen , Enfermedades de las Vías Biliares/cirugía , Gastroenterólogos/educación , Gastroenterología/educación , Humanos , Internado y Residencia/normas , Enfermedades Pancreáticas/diagnóstico por imagen , Enfermedades Pancreáticas/cirugía , Resultado del Tratamiento , Estados Unidos
8.
Nurs Manage ; 50(7): 38-44, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31246653

RESUMEN

How one healthcare system became the first in the world to achieve a combination of Magnet recognition and Pathway to Excellence designation for all of its hospitals.


Asunto(s)
Habilitación Profesional , Hospitales/normas , Mentores , Servicio de Enfermería en Hospital/normas , Humanos , Estados Unidos
10.
Cyberpsychol Behav Soc Netw ; 22(6): 423-427, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31135182

RESUMEN

A web-based experiment (n = 960) examined how debunking of publicly shared news on social media affects viewers' attitudes toward the source who shared the fake news, their agreement with the news position, and perceived credibility of social media as a news platform. Exposure to debunking information did not lower participants' agreement with the news position, but led them to derogate (1) the source who shared the misinformation and (2) social media as a news platform. However, participants who initially favored the source were less likely to attribute the sharing of fake news to the source's dispositions, rather than situational factors, thereby maintaining their positive attitudes toward the source.


Asunto(s)
Actitud , Comunicación , Decepción , Medios de Comunicación Sociales , Habilitación Profesional , Femenino , Humanos , Masculino , Percepción , Personalidad
12.
J Nurses Prof Dev ; 35(4): 180-184, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31135614

RESUMEN

Accreditation of transition to practice (TTP) programs are rapidly increasing. A review was completed on 13 TTP programs, accredited by the American Nurses Credentialing Center Practice Transition Accreditation Program. The review found six benefits of TTP accreditation that can translate into value for organizations. Nursing professional development practitioners should seek accreditation for TTP programs to elevate the potential for funding from national agencies.


Asunto(s)
Acreditación/normas , Desarrollo de Personal/normas , Acreditación/organización & administración , American Nurses' Association , Habilitación Profesional/organización & administración , Habilitación Profesional/normas , Bachillerato en Enfermería , Humanos , Internado no Médico/organización & administración , Internado no Médico/normas , Desarrollo de Personal/organización & administración , Estados Unidos
13.
J Nurs Adm ; 49(6): 289-290, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31135634

RESUMEN

Now in its 29th year, the American Nurses Credentialing Center's Magnet Recognition Program stands as the premier international acknowledgment of nursing excellence in healthcare organizations around the world. The program's applicability in general hospitals, community hospitals, and academic medical centers is established, but what about specialty hospitals? In this month's Magnet Perspectives, nursing leaders from 3 specialty sectors, rehabilitation hospitals, cancer hospitals, and children's hospitals, discuss the ways in which the Magnet framework enriches the practice environment and promotes outstanding nurse and patient outcomes. Insights are shared about how the Magnet journey provides the foundation to address current challenges in healthcare, including nurse staffing shortages, burnout, unit effectiveness, safety and quality imperatives, patient experience, and more.


Asunto(s)
Habilitación Profesional , Hospitales Especializados/normas , Servicio de Enfermería en Hospital/normas , Humanos , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/normas , Personal de Enfermería en Hospital/provisión & distribución , Estados Unidos
15.
J Vasc Surg ; 69(5): 1505-1509, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31010516

RESUMEN

BACKGROUND: The Best Endovascular vs Best Surgical Therapy for Patients with Critical Limb Ischemia (BEST-CLI) trial compares open surgery and endovascular therapy for the treatment of critical limb ischemia (CLI). This report describes the types and proportion of investigators participating in BEST-CLI and determines how these compare with those specialists treating peripheral artery disease (PAD) outside of the trial. METHODS: To be credentialed to enroll in BEST-CLI, investigators must be approved by the Surgical and Interventional Management Committee to have sufficient experience and skill in the management of patients with CLI. Investigators must attest to having completed at least 12 below-knee interventions in the last 2 years on CLI patients for endovascular approval and 10 lower extremity below-knee bypass procedures in the last 2 years for open surgical treatment. Investigators who met these criteria but were within their first year of practice were conditionally approved to do procedures under the oversight of a fully approved investigator. The type and proportion of specialists credentialed in BEST-CLI were compared with those treating PAD on a national basis by auditing 10% of Medicare claims for PAD. RESULTS: As of September 2017, a total of 865 physicians were credentialed to enroll in the BEST-CLI trial. Of these, 596 (69%) are vascular surgeons, 128 (15%) are interventional cardiologists, 123 (14%) are interventional radiologists, 7 (1%) are vascular medicine specialists, and 11 (1%) are other. Of the 596 vascular surgeons enrolling in the trial, 113 (19%) are credentialed for open surgery only, 409 (69%) are credentialed for both open surgery and endovascular therapy, and 3 (1%) are credentialed for only endovascular therapy. The remaining 71 participating vascular surgeons were conditionally approved. Of the 136 centers enrolling patients, multispecialty involvement is present in 98 (72%). In 38 (28%), vascular surgery alone is the service enrolling CLI patients. Endovascular treatment by specialty in BEST-CLI vs national Medicare claims is as follows: vascular surgery, 55% vs 51%; interventional cardiology, 17% vs 13%; interventional radiology, 16% vs 25%; and other, 2% vs 10%. CONCLUSIONS: BEST-CLI contains a diverse group of specialists enrolling and treating patients with CLI. Whereas a majority of the participating practitioners are vascular surgeons who do both open and endovascular procedures, a broad variety of specialists are represented in BEST-CLI in a pattern that represents national treatment patterns outside of the BEST-CLI trial. These treatment patterns will help ensure that findings from BEST-CLI are applicable to the real-world practice of treatments for PAD.


Asunto(s)
Habilitación Profesional/tendencias , Procedimientos Endovasculares/tendencias , Isquemia/cirugía , Enfermedad Arterial Periférica/cirugía , Pautas de la Práctica en Medicina/tendencias , Investigadores/tendencias , Especialización/tendencias , Cirujanos/tendencias , Procedimientos Quirúrgicos Vasculares/tendencias , Reclamos Administrativos en el Cuidado de la Salud , Enfermedad Crítica , Humanos , Isquemia/diagnóstico , Medicare , Enfermedad Arterial Periférica/diagnóstico , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Estados Unidos
16.
J Dent Educ ; 83(8): 914-923, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30962312

RESUMEN

With the closure of the Canadian dental therapy program in Saskatchewan in 2011 and the increasing need for oral health providers, there have been growing discussions at the national and provincial levels regarding the re-establishment of a provider with dental therapy abilities. The aims of this study were to define models for dental therapy education in Canada and explore how dental therapy abilities could best be integrated into Canadian post-secondary education. In 2017, purposeful sampling was used to invite key informants to participate in a semi-structured interview. Participants were individuals from government, education, and regulation and those working with underserved populations in Canada and internationally. A 75% response rate (n=53) was achieved. Thematic analysis was employed for coding of data and generation of themes. Respondents highlighted the need to include minimally invasive restorative services in the current scope of dental hygiene practice across all Canadian jurisdictions and to build dental therapy abilities with or upon accredited dental hygiene curricula. The models supported by respondents were a fourth-year option built on three-year diploma education, a one-year postgraduate diploma based on a baccalaureate degree and a current dental hygiene registration, and a three-year dental therapy diploma incorporating core courses in accredited dental hygiene diploma education. While the respondents' views were divergent, the educational model that received the most support involved a two- to three-term addition to current three-year dental hygiene diploma education. In contrast to international trends, the respondents valued learner flexibility to exit with a diploma dental hygiene credential, thus making the dental therapy scope optional. These educational models provide a starting point for further analysis and exploration.


Asunto(s)
Competencia Clínica , Habilitación Profesional , Higienistas Dentales/educación , Educación en Odontología , Modelos Educacionales , Canadá , Curriculum , Educación Continua , Humanos , Higiene Bucal/educación , Práctica Profesional , Saskatchewan
19.
Cyberpsychol Behav Soc Netw ; 22(4): 283-287, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30848675

RESUMEN

The increased reliance on social network sites for news and the proliferation of partisan news have refocused scholarly attention on how people judge credibility online. Twitter has faced scrutiny regarding their practices in assigning the "verified" status to Twitter accounts, but little work has investigated whether users apply this cue in making assessments for information quality. Using an experimental design, we test whether the Twitter verification mark contributes to perceptions of information and account credibility among news organizations. We additionally consider how account ambiguity and account congruence with political beliefs condition this relationship. Our results suggest little attention is paid to the verification mark when judging credibility, even when little other information is provided about the account or the content. Instead, account ambiguity and congruence dominate credibility assessments of news organizations. We propose that Twitter may need to revise their verification badges to increase their salience or provide more information to users. Currently, users appear to rely on other cues than the verification label when judging information quality.


Asunto(s)
Habilitación Profesional , Conducta en la Búsqueda de Información , Medios de Comunicación de Masas/normas , Medios de Comunicación Sociales/normas , Adulto , Femenino , Humanos , Juicio , Masculino , Confianza
20.
Rev. ADM ; 76(1): 38-43, ene.-feb. 2019. ilus
Artículo en Español | LILACS | ID: biblio-996012

RESUMEN

La apertura de un consultorio privado es de interés para muchos profesionistas odontólogos. Más allá de las cuestiones económicas o de habilidad técnica, una limitante importante para llevarlo a cabo es el desconocimiento de los trámites administrativos necesarios para ello. Es común que muchos odontólogos se atrevan a mantener en uso un negocio que, la mayoría de las veces, no cumple con este tipo de aspectos, lo que conlleva a ser susceptible a diversas sanciones. El objetivo de este trabajo es enunciar y describir los requisitos básicos para la apertura de un consultorio de prestación de servicios profesionales odontológicos dentro del territorio mexicano. Posterior a una revisión de la legislación y normatividad vigentes en la República Mexicana, se enlistan los trámites realizados ante cuatro dependencias públicas: Servicio de Administración Tributaria (SAT), regulación sanitaria, protección civil y gobierno local. Cabe resaltar que esta información se ofrece bajo ciertas consideraciones, ya que puede existir variación de acuerdo con los lineamientos establecidos por los gobiernos locales de cada entidad federativa. Se concluye que dar cumplimiento con estos requisitos es el primer paso para el adecuado funcionamiento de nuestro negocio, lo cual ayuda a evitar las sanciones correspondientes y el desprestigio del consultorio (AU)


Opening a private dental offi ce is of interest for many dentists. Beyond economic issues or technical ability, an important limitation to carry this out is the unawareness of administrative procedures necessary for it. Commonly, many dentists dare to keep into the business despite not complying with all the necessary procedures, which makes them susceptible to administrative sanctions. The objective of this work is to enunciate and describe the basic requirements for opening a dental service offi ce within Mexican territory. After a review of current legislation and regulation in the Mexican Republic, the procedures performed in four public agencies are listed: The Tax Administration Service (SAT), health regulation, civil protection, and local government. It should be noted that this information is off ered under certain considerations, highlighting that data presented is done in a generic way, since this may vary according to guidelines from local government of each federative entity. It is concluded that compliance with these requirements is the fi rst step for the proper functioning of our business, which helps avoid the corresponding sanctions and disrepute of the private practice (AU)


Asunto(s)
Administración Sanitaria/legislación & jurisprudencia , Habilitación Profesional , Protección Civil , Consultorios Odontológicos/legislación & jurisprudencia , Legislación en Odontología , Administración de la Práctica Odontológica/legislación & jurisprudencia , Responsabilidad Civil , México
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