Education, Ethics, and History: The Peer Review Process in the US.

Despite the near-universal acceptance of the benefits of a sound peer review process (PRP), the topic of peer review remains a source of controversy among surgeons. The current PRP is plagued by heterogeneity across different hospital and institutional systems. These inconsistencies, combined with a perceived lack of fairness inherent to the PRP in some institutions, led to concerns among practicing surgeons. In this review of the relevant literature on the PRP, we attempted to provide some context and insight into the history of the PRP, its role, its shortcomings, its potential abuses, and some key requirements for its successful execution.

Quackery in Dental Practice in Nepal.

Quackery and fraud in dental practice, seen in many countries, is also rampant in Nepal, and they are unethical practices. There is a growing need for strict enforcement of government policy measures to eliminate quackery and fraudulent dental practice in Nepal. The government should mobilize all dental workforce (dental specialists, dentists, and dental auxiliaries) and aware of their responsibilities and limitations. This article presents a brief review showing some cases of malpractice in dentistry in Nepal.

Los títulos, la ley de educación superior y los posgrados en medicina / TITLES, THE SUPERIOR EDUCATION LAW , AND POSTGRADUATE COURSES IN MEDICINE

Actualmente la oferta académica que disponen los profesionales de la salud es considerable y en muchos casos resulta engañosa dado que se publicitan múltiples formatos tales como diplomaturas, cursos superiores, etc que sugieren una supuesta especialización que en realidad no es tal. Por ello surge la intención de analizar este tema y revisar de manera clara y sustentada lo que significan cada uno de los títulos, que dice la la ley de educación superior y cuales son los posgrados en medicina así como su validez y eventual correspondencia con una especialización.

Currently the academic offer available to health professionals is considerable and in many cases it is misleading given that multiple formats such as postgraduate diplomas, higher courses, etc. suggesting a supposed specialization that is not really such. Therefore the intention arises to analyze this issue and review in a clear and sustained way what each of the titles mean, which says the law of higher education and what are the postgraduate courses in medicine as well as their validity and ventual correspondence with a specialization.

Knowledge of US Midwifery Credentials Among Members of the American College of Nurse-Midwives.

INTRODUCTION: Three midwifery credentials are granted in the United States: certified nurse-midwife (CNM), certified midwife (CM), and certified professional midwife (CPM). Confusion about US midwifery credentials may restrict growth of the midwifery profession. This survey assessed American College of Nurse-Midwives (ACNM) members' knowledge of US midwifery credentials. METHODS: ACNM members (N = 7551) were surveyed via email in 2017. The survey asked respondents to report demographic information and to identify correct statements about the education, certification, and scope of practice of CNMs, CMs, and CPMs. Responses to 17 items about all midwives certified in the United States, a 5-item subset specific to CNMs/CMs, and one item related to location of midwifery practice by credential were analyzed. RESULTS: Nearly a quarter of the membership (22.1%) responded to the survey. Higher scores on the survey indicated greater identification of correct statements about the education, certification, scope, and location of practice of CNMs, CMs, and CPMs. Significant differences in scores were found among ACNM members based on their level of education, degree of professional involvement in midwifery, and prior practice as a nurse. ACNM members with higher scores on the survey held a doctorate, worked in Region I, and had greater professional leadership involvement in midwifery organizations. Participants with less nursing experience prior to their midwifery education also scored significantly higher on the survey. DISCUSSION: Although two-thirds of respondents correctly answered items on the preparation, credentialing, and scope of practice of CNMs, CMs, and CPMs, a significant minority had gaps in knowledge. Results of this survey suggest the need for outreach about US midwifery credentials. Future research to replicate and expand upon this survey may benefit the profession of midwifery in the United States.

Authority of Health Care Providers To Practice Telehealth. Final rule.

The Department of Veterans Affairs (VA) is amending its medical regulations by standardizing the delivery of care by VA health care providers through telehealth. This rule ensures that VA health care providers can offer the same level of care to all beneficiaries, irrespective of the State or location in a State of the VA health care provider or the beneficiary. This final rule achieves important Federal interests by increasing the availability of mental health, specialty, and general clinical care for all beneficiaries.

Medicaid Credentialing Made Simple.

A new partnership by the Texas Medical Association and the Texas Association of Health Plans will soon streamline the process of getting credentialed - and recredentialed - for Medicaid health plans.

Mise au point sur la rédaction des certificats médicaux et médico-légaux

Le certificat médical est l'attestation écrite des constatations cliniques et paracliniques d'un patient. Sa rédaction doit suivre des règles de prudence et d'objectivité permettant la réponse à l'objet qui a motivé sa demande. Tandis que le certificat médical ordinaire est établi à la demande du patient pour l'obtention d'avantages sociaux ou administratifs, le certificat médico-légal est quant à lui établi à la demande du patient, de l'officier de police judiciaire ou du juge, dans un objectif judiciaire. C'est un document essentiel dans les procédures consécutives à des coups ; blessures. Il doit être écrit avec précision et détails, et indiquer en conclusion la durée de l'incapacité totale de travail (ITT), laquelle, exprimée en nombre de jours permettra au juge de qualifier les dommages corporels. Cette mise au point a donc pour objectifs de rappeler les principales règles de rédaction des certificats médicaux et médico-légaux, et de proposer à titre indicatif des ITT pouvant orienter l'évaluation du médecin

European registration process for Clinical Laboratory Geneticists in genetic healthcare.

Tremendous progress in genetics and genomics led to a wide range of healthcare providers, genetic tests, and more patients who can benefit from these developments. To guarantee and improve the quality of genetic testing, a unified European-based registration for individuals qualified in biomedicine was realized. Therefore a Europe-wide recognition of the profession 'European registered Clinical Laboratory Geneticist (ErCLG)' based on a syllabus of core competences was established which allows for harmonization in professional education. The 'European Board of Medical Genetics division - Clinical Laboratory Geneticist' provides now since 3 years the possibility to register as an ErCLG. Applicants may be from all European countries and since this year also from outside of Europe. Five subtitles reflect the exact specialty of each ErCLG, who can reregister every 5 years. A previously not possible statistics based on ~300 individuals from 19 countries as holders of an ErCLG title provides interesting insights into the professionals working in human genetics. It could be substantiated that there are around twice as many females than males and that a PhD title was achieved by 80% of registered ErCLGs. Also most ErCLGs are still trained as generalists (66%), followed by such ErCLGs with focus on molecular genetics (23%); the remaining are concentrated either on clinical (6%), tumor (4%) or biochemical genetics (1%). In conclusion, besides MDs and genetic counselors/nurses an EU-wide recognition system for Clinical Laboratory Geneticist has been established, which strengthens the status of specialists working in human genetic diagnostics in Europe and worldwide.

Regulação do trabalho e das profissões em saúde: relatório final apresentação / Regulation of work and health professions: final report presentation

INTRODUÇÃO: Este relatório apresenta os resultados da organização e desenvolvimento do conjunto de atividades desenvolvidas no âmbito da pesquisa Regulação do Trabalho e das Profissões em Saúde, realizada pela Estação de Trabalho Instituto de Medicina Social (IMS) da Universidade do Estado do Rio de Janeiro (UERJ) e pela Estação de Pesquisa de Sinais de Mercado (EPSM) do Núcleo de Educação em Saúde Coletiva (NESCON) da Universidade Federal de Minas Gerais (UFMG), que compõem a Rede Observatório de Recursos Humanos em Saúde (ObservaRH). OBJETIVOS: Analisar os processos de regulação da formação e do exercício de diferentes profissões da saúde, tendo como eixo a questão da expansão dos escopos de prática e reforçar as capacidades de avaliação e de monitoramento das políticas de formação de pessoal e o processo de revisão e expansão de escopos de prática das profissões de saúde no Brasil, objetivos específicos Analisar a formação e qualificação dos profissionais de saúde de nível superior para identificar as adequações às necessidades do SUS; Identificar as atribuições, competências e o escopo de práticas das diferentes profissões e ocupações de saúde no âmbito da APS, e as interfaces entre as diferentes profissões e ocupações de saúde. MATERIAL E MÉTODO: As atividades foram divididas em duas Metas, desenvolvidas e coordenadas por cada uma das duas Estações de Pesquisa participantes. Dessa forma, a Meta I - Análise da formação dos profissionais de saúde de nível superior às necessidades do SUS, foi realizada pela Estação de Pesquisa do IMS, sob a coordenação da Celia Regina Pierantoni e a Meta II - Análise das atribuições, competências e do escopo de práticas das diferentes profissões de saúde no âmbito da APS, foi realizada pela Estação de Sinais de Mercado em Saúde, do Nescon/UFMG, sob a coordenação de Sabado Nicolau Girardi. Esta pesquisa constitui-se de estudo avaliativo, exploratório e descritivo de abrangência nacional, que conjugou métodos quantitativos e qualitativos. Para a seleção das profissões alvo desse estudo, os seguintes critérios foram considerados: (1) profissões de nível superior com relevância na oferta de formação e demanda dos serviços de saúde, especialmente no nível primário, e (2) as de nível técnico que trabalham por delegação e sob supervisão dos profissionais de nível superior escolhidos. As técnicas de coleta de dados empregadas foram: revisão sistemática da literatura, análise documental, survey por entrevista telefônica assistida por computador (ETAC), survey online, entrevistas em profundidade in loco e diálogos online. Os dados foram coletados entre abril de 2015 e dezembro de 2016, e tratados por estatística descritiva, análise documental, análise bibliográfica e análise de conteúdo, considerando as particularidades de cada tipo de dado.

Embittered Backlog.

The Texas Medical Association Payment Advocacy Department has received complaints from several physicians that three of the state's biggest health plans are taking up to eight months to credential them. Without successful credentialing, physician payment for medical services can be delayed and even denied.

Informing Health Policy Decision Makers: A Nebraska Scope of Practice Case Study.

Medicare patients seeking care from nurse practitioners (NPs) increased 15-fold from 1998 to 2010, and a 2.5-fold patient increase was recorded in states that have eased the regulatory environment for NPs. It is increasingly important that state regulatory and licensing boards-charged with protecting the public through the assurance of a qualified health-care workforce-examine whether their state regulatory environment restricts or promotes public access to quality health care. This article presents a case study of a statutory scope of practice credentialing review process for NPs in Nebraska. It examines in depth what individuals involved in policy change processes found most useful for informed decision making. The methodology included observation of the process, review of submitted documents, and a survey to individuals involved in the decision-making process (n = 22/48). The study findings have application for those seeking scope of practice policy changes, with specific suggestions for how to better prepare themselves and present information in formats that are helpful to decision makers. Our results also shed new light on what specific evidence submitted during a scope of practice review process is most valued for promoting the understanding of decision makers to effect change.

Telemental Health for Children and Adolescents: An Overview of Legal, Regulatory, and Risk Management Issues.

OBJECTIVE: The use of technology to provide telemental healthcare continues to increase; however, little has been written about the legal and regulatory issues involved in providing this form of care to children and adolescents. METHODS: This article reviews existing laws and regulations to summarize the risk management issues relevant to providing telemental healthcare to children and adolescents. RESULTS: There are several legal and regulatory areas in which telemental health clinicians need to have awareness. These areas include: 1) Licensure, 2) malpractice liability, 3) credentialing and privileging, 4) informed consent, 5) security and privacy, and 6) emergency management. CONCLUSIONS: Although legal and regulatory challenges remain in providing telemental healthcare to children and adolescents, it is possible to overcome these challenges with knowledge of the issues and appropriate risk management strategies. We provide general knowledge of these key legal and regulatory issues, along with some risk management recommendations.

A game of snakes and ladders: negotiating the 'ups and downs' of endorsement as a nurse practitioner in Australia.

BACKGROUND: Australian legislation supporting the nurse practitioner (NP) role was enacted in 1998. Since then, NPs have played an important advanced practice role within the interdisciplinary healthcare team. However, the literature suggests that transition to the NP role can be challenging. AIM: This paper highlights the complex transition experiences of ten recently endorsed Australian NPs. The convoluted legislative and regulatory requirements that were negotiated by the NPs are presented as narratives. METHODS: Informed by an ethnographic approach, participants were interviewed several times during their first year. Interview transcripts were thematically analysed and aggregated into three narratives representative of key findings. KEY FINDINGS: The findings exemplify the complexity of navigating through a labyrinth of bureaucracy and the extensive negotiations required to appease those who yielded power over their future practice. CONCLUSION: This study raises awareness of the transition experiences of Australian NPs and their challenges and barriers during this time.