Virtual Mentor. May 2008, Volume 10, Number 5: 263-354 Full Issue PDF

May 2008 Contents

System Constraints on Optimal Care

Ethics Poll

Everyone claims that the U.S. health care system is broken. Which one of the following do you think contributes most to making health care delivery so frustrating and difficult for patients to navigate?
Insurance company precertification and reimbursement policies.
Complexity of Medicare and Medicaid eligibility and filing systems.
Malpractice law and professional fear of lawsuits.
Hospital billing systems.
Lack of coordination of care among the physicians one must see for total care.
Physicians' lack of concern for individual patients.
Physician shortage.
Public's demand for unnecessary services.

Some hospitals and clinics employ "secret shoppers" to report to management on the quality of the clinical encounter they observed while pretending to be patients. Which one of the following best describes your response to this practice?
It's a good idea; poor staff performance and inefficiency cause mistakes and add to the cost of health care.
Used judiciously, it's an effective quality improvement tool.
It's a bad idea; it takes time away from real patients and treats professionals as though they were retail staff.
It's wrong. Medicine is a moral practice and should not employ deception of any kind.

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From the Editor

Optimizing Medical Care with the Support and Limitations of Health Care Systems
Laura Sigman
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Virtual Mentor. 2008; 10:265-266.

Educating for Professionalism

Clinical Cases

Physician's Accountability for System Failure
Commentary by David Lovinger
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Virtual Mentor. 2008; 10:267-270.

Transplant Tourism: Treating Patients when They Return to the U.S.
Commentary by Sally Satel, and Andrew J. Aronson
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Virtual Mentor. 2008; 10:271-277.

Securing Diagnostic Services within System Constraints
Commentary by Bruce Patsner
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Virtual Mentor. 2008; 10:278-281.

Medical Culture and Error Disclosure
Commentary by Amy G. Lehman
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Virtual Mentor. 2008; 10:282-287.

Do Secret Shoppers Have a Place in Medicine?
Commentary by James C. Loden, and Richard C. Frederick
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Virtual Mentor. 2008; 10:288-294.

Medical Education

The Ambulatory Long Block: A Systems-Based Practice Innovation
Eric J. Warm
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Virtual Mentor. 2008; 10:295-299.

Journal Discussion

Keeping Patients Safe: The Ethics of Quality Improvement
Sara Platte
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Virtual Mentor. 2008; 10:300-303.

Clinical Pearl

Amniocentesis: Indications and Risks
Maura Parker Quinlan
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Virtual Mentor. 2008; 10:304-306.

Law, Policy, and Society

Health Law

ERISA: A Close Look at Misguided Legislation
Lee Black
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Virtual Mentor. 2008; 10:307-311.

Policy Forum

Medicare's “Never-Event” Initiative
Jared Hossack
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Virtual Mentor. 2008; 10:312-316.

Medicine and Society

Can Health Care Engineering Fix Health Care?
Peter J. Fabri
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Virtual Mentor. 2008; 10:317-319.

History, Art, and Narrative

Medical Humanities

Equity in Medical Care: An Aristotelian Defense of Imperfect Rules—and Bending Them
Geoffrey Rees
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Virtual Mentor. 2008; 10:320-323.

History of Medicine

The U.S. Health Care Non-System, 1908-2008
George B. Moseley III
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Virtual Mentor. 2008; 10:324-331.

Op-Ed and Correspondence

Op-Ed

The Teaching of Law in Medical Education
Nirav D. Shah
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Virtual Mentor. 2008; 10:332-337.

Resources

Suggested Readings and Resources
PDF
Virtual Mentor. 2008; 10:338-351.

About the Contributors
Full Text | PDF
Virtual Mentor. 2008; 10:352-354.