American journal of obstetrics and gynecology
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Am. J. Obstet. Gynecol. · Jun 2004
Comparative StudyComparison of laparoscopic-assisted vaginal hysterectomy with traditional hysterectomy for cost-effectiveness to employers.
The purpose of this study was to compare the cost-effectiveness of laparoscopic-assisted vaginal hysterectomy to traditional total abdominal hysterectomy and total vaginal hysterectomy with regard not only to direct hospital costs but also to indirect costs. ⋯ For most patients, laparoscopic-assisted vaginal hysterectomy provides a minimally invasive way to accomplish a hysterectomy with a lower cost to employers (payers) on the basis of lost work hours.
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Am. J. Obstet. Gynecol. · Jun 2004
Comparative StudyA follow-up evaluation of sexual misconduct complaints: the Oregon Board of Medical Examiners, 1998 through 2002.
The current study presents an analysis of sexual misconduct allegations that were closed from 1998 through 2002 and is compared with allegations from 1991 through 1995 (study 1). One hundred complaints were closed in study 1, which involved 80 licensees; 23.8% of those complaints resulted in reportable board actions. ⋯ Physician and patient awareness and board actions reduced total complaints of sexual misconduct. Family medicine was an exception, with 12 reportable board actions compared with 4 in study 1. Reportable disciplinary actions involved revocations, suspensions, and surrender of license; the disciplinary actions most often involved probation, education, counseling and/or psychiatric therapy, and practice limitation. Education, the identification of high-risk practitioners, and the appropriate use of deterrence continue to be areas of recommended focus.
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Am. J. Obstet. Gynecol. · May 2004
Resident physician attire: does it make a difference to our patients?
This study was performed to examine the preferences of patients regarding physician attire, and if their perception of physician competence was influenced by the physicians' clothing style. ⋯ Resident physician attire makes a difference to patients. Our patients prefer the white coat with surgical scrubs. Casual clothing is less well liked by our patients.
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Am. J. Obstet. Gynecol. · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialEffect of topical bupivacaine on postoperative pain after laparoscopic tubal sterilization with Filshie clips.
The purpose of this study was to evaluate postoperative pain after the administration of topical bupivacaine during laparoscopic sterilization with Filshie clips. ⋯ Topical bupivacaine that is applied to the fallopian tubes at the time of laparoscopic tubal sterilization with the Filshie clip decreases immediate postoperative pain.
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Am. J. Obstet. Gynecol. · May 2004
ReviewNeglected ethical dimensions of the professional liability crisis.
In response to the professional liability crisis, self-interest can become dominant and displace fiduciary professionalism from its central place in the moral lives of physicians and physician leaders. We provide preventive ethics tools to address this neglected ethical dimension of the professional liability crisis. We develop these tools on the basis of the concept of the physician as fiduciary of the patient, which was introduced in the English-language literature of medical ethics by Dr John Gregory (1714-1773). ⋯ Acceptable and unacceptable responses to the professional liability crisis are identified with the use of these 4 virtues. These virtues should be supported by an organizational culture of fiduciary professionalism. An organizational culture that is shaped by these 4 professional virtues should be used by physicians and physician leaders to create ethical best-practice models.