Lessons from London: the British are reforming their national health service.
(17/40)
In an effort to keep abreast of the changing needs of a more affluent society and to ensure better value for money, the British are reforming their National Health Service. They are promoting competition and entrepreneurship, and directing funding to follow a patient rather than flowing directly to institutions. British physicians are resisting these changes. The United States, in the middle of a health care crisis of its own, can learn a great deal from Britain, especially in the area of controlling expenditures. The low cost of the National Health Service can be attributed to four major factors: (1) It is general practitioner driven and no patient accesses a specialist or hospital directly. (2) Hospitals, which employ all the specialists and supply most of the technology, operate on very tight, cash-limited budgets. (3) Administrative costs are very low. (4) The expense of malpractice is not (yet) a major concern. Changes occurring in both countries foretell a future wherein our health care systems may look very much alike. (+info)
Fostering innovation without compromising integrity.
(18/40)
Industry's interaction with academia has created vast opportunity for innovation but also the potential for undue financial influence. Potential conflicts of interest can occur at the level of the individual researcher or the institution. Implementing guidelines and policies on conflicts of interest can help maintain appropriate separation between academic medicine and industry while permitting medical innovation to proceed. In an effort to retain public trust, Stanford University School of Medicine has enacted policies to identify and manage potential conflicts among its faculty, to divest of holdings in companies conducting studies involving Stanford investigators, and to ban all industry marketing and gifts from Stanford facilities. (+info)
Innovation and industry-academia interactions: where conflicts arise and measures to avoid them.
(19/40)
Every phase of the development of biopharmaceuticals and medical devices has the potential for conflict of interest, but adherence to established rules and practices throughout product development can eliminate the possibility of conflicts. Adherence to good practices should continue through the postmarketing period, with swift reporting and vigorous investigation of any safety concerns. Although some academic medical centers are restricting interactions between their faculty and industry to prevent possible conflicts in physician education about new products, industry and academia should look for new ways to come together in mutually agreed forums that focus on educating clinicians about new products in an efficient, transparent way. (+info)
Overregulation of conflicts hinders medical progress.
(20/40)
The revolution in medicine and technology over the past few decades is largely the result of partnerships--or a "harmony of interests"--between private companies and entrepreneurial scientists and clinicians. Regulations to prevent conflicts of interest by restricting medical education, medical research, expert advisory functions, or researcher ownership of inventions may have the unintended consequence of slowing medical progress. (+info)
Medical devices and conflict of interest: unique issues and an industry code to address them.
(21/40)
Development of medical devices requires interaction between physicians and industry that is considerably more intimate than that in pharmaceutical development. Progress in procedure-based medicine would be stalled if this collaboration were eliminated. This degree of interaction, however, creates conflicts of interest that must be managed to avoid compromising trust, credibility, and patient care. AdvaMed, a trade association for the medical device industry, has developed a code of ethics to manage many of these conflicts and to guide its members' interactions with health care professionals. This article reviews the rationale for the AdvaMed code and provides a brief in terms of c overview of the code itself.onflict-of-interest cons iderations, the world of medical devices is significantly dif- (+info)
Conflict-of-interest management: efforts and insights from the Association of American Medical Colleges.
(22/40)
The Association of American Medical Colleges has issued three major reports to help academic medical centers manage financial conflicts of interest in clinical research. One report addresses individual conflicts, another addresses institutional conflicts, and the third is a survey-based assessment of institutions performance to date in conflict-of-interest management. While implementation of policies to manage individual conflicts has been significant and widespread, the extent to which institutional conflicts are being managed is unclear. Developing effective and accepted policies to manage potential conflicts involving the funding of education remains a major challenge. (+info)
'What's the ethics of that?' A Conversation with Thomas O. Pyle. Interview by Donald M. Berwick and Madge Kaplan.
(23/40)
Thomas O. Pyle served in the top echelons of the Harvard Community Health Plan (HCHP) for nineteen years. In that time, HCHP became the largest health maintenance organization (HMO) in New England, and its reputation for innovation and entrepreneurship rose to the top ranks of the industry. HCHP pioneered the automated medical record, nurse practitioners, quality measurement, and sophisticated disease management. In this interview, Berwick and the Institute for Healthcare Improvement's Madge Kaplan explore Pyle's background, his interpretation of HCHP's evolution and eventual transition to a much different organization, and his recommendations for the future. At the time of this interview, Tom was suffering from advanced pancreatic cancer, from which he died ten weeks later, 18 July 2007. (+info)
Self rated health and working conditions of small-scale enterprisers in Sweden.
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This study was an investigation of prevalence and associations between self-rated health and working conditions for small-scale enterprisers in a county in Sweden. A postal questionnaire was answered by 340 male and 153 female small-scale enterprisers in different sectors, with a response rate of 66%. For comparative purposes, data from a population study of 1,699 employees in private companies was included in the analyses. Differences were tested by Chi(2)-test and associations were presented as odds ratios (OR) with a 95% confidence interval (95% CI). The frequency of health problems in male enterprisers was higher than in employees in the private sector, while the frequency of health problems in female enterprisers was equal to that of the control employees. The main findings highlighted that male enterprisers reported higher rate of health problems and female enterprisers equal rate compared with employees in the private sector. Enterprisers stated musculoskeletal pain (women 59%, men 56%) and mental health problems (women 47%, men 45%) as the most frequent health problems. Poor job satisfaction, reported by 17% of the females and 20% of the male enterprisers, revealed an OR of 10.42 (95% CI 5.78-18.77) for poor general health. For the enterprisers, the most frequent complaints, musculoskeletal pain and mental health problems, were associated with poor job satisfaction and poor physical work environment. An association between poor general health and working as an enterpriser remained after adjusting for working conditions, sex and age. (+info)