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False beliefs in medicine can be regulated by constitutional doctrines of false speech and professional speech, whereby government can restrict professionals' false beliefs or impose its own false beliefs on professionals. In our allegedly "post truth" society, such regulations and their foundations can have an important influence on health care practice., (© 2018 American Medical Association. All Rights Reserved.)

Objective: To assess public knowledge and expectations of the ways to assess doctors' competence to ensure patient safety., Design Setting and Participants: Telephone survey of a random sample of 1000 non-institutionalized Hong Kong residents., Measures and Results: Only 5% of public were correct that doctors are not required to periodically be assessed, and 9% were correct that the doctors are not required to update knowledge and skills for renewing their license. These results echo international studies showing a low public knowledge of medical regulation. The public overwhelmingly felt a periodic assessment (92%) and requirements for continuous medical education (91%) were important processes for assuring doctors' competence. A high proportion of the public felt that lay representation in the Medical Council was insufficient., Conclusion: There is a significant gap between public expectations and understanding of the existing medical regulation and the actual policies and practices. Despite a lack of public knowledge, the public thought it important to have an ongoing structured monitoring and assessment mechanism to assure doctors' competence. The public also expects a greater involvement in the regulatory processes as members of the Medical Council. There is a need to review and enhance the current regulatory system to meet public expectation and ensure accountability for the privilege and trust granted by the State in professional self-regulation. In the context of our complex health system, a thorough understanding on the dynamic interactions between different institutions and their complementary roles in a meta-regulatory framework is required in assuring patient safety.

The requirement of 'research completion' as necessary for specialist registration with the Health Professions Council of South Africa (HPCSA) has recently been subject to legal action, with a court order potentially shifting requirements beyond those envisaged by the HPCSA. The research requirement is congruent with National Department of Health strategy in this regard, i.e. the strengthening of research as a stated priority. While the expectation of research competency is not in itself contentious, the capacity of institutions and the ability of registrars to facilitate and complete, respectively, have brought the issue into focus. Specifically, the apparent discrepancy between a court order and a regulation needs to be resolved to ensure that specialist registration is not unduly hampered, while ensuring that a potentially important contributor to a national priority is not prejudiced.

Over the past decades, professional boundaries in health care have come under pressure, and the expansion of prescriptive authority to include nurses touches on issues of professional domains and interprofessional competition. Knowledge claims play an important role in achieving jurisdictional control. Knowledge can take on multiple forms, ranging from indeterminate to technical (I/T ratio) and from everyday to exclusive knowledge. To investigate the interrelatedness of jurisdiction, knowledge claims and professional status, we examine which knowledge claims were made by the medical and nursing professions in the Netherlands to secure or obtain, respectively, jurisdictional control over prescribing, and which form this knowledge took. The study is based on thirteen semi-structured stakeholder interviews and an extensive document analysis. We found that the nursing profession in its knowledge claims strongly emphasized the technicality and everyday knowledge character of the prescribing task, by asserting that nurses were already prescribing medicines, albeit on an illegal basis. Their second claim focused on the indeterminate knowledge skills of nurses and stated that nurse prescribing would do justice to nurses' skills and expertise. This is a strong claim in a quest for (higher) professional status. Results showed that the medical profession initially proclaimed that prescribing should be reserved for doctors as it is a task requiring medical knowledge, i.e. indeterminate knowledge. Gradually, however, the medical profession adjusted its claims and tried to reduce nurse prescribing to a task almost exclusively based on technicality knowledge, among others by stating that nurses could prescribe in routine cases, which would generate little professional status. By investigating the form that professional knowledge claims took, this study was able to show the interconnectedness of jurisdictional control, knowledge claims and professional status. Knowledge claims are not mere rhetoric, but actively influence the everyday realities of professional status, interprofessional competition and jurisdictional division between professions.

Rationale and Objectives: Whether first-year radiology residents are ready to start call after 6 or 12 months has been a subject of much debate. The purpose of this study was to establish an assessment that would evaluate the call readiness of first-year radiology residents and identify any individual areas of weakness using a comprehensive computerized format. Secondarily, we evaluated for any significant differences in performance before and after the change in precall training requirement from 6 to 12 months., Materials and Methods: A list of >140 potential emergency radiology cases was given to first-year radiology residents at the beginning of the academic year. Over 4 years, three separate versions of a computerized examination were constructed using hyperlinked PowerPoint presentations and given to both first-year and second-year residents. No resident took the same version of the exam twice. Exam score and number of cases failed were assessed. Individual areas of weakness were identified and remediated with the residents. Statistical analysis was used to evaluate exam score and the number of cases failed, considering resident year and the three versions of the exam., Results: Over 4 years, 17 of 19 (89%) first-year radiology residents passed the exam on first attempt. The two who failed were remediated and passed a different version of the exam 6 weeks later. Using the oral board scoring system, first-year radiology residents scored an average of 70.7 with 13 cases failed, compared to 71.1 with eight cases failed for second-year residents who scored statistically significantly higher. No significant difference was found in first-year radiology resident scoring before and after the 12-month training requirement prior to call., Conclusions: An emergency radiology examination was established to aid in the assessment of first-year radiology residents' competency prior to starting call, which has become a permanent part of the first-year curriculum. Over 4 years, all first-year residents were ultimately judged ready to start call. Of the variables assessed, only resident year showed a significant difference in scoring parameters. In particular, length of training prior to taking call showed no significant difference. Areas of weakness were identified for further study., (Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.)

Medical malpractice reform is both necessary and desirable, yet certain types of reform are clearly preferable to others. We argue that "traditional" tort reform remedies such as stringent damage caps not only fail to address the root causes of negligence and the adverse effects that fear of suit can have on physicians, but also fail to address the needs of patients. Physicians ought to view themselves as professionals who are dedicated to putting patients' interests ahead of their own. Professionally responsible malpractice reform should therefore be at least as patient-centered as it is physician-centered. Examples of more professionally responsible malpractice reform exist where institutions take a pro-active approach to identification, investigation, and remediation of possible malpractice. Such programs should be implemented more generally, and state laws enacted to facilitate them.

Case histories are based on actual medical negligence claims or medicolegal referrals; however certain facts have been omitted or changed by the author to ensure the anonymity of the parties involved. On 26 March 2008, the Council of Australian Governments signed an Intergovernmental Agreement for a National Registration and Accreditation Scheme for the Health Professions. The new scheme is scheduled to be introduced on 1 July 2010. As part of the scheme all registered health practitioners will be legally required to report any other registered health practitioner who has behaved in a manner that constitutes 'notifiable conduct'. The threshold to be met to trigger the requirement to report notifiable conduct in relation to a practitioner is high, and the practitioner or employer must have first formed a 'reasonable belief' that the behaviour constitutes notifiable conduct. This article discusses this new legislation, the circumstances in which a colleague's conduct must be reported and how a notification should be made.

This final rule revises existing regulations under sections 401 through 432 of the Health Care Quality Improvement Act of 1986, governing the National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners, to incorporate statutory requirements under section 1921 of the Social Security Act, as amended by section 5(b) of the Medicare and Medicaid Patient and Program Protection Act of 1987 (MMPPPA), and as amended by the Omnibus Budget Reconciliation Act of 1990 (OBRA). The MMPPPA, along with certain additional provisions in the OBRA, was designed to protect program beneficiaries from unfit health care practitioners, and otherwise improve the anti-fraud provisions of Medicare and State health care programs. Section 1921, the statutory authority upon which this regulatory action is based, requires each State to adopt a system of reporting to the Secretary of Health and Human Services (the Secretary) certain adverse licensure actions taken against health care practitioners and health care entities licensed or otherwise authorized by a State (or a political subdivision thereof) to provide health care services. It also requires each State to report any negative actions or findings that a State licensing authority, peer review organization, or private accreditation entity has concluded against a health care practitioner or health care entity.

The concept of the dual loyalty physicians may have to both a patient and a third party is important in elucidating the obligations of physicians. The extent to which loyalty may be deflected from a patient to a third party (e.g., an insurance company or a prison commander) is greatly underestimated and has not attracted significant scholarly analysis. We examined dual loyalty in civilian and military contexts and used the principles of public health ethics to construct a framework for determining the legitimacy of physicians' obligations. We illustrate the application of these principles to problems physicians encounter regarding communicable diseases, elder abuse, and driving fitness. In the complex military context, independent ethics tribunals should be created to adjudicate loyalty conflicts.

Purpose: The purpose of this project was to update the 1987 competencies for physical therapists who work in schools and their content to reflect present practice, legislation, and terminology., Methods: A review of the literature and competencies for professionals working in schools was completed. Four focus groups of school physical therapists were formed to ascertain their perspectives of the roles and responsibilities of school therapists and what knowledge and skills enabled them to be effective. This information was integrated into a listing of competencies. The competencies were reviewed regionally and nationally by experts in the field., Results: Nine content areas with specific competencies were identified for physical therapists working in schools. These competencies reflect an expanded role of school-based therapists compared with previous competencies., Conclusion: Physical therapists who work in schools require specific skills and knowledge to effectively serve children with disabilities. Competencies help guide professional development.

Heidrick & Struggles, the nation's largest executive recruiting firm and a staunch champion of the National Center for Healthcare Leadership, is fighting a lawsuit that may test the premise that the healthcare industry lacks future leaders. As far as the placement business goes, Michael Doody, left, a senior vice president at search firm Witt/Kieffer, is confident a hospital's lawsuit alleging Heidrick fell down on the job won't cause irreparable damage.

Three experiments addressed the proposition that jurors use short cuts in processing information when confronted with expert scientific testimony. The results of the first two studies demonstrated that experts who are highly paid for their testimony and who testify frequently are perceived as "hired guns." They are neither liked nor believed. The results of the third experiment replicated the hired gun effect and showed that it is most likely to occur when the testimony is complex and cannot be easily processed. The results were discussed in terms of the theoretical differences between central and peripheral processing of persuasive messages in a legal context.

The formation of nursing professionals has been a concern through nursing history in our country. Within the context of development of nursing history, authors analysed the evolution of the legislation about the formation of nursing professionals at the secondary level as well as the legislation about their practice.

A study comparing the regulation and control of the professional practice of nurses in Brasil, Argentina, Uruguay and Paraguay, delineating their particularities, differences and similarities in the perspective of the implementation of the Cone Sul Common Market, which presupposes the free circulation of workers in the workplaces of the member-countries of the Ascnsion Treaty.

Any meaningful reform of health care delivery will have to overcome current barriers to effective utilization of nonphysician providers. These barriers include cultural and professional realities, as well as a number of explicit legal impediments. Medical practice acts remain overly broad and indeterminate, with concomitant and unnecessary restrictions in the licensure and practice acts of nonphysician providers. If we are to achieve our goal of offering high-quality care, at an affordable cost, to everyone who needs it, we must ensure that all health care providers are able to practice within the full scope of their professional competencies.

This review examines the current medical disciplinary process in New York State and assesses whether it protects the public and is fair to respondent physicians. Clearly there is urgent need for reform. Results of 1,036 disciplinary actions over the years 1982-1989 have been reviewed, with special attention to the 878 cases during 1985-89. The types of misconduct and their incidences among these physicians represent but a small segment of the more than 40,000 licensed practising physicians in this state. Extrapolations concerning their incidence should not be made from these limited data to the general population of physicians. The many flaws in the present system have been noted. A brief review of the process in 32 other states, Ontario, and Great Britain has shown that New York's is the most cumbersome and lengthy. Changes are suggested to modify the present system preserving some features of the current process but eliminating others. Licensing and disciplinary processes should be included in a single agency within the Health Department and this must be kept independent.