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Biomedical subjects

Alice G Gosfield

Publications and source records attributed to Alice G Gosfield.

18 recordsLinked to original sources
PubMed2004

The doctor-patient relationship as the business case for quality: doing well by doing right.

The idea that healthcare quality in America has lagged behind optimal levels has been a central national policy issue since at least 1998. Reform efforts, however, have failed to acknowledge the critical and unique role physicians play in making quality initiatives real. This Article argues physicians are at the core of any effort to propel quality forward in a significant way and, therefore, must be taken into account directly and without apology. The Article examines the quality-accountability context present in this country. It addresses why the physician nexus on these issues is vital for real change to take place and sets forth a clear statement of what is essential to support the doctor-patient relationship in any quality agenda. Finally, it reiterates the author's previously proposed five principles for quality, as well as her unified field theory of quality, all of which are designed to advance quality in a very different way.

Documentation↗
PubMed2003

Decoding the myths. Physician supervision in Medicare.

Billing Medicare for services involving ancillary personnel has grown increasingly complex as more types of professionals provide services in the context of physician practices. In addition, Medicare recognizes some clinicians as eligible to submit claims on their own provider numbers within a group practice but recognizes others only for billing "incident to" a supervising physician. Practice managers and physicians are understandably confused about these provisions. The liabilities for improper handling of supervision include false claims, Stark violations and reassignment problems.

Allied Health Personnel↗
PubMedDate not supplied

The 100,000 lives campaign: crystallizing standards of care for hospitals.

The 100,000 Lives Campaign has the attention of U.S. hospitals, professional groups, and the media. Its aim has been endorsed, and its planks are being implemented, by more than 2,300 diverse hospitals in every state. We posit that the six planks of the campaign have become national standards of care and propose four theories of liability for hospitals that ignore the campaign or fail to implement its planks. As a result of the campaign, hospitals and their boards now face a legal incentive to reduce needless deaths through six specific interventions.

Hospitals↗
PubMedDate not supplied

Ten myths about the Stark statute debunked.

The Stark statute was enacted in 1995, but final regulations were not published until January 2001 and even then did not address all the Stark exceptions. Many people are confused about how to apply the exceptions and what the Stark statute means. This article identifies 10 of the most common myths about Stark and explains and corrects the misconceptions.

Centers for Medicare and Medicaid Services, U.S.↗
PubMedDate not supplied

The organized medical staff: should anyone care anymore?

Every hospital has an organized medical staff, but of what value is this organizational construct in the current environment? Given the New World Order of quality improvement, patient safety, the malpractice crisis, and the multiple demands physicians struggle to accommodate on a daily basis, it is time to reconsider the role of the medical staff This article looks at the legal basis for the medical staff's role; considers typical medical staff bylaws; and addresses some of today's hottest potatoes between medical staffs and boards, all in light of the new quality era. Based on more than 25 years of working with medical staffs on these issues, and reflecting themes around clinical practice guidelines (CPGs), the author makes the case that although the medical staff is still a vital component of the hospital's mission, both in the bylaws and in its functions, today's staff can be revitalized in ways that can be far more meaningful to physicians and far more likely to propel quality.

Communication↗
PubMedDate not supplied

The hidden costs of free lunches: fraud and abuse in physician-pharmaceutical arrangements.

When it comes to physician-pharmaceutical manufacturer relationships, the old adage "there's no such thing as a free lunch" has been given much support lately by federal fraud and abuse enforcement authorities. In light of recent enforcement developments and initiatives, physicians must now, more than ever, develop an understanding of the legal boundaries of regulatory and ethical guidelines and carefully evaluate their relationships with pharmaceutical manufacturers for compliance. This article reviews existing regulatory and ethical guidance applicable to physician-pharmaceutical industry relationships, applies that guidance to common interactions between physicians and the industry, and offers tips for maintaining compliance.

American Medical Association↗
PubMedDate not supplied

PROMETHEUS payment: better for patients, better for physicians.

Although pay for performance is a positive development in the history of quality improvement in this country, it is generally accepted that most pay-for-performance programs do not offer a sustainable business model. PROMETHEUS Payment is a new approach to provider payment that is predicated on paying for the resources to be brought to bear to treat a patient for a condition in accordance with good clinical practice guidelines. It is explicitly designed to reduce the administrative burden on physicians in favor of improved care coordination and collaboration among providers without requiring them to financially integrate or take insurance risk.

Humans↗