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Biomedical subjects

D P Wilcox

Publications and source records attributed to D P Wilcox.

At least 19 recordsLinked to original sources
PubMed1993

Recognizing physicians' rights under exclusive contracts.

As hospitals attempt to position themselves as competitive economic units with selected physicians, economic credentialing of hospital medical staff will accelerate. What recourse do physicians on staff have when a hospital enters into an exclusive contract with another group? Do the due process provisions in the medical staff bylaws apply? Is there a right to due process and to a hearing even when no quality issues are involved? This article discusses recent court decisions on this topic, focusing on Texas statutes and case law.

Contract Services↗
PubMed1990

National Data Bank to revolutionize peer review reporting.

In addition to state-mandated reporting requirements, hospitals and other health care entities soon must comply with the reporting requirements of the Health Care Quality Improvement Act, as implemented by Health and Human Services regulations. The regulations require reporting (1) adverse peer review and licensure actions involving physicians and dentists; and (2) malpractice claims payments involving physicians, dentists or other health care practitioners. Otherwise, reporting on other health care practitioners is voluntary. Hospitals must request information from the Data Bank about applicants for medical staff appointment or privileges and must review Data Bank information about practitioners on staff every two years thereafter. Hospitals must have policies and procedures for requesting such information.

Databases, Factual↗
PubMed1990

The medical liability insurance crisis: how it began.

Economic pressures, awareness that physicians can be sued, improved medical care, and increased patient expectations have led to the skyrocketing liability insurance costs physicians face today. In the early days when the doctor could offer hope but little medicine, patients were not inclined to sue for medical "failures." But with the Great Depression, World War II, more recent medical advances changed the patient-physician relationship. Patients had gained the expertise of specialists, but often lost the personal relationship they once shared with their primary physician. Thus, when treatments were unsuccessful, the patient often-times blamed the physician. Insurance premiums (and patient costs) increased, while patients became even more aware that physicians were covered by insurance. This article reviews key economic, medical, and social events that led to the present medical liability insurance crisis.

Costs and Cost Analysis↗
PubMed1990

New peer review reporting and disclosure requirements--Part I.

This article reviews the reporting and disclosure provisions of the Health Care Quality Improvement Act of 1986, the Medicare and Medicaid Patient and Program Protection Act of 1987, the Texas Medical Practice Act, and federal regulations promulgated in late 1989 to establish the operating rules and policies of the National Practitioner Data Bank. A table on pages 56-57 outlines the reporting requirements of these laws and regulations. Discussion focuses on the requirements the new federal regulations place on physicians and other health care practitioners, health care entities, and insurers.

Humans↗
PubMed1990

Medical experts compete to testify for malpractice plaintiffs.

This article describes the activities of physicians who offer their services for hire as witnesses and consultants to attorneys in malpractice litigation. Cases illustrating the extent of the problem are discussed along with legal and ethical restrictions on witnesses and contingent-fee payment of medicolegal consultants. A common belief is that the ever-present threat of malpractice litigation, which hangs over the heads of physicians like the sword of Damocles, is due to avaricious lawyers, unrealistic expectations of patients, and the reckless generosity of juries with other people's money. But physicians also have exacerbated a troublesome situation. Gone is the universal reluctance of doctors to testify against other doctors.

Ethics, Medical↗
PubMed1990

When cost containment interferes with clinical decisions.

Incentives to sparingly order diagnostic tests, make referrals to specialists, or discharge patients early, expand exposure to medical professional liability. Discharging a patient prematurely from a hospital, or denying a patient referral to a specialist because of HMO or government budgetary considerations is no defense to substandard treatment. Such accusations are difficult to defend. Not only is there the issue of negligence in denying proper care but also the conflicting interest of deriving financial profit from the denial of adequate care. This article documents these liability risks for physicians and those who seek to manage their treatment decisions.

Cost Control↗
PubMed1990

From informed consent to informed refusal.

This article traces the development of the informed consent concept, focusing on Texas case law and statutory provisions. We describe the proper use of the Texas Medical Disclosure Panel forms in establishing informed consent and illustrate common problems in proving that informed consent has been obtained. The need for effective physician-patient dialogue and communication is discussed.

Communication↗
PubMed1990

Remedies by competitors for false advertising.

Patients who are victimized as a consequence of false medical advertising are not the only ones who can sue for damages. Under section 43(a) of the Lanham Act, effective November 17, 1989, anyone "who believes that he or she is or is likely to be damaged" by deceptive advertising may bring a civil action for damages (1). Competing physicians may sue other physicians who falsely advertise that they possess unique skills and achieve better results than other physicians because they employ exclusive methods of treatment or claim that certain surgical procedures they perform in the office are absolutely safe and without risk or who advertise false professional credentials to lure patients. Voluntary informed consent excludes the use of deceit. Misrepresentation through advertising deprives a patient of the right to exercise an informed consent (2). A patient who relies on a doctor's false advertising in agreeing to a procedure that causes the patient injury may sue for malpractice even if the procedure was performed without negligence. False medical advertising also exposes the advertiser to litigation by competitors for unfair competition. This article is concerned with the remedy that may be available for instituting private litigation against physicians and other health care providers who engage in untruthful advertising.

Advertising↗