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Biomedical subjects

E Wallerstein

Publications and source records attributed to E Wallerstein.

8 recordsLinked to original sources
PubMed1985

Circumcision. The uniquely American medical enigma.

Ritual circumcision of males has been practiced for millennia, but was limited to fewer than 20 per cent of the world's population. About a century ago, only the English-speaking countries adopted non-religious circumcision as a prophylactic or therapeutic panacea for myriad ailments. Since these "health" claims are now known to be unsubstantiated, the English-speaking countries either abandoned the practice or reduced the frequency of its performance; the only exception is the United States. This article examines the background for this enigma and suggests solutions.

Australia↗
PubMed1983

Circumcision.

Explore the source record for details and available documents.

Circumcision, Male↗
PubMed1977

Cost factors in urban telemedicine.

This paper reports on the cost effectiveness of a pediatric primary care system utilizing nurse practitioners (NPs) linked to a physician consultant through bidirectional interactive cable television. In addition, it discusses ways in which multiple uses enhance the economic feasibility of a telemedicine consultation link in a given geographic area. The overall consultation rate during periods of remote physician coverage was 21 per cent, compared with 24 per cent during on-site coverage. The telephone became a partial substitute for the TV for some uses but could not replace it in diagnostic decisions. As telemedicine is obviously underutilized in a one-satellite system, we compare a five-satellite network with other ways of delivering service. The resulting estimated cost of $18.50 an hour, or 2/3 of the cost of a physician providing direct care, includes a TV component of $5.30 an hour of use in a 1,750-hour year. The critical factor is that the NP can be a physician substitute if there is TV backup. The TV appears to prevent unnecessary referrals compared to a physician on site. Whether TV increases the length of the consult compared to the phone for conditions of equal severity is not entirely clear. If TV is compared to transporting a patient to a central place, the implicit value of transport time and disutility required to justify using TV is $7.55 per consult in a five-clinic network. Geographic and other barriers to physician availability enhance the potential for application fo telemedicine.

Child↗