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J J Lindenthal

Publications and source records attributed to J J Lindenthal.

At least 19 recordsLinked to original sources
PubMed1999

Quality and cost of healthcare: a cross-national comparison of American and Dutch attitudes.

OBJECTIVE: To compare attitudes of consumers in America and Holland toward the quality and cost of healthcare. STUDY DESIGN: Data were derived from one American (n = 466) and two Dutch (n = 260, n = 1629) surveys. PATIENTS AND METHODS: Questionnaires were completed by respondents. Pairwise comparisons requiring respondents to compare statements with one another were used to assess preferences for quality of care. Respondents were asked to "indicate the extent to which each of the factors listed plays a role in placing demands on the American (Dutch) healthcare system." Factors included the public's tendency to consume, high technology, defensive medicine, decrease in informal care, increase in standard diagnostic procedures, and medicalization. RESULTS: Americans reported comparatively greater concern with empathy, whereas the Dutch were more interested in the continuity of care. Effectiveness, knowledge, information, and patient-physician relationships were ranked higher in both nations than waiting time, autonomy, and efficiency. Respondents in both countries attributed the increase in healthcare cost primarily to the high cost of technology. Compared with their Dutch peers, Americans were less likely to attribute increases in the cost of healthcare to the public tendency to consume and to the decrease in informal care and were more likely to implicate defensive medicine and an increase in diagnostic procedures. CONCLUSIONS: As both nations experience pressures to reduce costs while maintaining and augmenting the quality of healthcare, planners and government officials should tailor their approaches to each nation's problems within the context of their public perspectives. Replication of such studies should help assess the impact of changing societal values on healthcare delivery.

Adult↗
PubMed1992

Confidentiality in clinical psychiatry.

A brief history of the central role of confidentiality in the doctor-patient relationship is presented. Emphasis is placed on the positions of the American Medical Association and World Medical Association. The dilemma posed by the requirement of balancing the rights of the patient against those of society is portrayed. Particular attention is paid to the role of technology and mass society in exacerbating this tension, and the differences between the rights of confidentiality and those of privilege are offered. Recent court cases are cited to illustrate five legal theories to which a patient can resort in alleging damages for the inappropriate disclosure of confidences, as are others in an effort to show the directions in which American courts are heading. Several suggestions are offered to the clinician in dealing with confidentiality.

Codes of Ethics↗
PubMed1991

The management of confidentiality in general medical practice: a comparative study in the U.S.A. and The Netherlands.

This paper describes the results of two studies in New Jersey and the eastern part of the Netherlands into the management of confidentiality among physicians in general medical practice. The physicians were presented with vignettes about confidentiality and were asked what course of action they would pursue. The results suggest that the physicians in New Jersey are less willing to disclose information without the patient's consent to insurance physicians or occupational health physicians than their Dutch colleagues. However, in more conflicting situations the American physicians tend to favor more disclosure of information than their Dutch counterparts. Explanations of these differences include aspects of the legal system in New Jersey and the Netherlands.

Adult↗
PubMed1991

Methodological issues in the study of confidentiality: a reinterpretation of findings.

Investigations of confidentiality management have been constrained by an inability to obtain direct measures of clinicians' behaviors when deciding whether to breach or safeguard a confidence. Some researchers have used responses to hypothetical case vignettes to derive approximations of how clinicians manage confidences entrusted to them by their patients. However, these studies have focused primarily on total confidentiality scores, without exploring the possibility that subsets of clinical cases might elicit different confidentiality decisions. In this investigation, reanalysis of responses to case vignettes obtained from 436 psychologists, psychiatrists, and internists revealed that on the issue of confidentiality management, these health care providers discriminate among cases involving: Premeditated harm to others, socially irresponsible acts with possible dire consequences to self or others, and minor theft. Of these three categories of cases, those involving social irresponsibility elicited the greatest disagreement among the clinician groups studied.

Confidentiality↗
PubMed1991

The management of confidentiality in Egypt.

Patient confidentiality is an important issue for treating clinician regardless of the cultural background. Though cultural and religious issues may have an impact on the confidentiality standards. This article discusses the confidentiality standards in Egypt citing the laws and ethical codes governing them. This is followed by a research study in which a questionnaire containing ten vignettes representing different common themes confronted by the practicing clinician was completed by forty-one Egyptian psychiatrists. They checked off categories representing alternatives they might choose dealing with the themes. Each respondent received a score. The scores were compared with those of American and Israeli psychiatrists who participated in a similar study. There were no statistically significant differences though Egyptian and Israeli psychiatrists appear to be somewhat more inclined to break confidentiality. However, significant differences were found to exist for some of the vignettes between the three groups.

Adult↗
PubMed1990

Handling of confidentiality in general practice: a survey among general practitioners in The Netherlands.

This paper describes the results of a study of the handling of confidentiality by general practitioners. A sample of 272 general practitioners in the eastern part of the Netherlands was interviewed. The general practitioners were presented with 10 cases involving confidentiality and were asked what course of action they would pursue. Twenty-eight per cent of the general practitioners would never disclose information to others without the patient's consent, while 14% would disclose information to other physicians, members of non-medical professions and relatives. The largest proportion (38%) would disclose information only to other physicians. General practitioners were less likely to divulge information if they were: younger, female or practising in group practices. In particular, general practitioners who involved patients in decision making were less likely to disclose information to third parties. A plea is made for more education about confidentiality in the medical curriculum.

Adult↗
PubMed1990

Confidentiality in medical practice.

To assess physicians' attitudes toward confidentiality, a questionnaire was mailed to general practitioners and family physicians in New Jersey. The questionnaire was designed to measure their attitudes regarding confidentiality as well as what course of action they believed should be pursued in specific situations involving confidentiality. Data regarding personal and practice characteristics were also collected. One hundred twenty (50%) of the physicians responded. A particularly strong reluctance was found among physicians to divulge information to other physicians. More physicians appeared willing to disclose information to relatives of the patient without their consent. The argument for disclosure among physicians to family members may flow from their belief that they should care for the health of the whole family, and not only that of the patient.

Attitude of Health Personnel↗
PubMed1990

Trauma recidivism.

Surgeons have long recognized that a proportion of hospitalized trauma patients present with a history of a previous admission for trauma, termed by the authors as "trauma recidivism." The incidence of trauma recidivism was addressed by a review of 150 consecutive admissions to a level I Trauma Center. This study identifies this subset of trauma patients, establishes their magnitude, and analyzes mechanisms of injury and hospital courses. The implications for those who care for trauma patients is discussed.

Adolescent↗
PubMed1989

Ergotism: a possible etiology for puerperal psychosis.

Some reports in the medical literature have mentioned the occurrence of psychotic reactions in response to the use of certain ergot alkaloids in therapeutic doses. Prompted by these observations, we undertook a search for cases of "pure" puerperal psychosis (ie, typical manifestations 3-14 days postpartum) in order to evaluate the clinical background of this phenomenon. Special attention was paid to the medications that the patients had received peripartum. In the last 10 years, out of eight perinatal centers, we found only three cases that fulfilled the criteria of the quoted entity. In all instances, the manifestations of puerperal psychosis had been preceded by the administration of ergot derivatives. Based on the presented data, we hypothesize that typical postpartum psychosis may represent an idiosyncratic reaction to potent vasoactive drugs including ergot derivatives. The similarities between the clinical manifestations of ergotism and puerperal psychosis, and some of the epidemiologic features of the latter condition, appear to implicate ergot alkaloids as potential causative agents. Although the validity of the suggested interpretation requires further evaluation, we believe that the currently available data warrant caution with regard to the administration of ergot derivatives postpartum. These drugs should not be used in the absence of clear indication or in unnecessarily high doses. We suggest that ergotism be included in the differential diagnosis in cases of pure puerperal psychosis.

Adolescent↗
PubMed1982

Psychiatrists, the public, and confidentiality.

This paper represents a comparative study of the attitudes of psychiatrists, people under the regular care of psychiatrists, and those who have never had any experience with psychotherapy toward confidentiality in the doctor-patient relationship. The role played by knowledge of and attitudes toward confidentiality in the seeking of health care is also assessed. The samples consisted of 192 psychiatrists, 76 patients, and 76 nonpatients of psychiatrists. The findings and their implications are discussed.

Adolescent↗
PubMed1980

A comparative study of the handling of confidentiality.

Increasing concern with the problem of confidentiality has prompted the authors to examine factors associated with the handling of confidentiality among a sample of psychiatrists, psychologists, and internists. Significant differences were found among the three groups of clinicians. The nature of professional training and the predominant approach to treatment were found to be related to attitudes toward confidentiality, as was previous professional experience with socially threatening behavior. Implications of the findings are discussed.

Adult↗