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Biomedical subjects

S J Paine

Publications and source records attributed to S J Paine.

At least 19 recordsLinked to original sources
PubMed1995

Special report on patient care. The new federal patient-dumping regulations: some commonly asked questions and answers.

Until both providers and government surveyors become more familiar with the new EMTALA regulations, there will be an uncomfortable period of adjustment, and perhaps some turmoil as well, particularly regarding the new requirement that facilities who receive suspicious transfers report those transfers to HCFA. Providers should carefully examine their internal policies on discharge and transfer of emergency patients to assure that those policies are consistent with the new regulations. Particular attention should be given to inservice training for medical and support personnel in the emergency department, because they must precisely comply with the law and their errors can subject the hospital to costly investigations and potential fines of $50,000 for each violation.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1995

The HIV-infected health care provider. Doe v. Attorney General of the United States.

Doe demonstrates that once an employer enters into a relationship with an individual and thereafter determines that he or she may be disabled, the employer has the right to ask the individual questions about the possible disability when those questions are relevant to assessing his or her qualifications for continuing on the job. In fact, once a health care provider is on notice that an employee's or physician's disability may render the employee or physician no longer qualified, thereby potentially endangering patients, the provider is required to determine whether the person is qualified for the job. In these sensitive matters, employers must draw a fine line between unreasonably following up on every rumor on the one hand, and on the other hand investigating reliable information when there may indeed be a direct threat to patients.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Special report on patient care. New OBRA 1990 requirements regarding advance directives.

The provisions of OBRA 1990 regarding advance directives reflect a heightened awareness in Congress of the need to recognize individual rights and preferences in the provision of health care. In the wake of recent decisions such as Cruzan v. Director, Missouri Department of Health, 110 S. Ct. 2841 (1990) (see Newsletter, Vol. 5, No. 9, September 1990, at 12), holding that state law governs the right of a surrogate to order the discontinuation of medical treatment for an incompetent patient, it is likely to remain true for the foreseeable future that differing state laws on the subject of advance directives will create confusion for some patients, particularly those unaware of the laws of their state, those living near the border between two states, and those traveling between states for medical treatment. For such patients, the provisions of OBRA 1990 may help to ensure that state laws governing advance health care decisions are explained at the time of treatment.

Advance Directives↗
PubMed1991

Special report on medical staff relationships. Handling "impaired" health care professionals.

Applying the doctrine of corporate negligence, courts will, in appropriate circumstances, deem hospitals and other institutional health care providers responsible for the quality of patient care in their institutions and for the consequences of negligent physician performance that could have been discovered and prevented. See, e.g., Darling v. Charleston Community Memorial Hosp., 33 Ill. 2d 326 (1965), cert, denied, 383 U.S. 946 (1966); Johnson v. Misericordia Community Hosp., 99 Wis. 2d 709 (1981); Elam v. College Park Hosp., 132 Cal. App. 3d 332 (1982). In such a climate, and with Data Bank reporting now a reality, neither institutional providers nor health care professionals on their medical staffs can afford to ignore problems of practitioner impairment. Recognizing this reality, some state laws now mandate an organized approach--such as the establishment of an impaired practitioners committee--to problems of professional impairment. However, whether state-mandated or not, providers must have policies and procedures in place to insure not only that impaired professionals are referred to available treatment programs, but that they fully participate in and complete such programs, and achieve rehabilitation, before they return to practice at the institution. The earlier detection and treatment are initiated, preferably before peer review action becomes necessary, the better for patients, institutions, and practitioners themselves.

Liability, Legal↗