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Physician-hospital gainsharing

A practice that violates the federal anti-kickback statute, the Stark physician self-referral law and the civil monetary penalties provision of the Social Security Act is gaining legitimacy as a catalyst for physician-hospital collaboration and clinical quality improvement.

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Implementing a medical home

A wholesale change in the way that primary care is organized, delivered and reimbursed is being promoted by three primary care specialty societies, being tested in Pennsylvania and New Jersey, and gaining clout in the form of a federal demonstration project.

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Role of medical board discipline

As Pa. reforms the disciplinary activities of its medical boards, several issues emerge, including what constitutes a realistic expectation for the boards’ role in improving quality and reducing medical errors and malpractice claims in the state.

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Appraising PHC4’s infection report

Given the report’s methodological limitations, its accompaniment by new research minimizing the importance of those limitations, and its data displayed in a format that seems to encourage inappropriate comparisons of one hospital’s numbers to another hospital, the meaning and significance of the report become complicated questions.

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Angioplasty waiver compromise

Pressured by litigation and looming legislation, DOH has agreed to resolve the impasse by offering waiver extensions to hospitals doing elective angioplasty without open heart surgery programs that do one of three things: join a national randomized trial, join an in-state registry, or agree to a supervisory and cross-training arrangement with a tertiary hospital to oversee quality.

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Restricting drug company influence

Small gifts, modest meals and drug samples from pharmaceutical reps still get physicians to prescribe the newest and often most expensive drugs, according to a recent critique that some hospitals are taking seriously.

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Physician-patient communication

Recent developments are driving a paradigm shift in medical education: training medical students, residents and practicing physicians in “best practice” communication skills, restoring the value of empathy and rapport-building between physicians and patients.

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