Forensic pathology and related sciences. A model for teaching medical students

Recently, awareness of the importance of forensic pathology and related sciences in the United States has grown. At our medical center, we developed a concise and systematic program on this subject and offered it as an elective in pathology to level II medical students. The course was very successful and rated highly by the medical students.     

Public expectations of health professionals when patients telephone for medical advice

This article focuses on the ethical, social and liability implications of patients obtaining unsolicited medical advice over the phone. The ethical discussion centres on the demise of paternalism and the increase in patient autonomy and individualism and the growing public expectations of health professionals. The article then discusses the advantages and disadvantages of telephone consultations from a social and policy perspective. In light of these considerations it considers what the liability implications are for phone consultations. It argues that the ethic of individualism, coupled with recent Australian tort reforms, suggests that only in limited circumstances would a doctor be found liable for negligence in relation to telephone consultations. However, the increasing expectations being placed on medical personnel, as evidenced by the increase in unsolicited telephone consultations, if left untempered, may lead to a situation with which the health care system is ill equipped to deal.     

Reasonable charges for medical care or services. Final rule

This final rule amends the Department of Veterans Affairs (VA) medical regulations concerning "reasonable charges" for medical care or services provided or furnished by VA to certain veterans for nonservice-connected disabilities. It changes the process for determining interim billing charges when a new Diagnosis Related Group (DRG) code or Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) code identifier is assigned to a particular type or item of medical care or service and VA has not yet established a charge for the new identifier. This process is designed to provide interim billing charges that are very close to what the new billing charges would be when the charges for the new identifiers are established in accordance with the regulations. This final rule also changes the regulations by removing all of the provisions for discounts of billed charges. This will eliminate or reduce duplicate discounting and thereby prevent unintended underpayments to the government.     

Reimbursement offsets for medical care or services. Final rule

This document amends the regulations of the Department of Veterans Affairs (VA) concerning the reimbursement of medical care and services delivered to veterans for nonservice-connected conditions. This rule applies in situations where third-party payers are required to reimburse VA for costs related to care provided by VA to a veteran covered under the third-party payer's plan. This final rule adds a new section barring offsets by third-party payers and requires that third-party payers submit a request for a refund for claims when there is an alleged overpayment.     

医学留学生临床麻醉学教学实践与体会

医学留学生教育是我国高等教育的重要组成部分.通过对留学生临床麻醉学教学实践的总结,认为采取师资培养、课前备课与试讲、采用科学的教学方法和加强见习教学等手段,可以达到预期的教学目标.同时总结了教学中出现的问题,并提出一些可行的建议,以期进一步提高留学生教学的质量.     

Guidance of FDA's expectations of medical device manufacturers concerning the year 2000 date problem--FDA. Notice

The Food and Drug Administration (FDA) is announcing the availability of the guidance entitled "Guidance on FDA's Expectations of Medical Device Manufacturers Concerning the Year 2000 Date Problem." The guidance, which is included in this notice, is a Level 1 guidance that is immediately effective in accordance with FDA's good guidance practices (GGP's) criteria, which allow immediate implementation of guidance that is necessary for public health reasons. FDA will receive comments on the guidance at any time and consider them in determining whether to amend the current guidance.     

医学生对病历书写基本规范的认知差异及干预研究

为提高医学生病历书写技能、掌握病历书写要求和法律规定,本研究以《侵权责任法》第七章医疗损害责任和《病历书写规范》为依据,评估、干预、提高医学生的病历书写技能和法律意识。结果显示,实习生与在校生有统计学差异,干预前后的在校生对病历书写规范及医疗损害法律制度的认知有统计学差异。研究认为,在校生经针对性、综合性、规范化的病历书写规范培训后,能有效掌握病历书写规范的要求和法律制度。建议病历书写规范的培训应该常规化、制度化、规范化,纳入教学计划,提高医学生的病历书写技能和法律意识,减少病历记录不良和记录瑕疵,防范医疗纠纷。     

Hospital care and medical services in non-VA facilities--VA. Final rule and regulation

Department of Veterans Affairs (VA) is amending regulations which pertain to the authorization for contract non-VA hospital care and medical services for veterans. The Veterans Health Care Act of 1992 provides that veterans with a total disability permanent in nature from a service-connected disability may be authorized contract non-VA hospital care and medical services. Contract care may be authorized only if the VA facility is not capable of furnishing the care required, or is not capable of furnishing economical care or services because of geographical inaccessibility. This amendment will make the regulations consistent with the law.     

Reasonable charges for medical care or services. Department of Veterans Affairs. Interim final rule

This document amends the Department of Veterans Affairs (VA) medical regulations concerning "reasonable charges" for medical care or services provided or furnished by VA to a veteran: (1) For a nonservice-connected disability for which the veteran is entitled to care (or the payment of expenses of care) under a health plan contract; (2) For a nonservice-connected disability incurred incident to the veteran's employment and covered under a worker's compensation law or plan that provides reimbursement or indemnification for such care and services; or (3) For a nonservice-connected disability incurred as a result of a motor vehicle accident in a State that requires automobile accident reparations insurance. This document amends the regulations to update databases and other provisions for the purpose of providing more precise charges.     

医学生临床法律意识和能力的调查及分析

2008年教育部、卫生部联合印发了《本科医学教育标准——临床医学专业（试行）》（教高[2008]9号）文件,指出本科临床医学专业毕业生必须树立依法行医的法律观念,学会用法律保护病人和自身的权益。本文通过对250名在校医学生的法律意识和能力的调查统计,反映出现在医学院校中医学法律教育存在的问题,并针对问题提出了应加强医学生在校基础理论教育阶段、准备临床实习前期、临床实习阶段三个重要阶段的医学法律教育。     

海峡两岸法医现状之比较

海峡两岸法医从制度建设、人才培养、机构设施、业务范围、办案流程等方面都有着各自的特点。通过海峡两岸法医现状的分析比较,意在取长补短,进一步完善我国大陆法医制度和法医体系建设。     

Delegations of authority/claims for cost of medical care and services--Department of Veterans Affairs. Final regulations

The Department of Veterans Affairs (VA) has amended VA regulations to increase the settlement and waiver authority delegated to officials within the Office of the General Counsel and District Counsels. This change follows increased authority delegated by the Department of Justice to heads of departments and agencies of the United States.     

HealthConnect and the duty of care: a dilemma for medical practitioners

This article asks whether medical practitioners' duty of care to their patients will encompass participation in the HealthConnect shared electronic records initiative. Medico-legal aspects of the HeathConnect scheme relating to the nature of shared electronic health record summaries (SEHRS) are examined, focusing on their function as an element of patient care and their ultimate purpose. The analysis is based on the premise that an incomplete and hence inaccurate shared electronic health record summary is clinically and legally more perilous than no record at all.