Variations in appointment delays for physicians' services: Theory and empirical evidence

Waiting times for physician appointments have been used in past studies as a measure of access to, or excess demand pressure on, local ambulatory care systems. This paper offers an alternative view—that short appointment delays are one of several types of amenities produced by physicians in combination with health services. Empirical evidence is presented that illuminates some previously unknown relationships between appointment delays, patient diagnosis, site of care, and family income. A model is developed with the capability of predicting short-run responses to changes in demand for physicians' services. The model and empirical evidence are used as the basis for interpreting recent experience in Canada with its system of national health insurance (NHI) and for predicting potential consequences regarding the production of amenities of NHI in the US.This research has been supported in part by a grant (HS—00825) from the Center for Health Services Research, US Department of Health, Education, and Welfare, to the University of Florida. We are indebted to John B. Wayne and to Paula Sloan for their assistance and to University of Florida colleague Gary Shannon for comments on an earlier draft.     

Treating drug-dependent patients in hospitals

Are hospital staff legally permitted to test drug-dependent patients for drugs or infectious disease without the patient's consent in order to treat the patient or to protect themselves or other patients? What should staff do with "suspicious" items in the patient's possession (drugs, credit cards in different names, firearms)? Can drug-dependent patients lawfully use illicit drugs in hospital? Who should supply and administer them?     

The critical perspective in psychological jurisprudence theoretical advances and epistemological assumptions

The critical perspectives of psychological jurisprudence identified above, along with their corresponding epistemological assumptions, reflect a radical agenda for change at the law-psychology divide. Although not exhaustively reviewed, the individual theories represent different approaches by which structural reform can be enacted and citizen well-being can therefore be realized. Collectively, the critical perspectives and their attending presuppositions challenge conventional wisdom about prospects for transforming (i.e., humanizing) the legal apparatus. I submit that the future viability of the law-psychology movement, and its overall utility for society, considerably depends on its capacity to facilitate and secure such widespread change. By focusing on critical theoretical inquiry, this article makes painfully clear that much of what is wrong with the legal system, especially in its interactions with and interpretations of people, cannot be amended or solved through it. Indeed, as Roesch (1995) observed, "changes in the justice system will never be sufficient to create a just society, nor will within system changes by themselves ever have much of an impact on individuals who come into conflict with the law" (p. 3). I agree. Accordingly, it is time to move on and, where necessary, to look elsewhere for guidance. The radical agenda in psychological jurisprudence represents a provocative strategy, providing a meaningful basis for critique and a sustainable basis for reform. Both are integral to the call for justice embodied in the founding of the AP-LS decades ago. Realizing this challenge, however, remains an unfulfilled dream. Thus, the task that awaits is to apply the insights of critical psychological jurisprudence to relevant areas of research and policy. I submit that the academy can ill afford to dismiss this task. Indeed, in the final analysis, to do so would not only defer prospects for justice but would destroy its very possibility, especially for citizens disillusioned by the status quo and desperate for change that makes a difference.