Physician recruitment after Hermann Hospital

The state of physician recruitment changed after the Internal Revenue Service required Hermann Hospital to publish its closing agreement with the IRS. The closing agreement released the long-awaited IRS "Hospital Physician Recruitment Guidelines." The IRS' recently proposed revenue ruling provides additional insight on acceptable physician recruitment practices as well.     

Reviews

Barbara Caine and Rosemary Pringle (eds), Transitions: New Australian Feminisms (Allen & Unwin) 1995.

Peta Tait, Converging Realities: Feminism in Australian Theatre (Currency Press) Sydney, 1994.

Pauline Johnson, Feminism as Radical Humanism (Allen & Unwin) St Leonards, 1994.

Denise Russell, Women, Madness and Medicine (Polity Press) Cambridge, 1995.

R.W‐ Connell, Masculinities (Allen & Unwin) St Leonards, 1995.

Margaret Maynard, Fashioned from Penury: Dress as Cultural Practice in Colonial Australia (Cambridge University Press) Melbourne, 1994.

Joy Damousi, Women Come Rally: Socialism, Communism and Gender in Australia, 1890–1955 (Oxford University Press) Melbourne, 1995.

Susan Sheridan, Along the Faultlines: Sex, Race and Nation in Australian Women's Writing, 1880s—1930s (Allen & Unwin) Sydney, 1995.     

Evaluating adolescent decision making in legal contexts

Challenges the use by policy researchers of a model for comparing adolescent and adult decision making that is based on informed consent standards. An expanded decision-making framework designed to evaluate judgment in adults and adolescents can better test the empirical basis of paternalistic legal policies. The theoretical and empirical literature on the informed consent framework is critiqued and an alternative framework incorporating judgment factors is proposed. Three judgment factors—temporal perspective, attitude toward risk, and peer and parental influence—and their effects on decision making are explored. Finally, implications for future research are analyzed in several decision-making contexts.Several of the ideas in this article were originally presented by the first author and were published as part of a symposium on competence (see Scott, 1992). The current article expands and refines these ideas, provides a more substantial research base, and suggests several future research directions. We thank Joseph Allen, Richard Bonnie, Baruch Fischhoff, William Gardner, John Monahan, Edward Mulvey, Richard Redding, Paul Slovic, and three anonymous reviewers for their helpful comments. Special thanks to Thomas Grisso for providing much constructive criticism and to Wendy Shang for outstanding research assistance. Finally, we would like to acknowledge the MacArthur Foundation, which supported this work in its early stages.     

Issues raised by respiratory therapy arrangements

In large part due to the foregoing issues, Medicare program officials have focused on respiratory therapy as an area with great potential for abuse, and may well introduce significant reforms in the near future. Accordingly, any contractual arrangements for respiratory therapy programs of the type discussed above should be carefully reviewed for compliance with Medicare requirements and for a realistic assessment of the parties' potential exposure to liability under the anti-kickback statute. At a minimum, these agreements should provide for short "without cause" termination provisions, or include a so-called "jeopardy" provision that permits the parties to renegotiate or terminate their contract if significant changes occur in, or if the current arrangement is found or threatened to be found to violate, applicable law.     

As outcomes measurement and management become widespread, providers should beware of legal pitfalls

Until new statutes and court decisions clarify the law applicable to outcomes research, providers will continue to face new questions. In the meantime, paying careful attention to satisfying the requirements of existing laws protecting peer review information will put providers in the best position to minimize their exposure. Providers should review their current outcomes measurement and management systems to ensure that (1) they are structured to take full advantage of the confidentiality protections available under state law, and (2) appropriate access to outcomes data for those who need it is clearly provided for in the relevant documentation.     

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.     

The system's rigged — or is it?

From the beginning of the Seventies until almost the end of the Eighties, the Public Prosecution Service in the Netherlands concentrated a major part of its resources on combatting white collar and corporate crime. This effort climaxes in a number of spectacular fraud trials, involving in one case the directors of a large commercial bank, in another high-ranking public officials. Almost all were acquitted. As dramatically as interest in white collar and corporate crime had increased, so too did it decline at the end of the Eighties, until by now public interest in fraud is primarily concerned with social security frauds at one end of the scale, and money laundering by organised crime at the other. This article examines the rise and fall of the fraud-issue in Holland, the parts played by the Public Prosecution Service and the media, and the structural (economic and social) limitations to the criminalisation of white collar and corporate behaviour.     

The correlates of spouses' incongruent reports of marital aggression

Husbands' and wives' reports (n=97 couples) of engaging in or experiencing marital aggression were compared to determine congruence. Congruence was defined as spousal agreement on whether either spouse had been nonviolent, mildly violent, or severely maritally violent within the past year. Whereas approximately equal numbers of clinic couples were incongruent for husband and for wife violence (32% vs. 31%), only incongruence for husband violence (H W) was found to correlate with reports of affective and relationship functioning. Incongruent H W wives were more likely to be depressed and angry. H W incongruent wives were also more negative about the inter-spousal communication and rated the relationship as more unsatisfactory for them than did congruent wives. Incongruent H W husbands also perceived the relationship more negatively, but their levels of depression and anger did not differ from congruent H W husbands. These findings were not replicated for spouses who were incongruent for wife violence. Our results support the conclusion that spousal disagreement about H W violence has a more negative impact than does disagreement about wives' level of aggression.