Revenue Streams and Clinical Discretion

Total Quality Management and the Silent Patient

“…Without trust, the patient may not only be reluctant to agree to the services he is offered, he may also be suspicious on occasions when the physician suggests an intervention is necessary. 32 Good medicine may be good business, but such misapplications of good business models to an inappropriate context suggest that good business is not necessarily good medicine.…”

Accuracy in Pharmacoeconomic Literature Review: Lessons Learned From the Navajo Code Talkers

“…8 Consistent with Schulz and Lewis's concerns, examination of a convenience sample of these publications reveals numerous serious errors in describing the study's results (Table 2). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The most common and serious error was attributing inpatient hospitalizations to the cap although Soumerai et al found no significant relationship between the cap and hospital admission rates. 9,[11][12][13]19,21,23 Additional errors occurred when describing the cap itself, which was commonly represented as a formulary.…”

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] The most common and serious error was attributing inpatient hospitalizations to the cap although Soumerai et al found no significant relationship between the cap and hospital admission rates. 9,[11][12][13]19,21,23 Additional errors occurred when describing the cap itself, which was commonly represented as a formulary. 12,16,[19][20][21] Similarly, one description of the paper attributed negative outcomes to copayments despite Soumerai et al's finding that the risk of nursing home admission returned to its baseline (pre-cap) level when the cap was replaced by a $1 copayment.…”

“…9,[11][12][13]19,21,23 Additional errors occurred when describing the cap itself, which was commonly represented as a formulary. 12,16,[19][20][21] Similarly, one description of the paper attributed negative outcomes to copayments despite Soumerai et al's finding that the risk of nursing home admission returned to its baseline (pre-cap) level when the cap was replaced by a $1 copayment. 5,15 Notably, some discussions of the work cited outcomes that were not even studied by Soumerai et al; these included changes in physician practice patterns, prescribing rates, emergency room use, and even mortality.…”