The majority of obstetric triage encounters include an assessment of both mother and fetus but under certain conditions, clinical data may be unavailable. EFM triage is a skill of necessity that includes a brief and rapid assessment of fetal heart…
Four out of five prescriptions for psychotropic medications in the US are prescribed by primary care providers. Psychotropic medications have a relatively high rate of adverse side effects, and are an increasing source of claims for medical malpractice. Clinical practice…
H-CAHPS and CG-CAHPS are patient satisfaction surveys in the hospital and office settings. They are being collected, published and used by payers in determining hospital and physician reimbursement. Criticisms have been raised about the validity of the surveys and their…
Every physician in medical practice has at some time seen situations of patient past medical care that seemed inappropriate. In such situations physicians are immediately placed in the position of determining the immediate requirement for continuing medical care and the…
Occiput posterior (OP) malpresentation occurs 15-25% at term and 5-12% at birth, increases risk of surgical birth, and frequency coincides with category II or III FHR patterns. In an effort to reduce cesarean births, non-invasive and invasive rotational measures may…
Typical interventions used during the second stage of labor frequently impede oxygen delivery and increase risk to the patient, fetus, and practitioner. Underutilization of laboring down, open-glottis breathing and upright positions by physicians is evident nationwide. This activity outlines the…
When medi-spas first appeared, spurred by advances in laser technology, they were largely unregulated. Now, many states are requiring medi-spas to be associated with a physician as an owner, supervisor or contractor. Offers are being made, and physicians of many…
Informed Consent continues to be a source of medical error and medical malpractice claims. Obtaining consent is sometimes delegated to someone other than the physician performing the procedure; it is sometimes reduced to obtaining a signature on a piece of…
Nursing home patients today are older, sicker, and more frail than ever before. Multiple chronic conditions, reduced mobility, and cognition put them at risk for polypharmacy, falls, malnutrition, and pressure ulcers. Primary care physicians not based in the nursing home…
Physicians are under more stress than ever before, much of it due to factors beyond their control. Laurie Drill-Mellum, an emergency medicine physician describes the forces bearing down on physicians, including litigation stress, and presents techniques for actively managing the…
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