Junior doctors and moral exploitation.

This is a common occurence, possibly of educational benefit but proper balance is always necessary. This article thoughtfully explores the issue. -TH

Junior doctors and moral exploitation.:

Junior doctors and moral exploitation.

J Med Ethics. 2019 Jul 16;:

Authors: Parker J

Abstract

In this paper I argue that junior doctors are morally exploited. Moral exploitation occurs where an individual's vulnerability is used to compel them to take on additional moral burdens. These might include additional moral responsibility, making weighty moral decisions and shouldering the consequent emotions. Key to the concept of exploitation is vulnerability and here I build on Rosalind McDougall's work on the key roles of junior doctors to show how these leave them open to moral exploitation by restricting their reasonable options. I argue that there are a number of ways junior doctors are morally exploited. First, their seniors can leverage their position to force a junior to take on some discreet decision. More common is the second type of moral exploitation where rota gaps and staffing issues means junior doctors take on more than their fair share of the moral burdens of practice. Third, I discuss structural moral exploitation where the system offloads moral burdens onto healthcare professionals. Not every instance of exploitation is wrongful and so I conclude by exploring the ways that moral exploitation wrongs junior doctors.

PMID: 31311854 [PubMed - as supplied by publisher]

Dropping F-Bomb Increases Pain Tolerance By A Third, Study Finds

I can vouch for this. It is not the only study showing that profanity, used occasionally, has some internal emotional benefits. - TH





Dropping F-Bomb Increases Pain Tolerance By A Third, Study Finds:

LONDON — Can’t help but shout an expletive every time you stub your toe? Don’t feel too bad, you may actually be doing yourself a favor. A new study finds that swearing when injured has a measurable effect on pain tolerance. In fact, dropping the F-bomb specifically when in pain increases tolerance by up to…

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Study: Seniors Can Keep Memory, Brain Strong By Learning Multiple Skills Simultaneously

This makes a lot of sense. By developing talent stacks, we can be come more productive, brain healthy, and enthusiastic - TH



Study: Seniors Can Keep Memory, Brain Strong By Learning Multiple Skills Simultaneously:

RIVERSIDE, Calif. — As children grow up they absorb as much new information as possible and learn multiple new skills on an almost daily basis. This thirst for knowledge tends to fade away as we grow old, and many people avoid learning new skills past a certain age. Well, a new study finds that older…

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CRP Testing to Guide Antibiotic Therapy for COPD Exacerbations

=> This is a great idea. CRP tests can be done rapidly and are readily available. Benefit of stopping antibiotics as soon as possible, but not too soon, is high in terms of both the patient's health and the cost of hospitalization.



CRP Testing to Guide Antibiotic Therapy for COPD Exacerbations: In a randomized trial, point-of-care C-reactive protein measurements lowered antibiotic prescribing without compromising clinical outcomes for patients with chronic obstructive pulmonary disease.

Hate Speech On Twitter Predicts Actual Hate Crimes, Study Finds

=> This is not surprising. Will be interesting to follow this and see how law enforcement and governmental agencies start (or continue) using social media as a way to fight crime and/or exert more control over their populations.



Hate Speech On Twitter Predicts Actual Hate Crimes, Study Finds:

NEW YORK — Can hate speech online lead to real-life violence? Censorship in social media is a hotly contested topic these days, but a new study out of New York University may be able to shed some light on the real-life consequences of online racism. Researchers say that online hate speech on the popular social media…

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Incorporating Information From Electronic and Social Media Into Psychiatric and Psychotherapeutic Patient Care: Survey Among Clinicians.

=> No clear guidelines exist regarding this practice, however, it appears to be common



Incorporating Information From Electronic and Social Media Into Psychiatric and Psychotherapeutic Patient Care: Survey Among Clinicians.:

Incorporating Information From Electronic and Social Media Into Psychiatric and Psychotherapeutic Patient Care: Survey Among Clinicians.

J Med Internet Res. 2019 Jul 12;21(7):e13218

Authors: Hobbs KW, Monette PJ, Owoyemi P, Beard C, Rauch SL, Ressler KJ, Vahia IV

Abstract

BACKGROUND: Obtaining collateral information from a patient is an essential component of providing effective psychiatric and psychotherapeutic care. Research indicates that patients' social and electronic media contains information relevant to their psychotherapy and clinical care. However, it remains unclear to what degree this content is being actively utilized by clinicians as a part of diagnosis or therapy. Moreover, clinicians' attitudes around this practice have not been well characterized.

OBJECTIVE: This survey aimed to establish the current attitudes and behaviors of outpatient clinicians regarding the incorporation of patients' social and electronic media into psychotherapy.

METHODS: A Web-based survey was sent to outpatient psychotherapists associated with McLean Hospital in Belmont, Massachusetts. The survey asked clinicians to indicate to what extent and with which patients they reviewed patients' social and electronic media content as part of their clinical practice, as well as their reasons for or against doing so.

RESULTS: Of the total 115 respondents, 71 (61.7%) indicated that they had viewed at least one patient's social or electronic media as part of psychotherapy, and 65 of those 71 (92%) endorsed being able to provide more effective treatment as a result of this information. The use of either short message service text messages or email was significantly greater than the use of other electronic media platforms (χ21=24.1, n=115, P<.001). Moreover, the analysis of survey responses found patterns of use associated with clinicians' years of experience and patient demographics, including age and primary diagnosis.

CONCLUSIONS: The incorporation of patients' social and electronic media into therapy is currently common practice among clinicians at a large psychiatric teaching hospital. The results of this survey have informed further questions about whether reviewing patient's media impacts the quality and efficacy of clinical care.

PMID: 31301127 [PubMed - in process]

An Advanced Practice Provider Clinical Fellowship as a Pipeline to Staffing a Hospitalist Program.

Excellent Idea



J Hosp Med. 2019 06 01;14(6):336-339

Authors: Lackner C, Eid S, Panek T, Kisuule F

Abstract

BACKGROUND: Approximately 83% of hospitalist groups around the country utilize advanced practice providers; however, the demand for hospitalists continues to exceed the supply, and this has led to increased utilization of advanced practice providers in hospital medicine. Advanced practice providers receive very limited inpatient training, and there is wide variation in their clinical abilities after graduation.

OBJECTIVE: To determine if an advanced practice provider fellowship is a cost-effective pipeline for filling vacancies within a hospitalist program.

METHODS: In 2014, a one-year advanced practice providers clinical fellowship in hospital medicine was established. Working one-on-one with an experienced hospitalist faculty member, the fellows evaluate and manage patients. The program consists of 80% clinical experience, in the inpatient setting, and 20% didactic instruction. Up to four fellows are accepted each year and are eligible for hire, after training, if there are vacancies.

RESULTS: The duration of onboarding and cost to the division were significantly reduced after implementation of the program (25.4 vs 11.0 weeks, P = .017 and $361,714 vs $66,000, P = .004).

CONCLUSION: The advanced practice provider fellowship has proven beneficial for the hospitalist division by (1) reducing costs associated with having unfilled vacancies, (2) improving capacity on the hospitalist service, and (3) providing a pipeline for filling nurse practitioners (NP) and physician assistant (PA) vacancies on the hospitalist service.

PMID: 30897050 [PubMed - in process]