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Abstract: Rehabilitation nurses possess knowledge and skills that are ideally suited to a variety of roles. This article informs rehabilitation nurses about opportunities to work in private case management for medical-legal cases. A brief overview of the process of litigation gives nurses the context in which case management interventions are needed. Case examples illustrate the services that nurses provide to attorneys and their clients that help obtain needed care and aid in progressing litigation to resolution., (Copyright © 2024 Association of Rehabilitation Nurses.)

In 2000, the Institute of Medicine stunned many professionals with their published report that noted the vast number of deaths that occur each year in hospitals across the United States which reach as many as 98,000. Therefore, it comes as no surprise that the healthcare arena faces litigious issues regularly, with some specialties budgets being significantly impacted by the cost of maintaining liability insurance. Legal Nurse Consultants and forensic physicians working in tandem but who work independently from treating clinicians can carry out forensic independent medical examinations (IME). This can help to assess the validity of malpractice claims, including issues of causation and degree of injuries claimed due to the incident(s) and recommend treatment strategies where appropriate. Reviews can cover a wide range of issues such as a person's past or current testamentary capacity, a prisoner or an accused person's mental health and/or mental impairment where necessary sending them for more assessment or treatment outside prison. This article argues that independent medical reviews are a useful tool that can assist the civil and criminal courts processes.

It is a physician's certified continuing medical education category-rather than their actual medical activity, in this case in the field of trauma surgery-that is decisive in filling statutory health insurance (SHI) practice vacancies. This evaluation arising from §16 of the requirement planning guideline applies accordingly when filling physician vacancies. Thus physician vacancies or statutory health insurance (SHI) practice places can only be filled by a physician in the same physician group in line with requirement planning. Scope for argumentation initially remains in the context of filling surgical SHI physician vacancies where the ceding physician is certified as an accident insurance consultant.

Background: Authors' conflicts of interest may affect the content of medical guidelines. In April 2010, the Association of Scientific Medical Societies in Germany (AWMF) issued recommendations on how such conflicts of interest should be dealt with. Most AWMF guidelines are so-called S1 guidelines developed by informal consensus in a group of experts. We now present the first study to date on the management of conflicts of interest in S1 guidelines., Methods: On 2 December 2013, we selected the guidelines that had appeared from 1 November 2010 to 1 November 2013 among the 449 current S1 guidelines on the AWMF website. We extracted information about conflicts of interest from the guideline texts, reports, and/or conflict of interest statements and evaluated this information descriptively., Results: There were 234 S1 guidelines in this category, developed by a total of 2190 experts. For 7% (16/234) of the guidelines and 16% (354/2190) of the experts, no individual conflict of interest statement could be found. Where conflict of interest statements were available, conflicts of interest were often declared--in 98% (213/218) of the guidelines and by 85% (1565/1836) of the authors. The most common type of conflict of interest was membership in a specialist society or professional association (1571/1836, 86%). Half of the experts acknowledged a financial conflict of interest (911/1836, 50%). Conflicts of interest were more common among experts contributing to guidelines that mainly concerned treatment with drugs or other medical products than in guidelines that did not have an emphasis of this type (397/663, or 60%, versus 528/1173, or 45%). The conflicts of interest were assessed in 11% (25/234) of the guidelines, with practical consequences in a single case., Conclusion: Conflicts of interest are often declared in the S1 guidelines of the AWMF, but they are only rarely assessed by external evaluators. Clear rules should be issued for how experts' declared conflicts of interest should be acted upon, whether they are of a financial nature or not.

In 2005, the French law on patients' rights at the end of life ratified that decisions to withdraw or withhold life-sustaining treatments must be made and carried out by the physician in charge of the patient, after obtaining the advice of an independent consulting colleague. The purpose of this text is to put forward the perspective of a pediatric multidisciplinary workshop regarding the role of the consulting physician and to propose guidelines to help choose this consultant., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Up to approximately 15-20 years ago it could be safely assumed that the promotion to senior consultant surgeon was a lifetime position. Nowadays it is different. Contracts for senior consultants are normally for an unlimited period but as with other employees there is the possibility to legally terminate the employment conditions and approximately 50% make use of this. The reasons very rarely concern an inability of the physician and are mostly concerned with the surrounding working conditions. Poor contractual structures, incompatibility in the spectrum of responsibilities, financial restrictions by the finance department and poor communication with the finance department and colleagues are the main problem areas. In this article the potential points of conflict are demonstrated.

Background: UK policy direction for recipients of unemployment and sickness benefits is to support these people into employment by increasing 'into work' interventions. Although the main aim of associated interventions is to increase levels of employment, improved health is stated as a benefit, and a driver of these interventions. This is therefore a potentially important policy intervention with respect to health and health inequalities, and needs to be validated through rigorous impact evaluation.We attempted to evaluate the Pathways Advisory Service intervention which aims to provide employment support for Incapacity Benefit recipients, but encountered a number of challenges and barriers to evaluation. This paper explores the issues that arose in designing a suitable evaluation of the Pathways Advisory Service., Discussion: The main issues that arose were that characteristics of the intervention lead to difficulties in defining a suitable comparison group; and governance restrictions such as uncertainty regarding ethical consent processes and data sharing between agencies for research. Some of these challenges threatened fundamentally to limit the validity of any experimental or quasi-experimental evaluation we could design - restricting recruitment, data collection and identification of an appropriate comparison group. Although a cluster randomised controlled trial design was ethically justified to evaluate the Pathways Advisory Service, this was not possible because the intervention was already being widely implemented. However, this would not have solved other barriers to evaluation. There is no obvious method to perform a controlled evaluation for interventions where only a small proportion of those eligible are exposed. Improved communication between policymakers and researchers, clarification of data sharing protocols and improved guidelines for ethics committees are tangible ways which may reduce the current obstacles to this and other similar evaluations of policy interventions which tackle key determinants of health., Summary: The evaluation of social interventions is hampered by more than their suitability to randomisation. Data sharing, participant identification and recruitment problems are common to randomised and non-randomised evaluation designs. These issues require further attention if we are to learn from current social policy.

Historically, nephrology nurses have assumed various roles in the workplace, including staff nurse, educator, advanced practice nurse, and transplant coordinator. However, there is an emerging role that may be new and different to some nephrology nurses: the legal nurse consultant. With an increase in the number of lawsuits, it is imperative to have experienced and knowledgeable nephrology nurses working with attorneys on cases that involve our unique specialty. This article will define legal nurse consulting, differentiate the various types of consultants, and explain the roles and responsibilities of the legal nurse consultant.

Introduction: Legal liability is an increasing concern in many areas of medicine, although the extent to which this alters the practice of medicine is unclear. To date the risk for litigation against medical toxicologists serving in the role of poison control center (PCC) consultants has not been assessed., Methods: A survey questionnaire was mailed to medical toxicologists in the United States to assess their litigation history with regard specifically to their role as PCC consultants. In addition, state laws were examined for statutes that provide protective language with regard to medical toxicologists working as PCC consults., Results: This survey revealed that most medical toxicologists have served or currently serve as PCC consultants. Most had some degree of concern over legal liability, and several had been sued as a result of PCC consultations. Several states have specific statutes that limit the legal liability of PCCs and their employees, including medical directors and consulting medical toxicologists., Discussion: Based on the survey results, legal action against toxicologists serving as PCC consultants appears to be an uncommon occurrence. Lawsuits are usually based upon nonfeasance and have typically been settled or dropped before trial., Conclusions: Legal liability is a concern for PCC consultants. However, legal action against consultants appears to be rare, and respondents to the survey indicated that it did not affect their advice or willingness to serve as PC consultants. A limited number of states have enacted laws that provide protection for medical toxicologists serving as PCC consultants.

OIG is adopting in final form, without change, an interim final rule published on March 26, 2008 (73 FR 15937). We received no comments to the interim final rule. The interim final rule revised the process for advisory opinion requestors to submit payments for advisory opinion costs.

A new government focus on investigating physicians' consulting agreements and other financial arrangements with device manufacturers has been announced. Physicians would be well advised to prepare for investigations by reviewing any agreements they have and assembling all related documents. This article outlines additional steps that will assist a physician in preparing for a government investigation. These include notifying key employees, engaging counsel, developing a legal strategy, submitting a "white paper" response to the government, and realistically assessing a settlement position.

Study Design: Patient survey., Objective: To evaluate patient perspective on surgeons as consultants for industry and medical device manufacturers., Summary of Background Data: Relationships between surgeons and medical device manufacturers are becoming increasingly common. Little is known, however, about how patients perceive these relationships., Methods: Patients in the waiting area of an orthopedic surgery clinic were given a simple 1-page, 8-question anonymous questionnaire. Their responses were tabulated and analyzed for 3 variables: gender, age, and education level., Results: A total of 245 patients completed the questionnaire. An overwhelming majority (94.3%) believed that surgeon-industry relationship is beneficial to patients, and a majority (66.5%) of patients thought that physicians should be compensated for this role. Women were more likely than men to want this relationship to be regulated by physicians instead of the government or hospitals. Patients older than 55 years were less likely to be in favor of physicians being compensated than younger patients. The more educated the patient, the less likely he/she was in favor of allowing physicians to regulate physician-industry relationship., Conclusion: Patients support surgeons in the role of consultants for industry. Gender, age, and education level influence the way that patients perceive this issue.

Five orthopedic devicemakers recently settled kickback allegations with the government to the tune of $311 million, but some industry experts doubt that will put an end to the problem. Doug Clark, left, chairman of the conflict-of-interest panel at Henry Ford Health System, says: "Hopefully, this (settlement) will help speed along the movement towards transparency.

This article considers the law which applies to the giving of advice over the telephone and the respective liability of the adviser and the recipient of the advice. It also covers the law relating to the exclusion of liability.

We believe that clinical ethics consultation (CEC) has as its goal the delivery of healthcare in a manner consistent with the moral rules and the moral ideals. Towards this end, CEC pursues the instrumental ends of clarifying the limits of acceptable ethical disagreement and facilitating a choice among ethically acceptable alternatives. In pursuing these ends, healthcare ethics consultation (HEC) and CEC services confront three broad categories of questions: (1) questions of professional duty; (2) questions of law; and (3) questions of general morality. Professional duty questions concern what has been referred to as the "internal morality of medicine", and include questions such as the medical legitimacy of the goal(s) being pursued, or the acceptability of the means being employed. Questions of law concern themselves with what the law requires, permits or prohibits. Questions of general morality include all those not falling within the scope of the above categories. We submit that this has implications for the organization and structure of consultation services and HEC and for the methodology and processes employed in CEC. Thus: (1) questions of professional duty should be addressed only by physician members (whom we would distinguish by employing the term "ethicians") of the HEC or CEC service. The only role for non-ethicians under these circumstances would be in helping to resolve disagreements between/among professionals; (2) questions of law, in contrast, should be addressed only by the attorney member(s) of the HEC or CEC service; (3) questions of general morality may be addressed by the entire membership of the HEC or CEC service.

There have long been calls for the reduction of coercion in treating civilly committed psychiatric patients. The present study assessed whether a minor procedural change intended to reduce the adversarial nature of the treatment process would have a positive impact. Results suggested that the change in procedure had a positive effect for the most direct outcome variables but results were more mixed for the indirect outcome variables. Nonetheless, overall indications were that the change of procedure affected patient outcome.