In the 21st century world,people mostly behave with business mentality without considering moral obligations in society.In this behavioral change,the service market,particularly the medical care service market,has app...In the 21st century world,people mostly behave with business mentality without considering moral obligations in society.In this behavioral change,the service market,particularly the medical care service market,has appeared to be vulnerable.Because of supplying medical care services,the doctor or hospital receives capitation payments,fees-for-services,risk pool settlements,incentive payments or other fees.However,today it is probably the most criticized profession in world economy country-wise such as Bangladesh.Sometimes doctors here are blamed for requiring unnecessary tests of patients for doctors’own monetary gains.In some cases,doctors’efforts are assumed to relate to pharmaceutical products promotion by writing lengthy prescriptions.Some groups claim that today doctors spend less time on each patient.All these interactions justify claiming that a patient works for a doctor when the patient visits a doctor for medical care services.Here the existence of“asymmetric information”dominates the medical care market where doctor takes advantages in multiple facets.It causes market inefficiency that creates negative economic externalities-deadweight loss.Improving medical education with special emphasis on ethical aspects and soft skills in communication is considered important in order to reduce the magnitudes of today’s dilemma in the medical care service market.Also,strict enforcements of medical care provisions and ethical code of conduct among all health works can be instrumental.Finally,the answer to the question“Are medical care services becoming money-making machines under physicians’headship in the 21st century business-driven world?”depends on who are asked.But the reflections of today’s medical care market in economy of Bangladesh are no deniable,which deserves to be studied further curtailing the magnitudes of the problem.展开更多
The article begins with a short review of similarities between traditional Chinese medicine(TCM)and original Hippocratic medicine.Both were holistic,and taking every aspect contributing to illness into account,both fo...The article begins with a short review of similarities between traditional Chinese medicine(TCM)and original Hippocratic medicine.Both were holistic,and taking every aspect contributing to illness into account,both followed the dictum,“first do no harm.”A key difference between the two,even 2400 years ago,was the Hippocratic emphasis on scientific medicine.The explosion of science and technology in the latter half of the 2nd century was applied to Western medicine,which became ever more complex,specialized,and reductionist,losing much of its original holism.The strength of TCM is its holistic approach and techniques such as acupuncture,so necessary for the management for patients who have chronic illnesses such as pain for which Western medicine has few answers.展开更多
BACKGROUND Although deficient procedures performed by impaired physicians have been reported for many specialists,such as surgeons and anesthesiologists,systematic literature review failed to reveal any reported cases...BACKGROUND Although deficient procedures performed by impaired physicians have been reported for many specialists,such as surgeons and anesthesiologists,systematic literature review failed to reveal any reported cases of deficient endoscopies performed by gastroenterologists due to toxic encephalopathy.Yet gastroenterologists,like any individual,can rarely suffer acute-changes-inmental-status from medical disorders,and these disorders may first manifest while performing gastrointestinal endoscopy because endoscopy comprises so much of their workday.CASE SUMMARIES Among 181767 endoscopies performed by gastroenterologists at William-Beaumont-Hospital at Royal-Oak,two endoscopies were performed by normally highly qualified endoscopists who manifested bizarre endoscopic interpretation and technique during these endoscopies due to toxic encephalopathy.Case-1-endoscopist repeatedly insisted that gastric polyps were colonic polyps,and absurdly“pressed”endoscopic steering dials to“take”endoscopic photographs;Case-2-endoscopist repeatedly insisted that had intubated duodenum when intubating antrum,and wildly turned steering dials and bumped endoscopic tip forcefully against antral wall.Endoscopy nurses recognized endoscopists as impaired and informed endoscopy-unit-nurse-manager.She called Chief-of-Gastroenterology who advised endoscopists to terminate their esophagogastroduodenoscopies(fulfilling ethical imperative of“physician,firstdo-no-harm”),and go to emergency room for medical evaluation.Both endoscopists complied.In-hospital-work-up revealed toxic encephalopathy in both from:case-1-urosepsis and left-ureteral-impacted-nephrolithiasis;and case-2-dehydration and accidental ingestion of suspected illicit drug given by unidentified stranger.Endoscopists rapidly recovered with medical therapy.CONCLUSION This rare syndrome(0.0011%of endoscopies)may manifest abruptly as bizarre endoscopic interpretation and technique due to impairment of endoscopists by toxic encephalopathy.Recommended management(followed in both cases):1-recognize incident as medical emergency demanding immediate action to prevent iatrogenic patient injury;2-inform Chief-of-Gastroenterology;and 3-immediately intervene to abort endoscopy to protect patient.Syndromic features require further study.展开更多
For more than four hundred years,the modern medical system has primarily inherited the Western cultural tradition and taken shape gradually on the basis of innovating classical Western medicine.In the tradition of anc...For more than four hundred years,the modern medical system has primarily inherited the Western cultural tradition and taken shape gradually on the basis of innovating classical Western medicine.In the tradition of ancient Greek medicine,the Hippocratic school and its successor,the Galenic school,based their medical understanding on the humoral theory and theory of temperaments,holding that there exists an intimate connection between human bodily functions and the mind.展开更多
The authors think that a geoethical approach to the geospheresociety relationship is necessary in the epoch in which we live.Geoscientists have to improve their awareness of the geoethical dimension and the importance...The authors think that a geoethical approach to the geospheresociety relationship is necessary in the epoch in which we live.Geoscientists have to improve their awareness of the geoethical dimension and the importance for sustainable development of their work in geosciences.The introduction of a Hippocratic-like oath for young geoscientists-“the geoethical promise”-could be a way for this purpose.A draft text is proposed for discussion.展开更多
文摘In the 21st century world,people mostly behave with business mentality without considering moral obligations in society.In this behavioral change,the service market,particularly the medical care service market,has appeared to be vulnerable.Because of supplying medical care services,the doctor or hospital receives capitation payments,fees-for-services,risk pool settlements,incentive payments or other fees.However,today it is probably the most criticized profession in world economy country-wise such as Bangladesh.Sometimes doctors here are blamed for requiring unnecessary tests of patients for doctors’own monetary gains.In some cases,doctors’efforts are assumed to relate to pharmaceutical products promotion by writing lengthy prescriptions.Some groups claim that today doctors spend less time on each patient.All these interactions justify claiming that a patient works for a doctor when the patient visits a doctor for medical care services.Here the existence of“asymmetric information”dominates the medical care market where doctor takes advantages in multiple facets.It causes market inefficiency that creates negative economic externalities-deadweight loss.Improving medical education with special emphasis on ethical aspects and soft skills in communication is considered important in order to reduce the magnitudes of today’s dilemma in the medical care service market.Also,strict enforcements of medical care provisions and ethical code of conduct among all health works can be instrumental.Finally,the answer to the question“Are medical care services becoming money-making machines under physicians’headship in the 21st century business-driven world?”depends on who are asked.But the reflections of today’s medical care market in economy of Bangladesh are no deniable,which deserves to be studied further curtailing the magnitudes of the problem.
文摘The article begins with a short review of similarities between traditional Chinese medicine(TCM)and original Hippocratic medicine.Both were holistic,and taking every aspect contributing to illness into account,both followed the dictum,“first do no harm.”A key difference between the two,even 2400 years ago,was the Hippocratic emphasis on scientific medicine.The explosion of science and technology in the latter half of the 2nd century was applied to Western medicine,which became ever more complex,specialized,and reductionist,losing much of its original holism.The strength of TCM is its holistic approach and techniques such as acupuncture,so necessary for the management for patients who have chronic illnesses such as pain for which Western medicine has few answers.
文摘BACKGROUND Although deficient procedures performed by impaired physicians have been reported for many specialists,such as surgeons and anesthesiologists,systematic literature review failed to reveal any reported cases of deficient endoscopies performed by gastroenterologists due to toxic encephalopathy.Yet gastroenterologists,like any individual,can rarely suffer acute-changes-inmental-status from medical disorders,and these disorders may first manifest while performing gastrointestinal endoscopy because endoscopy comprises so much of their workday.CASE SUMMARIES Among 181767 endoscopies performed by gastroenterologists at William-Beaumont-Hospital at Royal-Oak,two endoscopies were performed by normally highly qualified endoscopists who manifested bizarre endoscopic interpretation and technique during these endoscopies due to toxic encephalopathy.Case-1-endoscopist repeatedly insisted that gastric polyps were colonic polyps,and absurdly“pressed”endoscopic steering dials to“take”endoscopic photographs;Case-2-endoscopist repeatedly insisted that had intubated duodenum when intubating antrum,and wildly turned steering dials and bumped endoscopic tip forcefully against antral wall.Endoscopy nurses recognized endoscopists as impaired and informed endoscopy-unit-nurse-manager.She called Chief-of-Gastroenterology who advised endoscopists to terminate their esophagogastroduodenoscopies(fulfilling ethical imperative of“physician,firstdo-no-harm”),and go to emergency room for medical evaluation.Both endoscopists complied.In-hospital-work-up revealed toxic encephalopathy in both from:case-1-urosepsis and left-ureteral-impacted-nephrolithiasis;and case-2-dehydration and accidental ingestion of suspected illicit drug given by unidentified stranger.Endoscopists rapidly recovered with medical therapy.CONCLUSION This rare syndrome(0.0011%of endoscopies)may manifest abruptly as bizarre endoscopic interpretation and technique due to impairment of endoscopists by toxic encephalopathy.Recommended management(followed in both cases):1-recognize incident as medical emergency demanding immediate action to prevent iatrogenic patient injury;2-inform Chief-of-Gastroenterology;and 3-immediately intervene to abort endoscopy to protect patient.Syndromic features require further study.
基金funded by National Social Science Fund of China,grant number 23XZX006.
文摘For more than four hundred years,the modern medical system has primarily inherited the Western cultural tradition and taken shape gradually on the basis of innovating classical Western medicine.In the tradition of ancient Greek medicine,the Hippocratic school and its successor,the Galenic school,based their medical understanding on the humoral theory and theory of temperaments,holding that there exists an intimate connection between human bodily functions and the mind.
文摘The authors think that a geoethical approach to the geospheresociety relationship is necessary in the epoch in which we live.Geoscientists have to improve their awareness of the geoethical dimension and the importance for sustainable development of their work in geosciences.The introduction of a Hippocratic-like oath for young geoscientists-“the geoethical promise”-could be a way for this purpose.A draft text is proposed for discussion.
