If we want more evidence-based practice, we need more practice-based evidence.*

If we want more evidence-based practice, we need more practice-based evidence.*



Los Angeles medical doctors unionize. July 1999. See story at http://www.world-psi.org/

SENATE SET TO DEBATE PATIENTS' RIGHTS MONDAY. Washington, DC, July 12, 1999). Time Daily, a World Wide Web news service of Time Magazine, reported on the patient rights issue at: http://www.time.com/time/nation/article/0,8599,27920,00.html

CLINTON MEDICARE PROPOSAL PUSHES PREVENTIVE CARE. Reuters News Service reported on the issue at:
     "In an odd bit of political jujitsu, Senate Republican leaders said Thursday that they would use a Democratic bill as the main vehicle for four days of debate next week on the rights of patients buffeted by turmoil in the health care industry," the New York Times reported. "Republicans apparently hope that this tactic will enable them to spend hours attacking the Democratic bill, rather than defending their own," the Times added. "Before the debate ends on Thursday,Republicans said, they intend to replace the Democratic bill with their bill." New York Times report: http://www.nytimes.com/library/politics/070999patients-bill.html
[The Times site requires users to register before accessing articles. There is no charge.]
       Meanwhile, a consortium of HMOs began a $9 million ad campaign Friday, July 9, 1999, seeking to promote the view that HMOs provide good patient care. The ad campaign's sponsor, the Health Insurance Association of America, has criticized health-reform legislation, and some have speculated that it is intended to influence the Congressional debate opening July 12. "The timing speaks for itself," said Dr. Nancy Dickey of the American Medical Association, which is lobbying lawmakers on behalf of doctors. See: http://www.usatoday.com/news/washdc/ncsfri04.htm
   A list of links to recent news articles on the "Patient Protection Debate" can be found at: http://headlines.yahoo.com/Full_Coverage/US/Health_Care_Debate/

Prenatal Discussion of HIV Testing and Maternal HIV Testing --- 14 States, 1996--1997. Morbidity and Mortality Weekly Reports 48(19), May 21, 1999.
    In July 1995, the Public Health Service recommended that health-care providers counsel all pregnant women about human immunodeficiency virus (HIV) prevention and encourage testing for HIV infection (1) and, if indicated, initiate zidovudine therapy (2). To evaluate compliance with these recommendations, CDC analyzed population-based data on HIV counseling and testing during 1996-1997 from 14 states participating in the Pregnancy Risk Assessment Monitoring System (PRAMS). This report presents an analysis of survey data collected from 1996 through 1997; results indicate that HIV counseling and testing of pregnant women were common but varied by state, type of prenatal health-care provider, Medicaid status, and maternal demographic characteristics. References cited:
1. CDC. US Public Health Service recommendations for human immunodeficiency virus counseling and voluntary testing for pregnant women. MMWR 1995;44(no. RR-7):1-14.
2. Connor EM, Sperling RS, Gelber R, et al. Reduction of maternal-infant transmission of human immunodeficiency virus type 1 with zidovudine treatment. N Engl J Med 1994;331:1173-80.

Adolescents And Risk-Taking: A 'Very Likely' Danger May Not Mean The Same To A Teen As To An Adult -(EurekAlert/UCSF, May 1999). In a finding that will surprise few parents, UC San Francisco researchers have shown that what adults say about the probability of harm from a risky behavior can have different - even opposite - meanings to teenagers... "If you give the same risk message to two people of different ages, they may walk away with different interpretations and may make different decisions," (adolescent medicine expert Bonnie) Halpern-Felsher said. That could mean, for example, that after a conversation with a physician, a parent assumes that her daughter has learned that the chance of getting a sexually transmitted disease from unprotected sex is high - after all, the doctor described it as "very likely." But the teenager may interpret the risk as much lower... For health practitioners who want to make sure that their messages about probability are getting across, Halpern-Felsher said that a numeric scale may be more effective than vague terms like "probably" or "possibly." To make sure that both the physician and the patient are visualizing the same numbers, it may help to ask the patient to repeat the concept in his or her own words. Adults and adolescents may understand percentages or phrases like "15 out of 100."... http://www.ucsf.edu/daybreak/1999/05/06_pedrisks.html

Independent Panel Formed to Review Benefits, Relative Risks of OTC Pain Relievers. (American Council on Science and Health, March 23 1999.)

TORONTO, Dec. 7, 1998 /CNW/ - Chatelaine, CTV and The Medical Post recently spoke to 1501 Canadian adults and 201 family physicians, examining physician-patient relationships. Their poll, conducted by The Angus Reid Group, revealed a breakdown in communication between doctors and patients.  Unfortunately, this isn't new news. The Bayer Institute for Healthcare Communication was founded in 1997 to respond to this very problem. The Institute is a non-profit organization dedicated to improving how Canadian health care professionals communicate with their patients.  According to The Bayer Institute, a doctor typically engages in more than 100,000 clinical interviews during his or her career. Studies show that such communication between doctor and patient is the more common procedure used to diagnose and treat illness, as well as a major factor in determining patient satisfaction.  And yet, according to patients, doctors aren't always the best communicators. Did you know that:  - Of the 1,566 complaints investigated in 1995 by the Ontario College of  Physicians and Surgeons, 612 cited a breakdown in communications. One random survey of 1,000 adults found that 25 per cent of people reported they had stopped seeing a particular physician because of communication problems.  Studies have shown that when clinicians communicate well with their patients, this leads to improved diagnosis, better compliance with treatment, greater satisfaction for both the health care provider and the patient, and fewer malpractice complaints.  Members of the Institute's faculty are available to comment on the importance of effective interaction between health care providers and patients and how to achieve this - especially in a time when there are growing pressures on the system and concerns that doctors don't have the "extra" time to spend with their patients.
For further information: Jennifer Schipper and Linda Artuso, Environics Communications, (416) 920-9000, ext. 253 or ext. 281