Abstract:
BACKGROUND:Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice. OBJECTIVE:To assess public attitudes regarding physician deception of insurance companies. DESIGN:Cross-sectional survey using clinical vignettes. SETTING:Philadelphia County Courthouse, Philadelphia, Pennsylvania. PARTICIPANTS:Convenience sample of 700 prospective jurors. MEASUREMENTS:Participants were asked whether, in response to restriction of health care, a physician should 1) accept restriction, 2) appeal restriction, or 3) misrepresent a patient's condition to obtain the desired service. The proportion of respondents reporting that the physician should misrepresent a patient's condition was determined. RESULTS:26% of respondents sanctioned deception, 70% supported appealing, and 4% supported accepting the insurance company decision. Among the 27% of respondents believing physicians have inadequate time to appeal coverage decisions, 50% sanctioned deception. CONCLUSIONS:Sanctioning of deception was substantial in this sample of prospective jurors. Preferences regarding insurance company deception are related to perceptions of physician workload and may further pressure physicians struggling to balance advocacy with honesty.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Alexander GC,Werner RM,Fagerlin A,Ubel PAdoi
10.7326/0003-4819-138-6-200303180-00011subject
Has Abstractpub_date
2003-03-18 00:00:00pages
472-5issue
6eissn
0003-4819issn
1539-3704pii
200303180-00011journal_volume
138pub_type
杂志文章abstract::Traditionally, acupuncture is embedded in naturalistic theories that are compatible with Confucianism and Taoism. Such ideas as yin-yang, qi, dampness, and wind represent East Asian conceptual frameworks that emphasize the reliability of ordinary, human sensory awareness. Many physicians who practice acupuncture rejec...
journal_title:Annals of internal medicine
pub_type: 历史文章,杂志文章,评审
doi:10.7326/0003-4819-136-5-200203050-00010
更新日期:2002-03-05 00:00:00
abstract::Vasodilator drugs were initially administered to patients with primary pulmonary hypertension based on the unproven hypothesis that pulmonary vasoconstriction played an important role in the pathogenesis of the disease. There were early reports of hemodynamic and clinical improvement after treatment with various vasod...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-103-2-258
更新日期:1985-08-01 00:00:00
abstract::Cost-effectiveness analysis and other forms of decision analysis are becoming more common in the medical literature and are increasingly influential in the development of health policy. Nevertheless, many clinicians find it difficult to apply policies developed from these analyses to individual encounters with patient...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-11-199506010-00007
更新日期:1995-06-01 00:00:00
abstract::Visual loss from the complications of advanced diabetic retinopathy now can be managed more effectively by surgical vitrectomy with a significant reduction in operative and postoperative ocular morbidity. Ocular structures are now maintained in a more normal physiologic state, leaving the patient's lens in place, help...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-4-562
更新日期:1983-10-01 00:00:00
abstract:BACKGROUND:Retail clinics are an increasingly popular source for medical care. Concerns have been raised about the effect of these clinics on the cost, quality, and delivery of preventive care. OBJECTIVE:To compare the care received at retail clinics for 3 acute conditions with that received at other care settings. D...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-151-5-200909010-00006
更新日期:2009-09-01 00:00:00
abstract::Asthma is characterized by inflammation, reversible airway obstruction, and increased airway responsiveness to various stimuli. It has received wide public attention in recent years because of increasing morbidity and deaths, particularly among black persons. The important role of inflammation in the immunopathogenesi...
journal_title:Annals of internal medicine
pub_type: 共识发展会议,杂志文章,评审
doi:10.7326/0003-4819-121-9-199411010-00011
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence of cognitive impairment among elderly primary care patients and to compare diagnostic evaluations and use of health services among patients with and those without cognitive impairment. DESIGN:Prospective cohort study. SETTING:Academic primary care group practice. PATIENTS:3954 pa...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-122-6-199503150-00004
更新日期:1995-03-15 00:00:00
abstract:BACKGROUND:Although the efficacy of adjuvant chemotherapy in prolonging survival for women with breast cancer has been well documented, limited population-based information is available on the actual use of chemotherapy. OBJECTIVE:To examine the relationship between age and chemotherapy use. DESIGN:Cohort study. SET...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-2-200301210-00009
更新日期:2003-01-21 00:00:00
abstract:OBJECTIVE:To validate prospectively the use of an artificial neural network to identify myocardial infarction in patients presenting to an emergency department with anterior chest pain. DESIGN:Prospective, blinded testing. SETTING:Tertiary university teaching center. PATIENTS:A total of 331 consecutive adult patient...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-115-11-843
更新日期:1991-12-01 00:00:00
abstract::Chinese herbal medicine (CHM) formulas are the major components of traditional Chinese medicine (TCM) interventions. The general reporting quality of randomized controlled trials (RCTs) of CHM formulas is disappointing, although CONSORT (Consolidated Standards of Reporting Trials) Statement extensions for herbal medic...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M16-2977
更新日期:2017-06-27 00:00:00
abstract::The expression of ischemic heart disease was studied in a large kindred with familial hypercholesterolemia. Tendon xanthomas, multiple generation transmission, and the appearance of bimodality in the distributions of total and low-density lipoprotein cholesterol were found. The segregation ratio was 0.9 in females and...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-89-6-871
更新日期:1978-12-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme (ACE) inhibitors slow renal disease progression and reduce cardiac morbidity and mortality in patients with diabetes. Patients' out-of-pocket costs pose a barrier to using this effective therapy. OBJECTIVE:To estimate the cost-effectiveness to Medicare of first-dollar coverage ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-143-2-200507190-00007
更新日期:2005-07-19 00:00:00
abstract:BACKGROUND:In previous open-label noncomparative clinical trials, both fluconazole and itraconazole were effective therapy for progressive forms of coccidioidomycosis. OBJECTIVE:To determine whether fluconazole or itraconazole is superior for treatment of nonmeningeal progressive coccidioidal infections. DESIGN:Rando...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-133-9-200011070-00009
更新日期:2000-11-07 00:00:00
abstract::The diagnosis of gout depends on showing urate crystals in synovial effusions or, with less certainty, recognizing a characteristic clinical presentation. The management of gout has four phases: control of inflammation, diagnostic evaluation, education of the patient, and treatment for the hyperuricemia. Sound logical...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-5-812
更新日期:1979-05-01 00:00:00
abstract:BACKGROUND:An effective national biosurveillance system expedites outbreak recognition and facilitates response coordination at the federal, state, and local levels. The BioSense system, used at the Centers for Disease Control and Prevention, incorporates chief complaints but not data from the whole encounter note into...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-156-1-201201030-00003
更新日期:2012-01-03 00:00:00
abstract::We performed selective venous catheterization and sampling for ACTH in six patients with ACTH-secreting pituitary adenomas (Cushing's disease) and four patients with occult ectopic ACTH-secreting neoplasms. In five patients with Cushing's disease in whom the inferior petrosal sinus could be catheterized, ACTH levels w...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-5-647
更新日期:1981-05-01 00:00:00
abstract::Breast cancer is the major cancer killer of women in the United States. Recent advances in therapy promise more effective control of this illness. The development of hormone receptor analysis permits us to better understand the mechanisms of action of steroid and peptide hormones and increases the likelihood of using ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-86-6-784
更新日期:1977-06-01 00:00:00
abstract::Three cases of carbamazepine-induced granulomatous hepatitis are reported. Each patient had ingested carbamazepine for less than 1 month before presenting with a febrile illness suggestive of biliary tract infection. After withdrawal of carbamazepine, symptoms disappeared rapidly. Histologically, all patients had gran...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-1-64
更新日期:1981-07-01 00:00:00
abstract:Background:The 2013 pooled cohort equations (PCEs) are central in prevention guidelines for cardiovascular disease (CVD) but can misestimate CVD risk. Objective:To improve the clinical accuracy of CVD risk prediction by revising the 2013 PCEs using newer data and statistical methods. Design:Derivation and validation ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M17-3011
更新日期:2018-07-03 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
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更新日期:2015-09-15 00:00:00
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journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-92-2-316
更新日期:1980-02-01 00:00:00
abstract::Since 1970, forty-two patients with pulmonary hypertension due to chronic, thromboembolic obstruction of the major pulmonary arteries have had pulmonary thromboendarterectomy at the University of California, San Diego, and the San Diego Veterans Medical Centers. Duration of symptoms before admission averaged 4.4 years...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-4-560
更新日期:1987-10-01 00:00:00
abstract::Polysaccharide vaccines against diseases caused by Neisseria meningitidis serogroups A and C meningococci are now licensed in the United States. They are prepared as monovalent and as bivalent antigens. This statement summarizes available information on these antigen and offers guidance regarding their role in the con...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Persons with abdominal aortic aneurysm are more likely to have a higher prevalence of risk factors for and clinical manifestations of cardiovascular disease. It is unknown whether these factors explain the high mortality rate associated with abdominal aortic aneurysm. OBJECTIVE:To describe the risk for mort...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-134-3-200102060-00008
更新日期:2001-02-06 00:00:00
abstract:BACKGROUND:Endoscopic retrograde cholangiopancreatography (ERCP) is a technically demanding procedure that can cause substantial complications. Competence in performing ERCP and the learning curve for achieving competence are poorly understood. OBJECTIVE:To evaluate the number of supervised ERCPs that physicians must ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-125-12-199612150-00009
更新日期:1996-12-15 00:00:00
abstract:OBJECTIVE:To determine the effect of the presence of a patent foramen ovale on the right-to-left shunt in patients with respiratory failure who receive positive end-expiratory pressure (PEEP). DESIGN:Convenience sample with randomized application of PEEP. SETTING:General intensive care unit of a university teaching h...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-119-9-199311010-00004
更新日期:1993-11-01 00:00:00
abstract::Antibiotic-associated diarrhea and colitis were well established soon after antibiotics became available. Early work implicated Staphylococcus aureus, but in 1978 Clostridium difficile became the established pathogen in the vast majority of cases. In the first 5 years (1978 through 1983), the most common cause was cli...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-145-10-200611210-00008
更新日期:2006-11-21 00:00:00
abstract:PURPOSE:To review the available data on the treatment of chronic stable angina and formulate a rational approach to the use of pharmacologic therapy, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass graft surgery (CABG). DATA SOURCES:A MEDLINE search of English-language literature publ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-128-3-199802010-00008
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Lack of awareness of hypoglycemia is a major limiting factor in the management of type 1 diabetes. OBJECTIVE:To examine whether reduction in the number of episodes of hypoglycemia restores hypoglycemia awareness by influencing beta-adrenergic sensitivity in patients with type 1 diabetes. DESIGN:Controlled ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-134-9_part_1-200105010-00009
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Despite advances in prevention and treatment, sexually transmitted infections (STIs) remain an important cause of morbidity and mortality in the United States. PURPOSE:To systematically review the evidence for behavioral counseling interventions to prevent STIs in adolescents and adults (nonpregnant and pre...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-149-7-200810070-00011
更新日期:2008-10-07 00:00:00