Abstract：
BACKGROUND:Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES:(1) Why is ADR needed? (2) Is ADR useful in health care? (3) What are the current legal and political developments favoring ADR? (4) What obstacles remain? METHODS:We performed MEDLINE, PubMed, and Google Scholar searches with key words "medical malpractice", "ADR", and "alternative dispute resolution" to obtain public policy studies, law review articles, case analyses, ADR surveys, and healthcare review articles. RESULTS:Early apology and disclosure programs report 50% to 67% success in avoiding litigation as well as substantial reductions in the amount paid per claim. Mediation boasts 75% to 90% success in avoiding litigation, cost savings of $50,000 per claim, and 90% satisfaction rates among both plaintiffs and defendants. Arbitration is viewed as less satisfying and less efficient than mediation but still more time- and cost-effective than litigation. The current legal environment is favorable to ADR with recent court decisions upholding pretreatment arbitration clauses. The main obstacle to ADR is the mandatory reporting requirement of the National Practitioner Data Bank (NPDB). CONCLUSIONS:ADR has the potential to help reform the current tort system, reducing cost and increasing both parties' satisfaction. Easing the reporting requirements for the NPDB would lead to more widespread acceptance of ADR among physicians.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Sohn DH,Bal BSdoi
10.1007/s11999-011-2206-2subject
Has Abstractpub_date
2012-05-01 00:00:00pages
1370-8issue
5eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract：BACKGROUND:Platelet-rich concentrates are used as a source of growth factors to improve the healing process. The diverse preparation protocols and the gaps in knowledge of their biological properties complicate the interpretation of clinical results. QUESTIONS/PURPOSES:In this study we aimed to (1) analyze the concent...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4192-2
更新日期：2015-05-01 00:00:00
abstract：BACKGROUND:To avoid ischemic necrosis, compartment syndrome is a surgical emergency treated with decompression once identified. A potentially lethal, oxidant-driven reperfusion injury occurs after decompression. N-acetylcysteine is an antioxidant with the potential to attenuate the reperfusion injury. QUESTIONS/PURPOS...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-010-1287-7
更新日期：2010-08-01 00:00:00
abstract：BACKGROUND:Although morbid obesity is considered a modifiable risk factor for periprosthetic joint infection (PJI), there is no consensus regarding an appropriate threshold for body mass index (BMI) above which a high risk for infection may outweigh the benefits of surgery. QUESTIONS/PURPOSES:(1) Is there a BMI cutoff...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000141
更新日期：2018-10-01 00:00:00
abstract：:The acetabular cartilages from hip joints in adult rabbits receiving daily intramuscular injections of 1 or 5 mg hydrocortisone/kg body weight for periods of four or 12 weeks were studied by electron microscopy for quantitative analysis, nucleus to cell ratio, Golgi apparatus to cell ratio, rough endoplasmic reticulum...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-10-01 00:00:00
abstract：BACKGROUND:There are few data on the types of procedures orthopaedic oncologists perform in their first years of practice. Because fellowships are graduating fellows each year and the number of tumor patients is limited, defining the practice patterns of early-career orthopaedic oncologists may help diminish early empl...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3934-x
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:Modern metal-on-metal hip resurfacing arthroplasty designs have been used for over a decade. Risk factors for short-term failure include small component size, large femoral head defects, low body mass index, older age, high level of sporting activity, and component design, and it is established there is a su...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2347-y
更新日期：2012-11-01 00:00:00
abstract：:Joint synovia and fluids taken from patients with various stages of rheumatoid arthritis (RA) were injected into embryonated chicken eggs, resulting in characteristic joint abnormalities ("crooked toes") in the extremities of the embryos and chicks. There was a direct correlation between the number of the induced lesi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：:Maduromycosis is a rare fungal infection in the northern United States, most frequently caused by Allescheria boydii, usually in debilitated or immunosuppressed patients. An 18-year-old Mexican-American, in excellent health, developed multiple draining sinuses at the sites of insertion of Ender nails for a closed tibi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-01-01 00:00:00
abstract：:Biopsy is an integral part of the overall management of patients with soft-tissue sarcoma. The types of biopsy are fine needle, trocar, open incision or en bloc excision. There are advantages and disadvantages of each. Open biopsy requires strict adherence to a number of surgical principles. Proper execution requires ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-04-01 00:00:00
abstract：BACKGROUND:Many patients change hospitals for revision total joint arthroplasty (TJA). The implications of changing hospitals must be better understood to inform appropriate utilization strategies. QUESTIONS/PURPOSES:(1) How frequently do patients change hospitals for revision TJA? (2) Which patient, community, and ho...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1007/s11999-014-3515-z
更新日期：2014-07-01 00:00:00
abstract：:Fractures of the femur in two women, ages 17 and 27, were treated with Brooker-Wills nails. While the distal deployment device was inserted into the nail in one patient, the tip of the driver/inserter broke into the proximal end of the distal deployment device. This complicated the extraction of the nail and the dista...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:Thirty revisions were performed on loose total hip replacements with a specific acetabular reconstruction technique combining the use of a bovine bone substitute and a support ring. One patient died of a cause unrelated to the procedure. No migration of the acetabular implant or bone lysis of the heterograft was seen ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199609000-00013
更新日期：1996-09-01 00:00:00
abstract：:Glomus tumors are benign vascular tumors composed of round to oval uniform cells associated with vascular structures, usually found in the soft tissue of the nail bend. A 24-year-old woman with a two-year history of progressive right elbow pain and swelling was found to have a histologically characteristic intraosseou...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
abstract：:The purpose of this study is to clarify the clinical features of the knee affected by multiple epiphyseal dysplasia. Thirty-one cases of multiple epiphyseal dysplasia were reviewed. Of the patients, 11 were male and 20 were female. The average age at onset of symptoms was 22.5 years. The average age at initial visit t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200011000-00025
更新日期：2000-11-01 00:00:00
abstract：:Treatment with asymmetrical pulsating direct current in combination with external fixation on pseudarthroses offers encouraging results. Using a fully automatic stimulator continuously for six months appears to eliminate previous electrode problems. Since pseudarthrosis is not a well-defined condition and as the above...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1981-11-01 00:00:00
abstract：:This biographical sketch of John Gregory Smith corresponds to the historic text, The Classic: Pathological Appearances of Seven Cases of Injury of the Shoulder-Joint: With Remarks, available at DOI 10.1007/s11999-010-1231-x . ...
journal_title：Clinical orthopaedics and related research
pub_type： 传,历史文章,杂志文章
doi：10.1007/s11999-010-1232-9
更新日期：2010-06-01 00:00:00
abstract：:The optimal reconstruction procedure after wide resection of bone tumors is debatable. We reviewed pasteurized intercalary autogenous bone graft combined with a vascularized fibula graft in 15 patients with malignant bone tumors, and assessed whether this procedure would improve bone union and function. The mean durat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000246565.03833.73
更新日期：2007-03-01 00:00:00
abstract：:The effect of autogeneic bone marrow (BM) cells and allogeneic demineralized bone matrix (DBM), alone or combined, as transplantation materials was studied in an experimental posterior thoracic spinal fusion model in rabbits. Transplantation of composite grafts composed of BM and DBM showed the first signs of fusion b...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-05-01 00:00:00
abstract：BACKGROUND:The use of traction during hip arthroscopy is commonly used to provide safe joint access and to improve visualization. However, traction during hip arthroscopy has been associated with complications ranging from transient neuropraxias to devastating soft-tissue necrosis. Trendelenburg positioning may be help...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1097/CORR.0000000000000804
更新日期：2019-08-01 00:00:00
abstract：:In two cases of post-traumatic radioulnar synostosis occurring in a father and his adult son, the bony bridge was excised and a Silastic sheet interposed between the forearm bones. Both patients benefitted and had improved function of the hand following the procedure, although the range of forearm rotation restored wa...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
abstract：:Synovial tissues taken from 13 cases of synovial chondromatosis (SC) were examined by light and electron microscopy. In three of the 13 cases, early cellular changes were observed by electron microscopy. Most of the foci were independently situated within an accumulation of fine, homogenous chondroid matrix in the sub...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:Surgical procedures are performed on the nonfunctional upper extremity following stroke to correct spastic flexion contractures that cause pain or prevent adequate hygiene. In the upper extremity surgical procedures are most commonly performed to improve extension at the wrist, fingers or thumb. If the deformity is pr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-03-01 00:00:00
abstract：:Aneurysmal bone cyst is a rare nonneoplastic expansile osteolytic bone lesion of unknown etiology. To the best of the authors' knowledge, no epidemiologic study concerning its incidence has been reported. The authors performed a retrospective, population based analysis of 94 patients with primary aneurysmal bone cyst ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1999-06-01 00:00:00
abstract：:The reliability of a closed double helix electrode in the lower limbs was studied. This electrode is an implanted intramuscular electrode and is used for a totally implantable functional electrical stimulation system. Eighty electrodes were evaluated retrospectively with a mean period of 15 months. The total implant t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
abstract：:In 33 cases of primary osteosarcoma of the skull in a relatively old age group, the sex ratio and poor prognosis is the same as in osteosarcoma of long bones. However, patients in the second decade of life free of neurologic disease have a better prognosis. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-10-01 00:00:00
abstract：:Percutaneous fixation of hand fractures is a common technique that takes advantage of the subcutaneous nature of hand bones, their small size, and their limited loading potential for stress placed on hardware. Percutaneous wire fixation supplements cast fixation when plaster cannot hold particular reductions, and allo...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200006000-00014
更新日期：2000-06-01 00:00:00
abstract：:Thirty-three patients (average age, 78.9 years) with femoral neck fractures were treated with Giliberty bipolar prosthesis inserted through a posterior approach. There were four procedure-related deaths. Nine patients required readmission for treatment of complications including five patients with a dislocated prosthe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：:The prognosis of patients with bone metastasis from lung cancer has not been well documented. We assessed the survival rates after bone metastasis and prognostic factors in 118 patients with bone metastases from lung cancer. The cumulative survival rates after bone metastasis from lung cancer were 59.9% at 6 months, 3...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-007-0051-0
更新日期：2008-03-01 00:00:00
abstract：:Pigmented villonodular synovitis (PVNS) is an uncommon disorder of the synovium that rarely involves the hip joint. The natural history of an untreated case of PVNS is presented herein. A young adult with a painful hip and destructive changes on plain roentgenograms requires further diagnostic evaluation. The relative...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-02-01 00:00:00
abstract：:Femoral head vitality was evaluated by tetracycline labeling and 99mTc-MDP scintimetry in 317 femoral neck fractures before and after internal fixation with two hook-pins. The preoperative vitality was about the same as that observed by others using comparable methods. The postoperative vitality was reduced in five of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-12-01 00:00:00
