When a physician makes a mistake

Inevitably, doctors make mistakes in the normal course of providing care. Making a mistake often causes distress for the doctor involved, but it can also be an important source of knowledge and self-reflection. This article discusses central aspects with respect to mistakes and medical malpractice. The doctor's relationship to ethics and legislation is discussed, and an overview of the administrative action taken by the Norwegian health authorities is presented. The organisations and offices a physician may come into contact with when involved in a patient's complaint are briefly presented. "Meldesentralen" was formed in 1993 by the Norwegian Directorate of Health for the purpose of collecting reports on accidents in medical practice. We argue that the accidents reported to "Meldesentralen" do not reflect the true situation on this issue. We introduce a model for a systematic approach towards a colleague who has made a mistake or who is suspected of having made one.     

Valuing a practice for a partnership

The hot topic from Capitol Hill in Washington to Capitol Hill in Jefferson City is health care reform. President Clinton started the ball rolling during the campaign in 1992 by including health care reform in his platform. He continued the effort after his election by appointing his wife, Hillary, to chair a task force to present an outline for federal legislation. Since the package was presented to Congress, there has been much discussion, lobbying, and rumoring about the implications of health care reform and what it could mean to all of us as dentists. On the home front, Governor Carnahan has introduced legislation in Missouri to reform the health care system. This effort is known as the Missouri Health Assurance Plan (H.B. 1622). Missouri Dental Association members are vitally concerned about the impact of health care reform on their practice, their taxes, their relationship with their patients and employees, and on their ability to seek out health care services since each member is also a consumer of health care. This article represents answers to some of the questions being asked by MDA members in order that they might be more aware of the activities by the MDA, the ADA, and other levels of organized dentistry relating to health care reform.     

Aspiration of a primary tooth in a patient with a tracheostomy

We report a clinical case of a patient affected by splenic non-Hodgkin lymphoma and virus C hepatitis. It seems that this kind of association is original because as far as we know the association between non-Hodgkin lymphoma and HCV did not include non-Hodgkin lymphoma involving the spleen. Indeed, in our patient, there was an increase of CD/57 lymphocytes. In our opinion this could be interesting in the disorders of the immune system associated with lymphoma.     

Understanding deafness as a culture with a unique language and not a disability

The traditional view of deafness and deaf patients and families is based on a pathological perspective of deafness rather than a cultural perspective. The purpose of this article is to offer advanced practice nurses an alternative approach to this often misunderstood community of patients who have their own unique language, values, and experiences.     

Can a chimpanzee make a statement?

Investigated, in 2 experiments conducted over a 7-yr period using 2 male chimpanzees, whether the gestural-referential complex can be developed. In Exp I, a test was designed to determine whether Ss could produce accurate requests for things they could not see and whether, as they produced these requests, they had an idea of the specific absent objects that corresponded to their symbolically encoded requests. In Exp II, a test was devised to eliminate all potential means of cuing and order strategies that might result in the S's selecting a symbol and giving the appropriate object without anticipating and planning the complete sequence in advance. Results demonstrate that the gestural-referential complex can be developed, with training, in the chimpanzee and that, consequently, naming with reference does appear. A review of the training that preceded the emergence of referential function in these chimpanzees suggests that symbolization is not a unitary skill but rather a combination of diverse productive and receptive skills. (57 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Just a 'wee prick' with a needle

Difficulty with vascular access is a common problem in neonatal medicine and surgery. Recent advances in parenteral therapy/nutrition and manufacture of high quality intravenous lines have enabled smaller infants to survive. Thus, in the small surgical neonate, the insertion of an indwelling intravenous long line (either percutaneously or at cut down) is a frequent occurrence. This procedure is not without its complications and it is thus necessary for the clinician inserting these lines to be aware of this and fully understand the regional anatomy of the area being used. I wish to report an unusual complication which posed several diagnostic and management problems.