Deck 11: The Physician in a Changing Society

Question 1

Mistakes and errors in medical practice, through neglect or ignorance, can sometimes be defended as:

A) Cultural latitude.
B) A difference of opinion.
C) Accidental.
D) Unintentional.
E) None of the above.

Answer 1

A difference of opinion.

Question 2

_______________ are composed of licensed physicians and osteopaths who determine if the services rendered are medically necessary, meet professional standards of quality, and are provided as efficiently and effectively as possible.

A) PSROs.
B) DRGs.
C) HMOs.
D) PPOs.
E) AMAs.

Answer 2

PSROs.

Question 3

Millman contended that _______ errors, if they were made in "good faith," were less serious than _______

A) Technical; moral.
B) Moral; technical.
C) Accidental; real.
D) Real; accidental.
E) Accidental; personal.

Answer 3

Technical; moral.

Question 4

Which group may hold doctorates in their field?

A) Nurses.
B) Physical therapists.
C) Pharmacists.
D) Nutritionists.
E) All of the above.

Question 5

What situation has reduced public confidence in medicine more than any other single issue?

A) Refusal to be regulated by an external body.
B) Resistance to cost controls.
C) Acceptance of HMOs and PPOs.
D) Adoption of medical technology which does the doctor's work "for them."
E) None of the above.

Question 6

What restricted the evaluation of work and discouraged the expression of criticism within physician circles?

A) Rules of etiquette.
B) Laws.
C) Formal sanctions.
D) Hospital guidelines.
E) None of the above.

Question 7

Millman contended that _______________ errors resulted in unfavorable letters of recommendation for those seeking jobs and social isolation from other physicians in the hospital.

A) Moral.
B) Technical.
C) Accidental.
D) Real.
E) Personal.

Question 8

Which is NOT an important feature of a positive relationship for patients with their physician?

A) High levels of trust.
B) General satisfaction.
C) Participation in decision-making.
D) Gender matching.
E) None of the above.

Question 9

Millman contended that a "gentlemen's agreement" existed among the hospital physicians. What did this agreement allow for?

A) Overlooking each other's mistakes.
B) Not to discuss personal issues with physician's partners.
C) Assisting in negotiating the highest pay possible for physicians.
D) Doctors to be unreliable.
E) Irresponsibility to patients.

Question 10

The "golden age" of doctoring was marked by:

A) Escalating prices and overcharging to a degree previously unknown.
B) Provider-structured insurance that paid for almost any mistakes.
C) A proliferation of unnecessary tests, hospitalizations, prescriptions, and surgical operations.
D) All of the above.
E) None of the above.

Question 11

Etiquette was a more important _______________ than accountability in undermining attempts at critical evaluation of physicians by physicians.

A) Value.
B) Belief.
C) Norm.
D) Opinion.
E) All of the above.

Question 12

Public dissatisfaction with the medical profession in the United States is generally viewed as having ______________ and ________________ origins.

A) Educational; economic
B) Educational; social
C) Economic; social
D) Economic; ethnic.
E) None of the above.

Question 13

Freidson argues that it can be ___________ that physicians are dedicated to their patients.

A) Guessed.
B) Believed.
C) Denied.
D) Assumed.
E) None of the above.

Question 14

What is medicalization?

A) Path by which a student becomes a medical professional.
B) Process of turning commonly regarded normal human conditions into medical ailments.
C) Process where a traditionally non-medical professional/occupational sphere becomes labeled as medical (e.g. insurance companies).
D) None of the above.
E) All of the above.

Question 15

__________________ considerations have become a primary motivation among physicians, hospitals, and private health insurance companies.

A) Economic.
B) Social.
C) Governmental.
D) Insurance.
E) All of the above.

Question 16

______________were established in 1970 in conjunction with Medicaid and Medicare, to review and evaluate the medical care given to patients eligible to use these services.

A) PSROs.
B) DRGs.
C) HMOs.
D) PPOs.
E) AMAs.

Question 17

Medicalization is a form of ______________ action.

A) Socioeconomic.
B) Individual.
C) Collective.
D) Physician-driven.
E) None of the above.

Question 18

Millman contended that ________________ errors could be forgiven and often had the result of motivating the offending physician to work harder, spend more time with patients, double-check procedures, and learn from the mistake.

A) Moral.
B) Technical.
C) Accidental.
D) Real.
E) Personal.

Question 19

A major defect in the professional autonomy argument arises from the fact that the autonomy granted to the medical profession is granted _____________, on the assumption that it will resolve significant issues in favor of the public interest.

A) Partially.
B) Completely.
C) Conditionally.
D) Unconditionally.
E) None of the above.

Question 20

The decline in the status of physicians is largely due to greater:

A) Government regulation
B) Corporations in the health care market
C) Changes in the physician-patient relationship
D) All of the above
E) None of the above

Question 21

Public attitudes toward the medical profession have shifted away from the unquestioning acceptance of physician authority to a more critical view of doctors today.

Question 22

____________ refers to health care organizations that control the cost of health care by monitoring how doctors treat specific illnesses, limit referrals to specialists, and require authorization prior to hospitalization, among other measures.

A) Health savings companies.
B) Medicare and Medicaid.
C) Health insurance.
D) Managed care.
E) None of the above.

Question 23

The movement of public opinion has been toward less confidence in physician authority.

Question 24

Americans still have high regard for medicine as a social institution.

Question 25

Physicians are rarely judged by their patients. Typically, only health care professionals judge the performance of doctors.

Question 26

Support through planning grants and loan guarantees was provided to encourage the development of _______________; a form of prepaid group practice emphasizing preventive care.

A) PSROs.
B) DRGs.
C) HMOs.
D) SCHIPs.
E) AMAs.

Question 27

What is a double agent?

A) Physicians who look out for the interests of the patient and the interests of a managed care organization.
B) Insurance agents who seem to be offering a great financial package, but are actually creating more profits for insurance companies.
C) A physician who is also a patient.
D) A nurse who reports on the mistakes of a physician who he/she works for.
E) None of the above.

Question 28

What is a gatekeeper?

A) Typically, the government.
B) A primary care physician who screens patients prior to referring them to a specialist.
C) A physician who blocks the review of another physician in an attempt to protect him/her.
D) None of the above.
E) All of the above.

Question 29

The profit motive has bred resentment among consumers and demands that the professional power of doctors be increased.

Question 30

Physicians cannot be arrested and/or sentenced to prison for misrepresenting care they claimed they gave to Medicare and Medicaid patients, because of the "veil."

Question 31

_____________ are schedules of fees placing a ceiling on how much the government will pay for specific services rendered to Medicare patients by hospitals and doctors.

A) PSROs.
B) DRGs.
C) HMOs.
D) PPOs.
E) AMAs.

Question 32

At the beginning of the 21st century we are witnessing that the dominance of medical profession is:

A) Declining.
B) Expanding.
C) Increasing.
D) Stagnating.
E) None of the above.

Question 33

Medical standards and practices continue to be regulated by the practitioners themselves.

Question 34

What attracted corporations to health care delivery is the potential for:

A) Improving health care.
B) Helping people.
C) Financial profit.
D) All of the above.
E) None of the above.

Question 35

Rates for malpractice insurance have declined as states have set limits on the amount of money awarded in malpractice lawsuits and physicians have become more careful in dealing with patients.

Question 36

Which is NOT a term used to describe free-standing emergency centers?

A) Docs-in-a-Box.
B) 7-Eleven Medicine.
C) Quick-fix facilities.
D) None of the above are correct terms.
E) All of the above are correct terms.

Question 37

______________ are forced to spend time as "patient advocates," convincing various bureaucrats that more specialized and expensive care is warranted.

A) Specialists.
B) Physicians' assistants.
C) Nurses.
D) Primary care physicians.
E) All of the above.

Question 38

Millman contended that a technical error was making the mistake of being unreliable, uncooperative, lacking in responsibility to patients, and failing to acknowledge subordination to superiors.

Question 39

The social control of medical practice has been beneficial for American society.

Question 40

Which is a feature of a free-standing emergency center?

A) Open around 18-24 hours a day, 7 days a week.
B) Attend to their patients with a minimum of waiting time.
C) Treat cuts, broken bones, bruises, and minor ailments.
D) Sometimes these are located in shopping centers or other convenient locations.
E) All of the above are features.

Question 41

Free-standing emergency centers do not take business from hospitals..

Question 42

What does the term "countervailing power" mean? What are the sources of this notion? Discuss.

Question 43

The medical profession has been strengthened through an oversupply of doctors.

Question 44

The rise of the profit orientation in medicine signifies a trend in medical practice away from formal rationality toward greater substantive rationality.

Question 45

About 18 percent of all U.S. hospitals are owned by profit-making organizations.

Question 46

There is a changing relationship between physicians and their patients. Identify and discuss trends contributing to this change.

Question 47

It is generally difficult to find a physician who will be openly critical of another physician or who will publicly testify against a colleague.

Question 48

Is there a deprofessionalization of physicians occurring? Why? Why not?

Question 49

The problem with a professional dominance thesis is that it does not allow for decline.

Question 50

What is managed care? What is its role in health care delivery? What effect does it have on the work of physicians?

Question 51

"The social control of medical practice has traditionally presented special problems for American society." How so? What kind of problems?

Question 52

One of the most extensive changes in health care delivery, reducing the authority of physicians, has been the introduction of managed care.

Question 53

Rising costs of health care resulted in physician demands for government intervention.

Question 54

The AMA was a major proponent supporting the creation of Medicare.