I/41HbGpCmuqL._SR600%2C315_PIWhiteStrip%2CBottomLeft%2C0%2C35_PIStarRatingFOUR%2CBottomLeft%2C360%2C-6_SR600%2C315_ZA(34%20Reviews)%2C445%2C286%2C400%2C400%2Carial%2C12%2C4%2C0%2C0%2C5_SCLZZZZZZZ_.jpg' alt='Pocket Emergency Medicine Pdf' title='Pocket Emergency Medicine Pdf' />Gregory Roslund, MD is an emergency medicine doctor in Dallas, Texas and is affiliated with multiple hospitals in the area, including Methodist Charlton Medical. OTTAAW KNEE RULE For Knee Injury Radiography A knee xray series is only required for knee injury patients with any of these findings 1. Harrisons Principles of Internal Medicine 19th Edition PDF eBook Free Download. Volumes Set. Edited by Kasper, Fauci, Hauser, Longo, Jameson and Loscalzo. The Medical Malpractice Rundown A State by State Report Card. When it comes to medical liability laws and culture, where you live matters. Depending on your state, your liability and premiums might be sky high or totally reasonable. Find out how your state stacks up against the other 4. Do you think our medical liability system has been broken for a while If so, youre not alone. And now, with the recent enactment of the Affordable Care Act, our resources are more limited, our decisions more scrutinized, and were going to have to do more with less. The current medical liability system is simply not compatible with government run health care rationing. We are now expected to discharge more and test less yet, tort reform is not part of the Obama. Care equation. So whats the solution If you examine medical liability at the state level, youll find that some systems are working well, while others are hardly working at all. Here, in Texas, things are working out big time, thank you for asking. Thanks to the passage of landmark malpractice reforms in 2. Liability carriers have slashed their rates, doctors have flocked to the state, access to care has improved and physician morale has soared 7. But questions remain Does this new system work for patients Have these new laws decreased the practice of defensive medicine and, in turn, decreased health care costs Are patients who have been genuine victims of malpractice in Texas receiving the compensation they deserve And, on a larger scale, why does medical liability vary so much state to stateThe answer is complicated. Each states medical liability system represents a delicate and convoluted interplay between physicians, lawmakers, and patients. Additional factors include supply and demand how many attorneys are in the state How easy is it to recruit doctors to the state, political history red vs. And of course, in the end, its all about money. I have now experienced three vastly different medical liability environments as my medical career has taken me from Chicago to South Bend and now Dallas, and I have become increasingly fascinated with this topic. In the last two years, on behalf of AAEMs Legal Committee, I set out on a quest to fully understand the ins and outs of our medical liability labyrinth. My modest goal was to construct the most accurate and comprehensive medical liability database ever for emergency physicians. Youll find the findings summarized here. A detailed report for all 5. AAEMs Common Sense newsletter. These state by state summaries have generated a multitude of insightful questions and inquiries from friends, colleagues, and Common Sense readers. Here are the top 1. What constitutes a good liability environment for emergency physicians Although a formal definition does not exist, the best liability environment for an emergency physician is one in which litigation and malpractice costs are both kept to a reasonable minimum. In an ideal environment, frivolous suits are minimal and meritorious cases are quickly identified. If this happens, the stress and cost associated with litigation is minimized, and patients who are truly victims of negligence are compensated fairly and in a timely manner with reasonable limits. Secondary benefits include decreased costs in the form of reduced litigation and annual premiums, costs previously absorbed by physicians but sometimes passed on to the patients and a reduction in defensive medicine, whose costs had been passed on to taxpayers and patients. Additional secondary benefits include improved quality of life for physicians as a result of decreased litigation stress, more money in their pockets, heightened morale, and the ability to practice good medicine without being defensive. Finally, patient safety is arguably improved as states have an easier time recruiting and retaining doctors, which, in turn, equals greater access to physicians, especially those performing high risk procedures. Theoretically, states that have enacted special laws to reduce unreasonable litigation expert witness reform, case certification requirements, and medical review panels and curb excessive rewards damage caps should have the most favorable environments, with physicians paying the lowest annual premiums. However, this is not always the case. The relationships between tort reform, malpractice costs, and medical liability environment favorability are complex and nonlinear. Sometimes, a states legal culture can overwhelm tort reform laws favoring physicians or can protect physicians despite the absence of meaningful laws. The best, the worst and the watch list. The best states are California, Colorado, Kansas, and Texas. All four of these states have enacted a reasonable cap 2. Litigation in these states has markedly decreased over time and annual malpractice premiums for physicians remain low 1. Following close behind are Indiana which long ago implemented a 1. Alaska, North Carolina, North Dakota, and South Dakota which have all implemented caps on non economic damages of 5. The majority of these states have some of the lowest medical malpractice payouts per capita 3. The worst states include Illinois and a cluster of states on the East Coast New York, DC, Pennsylvania, New Jersey, and Delaware. In all of these states, litigation is frequent and malpractice premiums for physicians are debilitating OBGYNs and surgeons in New York City and Philadelphia pay north of 1. These states all have some of the highest malpractice payouts per capita and meaningful tort reform is non existent 3,3. Which states have seen the most change in recent years and why Texas The Lone Star state has become the poster child for tort reform. Litigation, paid claims, and premiums have been slashed in half after sweeping reforms were passed in 2. Applications for Texas licenses have surged and the malpractice payout per capita at 3. Ohio Litigation has dropped 4. Pennsylvania Reforms were passed in 2. In the last 1. 0 years, medical malpractice case filings have decreased 4. Philadelphia 6. Mississippi Since passing strong reforms in 2. North Carolina The state passed vigorous reforms in 2. EMTALA providers 3. North Carolinas per capita malpractice payout 4. Aletta Ocean Tight. Which reforms have had the greatest impact There is significant data to support the efficacy of a hard cap on non economic damages 7. Twenty five states currently implement a cap on non economic damages although Floridas cap is in the process of being overturned 3. The 2. 50k cap is most closely tied to good liability environments Texas, Alaska, California, Kansas. The benefits of this cap are significantly diminished if it allows for too many exceptions e. Maryland 3, if it is increased in cases with multiple defendants South Carolina 3 or if it is simply too high to make an impact Tennessee. Twenty four states are currently implementing a case certification mandate. This has been credited for reducing the volume of frivolous lawsuits in many states, such as Pennsylvania 6. Tennessee. Nineteen states currently implement a pre litigation panel review process mandatory in 1. Based on my own experiences as a physician in Indiana where I sat on both sides of the panel, this law is effective in weeding out frivolous claims and reducing practitioner fear knowing that a bad outcome in which no error was made will be dismissed by the panel. GEMS Government Employees Medical Scheme. Membership Dependants Can contract workers join GEMS Contract employees whose term of appointment is at least 6 months may join GEMS. Note that some contract employees are remunerated by means of all inclusive remuneration packages, i. PERSAL will not generate an employer subsidy when such a contract worker joins GEMS since the subsidy is already built into the remuneration package. Who qualifies as a dependant A dependant is. Husband, wife or partner involved with the main member in any same sex or heterosexual union. Ex husband or ex wife if required by a divorce settlement. Children biological, adopted, step or foster Parents, parents in law, step parents, step parents in law, grandparents and grandparents in law if they are factually dependent on the main member Grandchildren and great grandchildren if they are factually dependent on the main member. Siblings brothers and sisters, half siblings, step siblings and in law siblings if they are factually dependent on the main member Nephews and nieces if they are factually dependent on the main member or of a members spouse A person, other than family, who is dependent on the main member for family care and support. To be registered as a child dependant, a person must either be. Board within South Africa or any other educational institution abroad ortotally dependent on the main member and who is deemed by the Board to be permanently disabled, irrespective of age. For most of the dependant categories outlined, an affidavit that proves factual dependency should be submitted with the application form. Not older than three months. An affidavit is a written declaration made under oath in front of someone legally authorised to administer an oath for example, a Commissioner of oaths, or a police officer. If a member dies, will his registered dependants still be covered Yes, if the member has not had a break in membership and provided that the contributions are paid. The eldest dependant if no spouse is registered as a dependant will then be registered as the main member adult dependant rates then apply. Normally the Estate is responsible for the monthly payments. What role does my employer play in my relationship with GEMS GEMS is a legal entity separate from the employer and is governed by a Board of Trustees. In other words, the Board of Trustees determines the rules under which the Scheme operates, including benefits and contributions. The employer on the other hand determines the conditions of service of employees through negotiations with trade unions. In determining the conditions of service of public service employees, the employer may for example determine whether or not its employees are compelled to belong to one scheme or whether the employees have total freedom of choice of scheme. The employer also determines what level of subsidies will apply to different categories of employees or in general. Employers also play an important role in collecting contributions and ensure payment thereof to the scheme concerned. Why is my subsidy less on GEMS than with my previous scheme The subsidy structure implemented on 1 July 2. June 2. 00. 6, or the subsidy per the 7. For example, a single employee with no beneficiaries who joins GEMS will receive a subsidy of 7. R6. 70. If the employee received an employer subsidy of R7. June 2. 00. 6, the employee will continue to receive the R7. Please note that the no worse off clause only applies to employees who received an employer subsidy on 3. June 2. 00. 6. If no employer subsidy was received on 3. June 2. 00. 6, the employee will only qualify for a subsidy equal to the 7. Another requirement for the no worse off clause is that there should be no break in membership when moving from your previous scheme to GEMS. Please refer to the contribution calculator for further guidance on the calculation of your employer subsidy. Why am I suspendedThere are various reasons for suspending benefits, each with a different cause and impact on you. Suspension due to incomplete registration This type of suspension is caused when insufficient supporting documentation was provided for the registration of the member or dependant. As the registration process is not complete, no benefits will be made available, nor will contributions be collected. Please provide GEMS with all the requested documents in order to complete the registration. Suspension due to contribution or claims debt This type of suspension is caused by non receipt of contributions or any members share of claims. There are several reasons for not receiving a contribution, and it is in your interest to contact GEMS to resolve the matter. Please note that although benefits are not available during the period of suspension, contributions are still payable. You will not be entitled to a refund of contributions should benefits have been suspended, therefore always ensure that deductions are made from your monthly salary or bank account, where applicable. What is chronic medicine Chronic medicine is medicine used on an ongoing basis to treat disabling andor potentially life threatening chronic long lasting illnesses, like diabetes, that have a negative effect on your health and quality of life. Chronic medicine must be pre authorised by the Medicine Management Department to ensure appropriateness and cost effectiveness. Some medicines are not paid in full if they are not on the Schemes formulary or Medicine Price List MPL. Always check with your doctor to see if the most cost effective medicine is prescribed according to the MPL and the formulary so that you do not need to pay out of your own pocket. How do I apply for authorisation of my chronic medicine Call GEMS on 0. Chronic Medicine Application Form or download one from the GEMS website at www. Click on Forms under Members. Your treating doctor must complete the form. A separate form must be completed for each member or dependent who needs chronic medicine. You only need to complete this application form once. Ensure that your application form is completed in full. Ensure that both you and your doctor have signed the application form. Fax the completed form to 0. Email your form at chronicdspgems. We will then review your application. We will check it against the Scheme Rules to see if we can cover the medicine under the chronic medicine benefit. If we approve your application, you will receive a Medicine Access Card, listing the medicine that we have agreed to pay for from your chronic medicine benefit. If the medicine that we have agreed to pay for differs from the medicine your doctor has prescribed, we will attach a letter to your Medicine Access Card that will explain the reasons for this. We will also send a copy of the letter to the doctor who prescribed the medicine. If we do not approve your application for chronic medicine, you and your doctor will both receive a letter explaining this decision. How do I obtain my approved chronic medicine The Scheme will give you a choice of receiving your medicine through our Courier Pharmacy or your nearest GEMS Network pharmacy. Once you have indicated your choice you can go and collect your medicines at your nearest Network pharmacy if that was your choice. If you chose the Courier pharmacy then they will contact you to make medicine delivery arrangements.