Deaf and hard-of-hearing (DHoH) individuals are underrepresented among physicians and physicians-in-training, yet this group is frequently overlooked in the diversity efforts of many medical training programs. The inclusion of DHoH individuals, with their diverse backgrounds, experiences, and struggles, contributes to medical education and health care systems in a variety of ways, including (1) a richer medical education experience for students and faculty resulting in greater disability awareness and knowledge about how to interact with and care for DHoH individuals and their families, (2) the provision of empathetic care desired by many patients and their families, including individuals who have a disability or chronic condition, and (3) the promotion of a more supportive and accessible professional environment for physicians, including older physicians in practice and as educators, who are experiencing age-associated decreased hearing acuity or other acquired disabilities.Today, many qualified DHoH individuals face barriers to pursuing medical careers even while physicians who become DHoH can continue to practice medicine. These barriers still exist two decades after the implementation of the Americans with Disabilities Act of 1990 and despite technological advancements and changing attitudes. In light of the findings by Moreland and colleagues, the authors of this commentary discuss reasons to include DHoH individuals in the physician workforce, explain why this group remains underrepresented among physicians, and suggest ways that medical schools and training programs can ensure fair application processes and inclusive educational opportunities for work with DHoH students who are interested in health care careers.

An in-vision commentary is commentary in which the participants are filmed and the resulting video dropped into the video of the episode on which they were commenting. This lets the viewer divine extra meaning by reading the facial expressions of the participants as they speak. It also overcomes the occasional problem encountered on audio commentaries of participants making visual references. Such commentaries were a major feature of the series 2 box set, but they were not extensively used thereafter until the series 5 box set.


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A form of "video commentary" was also later used on the official Doctor Who website, as a part of the Adventure Calendar series. These commentaries differed from those on the DVD boxset, in that they were simply recordings of the commentary participants; no footage from the actual episodes was included. Indeed, most of these "in-vision commentaries" were later repurposed as simple audio commentaries in the podcast series of commentaries used in the first Russell T Davies era or on the DVD box sets. Nevertheless, they were labelled "in vision commentary" on their respective title cards.

The Indiana Supreme Court on Thursday publicly reprimanded a defiant Indiana Attorney General Todd Rokita for his televised comments about the doctor who oversaw a medication abortion for a 10-year-old rape victim from Ohio.

The Indiana Capital Chronicle is an independent, nonprofit news organization dedicated to giving Hoosiers a comprehensive look inside state government, policy and elections. The site combines daily coverage with in-depth scrutiny, political awareness and insightful commentary.

Nevertheless, Barry accepts the assistant position and begins to learn that so much of healing involves the relationship between doctor and patient, whether in his vigilant care of a little girl with appendicitis, an old man, Sonny, living in his car to fend off the village real estate tycoon who wanted to seize his property, or Julie, a girl in service who turns up pregnant out of wedlock.

Any person who is insured by a health insurance company has the opportunity to seek an IMR whenever health care services have been denied, modified, or delayed by the health insurer if the decision was based in whole or in part on a finding that the health care service was not medically necessary or deemed to be experimental or investigational. As the insured, you can designate a person to act as your authorized IMR assistant to help you with this process. Also, a health care professional (such as your doctor) is allowed to join with you and assist you with the IMR request. To designate a person to act on your behalf, you must complete and sign the Authorization for Release of Medical Records and Designation of IMR Agent found on the third page of the Application for IMR form.

The IMR process allows for exceptions to be made when there is a serious or imminent threat to your health. CIC Section 10169.3(c) states that if the "insured's provider [your doctor/medical professional] or the department (CDI) certifies in writing that an imminent and serious threat to the health of the insured [you] may exist, including but not limited to, serious pain, the potential loss of life, limb, or major bodily function, or the immediate and serious deterioration of the health of the insured," the IMR organization must make its determination within three days of receiving the proper case information. Moreover, your insurance company must deliver the necessary information and documents to the IMR organization within 24 hours of approval from the CDI of your IMR request.

Medically Necessary - A drug, device, procedure, treatment plan, or other therapy that is covered under your health insurance policy and that your doctor, hospital, or provider has determined essential for your medical well-being, specific illness, or underlying condition.

In a commentary published ahead of print Sept. 8 in BMJ Quality & Safety, Martin Makary, M.D., M.P.H., and his co-authors urge the wide adoption of protocols to end the practice of imposing needlessly long fasts on patients preparing for operations and to improve sleep quality in those recovering from such procedures.

In their commentary, the authors describe what they say is a typical case of a 65-year-old woman who develops pneumonia at home and feels too sick to eat or drink much for several days. She then goes to the emergency room, where food is withheld by medical personnel in case she needs certain invasive tests or actual surgery. If needed, surgery might add more days without food and little sleep, owing to continuous monitoring and noise in and outside her hospital room.

A recent study led by Johns Hopkins surgeon Elizabeth Wick, M.D., a co-author on the commentary, demonstrated that the ERAS approach can reduce the average length of stay by two days among colorectal patients, among other complications. The average cost of treatment also decreased from nearly $11,000 to $9,000 per patient.

Dr. Jones will probably end his medical career frustrated at his inability to do much more than his job as a competent clinician. He could be the best clinician in the world. Chances are, however, that the lead poisoning diagnoses, the poverty-induced chronic diseases, and the preventable, life-shortening afflictions will keep arriving at his doorstep until he takes down his shingle or restricts his practice to some affluent American suburb where those problems are less visible. Certainly, being a competent doctor is enough for any one individual in his or her lifetime. But is Dr. Jones required to do any more than what he can as a clinician to improve health in his practice community?

As a sociologist who studies medicine, I see a profession that has difficulty assuming an identity with respect to the larger purposes it serves for assuring the health of populations. In studying why doctors belong to organizations like professional associations, for example, I found that economic and instrumental interests, ie, the self-interest motivation, far outweighed concerns about achieving social justice in health care or using the power of the collective to lobby for and shape the kinds of changes needed to improve people's lives enough to make them healthier.3

There are so many professional organizations competing with each other now for the attention and business of individual physicians that these organizations must focus on bread-and-butter issues like income and reimbursement, continuing medical education, and the advancement of legislation that furthers the interests of medicine. Improving the health of disadvantaged populations is simply not important enough in the mind of the average doctor to succeed as a marketing pitch for membership. Just getting physicians To join more than their little specialty organization is a major task these days. The professional associations know this; they know that the world of managed care presents challenges that affect the individual doctor's work life, and they know that doctors want to see these challenges solved by their membership group.

For many in the profession, being a doctor is a tough calling these days. Becoming a clinician creates massive personal debt. Most need intensive advance preparation even to qualify for entrance into medical school and residency. The unique challenges faced by an increasingly diverse profession (eg, female physicians) in the workplace, the likely reality of salaried worker status once practicing, and the dizzying pace of knowledge change within some areas of medicine conspire to make the modern-day physician more prone to career dissatisfaction. At the least, these challenges create a life where the everyday work of patient care drains the energy and enthusiasm needed to tackle bigger-picture issues.4 We cannot expect, nor should we, that the Dr. Joneses of this world will become individual crusaders, spending 10-20 hours per week trying to help solve the health problems brought on by persistent poverty, substandard living and nutritional conditions, lack of health care insurance coverage, and inadequate access to care. It is unrealistic, given how demanding and personally testing the life of the average doctor is these days. 2351a5e196

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