Disclosing medical errors in Missouri: how to say "I'm sorry".

Most physicians and patients agree that errors should be disclosed to patients and their families. A major barrier to disclosure is fear of litigation on the part of the physician. Some states, now including Missouri, have adopted so-called "apology laws", which are designed to facilitate disclosure by making certain statements of apology inadmissible as evidence in a court case.

The Program in Medical Humanities at the University of Missouri-Kansas City School of Medicine.

Unlabelled: The University of Missouri-Kansas City School of Medicine opened officially in 1971, offering a combined BA/MD in a six-year program. The program has a defined goal of offering humanities courses throughout the curriculum. The Sirridge Office of Medical Humanities was established in 1992, and it assumed the responsibility of developing conveniently scheduled courses in medical humanities, making more specific requirements for such courses in the medical curriculum.

Body image and the innocent eye.

This paper describes the development, content, teaching experience, and impact of the course "The body image in medicine and the arts" which is offered annually in a one-month format for medical students and other upper division students at the University of Missouri-Kansas City (UMKC). Literature, photography, art, anthropology, art history, cultural studies, feminism, modernism, and medicine are all employed in the course as a way of encouraging students to consider the broader cultural interpretations of the human body. Any medical humanities instructor wishing to explore new ideas and themes related to teaching students about past and present body image issues and their impact on contemporary biomedical culture can gain insight through an overview of this course.

Deep venous thrombosis in surgical patients: possible laboratory predictors.

We tested 18 surgical patients before and after operation in an effort to determine whether or not laboratory tests could be used as predictors of deep venous thrombosis. During the period of study, none of the patients tested had deep venous thrombosis. Coagulation tests showed no significant changes, but all tests used to measure platelet numbers and functions yielded different preoperative and postoperative values.

Laboratory evaluation of the bleeding patient.

The laboratory evaluation of bleeding patients is often inaccurate and incomplete when the history and physical examination are not adequately evaluated. Using such information the next step is to use screening tests to evaluate platelet numbers and function, clot formation and clot stability and then to proceed to appropriate follow-up testing when indicated. In this way the number of tests can be significantly reduced and an accurate diagnosis becomes more likely.

Contribution of education to cost-effective care of microcytic, hypochromic anemia.

Through a handbook, a seminar, and multiple opportunities for reinforcement in clinical settings, faculty in family medicine conducted an educational program that presented cost-effective practice standards for the care of anemia patients to resident physicians. A comparison of the quality and cost of anemia care by the residents before and during the program ascertained its value. The quality of patient care by residents rose significantly during the program.

"Effort thrombosis" of the subclavian vein associated with oral contraceptives.

We report a case of "effort thrombosis" of the subclavian vein in a 33-year-old woman with several thrombotic risk factors, including the use of oral contraceptives. The signs and symptoms associated with this syndrome, as well as concepts concerning diagnostic techniques and management, are discussed.

The docent system: an alternate approach to medical education.

There are many applications of the docent system for schools in which students are older and engaging in more conventional educational approaches. There are advantages in bringing students from different classes together over a prolonged period of time, starting with their entrance into the program. Advisors in docent roles can contribute much to such groups.

A study of blood coagulation parameters.

The object of this study was to determine the presence or absence of abnormalities in a variety of blood coagulation parameters in women on contraceptive medication. A prospective double-blind study involving a control group with a total study enrollment of 211 women during a 29 month period was established. Although research has not proved that changes in coagulation parameters will cause abnormal clotting in normal patients, a pattern appears to be developing involving antithrombin III determinations.