This article examines the relationships between antipsychiatric activism and feminism, paying particular attention to the civil liberties of mental health consumer/survivor/expatient (c/s/x) individuals in relation to mental health practices. It argues that a continually rigorous exploration of the complex (and at times uneasy) relationships between antipsychiatric activism, feminism and mental health practice is necessary and useful for pursuing social justice by working toward the diminishment of mental health inequalities. The article includes an overview of the ’spectrum’ of antipsychiatric stances and a review of some of the literature covering the relationship between antipsychiatry and feminism, and uses cinematic and literary examples to highlight the complexity of addressing issues like medication ‘compliance’ and ‘non-compliance’ among mental health users and consumers in biomedical contexts.

Income is an important and challenging concept to measure in household health surveys. Income is highly associated with a wide array of important health, economic, and sociological outcomes (Williams 1990; Link and Phelan 1995; Krieger, Williams, and Moss 1997; Norris et al. 2003) and determining income levels is critical to policy analysts because public programs specify income cutoff points beyond which people are no longer eligible (e.g., Temporary Assistance to Needy Families, Medicaid and State Children’s Health Insurance Program) (Dubay and Kenney 2000). There are two principal challenges in measuring income in surveys. First, there are many potential sources of income. Asking about these multiple sources and the exact amounts deriving from each source can prove quite burdensome for respondents. For example, people can have earned income from a job, dividend income from stocks, interest income from a savings account, government transfer program income, self-employment income from a business, and self-employment income from various odd jobs or consulting. There can also be losses of income because of stock transactions and privately owned business losses.

Question: Why become a certified physician executive?

answer:

The CPE certification after your name speaks to your commitment to excellence and can be a valuable asset toward advancing your career and enhancing your credibility. CPE on your resume indicates that you’ve reached a superior level of excellence in medical management, with the education, management experience, and demonstrated skills to effectively lead health care organizations in today’s challenging markets.

Many requirements must be met before you can attend the four-day skill building Tutorial. You must provide proof of your:

* Stature as a physician–a licensed MD or DO who is board certified in a specialty

* Management education-150 hours of tested management education or a management degree

* Management experience-at least a year with a letter from a CEO attesting to your management accomplishments

The four-day skill building Tutorial includes an oral evaluation, a written evaluation, and daily video evaluation of skills.

Becoming a CPE lets hiring organizations and recruiters know you have a wealth of knowledge and experience and that others will benefit from it.

I have a family history of melanoma, and to make matters worse, I spent way too many of my teenage summers slathered in baby oil, lying in the sun. My skin-cancer risk is relatively high, so I get regular exams. This time, I was seeing a new dermatologist. She barreled into the room, gave me a quick once-over while she jabbered to the nurse about another patient, then left. She’d barely glanced at my skin, much less given me a chance to ask her anything. I knew that if she had missed a cancerous mole in her hurry to complete the exam, it could mean the difference between life and death–to me.

Fortunately, it didn’t, but her brusque manner had left me tongue-tied, vulnerable and ill at ease, an all too common experience for patients today. “Doctors stand over us while we’re lying on exam tables and call us by our first names while we call them by their titles,” says Jonathan H. Amsbary, Ph.D., an associate professor of health communications at the University of Alabama in Birmingham. “Plus, they’re clothed and we’re not. Of course we feel uncomfortable!”

However, from wrong diagnoses to prescriptions for medications that don’t help, studies show that poor doctor-patient communication is to blame in many cases of bad health care. So it’s vital to know what to say and when to say it during all health-related visits–including those with dentists and dietitians. Here, advice on how to better navigate your next appointment.

* Record your medical history. “For an annual exam, take a few minutes to review your ‘health story’ from the past year,” advises Michele Curtis, M.D., M.P.H., a gynecologist in Houston. “Write down anything that’s changed, both major things like surgeries and minor things like new vitamins [or herbs] you’re taking.” Also note any health issues that have come up among your parents, grandparents and siblings, he suggests–your doctor may recommend steps to help prevent the same problems.

* Get your records. If you’ve had gynecologic surgery or a mammogram, request a copy of the procedure records from your surgeon or specialist to bring along (and keep a copy for yourself as well).

Question: Why become a certified physician executive?

answer:

The CPE certification after your name speaks to your commitment to excellence and can be a valuable asset toward advancing your career and enhancing your credibility. CPE on your resume indicates that you’ve reached a superior level of excellence in medical management, with the education, management experience, and demonstrated skills to effectively lead health care organizations in today’s challenging markets.

Many requirements must be met before you can attend the four-day skill building Tutorial. You must provide proof of your:

* Stature as a physician–a licensed MD or DO who is board certified in a specialty

* Management education-150 hours of tested management education or a management degree

* Management experience-at least a year with a letter from a CEO attesting to your management accomplishments

The four-day skill building Tutorial includes an oral evaluation, a written evaluation, and daily video evaluation of skills.

Becoming a CPE lets hiring organizations and recruiters know you have a wealth of knowledge and experience and that others will benefit from it.

If you have further questions on this topic, contact Barbara Linney at ACPE, 800-562-8088.

Answers to questions frequently asked by members of ACPE in reference to completing the Section I curriculum toward a graduate degree and/or certification.

In this age of hurried health care, you’ll probably spend more time in the waiting room than in the examining room. But we can’t afford to get short shrift when it comes to our well-being. So we posed this question to several physicians: What can we do to get the most out of even the briefest of doctor’s visits? Here’s what they told us:

Sweat the small stuff

Doctors say they base the vast majority of their diagnoses on what their patients tell them. But if you’re complaining about, say, an irregular period and you can’t remember when it started, you make it hard for your doctor to figure out what’s wrong, says Andrea N. Price, M.D., an ob-gyn at the Women’s Health Alliance of New Jersey. To give your doctor a better understanding of what ails you, set aside a diary just for your health and record when you feel off, what your symptoms seem to be and what’s going on in your life at the time. Then bring it with you to your appointment.

Be your own expert

Doctors admit that well-informed patients instantly get more respect. “Doing your research beforehand alerts your doctor that you are knowledgeable and there are expectations to be met,” says Tina Raine, M.D., associate professor of obstetrics and gynecology at the University of California, San Francisco. The Internet is the best place to start. While there is a lot of bunk to avoid, government health sites such as the National Institutes of Health (nih.org), and home pages for medical schools and medical associations are loaded with useful information. Sift through them for info on screenings recommended for women in your age group. You can also do research on any symptoms you might have, as long as you don’t try to diagnose yourself, Price says.

Tell the truth–the whole truth

“Sometimes patients are concerned about how they’re going to be perceived and don’t disclose as much as they should,” says Evelyn Lewis, M.D., medical and research specialist at Pfizer, Inc. Being up-front with your doctor can be tough when it comes to your sexual history or lifestyle choices you’d rather keep to yourself. But most doctors aren’t judging you; they just need to know if anything is jeopardizing your health, so ‘fess up.

Q My fellow technologists say it is not our responsibility to ask patients if they are fasting before we draw their blood for lipid profile tests. What do you recommend?

A If your fellow technologists are saying that it is not their responsibility to make sure that test requirements are met, I take issue with that. It is one thing to make a bad widget, but another thing to report compromised laboratory results that impact patient care. Drawing a lipid profile on a nonfasting patient is no different from drawing a fasting glucose on a nonfasting patient.

If the physician is comparing this month’s nonfasting lipid profile against last month’s fasting profile, the information is not of much use. If the techs are drawing and reporting nonfasting lipids as fasting lipids, this practice is misleading and unethical. If they are reporting nonfasting lipids with a note indicating that the patient is not fasting, at least they are preventing a misinterpretation of the result, but they are still wasting the patient’s time and money and the lab’s resources by generating an irrelevant result.

Any laboratory can report results, but physicians count on the lab to make the results meaningful. According to CLIA ‘88, the laboratory is responsible for the quality of the specimen tested. (1) If the test requires the patient to be fasting and the patient is drawn in a nonfasting state, the results are compromised and of little use. I would make sure all techs are aware of your facility’s requirement for lipid profiles and adhere to them.

I. INTRODUCTION

The sensitive issues and deeply held beliefs involved in this country’s ongoing abortion debate have generated intense controversy. Although the U.S. Supreme Court1 or Congress2 have occasionally entered the fray, regulation of the specifics regarding abortion is often left to individual states. In particular, states have been able to determine whether parents can sue physicians for medical advice and procedures related to birth and abortion. In the wake of various state court decisions allowing such suits,3 and a decade after the U.S. Supreme Court’s controversial decision in Roe v. Wade, the Utah legislature passed the Utah Wrongful Life Act4 (the “Wrongful Life Act” or the “Act”), prohibiting suits against physicians for such advice or procedures.5 For twenty years, the Act garnered only passing mention in Utah Supreme Court cases.6 But in 2002, the plaintiffs in Wood v. University of Utah Medical Center7 challenged the Act as unconstitutional, thus ushering it into Utah’s jurisprudential limelight.

This Note analyzes the Wood decision and the constitutionality of the Wrongful Life Act. In doing so, it is intended neither to add to the extensive commentary on the constitutionality of abortion, nor to make normative arguments for or against the practice. Rather, it focuses both on the effect of the Wood decision and the constitutionality of the Act as challenged under the “open courts” clause of Utah’s constitution. This Note first argues that the alignment of the Justices in Wood left at least part of the constitutional question unanswered. Next, it suggests an alternative to the conflicting standards of review used both in Wood and in past Utah decisions. Finally, it argues that, regardless of the standard of review used, the Act should be upheld as constitutional.

Part II of this Note gives background information on the Wrongful Life Act and the Utah Constitution’s “open courts” clause. Part III describes the facts, procedural history, and holding of Wood. Part IV analyzes the Wood opinions: Part IV.A recommends a standard of review in open courts cases, and Part IV.B asserts that the Wrongful Life Act was properly upheld as constitutional. Part V offers a brief conclusion.

People often ask me why I chose ophthalmology as my specialty. I state the reason quite simply: “Mrs. Rodell.”

I met Mrs. Rodell when I was in medical school. I had wanted to earn some extra money; perusing the ads in the local paper, I read: “Intelligent, blind widow needs someone to read to her a few hours a week. Special interest in topics of medicine. Excellent compensation.” A few hours a week seemed reasonable and wouldn’t cut into my study time too seriously. I wondered why she was interested in medicine. Was she a physician? I called and scheduled an interview.

Mrs. Rodell lived in a huge red brick house in a nice section of town. A maid answered the door; she led me upstairs to a large bedroom with lace curtains and oriental rugs. Mrs. Rodell sat in an immense, four-poster bed and was propped up with several plump pillows. She wore a cashmere sweater over her nightgown. As I walked in, she held out a frail hand but didn’t look at me, her eyes staring blankly ahead. I took her hand and sat on the edge of the bed.

“So. You are here,” Mrs. Rodell said with a smile. “Tell me about yourself.” I shrugged and told her I was a medical student who loved literature as well as science, so her ad had caught my eye. “Do you read or write literature?” Both. She nodded. “My husband was a physician. I always enjoyed hearing about his patients, his cures, his tragedies. Ah, and now you are the new bud entering his world … or what used to be his world. Maybe you’ll find a cure for my disease.” She turned toward me. “I have macular degeneration in both eyes. Do you want to be an ophthalmologist by any chance?” I answered no. At the time the eye didn’t interest me.

I visited Mrs. Rodell three times a week. I read her the newspaper and the classics and described my classes. She enjoyed hearing about my professors and my labs. She was always sitting up in bed when I arrived, and only occasionally did she sit in a chair by her window.

Soon I began to read to her from my medical texts, and our time together became a study session. She liked psychiatry in particular and, of course, ophthalmology. There wasn’t much information about macular degeneration, and I could find nothing on how to reverse progression of it.

“I hemorrhaged in the backs of my eyes,” Mrs. Rodell would often say. “Does the book say anything about reversing bleeding?” The answer was always no, no matter which text I had taken from the school library.

Traditionally, VA care has been viewed as primarily designed to cover the needs of veterans disabled on duty or whose health was permanently damaged while serving their country. Veterans with non-service-connected medical problems have been treated on a discretionary basis.

The solution to this problem is to privatize the complete VA health care system. What is wrong with eligible veterans going to their local doctors and hospitals with the VA paying the costs? Why don’t you survey your readers to see what they think of this proposal?

The reason for so many treatment delays is not the number of people entering the system. It’s because not enough staff are hired and Congress wants to close existing facilities.

If a vet has a service-connected injury or illness, I say, yes, let’s take care of him or her for life. That’s what the VA was originally set up to do. But just because I happened to serve during the Korean War does not entitle me to VA medical care for the rest of my life. That’s known as taking responsibility for my own needs.

Leo Friedrich, Ky.

I am retired and live on Social Security and a small pension. If I were to pay extra pharmacy costs at a drug store, it would cut into other cost-of-living expenses. I could not afford to buy supplemental insurance to go along with Medicare.

Cecil Steele, N. Y.

I feel that service-connected disabilities should be the only priority for the VA hospital system. There are other facilities available for the indigent, including vets. I take care of my own medical expenses, with the help of Medicare. I feel that some veterans forget they were fighting for their country, not just a free pass.

Don Watson, Va.

I am lucky to have my own medical coverage. If veterans have their own health insurance, they will not use the VNs facilities, except maybe to obtain the prescription benefit.

Veterans have given up prime years of their lives to serve. Those who have not served have gained career advantage up to four years. This could represent a college degree or job advancements. Over a career, this adds up to tens of thousands of dollars. No veteran should have to wait for medical care in a public hospital with the indigent.