TMR: An Automated System for Managing Revenue

Abstract

The Total Medical Record (TMR) system used by the Division of University Health Services at Duke University is an integrated medical and management information system. One module supports the financial needs of the division. To facilitate managerial performance, TMR automatically prints insurance claims, refund statements, revenue summary data, service utilization, itemized visit statements, monthly patient bills, dunning letters, and has a host of unique features that aid management with controlling the private fees generated by the University Health Services. In addition, the servicing of prepaid programs is accommodated, and the splitting of charges between prepaid and fee-for-service programs occurs automatically.     

Engendering Response: Professional Gesture and the Assessment of Eyesight in Optometry Consultations

Many of the procedures undertaken within healthcare require specialized forms of participation that may be unfamiliar, even disturbing, to patients or clients. The practitioner has to encourage and enable participation in the investigation in an appropriate fashion while preserving the structure and integrity of the procedure. In this article, we consider optometry and the deployment of a vision test, known as subject refraction, that provides data to help determine the characteristics of any corrective lens that may be required by clients. The procedure's ability to establish robust and reliable data relies upon the optometrist's ability to encourage the client to respond to a series of stimuli without consideration or reflection. That is, the client is required to produce an unwitting response—conduct that might be considered nonsymbolic rather than symbolic. In this article, we also consider the optometrist's talk and bodily comportment during subjective refraction and how it serves to shape and determine the quality of the client's response and participation, and in turn to produce reliable test results.     

Vocal determinants of first impressions of young children

Audiotapes of the voices of77 preschool children were prepared. Subjects listened to the tapes, and then provided their impressions of the competence, leadership, dominance, warmth, and honesty of the children. Judgments of the voices' babyishness and attractiveness were also obtained. Perceivers reliably discriminated the children's voices along the dimensions of babyishness and attractiveness. Moreover, analyses revealed that the previously documented impact of these characteristics on first impressions of adults extends to impressions of young children. The similarity of the effects of these characteristics on impressions formed about children to those revealed for adults suggests that vocal qualities may have an impact on personality development via a process of self-fulfilling prophecy.     

Consequences and Costs of Closing a Publicly Funded Methadone Maintenance Clinic

Objective. We examine volunteering to support the relief effort after the bombing of the Murrah Federal Building. We address two issues: (1) how widespread was volunteering and what forms did it take, and (2) does Wilson and Musick’s (1997a) “integrated theory of volunteer work” help to explain variation in volunteering in this disaster situation? Methods. We use data from the 1996 Oklahoma City Survey (OKC Survey). The 1996 OKC Survey is based on a random sample of the adult population of Oklahoma City and was administered 10 months after the bombing. Results. Nearly 75 percent of the sample respondents volunteered to support the relief effort in at least one way; giving money and donating nonprofessional goods or services were the two most prevalent volunteer activities. Socioeconomic status, knowing someone killed or injured in the bombing, belonging to voluntary organizations before the bombing, and being affiliated with a religious denomination were predictors of volunteering, depending on the type of volunteer activity considered. Conclusions. The magnitude of volunteering after the Murrah Building bombing was in line with volunteer efforts after other disasters. The integrated theory of volunteer work is a useful framework for studying volunteering after disasters.     

Decision Making for Animal Health and Welfare: Integrating Risk‐Benefit Analysis with Prospect Theory

This study integrated risk‐benefit analysis with prospect theory with the overall objective of identifying the type of management behavior represented by farmers’ choices of mastitis control options (MCOs). Two exploratory factor analyses, based on 163 and 175 Swedish farmers, respectively, highlighted attitudes to MCOs related to: (1) grouping cows and applying milking order to prevent spread of existing infection and (2) working in a precautionary way to prevent mastitis occurring. This was interpreted as being based on (1) reactive management behavior on detection of udder‐health problems in individual cows and (2) proactive management behavior to prevent mastitis developing. Farmers’ assessments of these MCOs were found to be based on asymmetrical evaluations of risks and benefits, suggesting that farmers’ management behavior depends on their individual reference point. In particular, attitudes to MCOs related to grouping cows and applying milking order to prevent the spread of mastitis once infected cows were detected were stronger in the risk domain than in the benefit domain, in accordance with loss aversion. In contrast, attitudes to MCOs related to working in a precautionary way to prevent cows from becoming infected in the first place were stronger in the benefit domain than in the risk domain, in accordance with reverse loss aversion. These findings are of practical importance for farmers and agribusiness and in public health protection work to reduce the current extensive use of antibiotics in dairy herds.     

CUMULATION AND ITC DECISION-MAKING: THE SUM OF THE PARTS IS GREATER THAN THE WHOLE

In 1984 Congress amended the antidumping and countervailing duty laws, man-dating that the International Trade Commission (ITC) "cumulate" imports across countries when determining injury. We estimate that cumulation increases the probability of an affirmative injury determination by 20 to 30 percent and has changed the ITC's decision (from negative to affirmative) for about one-third of cumulated cases. We also show that the protective effect of cumulation increases as the number of countries involved increases, holding import market share constant. That is, cumulated imports have a super-additive effect on ITC decision-making.     

Career Development and Guidance Programs Across Cultures: The Gap Between Policies and Practices

The authors summarize the presentations and discussions contributed to the symposium International Perspectives on Career Development by members of Group 5, who considered the topic of the structure and organization of career development programs in different nations. A capsule picture of the national setting, primary goals, components, objectives, and implementation strategies is presented. Papers fell largely into 4 categories: national programs with several components; large, but more specific programs, serving a national population; smaller programs serving diverse populations; and focused programs. One theme emerged strongly from virtually every presentation: There is a gap, often profound, between policy or vision and reality. Although every nation about which participants heard had laudable policies and had made genuine attempts to assist its people with life career development, many individuals do not have access to quality, or even any, services.     

The Dodo Manifesto

In this article I review the psychotherapy outcomes literature as it pertains to the Dodo hypothesis. This is the proposition that the effects of psychotherapy are due to common factors rather than specific techniques. A variety of sources provide substantial empirical support for the Dodo hypothesis. I conclude that CBT and medication do not appear to be any better than other methodologies for the treatment of psychological distress. I look at some of the criticisms of the Dodo hypothesis. I suggest that the major themes that emerge from the literature as it stands are conclusions that would be immediately obvious to most clinicians. Further, the utility of specific techniques has not been ruled out, due to some serious conceptual flaws in efficacy trials. I suggest that there are a number of ways for family therapists to survive in an evidence‐based world. One is to point out to champions of evidence‐based practice just how flimsy their claims are. Another would be to advocate for pluralism and to practise and conduct research under the aegis of a contextual philosophy.