A review of strategies for enhancing the completeness of notifiable disease reporting.

Notifiable disease surveillance systems provide essential data for infectious disease prevention and control programs at the local, state, and national levels. Given that reporting completeness is known to vary considerably, this review identifies methods that can reliably enhance completeness of reporting. These surveillance-related activities include initiating active surveillance when appropriate; implementing automated, electronic laboratory-based reporting; strengthening ties with clinicians and other key partners in notifiable disease reporting; and increasing the use of laboratory diagnostic tests in identifying new cases. Despite ample data in support of these strategies, notifiable disease surveillance continues to receive insufficient attention and resources. Recent attention to public health preparedness provides an opportunity to strengthen notifiable disease surveillance and enhance completeness of reporting.     

The emergency physician and patient confidentiality: A review

Confidentiality is a promise rooted in tradition, law andmedical ethics. Emergency physicians treat a variety of patients to whom confidentiality is of vital importance: employees, celebrities, victims of violence or disaster, minors, students, criminals, drug abusers, and patients with STDs. EDs should develop methods of ensuring confidentiality for all patients.³⁴Although confidentiality is an important principle thatshould be respected and guarded, it is not absolute. Various laws mandate disclosure of certain patient information; in addition, an overriding moral duty may occasionally require, a breach of confidentiality. As Beauchamp and Childress noted, “the therapeutic role may sometimes have to yield to ones role as citizen and as protector of the interests of others”.¹⁹ In general, however, circumstances requiring a breach of confidentiality are rare.     

National Alliance for Oral Health Consensus Conference on Medically Necessary Oral Health Care: Legal issues

This paper examines medical malpractice law as it applies to medically necessary oral health care. The basic legal concepts and reported cases involving medically necessary oral health care are reviewed. It is concluded that dental professionals and consumer advocates must advance their educational and legislative advocacy efforts so that health professional colleagues and the public will become aware of the importance of these services and insurers will routinely include coverage of medically necessary oral health care in their medical and dental policies. While failure to provide medically necessary oral health care can be violative of patient rights and legally actionable, medical malpractice litigation should always be the behavior modifier of last resort.