David A. Fleming

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This position paper concerns improving health care in the United States. Unlike previous highly focused policy papers by the American College of Physicians, this article takes a comprehensive approach to improving access, quality, and efficiency of care. The first part describes health care in the United States. The second compares it with health care in(More)
and this updated policy paper is a collaboration between the ACP and the HIVMA of the IDSA. Since the last statement, many new developments call for the need to reexamine and update our policies relating to HIV infection. First, there have been major advances in treatment for HIV infection that have transformed HIV/AIDS from a terminal illness to a chronic(More)
Nonprofessional caregiving is crucial to effective end-of-life care for patients who wish to die at home. The burden of caregiving may lead to physical illness, emotional distress, financial hardship, and early mortality in the caregiver. Unmet caregiver needs have historically been poorly recognized and incompletely studied. Early recognition of caregiver(More)
All rights reserved. Individuals may photocopy all or parts of Position Papers for educational, not-for-profit uses. These papers may not be reproduced for commercial, for-profit use in any form, by any means (electronic, mechanical, xerographic, or other) or held in any information storage or retrieval system without the written permission of the(More)
(Washington) – The American College of Physicians (ACP) is deeply concerned about the adverse impact on healthcare that may result from today's Supreme Court ruling that allows " closely held " for-profit employers to opt-out of evidence-based contraceptive coverage requirements. We believe that this decision will make it more difficult for women to access(More)
All rights reserved. Individuals may photocopy all or parts of Position Papers for educational, not-for-profit uses. These papers may not be reproduced for commercial, for-profit use in any form, by any means (electronic, mechanical, xerographic, or other) or held in any information storage or retrieval system without the written permission of the(More)
When caring for patients with end stage illness there tends to be universal agreement that overly aggressive treatment should be discouraged or limited when death is near and when further intervention would be futile or otherwise inflict undue suffering on the patient (1; 2; 3). The modern ability to delay the natural course of dying, however, has(More)
Peoples' behavior in the aftermath of natural disasters may depend critically on various conditions. In this paper we postulate three conditions, likely to occur after massive natural disasters, that can adversely affect the trusting behavior of people within communities: rivalry for scarce relief and recovery recourses, increment of information asymmetries(More)
Patients respond more favorably and are more trusting of physicians who provide full disclosure about medical errors than physicians who are less forthright or purposely hold things back when things go wrong. But there is no guarantee that full disclosure will prevent a lawsuit. In general, though patients may trust their physicians more if they are(More)