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Legal Risks of Off-Hour Calls

Physicians frequently receive off-hour calls, but failure to respond to them carries legal and other risks. Some 37% of respondents to Medscape’s Employed Physicians Report said that they deal with 1-5 hours of calls per month; 19% said that they have 6-10 hours of calls, and 12% reported 11 hours or more.

Responding to such calls is not optional. If on-call physicians don’t perform their duties, they could lose hospital privileges or face federal government fines and malpractice lawsuits. Hospitals could also face fines.

Patient calls: Courts have established that physicians must provide an answering service or other means for their patients to contact them after hours and that they must respond to the calls in a timely manner.

Answering services: Physicians may also be responsible if their answering service does not send critical messages to them immediately, if it fails to make appropriate documentation, or if it sends inaccurate information to them.

Dealing With Patients Who Are Disabled


Doctors should receive more training to deal with patients who have intellectual and developmental disabilities, stopping ambien insomnia advocates say. Some physicians admitted that they lack the resources and training to properly care for patients with disabilities or that they struggle to coordinate care for such people, according to a survey published in Health Affairs. Some admitted that they avoid treating patients with disabilities.


More than 13% of Americans, or roughly 44 million people, have some form of disability, according to the National Institute on Disability at the University of New Hampshire. Some 17% of children aged 3-17 years have a developmental disability, according to estimates by the CDC.


Kim Bullock, MD, an associate professor of family medicine at Georgetown University Medical School, seeks to create better training and educational opportunities for medical students who will likely encounter patients with disabilities.

Don’t make assumptions: The first step is not to assume that patients with disabilities can’t communicate. Talking not to the patient but to a caregiver or spouse “[takes] away their agency, their autonomy to speak for and about themselves,” Bullock said.

Treatment training: Bullock advocates that medical schools make treatment of patients with disabilities part of all training. “Not as something separate, but as people that have special needs just as other populations have,” she added.

Birdsong May Calm Anxiety and Paranoia

The sound of birds singing may have a positive and significant effect on mental health and mood, new research suggests. People who listened to recordings of birdsong had a significant reduction in anxiety and paranoia, according to a study published in Scientific Reports. Recordings of traffic noise, car engines, sirens, and construction increased depressive states, the study adds.

Nature’s importance: “Taken together, the findings of the current study provide another facet of why interactions with nature can be beneficial for our mental health, and it is highly important to preserve nature,” said study investigator Emil Stobbe, MSc, a predoctoral fellow at the Max Planck Institute for Human Development in Berlin.

Mixed soundscapes: Future research should focus on mixed soundscapes and whether natural sounds in urban settings lower the effects of stressors such as traffic noise, according to Stobbe.

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