Global Digital Store – Ebooks and Softwares

Tag: Selecting

  • Selecting the Character's Emotion

    Selecting the Character's Emotion

    [ad_1]

    The last article covered the process used in selecting and portraying the character's objective. Many of the same principles also apply to the selection of the emotions. As with the objective, the ability to choose and convey strong emotions is a valuable tool for the actor. Many performances work mainly because of the powerful emotional portrayals.

    In a dramatic sense, what are emotions and how do they affect the audience? Emotions, together with intentions and obstacles, are the forces that move the characters through the story. They are feelings so powerful that they can change the character's life or destroy it. And by destroy, I mean decimate one's inner powers, beliefs, even one's life. For the actor, such feelings must be larger than life. They must also be readable to stir and lead the audience in the desired story direction.

    Emotions affect the audience in many ways. Most important is the empathy they create causing the audience to care about certain characters and follow their struggles. They likewise, create a for or against polarity for each main character as the audience observes, evaluates, judges, and even takes sides. As part of the behavior, emotions create deeper awareness of the character, often justifying their actions. In addition, emotions can change the audience perspective and the way they feel or think about a given issue. They are instrumental in leading the audience in the desired story direction

    Like the intention, the emotion can intensify the conflict within or between characters. It can likewise, establish sympathetic or antagonistic roles, ones that make the audience root for the hero and boo the villain.

    In choosing the emotion, the guidelines are similar to those used in selecting the objective. First read and study the entire play. Look for clues in the dialogue, the action, the stage directions, and in the resolution of the story. Select choices that result in the story line making sense.

    Like the intent of the character, the emotion is derived from the character's viewpoint, what the character knows and feels up to that point in the story.

    No one lives in a realistic world. We occupy a space of our own creation – bits and pieces of actuality mixed together with our internal perceptions, our hopes, our fears, our memories, and our anticipations. This "reality" we live in – half fact, half fantasy – is as much the product of our emotions as our rationality. Thus, in any given situation, what might be an acceptable intention and emotion for one character might be a contradiction for another character. Knowing the character's goals, flaws, and inclinations in context of the total story will aid in determining these choices.

    Next, we need to answer the question, does the character's emotion assist the intention or does the emotion create an obstacle? Placing the objective, what the character wants, in conflict with what he or she feels will likely shift the focus of the scene to the character with the greater internal struggle.

    Let's use the example where a man is at a dance and sees the women of his dreams sitting alone. His intention might be: To get to know her. But his emotion, fear of being rejected, would be in conflict with his intention. Thus the focus of the scene would be primarily on his internal struggle and the purpose of the scene might be to show the man overcoming his fear.

    But let's say her intention, to marry rich, is assisted by the emotion, ambition. And the scene resolves when the women walks away when she discovers the man is dirt poor. If his initial emotion of fear were replaced by desire and his intention remained to get to know her then the focus of the scene would center more on the relationship and the impending discovery. The purpose of the scene could be to introduce his major obstacle in the story, the women, along with his over all goal: To win her love.

    The initial choices for each character might look like this:

    MAN

    Objective: To get to know her

    Emotion: Fear / Desire

    WOMAN

    Objective: To marry rich

    Emotion: Ambition

    The above choices set up confrontations, the inner doubts of the man, and then, his desire for her is countered by the revelation that he's not rich enough for her. After the woman learns this, her emotion changes to contempt for the man and she walks away. The characters' choices would now change to:

    MAN

    Objective: To win her love

    Emotion: Determination

    WOMAN

    Objective: To marry rich

    Emotion: Contempt (for the man)

    These choices place the focus of the scene on the major conflict that is resolved later in the story when he wins her love. It, likewise, centers on what's important, the relationship.

    As with the intention of the characters, the emotion need not follow the logic of the dialogue and action. Modern plays and movies do not always express the thoughts and emotions of the characters clearly, nakedly, up front. Today, we have to play the duality of people; playing what they appear to want against what they really want. And sometimes the two may have no connection what so ever.

    In modern plays, every character has two behaviors. What is really going on and what they are willing to show to the world? So many emotions, to be played properly, need to be partially masked or repressed.

    Using the man and woman from our earlier example, let's set up a scene later in the story, one that demonstrates the duality of the characters and uses of partially masked or repressed emotions. At a shopping mall, they meet by chance and their dialogue is mainly small talk. The scene ends with each alluding to errands undone. The only hint about what is really going on is found in the following script action lines:

    He rarely looks directly at her.

    They shake hands, each holding on longer than necessary, and then each goes their way.

    In view of the story's final outcome, this is likely a scene where her objective, to marry rich, is weakening, and that she has some attraction for the man. Based on how their first meeting resolved, their selections might be as follows:

    MAN

    Objective: To not upset her / To win her love

    Emotion: Desire / Determination

    WOMAN

    Objective: To show him I don't care / To make him want me

    Emotion: Determination / Curiosity

    This would be a scene where the characters are not open with each other, yet the audience (or camera) is aware of the inner conflicts and what's really happening. The behavior could best be reflected through masked and / or repressed emotions.

    If the man were to play his emotion of desire openly, he would surely upset her. So he has to repress it or use a mask technique and unleash his desire when she is not looking at him. The woman is determined to show the man she doesn't care about him, but now he appears to have no desire for her. From her point of view, something has come to change the relationship and as a result, she alters both her objective and emotion.

    His apparent disinterest makes her curious and her objective in now: To make him want me, like all men do. Her actions might be to get his attention, to entice him. But the problem is, he's not looking at her. How can she obtain what she wants? She uses the lingering handshake.

    You can see where these choices create conflict both within and between the characters. They also create subtle shifts in behavior that move the story forward. Interest in the relationship is likewise increased because the audience is aware of something the characters are not. And as the scene ends, the audience has a pressing question: "What will happen the next time they meet?"

    The foregoing example demonstrates one answer to the character's choices. These are, by no means, the best or only selections. In fact, the type of actor you are is also a consideration. If you were Jack Nicholson, your emotions might be different than if Arnold Schwarzenegger were he playing the same role. Each actor brings to the scene his or her own perspective and emotional latitudes. Furthermore, a scene played as a comedy versus one being played as a drama might result in different sets of emotions for the characters.

    Here are some other factors that should be considered: Who are you in the story? What is the situation, and what is the relationship? For instance, if you were playing a love scene as a character that had little experience with the opposite sex, your emotion might be fear (fear of the unknown) rather than the expected desire or lust.

    Now change the situation to your having a good dinner with your loving spouse. Your emotion would change to maybe contentment or joy. Now change the relationship to your having dinner with an important client. Your emotion might range from apprehension to ambition to greed. Who you are, the relationships, and the situation, all have a bearing on the emotion selected.

    How many emotions can you use in a scene and how long do you play an emotion? As a general rule, work with only one dominant emotion in a scene – until something occurs to change it. These occurrences could be a change in the relationship, the situation, who you are, new information, overcoming obstacles, new obstacles, and succeeding or failing at one's intention. Any one of these events could have enough impact to motivate a change.

    Most scenes have one dominant emotion running through them and while the actor may use subtle shadings of other emotions, that one feeling prevails – until something occurs to change it. If the actor were to change the emotion at each minor occurrence, the audience would question the character's integrity and loyalty to the cause for which he is fighting.

    Too many changes cause the character to lose part of his identity. We become uncertain about who he is, what he's attempted in the past, or what he's after now. Credible characters are made up of consistent behavioral patterns. By that I mean, what has happened before will likely happen again should the same situation occur. There will, of course, be a few surprises, but for the most part, certain emotions will dominate each character's behavior as he or she progresses through the story.

    So when you research and study the entire play, you will likely find certain emotions and emotional patterns repeated to reinforce the identity and commitment of the character. For instance, the repeated pattern of mischief – embarrassment – fear might be the dominant emotions for a small overly rambunctious boy. A young executive struggling with business ethics might have an emotion pattern of ambition – determination – greed – guilt. A woman in jeopardy might follow a curiosity-suspicion – fear – terror progression.

    As you can see, certain emotions and their progressions make up a portion of the character. Also look for surprises where the emotion swings 180 degrees, ie, contentment to fear, desire to contempt, revenge to compassion.

    When working on a play or scene, write down in the margin of the script your choices in objectives and emotions, where the changes occur, and the motivation for making the change. Beginning actors tend to be non-committal while experienced actors, however, take dramatic risks and commit themselves to their choices. By writing them down, you've made a major step to that commitment.

    To aid in selecting the emotion, I've compiled discussions of root emotions , the primary forces in most scenes. These discussions explore the physical sensations, sources, forms, and dynamics of the most common root emotions. They will serve as a guide in stretching the clarity, strength, and polarity of your emotional repertoire.

    This article has covered the basic skills used in the selection of dramatic emotions. Use these skills as tools to nurture and release the character's true feelings, to foster the isolation and control of emotional behaviors, and to achieve the desired strength (story importance), clarity (audience knowing / feeling it) and polarity (protagonist-antagonist orientations ).

    Implementation of your selections is addressed in another article. This article will cover the various methods used to generate credible emotions.

    [ad_2]

    Source by Erik Sean McGiven

    Views: 0

  • Choosing the Right Email Service Provider

    Just as email marketing can be complex, so is choosing a top tier ESP (Email Service Provider). Comparing ESPs to each other isn?t always an apples-to-apples comparison. They each have their specific areas of strengths and weaknesses. For example, some ESPs excel at integration with web analytics or CRM (Customer Relationship Management) systems, some are very strong in deliverability, and others have a more intuitive interface. The differences don?t just stop there: The same piece of content sent to the same list on different ESPs will give you different delivery results.

    This white paper will help you narrow down the services that are most important to you and what to look for when selecting an ESP. It also includes an ESP Scoring Sheet!

    Read More
    http://www.associationofmarketing.org/whitepapers/view.php?whitepaper_id=72

    Views: 0

  • How to Select the Right Hair Transplant Doctor

    [ad_1]

    1. Do your research

    Before selecting a doctor for the job, it is very important that you do your research. Use the Internet as well as referrals from your friends and family to make a list of at least 4 to 5 best hair transplant surgeons for hair loss treatment in the town.

    Note: Though the best way to find the right surgeon is through a referral, avoid referrals from your hairstylist. Friends and family are the most trusted sources in any case.

    2. Find the right doctor

    Once you have prepared the list of doctors, book consultation with all of them to have a better understanding of their skills and the services they offer. During the consultation, judge your physician for his approach towards hair restoration. He or she should have holistic approach towards the surgery and must be able to help you evaluate your hair restoration options, both surgical and non surgical. Also make sure that hair restoration is the primary focus of your physician’s practice.

    Based on the above facts, choose the best physician out of the list.

    3. Find the right clinic

    Besides choosing the right doctor, it is also important that you choose the best clinic in the town that is patient focused. Check if the clinic has made investment in state of the art equipment as well as in hiring the most skilled staff that is dedicated and trained for all types of Hair Transplant surgeries.

    4. Ask for references

    Another thing that helps in selecting the right doctor for the procedure is his score. Ask your doctor how many patients he has produced for excellent results. It will be very good if the surgeon could give you a couple of references – the patients he or she has operated over the last few months. You can meet them to know their experience. This will give you a better idea of the surgical skills as well as patient handling of your prospective surgeon.

    5. Before and after pictures

    After references, the best source to check the surgical skills and the results the surgeon has produced in the past is the “Before and After Pictures” of the patients your prospective physician has operated in the past.

    6. Read the reviews

    You can also have a better understanding of the physician’s reputation in the hair transplant industry by reading the patient reviews on different hair transplant related discussion forums on internet. A vast majority of patients participates in these online discussion forums and post not only their experiences but also their before and after photos.

    7. Don’t let low prices tempt you

    Having that said, never let the low prices tempt you. Nurse practitioners and assistants are also performing hair transplant surgeries nowadays, at quite cheap rates. But don’t compromise on the quality of the services just to get the surgery done at cheaper rates.

    [ad_2]

    Source by S Muddassar Shah

    Views: 0

  • Internal Customer Service: Guidelines for Suppliers and Contractors

    [ad_1]

    Change management and organization development experts talk about ‘creating alignment’ – aligning organizational strategy with daily business needs. And a big part of this is creating alignment between customer needs and employee actions as customer service providers. But we also have to take note of internal customers – those people within the organization that service us – as internal customers and who we service as internal customers. “There is a remarkably close and consistent link between how internal customers are treated and how external customers perceive the quality of your organization’s services. It is almost impossible to provide good external service if your organization is not providing good internal service.” R. Zemke and K. Anderson, Delivering Knock Your Socks Off Service, 1981.

    And it’s not just about internal customers within the walls of your organization, it’s also about those arms-length internal customers and customer service providers – suppliers and contractors – those people who either supply your organization directly or come into contact with your external customers, directly, as your representative. These suppliers and contractors should be considered an integral part of your organization and the service they provide should be measured as accurately and frequently as you measure the service level you provide.

    To my mind, servicing others, whether internal or external (customer, supplier, colleague, peer, supervisor, contractor), should reflect the values of your organization and the process to retain the best customers – again, whether internal or external – can be applied across any of these groups. Suppliers and contractors should be selected and retained based on their commitment to servicing your customers – and your employees – as you require them to be serviced. Although you do not ‘own’ these suppliers and contractors, you have the right to demand the equivalent level of service you provide to your customers. When selecting your suppliers and contractors, or measuring the ones you currently are associated with, the following guidelines may help ensure that internal service meets the standard.

    Recruit suppliers and contractors as you would your employees.

    You should be seeking out the best person for the job, the high performer who will be able to deliver on your business expectations and drive up results for your company. Why not utilize some of the recruiting tools you use when conducting a search for an employee? Think about it. You will be paying this supplier or contractor to perform services for you or your customers so you should expect them to be of the calibre you expect from a new employee. Consider requesting a resume of their qualifications and experience, customers they have serviced, certifications that may be required, and if available, customer testimonials. Interview them in a similar fashion to the way in which you interview for employees. Check their references and make sure you put in place a contractual arrangement that clearly documents what you expect from them and what they can expect from you (this is just another version of position profiles and expectations for the role).

    In these cases, you are seeking high performers capable of servicing both your customers and your employees. And you have a responsibility to provide them with the information, resources and possibly, tools, they will need to service both these groups accurately and professionally.

    Provide clear expectations of performance.

    Even if your suppliers and contractors have worked with your organization for a long period of time, it is critical to periodically review your expectations of their role and how you expect them to service your customers. Customers are retained because they have developed a good relationship with their supplier and any contractor or supplier who is dealing with your customer directly, is seen by the customer to be an employee of your company, and hence; representing your company.

    When I was a general manager for an energy distribution company, one of our contractor service technicians accidentally cut the customer’s phone line. The first issue for the customer was, of course, the cut phone line and the inconvenience associated. The second issue was that the contractor apologized but told the customer he would have to call our company to secure satisfaction regarding the cost and inconvenience of having the line repaired. The third issue was the response the customer received from the Branch Manager when he called our company office to complain. He was told we were not responsible since it was a contractor that had cut the line! Yes, I too, was shocked when the customer got through to me to complain and told me what the Branch Manager had said. Even more distressing was the fact that the Branch Manager defended his position when I called him about the complaint!

    No doubt we did not clearly identify to our contractor our customer service expectations. To me, they were simple. Apologize to the customer, call our office immediately to request a solution and then work with the customer to get the solution implemented. Simple to me but certainly not to our contractor or, I quickly discovered, to my Branch Manager.

    So my next step was to build a contractor customer service agreement and develop a customer service training program to implement with both our employees and our contractors. We then implemented it across my region. We still had customer service issues with both our contractors and our employees, periodically,but this was a great first step.

    Conduct frequent performance reviews.

    Providing your suppliers and contractors with regular, specific feedback will not only give you confidence that they are meeting your needs but will also provide opportunities for them to discuss any customer service challenges, issues, or problems with you before they result in lost customers. These regular reviews should be part of the contract between you and the contractor and they should be implemented on schedule. During these reviews you should include their primary employee contacts to ensure all partners are clear about the issues and able to participate in developing the solutions. This secures commitment to the solutions.

    Reward and recognize customer service excellence.

    At a minimum, providing them with a reference signifies that you are pleased with their customer service performance. But, without a doubt, the best reward for suppliers and contractors is securing more work from you.

    Following these guidelines will go a long way to ensuring alignment between your company, your employees and your suppliers and contractors – to the business goals and strategy. All sectors can then be focused on delivering the expected level of customer service to the customer base you want to retain.

    [ad_2]

    Source by Donna Stevenson

    Views: 0

  • Holly Mann Honest Riches Review – Is This a Scam?

    [ad_1]

    Honest Riches was written by Holly Mann, a mother and disabled veteran. She started internet marketing to supplement her income. After several requests she decided to write the Honest Riches ebook. This book teaches you how to successfully start an online affiliate business with little start up money. Several of the strategies mentioned are free. When Honest Riches was updated, Holly added more information and changed the name from Breakthrough Money Making Secrets Revealed.

    Here is a break down of what you will receive with Holly Mann Honest Riches:

    Chapter 1:

    This chapter is primarily for beginners. It explains how to pick a topic that will yield the fastest results and greatest chance of success by selecting a sub topic (niche). For example, if you are interested in cars, you might want to choose a niche on custom auto wheels.

    The next topic is how to obtain information for free. Holly provides links to several free websites to improve your site’s ranking. Search engine optimization basics and domain name selection are explained. I wish that I would have read this book before picking my domain name. Your domain name is very important. Most people don’t give it enough thought.

    Holly explains how to get inbound links by submitting articles. She gives you the actual links to the best sites. This is very helpful and will increase your search engine optimization. Keyword selection is the next topic. Holly provides links for several tools to help make setting up your website easier. Some are free.

    She provides enough information to help the beginner get started on a budget. This chapter also explains how to see what your competitors are doing. The next section is about setting up a partnership if money is tight. A sample contract is attached.

    Chapter 2:

    This is a relatively short chapter on how to find content that will drive more people to your website for free. Links are provided to search for free content.

    Chapter 3:

    This chapter explains how to get a free website up in minutes. Holly explains how to set up your own free blog. She than provides some ideas on how to make money with blogs and how to improve your ranking. You don’t have to spend any money to get ranked on Google and other search engines. A free tool is provided to update your blog.

    Chapter 4:

    This chapter is about advertising your website. Links to free online advertising directories are provided. AdWords advertising is also briefly mentioned.

    Chapter 5:

    This chapter explains how to get free site traffic from Forums. This technique is completely free and has worked very well for Holly. She also explains how to start your own group or forum. Paid advertising is also mentioned here.

    Chapter 6:

    This chapter lists the top paying affiliate programs to sign up with. This is completely free. Holly provides information about each affiliate program. She also mentions a few of the highest paying affiliates to promote.

    Chapter 7:

    This chapter is about drop shipping and Wholesalers. A list of 6 droppshippers is provided.

    Holly also provides a nice bonus tip for eBayers at the end.

    Holly Mann’s Honest Riches teaches you how to successfully make money online with very little start up money. Holly gives you several methods that are totally free. This ebook is also very easy to understand. Everything is explained well.

    Because I am always looking for free or very low cost advertising, I have used some of the techniques in Holly Mann Honest Riches, and they have worked very well for me. This is one of the best books to get you started if you are on tight budget. Holly has also added a free website and forum for anyone that purchases Honest Riches.

    [ad_2]

    Source by William Miller

    Views: 0

  • Better Customer Service Through Effective Time Management

    [ad_1]

    Being able to manage and prioritize is an important skill when servicing customers. Planning events, activities, and tasks on a yearly, monthly, weekly, and daily basis-that is, prioritizing time-can be rewarding from the standpoint of allowing you to be more proactive in preparing to deal with situations. Such planning can reduce your need to be a crisis manager. It is important on and off the job because, if you do not manage your personal life well, you may carry over personal stress into the workplace. This is not only inefficient; it is also unfair to your employer, peers, coworkers, and external customers.

    After you have scheduled key events and tasks using some type of scheduling system (e.g., time management software, written planning system or calendar, or electronic scheduling device that can download information into your computer), review the information regularly to avoid forgetting something.

    One way to manage events, rather than having them manage you, is to create a list of activities each day and assign a value to each based on importance. The key is to be consistent and prioritize each day. Some people make planning the last activity of their workday. When they arrive to work the next morning, they are ready to begin rather than spending time preparing.

    Guidelines for Setting Priorities

    Three guidelines can help you in determining what tasks to do first. These can help you create a realistic and achievable list of daily tasks. As you learned when you read about goal setting in other chapters, goals must be attainable. Use the following standards as a guide when setting priorities.

    Judgment. You are the best judge of what you can accomplish in any given day. You know your strengths and what has to be done. When selecting priorities, remember that the ones having the most impact on customers and others should be placed high on your list. On the other hand, do not put so many priorities on a daily list that you will not get them done. If this happens, you might become discouraged and give up.

    When you find that you have more high priorities than you have time, you may need to ask for help or guidance from your boss. Many times, simply asking for assistance helps develop your relationship with others. They feel respected and trusted by your gesture, as long as you do not abuse their help or appear to be unloading your tasks onto them. Also, consider other resources that you might use to accomplish tasks (e.g., technology, outside vendors, or customers).

    Relativity. Assigning priorities is a matter of relativity. Some tasks and projects are readily rated higher than others. You should be guided by the question “What is the best use of my time?” Many people fill their daily schedule with frivolous or easy tasks and with tasks that they like to do. This produces a hollow feeling of accomplishment. They may get a lot done throughout the day and enjoy doing it, but they have not added a lot of value to customer service or aided in accomplishing organizational goals. Keep in mind when setting priorities in the workplace that your primary focus should be your customers and activities that support them.

    Timing. Reality and deadlines have a way of dictating priorities. The starting time of a project or task also may establish priorities. Once you begin a task, there must be enough time to finish it. If this is not possible, you may have to re prioritize or seek assistance.

    Be realistic about the time it will take to complete a task. Make sure that you schedule that much time, plus a little extra, on your daily planning sheet. Also, consider your peak time period for performance. Each person typically has a period of the day in which he or she has more energy and can get more done. Capitalize on your peak period and schedule high-priority tasks during that time, if possible.

    Prioritizing System

    To set up your own priority system, list all of your pending activities and then group them according to their level of importance. How you assign value to a task is not as important as long as you use the same format each day. Many people use an A, B, C system, and others use a 1, 2, 3 format. Here are suggested criteria for assignment:

    Priority A-Must do or critical items. Some things must be done because of management directives, local, state, or federal regulations, importance to customers or clients, deadlines, or opportunities they provide for your success or advancement (e.g., state tax reports, actions requested by a customer, or application for a position in the organization with a specific cutoff date for submission).

    Priority B-Should do. Items in this category are of medium value. Although they may contribute to customer satisfaction and improved performance, they are not essential or do not have critical deadlines (e.g., mailing an unsolicited information kit to a customer about a new product or developing a proposal for changing an existing system or process).

    Priority C-Nice to do. This is the lowest category and includes tasks that are not a direct link to customer satisfaction. They may even be fun or interesting, but could be omitted or left undone. Postponing or scheduling such priorities until a slower time period will likely have little or no impact on customer service (e.g., meeting with team members to brainstorm ideas for a more efficient layout of cubicles, cleaning old e-mail files, or neatly lining up the products on a shelf).

    Note: As you go through your e-mail and voice mail messages at the times you have scheduled throughout the day, prioritize them, and add them to your list of things to do.

    The key to effective time management is to have a plan and work that plan. If you control your time, you and your customers both stand to gain from your efforts.

    [ad_2]

    Source by Bob Lucas

    Views: 0

  • Department Administrator Interference in the Doctor-Patient Relationship

    [ad_1]

    I contacted a resident doctor in Internal Medicine at a teaching hospital and asked if he would be interested in becoming my primary care physician (PCP). My note briefly described my background in health outcomes research and two of my prescription drugs. He wrote back that he would be honored to be my PCP, and came across as professional, humble, and sincere. A new doctor-patient relationship was formed, and I contacted my existing doctor’s office to arrange for my medical records to be transferred, which immediately informed that office that I must be dissatisfied and going to a new doctor. I also shared with the resident doctor confidential information from my medical records and a copy of one of my professional presentations at a health care conference.

    A department administrator then contacted me to say the resident doctors are not available every day of the week for clinic and are not even here when they do their ICU rotation. Also, the Internal Medicine department protocol would not allow the resident doctor to write me a drug prescription for off label use. Finally, she was concerned that in the past I have ordered and correctly interpreted my own blood tests. The administrator’s attitude reflects one of the chief complaints Americans have with the health care system: the system is coming at them and requiring them to get health services in some predefined structure to which the facility is accustomed but which eliminate any potential for individualized treatment according to individual patients’ needs.

    Apparently the administrator did not spend enough “careful consideration” to get her facts straight. I do not need to see my PCP daily or even monthly. My track record shows I saw my existing doctor once in a calendar year, and the prior doctor before him I saw once in a 15-month period. So the administrator based her decision on her own ignorance of the facts.

    She also misstated facts concerning off-label prescriptions for drugs by resident doctors. One of the drugs we are talking about is Clomiphene. Both a resident doctor and an attending faculty physician at the teaching hospital advised me that they would be willing to write me (off-label) prescriptions for this drug, and the attending physician did indeed phone in a prescription for one of the drugs at my request. Similarly, the Dept. of Obstetrics and Gynecology (OB-GYN) advised me that their doctors, both resident and attending, have prescribed Clomiphene to patients. Therefore, residents in Family Medicine and OB-GYN (both primary care departments) can write prescriptions for Clomiphene, but “protocol” prevents residents in Internal Medicine (also primary care) from writing off-label prescriptions. What kind of a cockamamie rule is that? What, the residents in Internal Medicine are too dumb or too naive to understand off-label benefits of medicines?

    Finally, I had planned for my resident PCP to order and interpret blood tests each time I visited him. The administrator could have learned that fact if she had bothered to call or write me before jumping to conclusions and interfering in my doctor-patient relationship. I strongly reject the Director’s paternalistic view of medicine in which she feels she has to protect resident doctors from patients who order or interpret their own blood tests. These resident doctors are young professionals who have completed their medical degrees; they don’t need paternalistic oversight from a department administrator telling them who they can and cannot invite to be patients.

    Apparently, an overwhelming number of patients who visit this teaching hospital’s doctors want to be told what to do and how to feel. I am the exact opposite; I take personal responsibility for and manage my own health, which is strongly advocated under health care reform. Having a more equal, collaborative relationship with my PCP works for me, and that seems to be the true reason for the administrator’s interference. Studies show that medical malpractice rates drop with a non-paternalistic model of health care services. That fact of reducing litigation risks is pushing more health care systems across the country to migrate to a non-paternalistic model.

    LEGAL ANALYSIS

    I. Formation of Doctor-Patient Relationship

    The first question to address is whether, based on this fact pattern, a doctor-patient relationship was formed. When I gave the Internal Medicine resident doctor confidential information on two off-label drugs that I take, that act would be analogous to a prospective client approaching a lawyer with facts about his case to see if the lawyer will assist him. Contacting a lawyer this way does not create an attorney-client relationship. However, the lawyer is under an ethical duty to protect the confidentiality of the information shared by the prospective client. Similarly, the resident doctor was under an ethical duty to keep the information I shared with him confidential.

    When a lawyer responds to a prospective client, “I agree to take your case,” or “I will be your lawyer,” or words to that effect, then an attorney-client relationship is created, and the protection afforded to the client’s information rises to the level of constitutionally protected attorney-client privilege. In this case, when the resident doctor responded that he would be honored to be my PCP, we have offer and acceptance forming a contract. The offer-acceptance could be construed as my offering to be his patient, which he accepted, or his offer to be my PCP, which I accepted.

    But offer and acceptance are only two of the three required elements to form a contract. The third essential element is exchange of consideration, expressed in Latin as the quid pro quo. In this case, there were several separate exchanges of consideration that complete the formation of a contract and thereby render it enforceable in a court of law. Consideration is defined as some act or some transfer of an item from one party to the other, for which the receiving party had no legal right to otherwise obtain that consideration. There is no requirement that the consideration have intrisinc value. For example, the transfer of a scrap piece of paper can constitute valid consideration that renders a contract binding and enforceable.

    The initial disclosure of confidential information from my health history amounts to sufficient consideration. Second, the fact that both I and the doctor each began pursuing scheduling an appointment for me to see him is also consideration: neither of us had a prior legal right entitling us to that action by the other person. Third, when we continued to correspond after offer and acceptance, with additional information being shared back and forth, further consideration was exchanged. My sending the resident doctor a copy of one of my professional presentations was a fourth example of consideration. Finally, my request that my medical records be transferred to the resident doctor’s clinic constituted an obvious legal detriment based on reliance rendering the contract enforceable.

    If a lawsuit were filed for enforcement of this contract, I am confident that the plaintiff would overcome any attempt to dismiss the lawsuit by the teaching hospital’s attorneys based on the absence of a contract. Defendant might attempt to argue that no contract could be formed, because the resident doctor is not licensed. According to the website http://medical-dictionary.thefreedictionary.com/resident+physician, a “resident physician is a graduate and licensed physician receiving training in a specialty, usually in a hospital.” The resident’s licensing status would not prevent the formation of an enforceable contract, as we have in this fact pattern, for treatment in the supervised residents’ clinic.

    In court, we would pose a series of questions: 1) Is the resident a graduate of a medical school? Yes! 2) Was our conversation focused on health care treatment? Yes! 3) Does the resident see other patients (whether supervised or unsupervised) in the resident clinic? Yes! 4) Are the resident’s services billed to the U.S. government and to private insurers as the services of a doctor (not a student or a doctor’s aide)? Yes! 5) Did we both use the term PCP in describing our relationship? Yes. 6) Did the resident undertake to assist me in obtaining a medical appointment to see him? Yes! With these answers, any court of law is going to recognize if it looks like a duck, swims like a duck, and quacks like a duck, then it is a duck. Therefore, the defendant’s argument on licensing will be viewed as a red herring and will fail. In a similar vein, courts have noted “it is axiomatic that a doctor-patient relationship may arise from, briefly exist, and be limited by the unique circumstances presented in a transfer situation.” Sterling v. Johns Hopkins Hosp., 145 Md. App. 161 (Md. Ct. Spec. App. 2002). It does not matter how long the doctor has been seeing patients or how brief the contact with any given patient, a doctor-patient relationship can be formed.

    Selection of a PCP and other medical decisions are “core” private decisions. A fundamental tenet of privacy jurisprudence, as it has been applied to other types of personal matters, is that the individual most directly concerned is entitled to make and implement the protected decision autonomously and free from paternalistic government intrusion. See, e.g., Zablocki v. Redhail, 434 U.S. 374, 54 L. Ed. 2d 618, 98 S. Ct. 673 (1978) (decision to marry); Moore v. East Cleveland, 431 U.S. 494, 52 L. Ed. 2d 531, 97 S. Ct. 1932 (1977) (decision to live with extended family members); Griswold v. Connecticut, 381 U.S. 479, 14 L. Ed. 2d 510, 85 S. Ct. 1678 (1965)(reproductive choice). I would argue that the constitutional right to privacy also protects autonomy in selecting a PCP among a wide choice of available doctors, selecting which medications I want prescribed, and choosing what lab tests I want to order myself to monitor my health.

    In 2005, the Supreme Court of Arkansas provided the best statement in American jurisprudence on the elevated status of the doctor-patient relationship. The court noted the relationship of doctor-patient is unique. “The loss of this relationship, even temporarily, causes irreparable damage to the doctor and the patient. There is no adequate remedy at law because the loss is a loss of a one-time opportunity.” Baptist Health v. Murphy, 362 Ark. 506 (Ark. 2005)

    The court noted that the hospital had violated the Arkansas Department of Health rules and regulations for hospitals by failing to enforce policies that protected the doctor’s selection of patients and the patient’s choice of a physician. “We interpret this to mean that an otherwise qualified doctor must be granted access to his patient for the purpose of treating his patient, if that is what both the doctor and the patient want. Or, stated another way, a hospital cannot deny the services of a physician of the patient’s choice if the patient is already being seen by physicians at the hospital. Baptist Health v. Murphy, 362 Ark. 510-511 (Ark. 2005)

    Based on reading Baptist Health, I will now forward a copy of this article to the state Department of Health to determine whether the teaching hospital violated any of my state’s regulations requiring Tennessee-licensed medical centers to have policies or bylaws that respect the patient’s right to select his own physician. If so, then the teaching hospital is violating those regulations.

    II. Tennessee’s Tortious Interference Statute

    Tenn. Code Ann. § 47-50-109 is captioned, “Procurement of breach of contracts unlawful – Damages.” The administrator tortiously interfered in my doctor-patient relationship and prevented the resident doctor from performing his services under our contract. She therefore procured a breach of that contract. The administrator will argue that she was merely performing her duties, but that is no excuse for interfering in an existing doctor-patient relationship.

    Although Tennessee jurisprudence does not have a case on point, courts across the country have taken a dim view and expressed disapproval of employer interference in the doctor-patient relationship. For example, the U.S. Supreme Court stated, “The ethical objection has been that intervention by employer… makes a tripartite matter of the doctor-patient relation. Since the contract doctor owes his employment and looks for his pay to the employer… rather than to the patient, he serves two masters with conflicting interests.” United States v. Oregon State Medical Soc., 343 U.S. 326, 329 (U.S. 1952).

    [ad_2]

    Source by Michael Guth

    Views: 0

  • Boost Your Productivity With Customer Service Outsourcing

    Boost Your Productivity With Customer Service Outsourcing

    [ad_1]

    Outsourcing is getting more and more popular from year to year among small start-ups along with big enterprises. It looks like outsourcing is now the most recent business trend in national and global industry. Customer service outsourcing helps you free up your time to focus on border strategies. It allows companies improve their customer experience. It can let you use multiple marketing channels with ease. It can help your organisation benefit at various levels and is a great way to boost your productivity and profitability. Additionally, it can increase your return on investments (ROI) and give you a competitive advantage. It also saves a lot on manpower, thereby allowing you to save money and time on training professionals.

    Today, outsourcing is the very best thing you can do to help your business to cultivate online if you’re a small company. Delegating some functions saves time as it can help to concentrate on key areas of activity. One of the greatest benefits of outsourcing is that it provides your company with a chance to stay ahead of the crowd.

    Immediate Access to Technology

    Another major advantage of customer service outsourcing is that you’ve got instant accessibility to services, often around-the-clock, along with the latest technology in the area. It is possible to maintain funds for different items directly associated with your products or services. In reality, by selecting an IT outsourcing company, you can acquire the means to offer great customer satisfaction.

    Why is customer service outsourcing beneficial?

    When it has to do with establishing a business, you might be seeking affordable customer service services. You might be having years of experience in all types of industries dealing with all types of service troubles.

    Customer assistance, though, is composed of many diverse aspects. When you outsource customer service to somebody who has experience in the area and a portfolio to back this up, you can offer your business the competitive edge in regard to keeping your customers contented. Customer service is a significant part of any company. In any case, outsourcing customer service can help you come up with better campaigns which will help convert new clients into loyal clients. At the end of the day, it can be cost-effective. Outsourcing call center services may be among the smartest decisions you could ever make as a business proprietor.

    Customer Focused

    Whether you are only starting up an organization or been in operation for some time, you must be customer focused. Customers are the key to your small business success. In order to obtain the benefit of reduced costs and, most significantly, reduced errors. You would be able to allow your clients to get the flexibility to get in touch with you and also address their concerns.

    If your customer is satisfied, your organization will flourish by itself. Whenever your customers are happy, they return to purchase from you over and over. This is the greatest benefit of customer service outsourcing . Customers expect agents to have access to all their information, no matter what channel they use. With timely response and higher excellent service levels, your clients will always be happy with you.

    [ad_2]

    Source by Alicia Gray

    Views: 0