Objectives To compare physician productivity and billing before and after implementation of electronic charting in an academic emergency department (ED). Materials and methods This retrospective, blinded, observational study compared the 6 months pre-implementation (January to June 2012) with the 6 months post-implementation 1 year later (January to June 2013). Thirty-one ED physicians were recruited, with each physician acting as his/her own control in a before-after design. Productivity was measured via total number of encounters and “productivity index” defined as worked relative value units divided by the clinical full-time equivalent. Values for charges, encounters, and productivity index were determined during each study period and separately for procedures, observational stays, and critical care. Results No differences were found for total productivity index per month (758 [623-876] pre-group vs. 756 [673-886] post-group; P = 0.30). There was, however, a 9% decrease in total encounters per month (138 [101-163] pre-group vs. 125 [99-159] post-group; P = 0.01). Significant decreases were seen across all observation stay categories. Conversely, significant increases were seen across all critical care categories. There was no difference in total charges per month. Discussion This is one of few studies to demonstrate minimal disruption in physician productivity after transitioning to electronic documentation. The reasons for these findings are likely multi-factorial. Conclusion In this study, implementation of electronic charting was not associated with decreases in productivity or billing for total ED care, but may be associated with increases for critical care and decreases for observational stays.
Aristotle considered μίμησις/ mimēsis (“imitation”) to be innate in humanity from childhood, pedagogical in nature, and that humans are the most mimetic species ( Poet. 4.5–8). This essay investigates the relationship between Christian discipleship and education through the lens of René Girard’s “mimetic desire,” and how 1 Pet 5:1–5 (especially the hapax legomenon συμπρεσβύτερος/ sympresbyteros) can be informed by this pedagogical concept. Going beyond mere mimēsis and the imitation of surface-level actions, “mimetic desire” explores how modeled behaviors and desires – whether positive or negative – affect the desires and motivations of others. This is important for ministry as pastors/Christian educators should faithfully model the gospel externally and internally, so their congregants/students may learn to live as good citizens worthy of the gospel of Christ (Phil 1:27).
This essay contends that God created humanity as His co-creators to bring Him glory with one’s entire being, including imagination and creativity. Throughout Scripture, YHWH is depicted as the artistic Creator of all that is beautiful, true, and transcendent. The Bible attests the creation of humanity in the imago Dei--sharing God’s innate creativity--and divine gifting of Spirit-inspired artisans utilizing their talents for God’s glory. Yet, over the centuries, “art” was oft misunderstood and grossly neglected in Christ’s church. Philip Ryken explains how medieval skeptics began removing and destroying art believed to violate the Decalogue. Imbalanced suspicions toward art in Christendom still persist, despite the positive, inspirational effects of icons in Catholic and Orthodox traditions and scientific research that shows the therapeutic value of art across a broad spectrum of mental and physical challenges, including isolation and depression. Makoto Fujimura posits that Christian creatives possess a common faith as “border-walkers,” and can affect phoenix-like positive cultural and ecclesial change by reintroducing beauty as a visible “sermon” into a fragmented, post-pandemic world.
The implications of fatherless families—be they single-mother households, same-sex marriages, or matriarchal cultures—has too often been a neglected (perhaps avoided) topic within the context of the local church. Consequently, there is a cacophony of secular voices competing for our attention. Some of these voices argue that the role of “male” fatherhood is superfluous; however, this essay will argue that fatherlessness is, indeed, a pervasive problem. Fatherlessness, an epidemic arising primarily from two root causes in the Western world: divorce-on-demand and unwed pregnancies, has severe implications regarding God's word, church, and world.
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