Full-time Physicians Research Articles

The Prescription of Antimicrobics in Hospitals.

s1 May 1966The Prescription of Antimicrobics in Hospitals.Hobart A. Reimann, M.D., F.A.C.P.Hobart A. Reimann, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-5-1169_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo obtain an idea of the amount of antimicrobics currently prescribed, the chief pharmacists of a number of large hospitals in Philadelphia and elsewhere were requested to prepare lists of the amounts of antimicrobics dispensed in an average month and their cost to patients. The figures obtained varied widely in hospitals of comparable bed capacity, from $1,000 to $16,000 monthly, or about $12,000 to $190,000 annually. Low figures generally were from governmental hospitals where the staff is limited to small numbers of full-time physicians, and prescription is well controlled.In one hospital, the cost to patients for antimicrobics was 60%... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1966Volume 64, Issue 5Page: 1169-1169KeywordsPharmacists Issue Published: 1 May 1966 PDF DownloadLoading ...

Impact of a Reduced-Charge Drug Benefit in a Prepaid Group Practice Plan

SINCE October 1962 a reduced-charge outof-hospital drug benefit has been available to the membership of the Oregon region of the Kaiser Foundation Health Plan. The out-ofhospital drug benefit was an attempt to broaden the plan's scope and to increase its value to the membership. The plan, which presently has more than 83,000 members enrolled, provides comprehensive nmedical care services in a prepaid group practice setting. Its membership in the Oregon region is quite diverse, including the full range of occupational and socioeconomic groups, and has grown from 25,000 in the last 10 years. Services are centered at a hoispital complex. The hospital was opened in 1959 and has 141 beds for short-term patients. A building project is underway to increase the hospital's capacity by 36 beds for short-term patients and to add a 72-bed extended care unit. The complex provides the full range of ancillary servi,ces for both inpatients and clinic piatients including pharmacy, X-ray, physical therapy, optical, audiology, and laboratory services. Physicians' services are provided at a central clinilc integrated into the hospital complex and at two neighborhood clinics located in population centers in outlying parts of 'the metropolitan area. A pharmacy is operated as an adjunct to each clinic. The Permanente Clinic, a partnership of full-time physicians providing the physicians' service, includes more than 60 board-certified or board-eligible specialists in all maj or specialties, including psychiatry. The Permanente Clinic is paid a negotiated capitation fee per member per month by the health plan, and its total income is redistributed in a manner determined by its partners. Health plan benefits include physicians' care in the hospital, home, or office, hospitalization, surgery, special nursing, laboratory, X-ray, physical therapy, emergency service, immunizations, routine physical examinations, and some mental health services. However, before October 1962 the members had to pay out oif pocket nearly full market price for all drugs prescribed for outpatients. The plan's management has been concerned with the members' drug costs since totally prepaid drugs coverage had been dropped from the plan in the early days of its struggle for survival and growth. In the 17 years between the end of World War II and the inception of this benefit, drug costs obviously had become more burdensome for many members. Prescription price difsicounting had little effect in the Portland area and therefore drug prices had been maintained at a relatively high level. The plan pharmacies, by pricing prescriptions only slightly below the general market level, were earning considerable revenue for the plan-$112,000 during 1961 or 18 cents per member per month. During 1962 it was decided to reduce the cost Mr. Greenlick is director of medical care research and Dr. Saward is medical director, Kaiser Foundation Hospital, Portland, Oreg.

A DEPARTMENT OF MEDICINE IN 1963-1973.

The commemoration of the fiftieth anniversary of the founding of the Peter Bent Brigham Hospital provides a uniquely appropriate opportunity to discuss the plans of the Department of Medicine for the decade 1963–1973. At this point in time the Department is responsible for approximately 120 patient beds and includes a professional staff of approximately 100 full-time and part-time physicians, with 80 to 90 interns, residents and research fellows in training. The Department is responsible for approximately a fourth of the Harvard Medical School second-year, third-year and fourth-year teaching in medicine. We are fortunate indeed in having Harvard Medical School, with . . .

The 1959 survey of group practice.

IT iS widely recognized that there has been a progressive increase in medical group practice in the United States. This form of medical organization has been the .subject of a number of previous studies,'-4 the results of which have met with considerable interest. The present study was undertaken because of an evident need for detailed data on medical organization and in order to begin to develop a time trend in this field. This latter objective is possible because the methodology of the 1946 Public Health Service survey of group practice could be utilized and much of it repeated. Personnel who had participated in the earlier survey were available, either as active participants or as consultants. The present paper is one of a series of reports being made of various aspects of the study. It will discuss the number of medical groups in 1959 and in 1946, and their distribution by state and by county type, the number of and degree of specialization of their full-time physicians, and some indication of their programs and standards. This study was made possible by the cooperative efforts of a number of persons and organizations having an interest in the field. The assistance of those state and local health officers who furnished the names and addresses of groups in their locality is especially noted. Undoubtedly the level of the response rate is attributable to the stature of the cooperating organizations: The Council of Medical Service of the American Medical Association, the American Association of Medical Clinics, the National Association of Clinic Managers, and the Group Health Association of America.

Modern Occupational Medicine—

This publication represents an extensive revision of the first edition, published in 1954, and the addition of new chapters. Among the 23 contributors, all of the du Pont organization, are medical administrators, psychiatrists, a surgeon, a dermatologist, chemical engineers, industrial hygiene engineers, a toxicologist, a lawyer, and a statistician. The authors have slanted their contributions toward the chemical industry where toxicological hazards are important, as evidenced by their recommendation of a full-time physician in a plant of 1,000 employees. Nevertheless, the principles of organization and procedures, as expressed in this book, are generally applicable. The toxicity and biological action of chemicals, singly and in groups, are described, as well as the treatment of accidental poisoning. This authoritative and well-rounded book is a valuable source of information not only for industrial physicians but also for all persons concerned with occupational health, including physicians in rural areas who deal with the farmer

Medicine in the teaching hospital of today and tomorrow.

Good medical care must still depend on the dedicated and well-trained physician. The integration of medicine depends on the integration of medical teachers. The educational experiment here described involved the creation of integrated units within a teaching hospital, each unit being a miniature department of medicine made up of full-time and part-time physicians, clinical investigators, and, in some instances, basic scientists. The units are devoted to such fields as hematology, gastroenterology, and cardiology, and the arrangement is not to be confused with the division of a hospital into arthritis wards, gastroenterology wards, pulmonary disease wards, and so on. The unit team plan provides superb opportunities for broadening the viewpoints of medical students and house staff alike. Teaching is improved, research is stimulated, and the purpose of the whole enterprise, to give the individual patient the best possible care, is constantly kept in view.

Medical Group Practice in California.

This pamphlet is a study of group practice in California in 1950 as it compares with the 368 medical groups in the United States as a whole studied by Hunt and Goldstein in 1946. The authors defined a "true general medical group" as follows: "1. A systematic association of at least three full-time physicians; 2. More than one specialty of medicine represented; 3. Joint use of office facilities and auxiliary personnel; 4. Formal organization for administration and financing; 5. Pooling of income and sharing of common overhead expenses with net payments to physicians made according to a pre-arranged plan." This is similar to the Hunt and Goldstein definition and differs only slightly from that used by the Bureau of Medical Economic Research of the American Medical Association. The authors have done a thorough job on statistical data. They determined that 52 groups definitely satisfied their definition out of an original

GOVERNMENT SERVICES

<h3>ARMY</h3><h3>Symposium on Trauma.—</h3> A symposium on the treatment of trauma in the armed forces will be conducted at the Walter Reed Army Medical Center, Washington, D. C., March 10-12. Sponsored jointly by the Division of Medical Sciences of the National Research Council and the Army Medical Service Graduate School, the symposium is designed to review the problems of trauma in military medicine. Scheduled for discussion are medical organization for handling of trauma in military campaigns and civil disasters, emergency treatment of the wounded, surgical problems related to traumatic injury, rehabilitation of battle casualties, complications related to traumatic injury, and research in military medicine. National and international authorities in these fields will appear on the various programs. Physicians eligible to attend the symposium include medical officers of the armed forces on active duty, with the exception of those enrolled in the residency training program; full-time civil service physicians on duty

Medical News

(Physicians will confer a favor by sending for this department items of news of more or less general interest: such as relate to society activities, new hospitals, education, public health, etc.) <h3>ALASKA</h3><h3>Report of Medical Service.</h3> —The commissioner of education, in his report to the Secretary of the Interior for the year ending June 30, 1926, says that it has not been possible to secure funds to relieve natives who have tuberculosis, and he recommends that a sanatorium be erected. More success has been encountered in relieving natives who live along the Yukon River and its tributaries, where a small boat was remodeled and equipped in 1926 as a floating hospital during the season of navigation. Plans are being considered to remodel buildings at the abandoned Fort Gibbon Military Reservation with a view of opening another hospital on the Yukon. During the year, five full-time physicians, three part-time physicians, and

The Place of the Full-Time and Part-Time Physician in the Modern Hospital

The Place of the Full-Time and Part-Time Physician in the Modern Hospital