The new health care civilization: integration of physician land and manageria.

Changes occurring in health care demand that physicians expand their professional knowledge and skills beyond the medical and behavioral sciences. Subjects absent from traditional medical education curricula, such as the economics and politics of health care, practice management, and leadership of professional organizations, will become important competencies, particularly for physicians who serve in management roles. Because physicians occupy a central role in planning and allocating medical care services and other health care resources, they must be better prepared to work with other health care professionals to create a new civilization, even if this means leaving the cloistered domain of "physician land" to serve as interface professionals between the delivery of medical services and the management of health care.

Ambulatory surgery and the hospital.

Ambulatory surgery can be a win-win proposition for patients, physicians, payers, and even for hospitals. The main elements at risk are high costs and the traditional models of hospital-based surgical care. If hospitals delay their responses to the challenges of the free-standing surgicenter, the latter will become as common as the multispecialty group practice.

Practical methods to improve fee collections.

A medical practice's financial policies should be frankly discussed with patients and explained at the initial visit. At that time, health insurance coverage should also be discussed. This candid conversation not only opens the door to further communication regarding a once-sensitive subject but also facilitates collection of fees--especially important when high-priced procedures are contemplated.

Strategic planning in academic medicine: a departmental case study analysis.

Family medicine departments face a variety of external and internal pressures that make astute planning imperative. A systematic planning process produces measurable outcomes, timetables to evaluate results, and assignments for individual responsibility. Strategic planning is discussed as it occurred during a year-long planning process in a family medicine department.

Anesthesiologists in North Carolina: a survey reflecting emerging subspecialization.

This North Carolina case study addresses the migration of anesthesiologists into subspecialty, clinical areas of anesthesiology over a 4-year period (1984 to 1987). Three hundred fourteen members of the North Carolina Society of Anesthesiologists (NCSA) were surveyed using a one-page questionnaire. The response rate was 93.