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Biomedical subjects

E R Washburn

Publications and source records attributed to E R Washburn.

10 recordsLinked to original sources
PubMed1997

Health care evolution. Or is it?

Should we be using evolution as our theory for understanding the radical changes overtaking medicine? Evolution is a theory for explaining changes in biological systems. The power and simplicity of evolutionary theory have made it the major scientific framework for looking at why certain animals and plants dominate ecosystems, and why one species dies out only to be replaced by another. Health care is a socio-economic system--changes occur because of scientific, economic, and political reasons. Using evolutionary jargon and examples can lead us astray. So, why do we often use evolutionary language and ideas and what is a better way of looking at the changes confronting the industry at such a rapid pace? This author finds the answer in dialectic thinking.

Biological Evolution↗
PubMed1996

Focus on the fundamentals.

What business are we in? Who are our customers? as health care evolves, the answers to these questions become increasingly complex. And as physicians become more involved in the business side of medicine and the business side of medicine becomes more sophisticated itself, we must not forget the fundamentals. Successful business people do not lose touch with the essential concerns of their industry. Future success in the medical marketplace will require physicians and physician leaders to keep in mind what business we are in and who our customers are. This article offers a set of answers to these questions.

Commerce↗
PubMedDate not supplied

Fatal hepatocerebral syndrome in siblings discordant for exposure to valproate.

Occurrence of a progressive encephalopathy with seizures in siblings was associated with hepatic pathology. One of these patients was exposed to valproate (VPA) and developed hepatic necrosis, confirmed at autopsy. The other had not been exposed to VPA, and her hepatic lesions at autopsy were less severe. The liver pathology in both was within the range described in previous cases of liver disease attributed to VPA. These facts and the otherwise similar course of their disease suggests that in these patients, and probably in other cases of fatal liver failure attributed to VPA, the drug actually either had no effect or acted only to increase the severity of the preexisting hepatic component of the hepatocerebral disorder.

Child, Preschool↗
PubMedDate not supplied

Budgeting for a more likely future.

"The future isn't what it used to be!" Medical group managers must take this humorous truth as gospel. Managed care and capitation are rapidly changing everything about medical group planning and budgeting. Profit centers will cease to exist and instead, all departments will become cost centers. Specialists and primary care physicians will find themselves in very different--and much less comfortable--roles. Administrators must strive to keep the whole team working together even in the face of unprecedented stress. Incentives may change, but quality of care and patient satisfaction will need to stay high and even improve to ensure survival. The budgeting process can be an important tool for helping to prepare for the evolution of medical groups, but first the implications of medical marketplace reform must be understood and accepted. This task will be emotionally and intellectually challenging. Accepting the shape of our future is painful but necessary. The choice is clear: rapidly evolve or disappear.

Budgets↗
PubMedDate not supplied

The physician leader as logotherapist.

Today's physicians feel helpless and angry about changing conditions in the medical landscape. This is due, in large part, to our postmodernist world view and the influence of corporations on medical practice. The life and work of existentialist psychiatrist Viktor Frankl is proposed as a role model for physicians to take back control of their profession. Physician leaders are in the best position to bring the teachings and insight of Frankl's logotherapy to rank-and-file physicians in all practice settings, as well as into the board rooms of large medical corporations. This article considers the spiritual and moral troubles of American medicine, Frankl's answer to that affliction, and the implications of logotherapy for physician organizations and leadership. Physician executives are challenged to take up this task.

Adaptation, Psychological↗
PubMedDate not supplied

The coming medical apocalypse.

Is there a medical apocalypse in our future? Will it happen soon? No one can say for sure, but five ominous trends suggest that a medical meltdown could occur at any time. These trends are: (1) The practice of providing medical care becoming too complex from both a business and a legal perspective; (2) Less money being spent on medical care without any corresponding reduction in services provided, creating long-term operating deficits; (3) Investor-owned, for-profit corporations changing the focus of medicine by putting shareholder concerns ahead of patient care; (4) Employment-linked health care insurance creating a growing uninsured population, adding extra financial stress to our hospitals; and, (5) Providers losing faith in their future and becoming increasingly demoralized about practicing the healing arts. These dangerous trends are considered, along with some suggestions that physician executives and organizations might take to protect themselves.

Delivery of Health Care↗
PubMedDate not supplied

Are you ready for generation X?

Generational analysis considers the differences in world view and attitude between various generations of Americans and uses this information to develop insight and business strategies. The much discussed generation gap between the Baby Boomers and their elders during the 1960s and 1970s is equaled or exceeded by the differences between Generations X and Y and the Boomers. Generation X physicians will be coming into practice over the next two decades. Successful medical leaders must understand Gen-Xers to create clinical environments that meet their unique needs and concerns. This article describes some of the philosophical and attitudinal differences between the generations and what these differences may mean to the future of medicine and health care organizations.

Attitude of Health Personnel↗
PubMedDate not supplied

Fast forward: a blueprint for the future from the Institute of Medicine.

A newly released report from the Institute of Medicine outlines an ambitious program for changing the direction of U.S. health care. Crossing the Quality Chasm: A New Health System for the 21st Century recommends switching health system priorities from predominantly acute care treatment to focusing on chronic medical conditions. The report also recognizes 15 conditions that it says should take priority for funding and support from all health care agencies. Evidence-based medicine must be fostered and the entire fabric of medical care must become more patient-centered. The IOM report proposes six aims for our 21st Century health care system. The system we should strive for needs to be: (1) safe; (2) effective; (3) patient-centered; (4) timely; (5) efficient; and (6) equitable. This article looks at some of the IOM recommendations and analyzes their strengths and weaknesses. Ultimately, the report advocates an environmental restructuring of health care in the United States.

Delivery of Health Care↗
PubMedDate not supplied

Medical privacy: from the 4th Amendment to HIPAA. Right to privacy vs. public health: showdown looms over patient genetic information.

Newly adopted federal privacy regulations set a high standard for control of medical information that all medical offices and clinics must meet. Yet, the federal government can't even secure its own database of medical information. We have less than two years to come into full compliance with regulations that may well change over the coming months, making compliance a moving target. Learn the history of our privacy rights and regulations. And preview the privacy debates and dilemmas that await our digital society.

Confidentiality↗