Gaining physician support for risk management. "If we are in this together, why do I feel so alone?" (Reprinted from 1987).
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Biomedical subjects
Publications and source records attributed to M B Guthrie.
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Many of the issues confronting healthcare organizations require physician involvement and understanding, and the physician executive is a tool to achieving physician participation. Physician leaders can become the mediators between physicians and organizational management, minimizing miscommunication and maximizing agreement and understanding. Yet few doctors seem willing to stand up and speak positively for the plans and proposals that will move the institution forward, and healthcare executives are often frustrated by physician leadership that fails to articulate and implement the vision and objectives of the organization. Understanding physician leadership and exploring the challenges in managing and leading physicians require an understanding of the physician mindset--a completely different mindset than that of the typical healthcare executive. Beginning with a discussion of the unique situation faced by physicians in leadership positions, this article attempts to define the obstacles faced by both the physician and the executive in developing the role of physician executive. After reviewing the opportunities open to physician executives for improving leadership ability, the author presents the essential characteristics and core skills for effective leadership. The second half of the article suggests ways in which an organization can reemphasize physician leadership development within an organization from selection of potential candidates to creating training and networking opportunities and offering appropriate incentives.
Physicians in many metropolitan areas of the United States now have the novel opportunity of joining more than one alternative delivery system(s) (ADS); they may work for several competing provider panels. Now, as the number of organizations increases, physicians participating in more than two or three ADS find their time and effort stretched increasingly thin. As with other business choices, however, there are criteria that can be used to make these decisions wise ones. The outcome of more reflective and orderly choice for the physician is an improvement in his or her effectiveness and time utilization.
The development of preferred provider organizations (PPO) is of special interest to physicians because of the strengths of this form of medical services organization. Given the threats and opportunities in the health care environment, the PPO concept will evolve and impact both positively and negatively on physicians' practices. Specific impacts are predicted in the areas of product and service offering design, the type and number of partners in PPOs, the pricing models for medical services, promotional opportunities, and the change in the nature and extent of distribution of health care services. Examples of the evolution of the PPO concept and a short case history are included.
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Involvement of the medical staff in the capital budgeting process at one facility resulted in greater commitment by the staff to the organization and the incorporation of 60 percent of the programs and equipment requested in the final budget. This article discusses the process used to secure that involvement.
Too often, an "us verus them" theme seems to dominate the relationship between hospital administration and the hospital medical staff. It is time to put aside differences, according to the physician-administrator who wrote this article, and to work collaboratively for the mutual benefit of each other as well as for the benefit of the institution. Indeed, he says, collaboration is the only alternative if hospitals are to survive in these troubled times.
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A case report is presented of a 62-year-old female admitted to a general hospital with a provisional diagnosis of mania and organic brain syndrome, whose unusual behavior and history prompted evaluation using computed tomography of her brain. Bilateral frontal lobe cystic lesions were discovered as a result of a bilateral transorbital leukotomy performed 21 years earlier. CT scan is presented, demonstrating the extent of these lesions.
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A survey was conducted in the fall of 1989 to determine how hospitals handle the task of overreading of computer-generated electrocardiograms. All hospital-based members (1,451) of the American College of Physician Executives were sent questionnaires. Responses were received from 413 physician executives, a response rate of about 28 percent. The results of the survey are summarized in this article.