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Biomedical subjects

R C Burchell

Publications and source records attributed to R C Burchell.

At least 19 recordsLinked to original sources
PubMed1988

Physicians and the organizational evolution of medicine.

Within medicine there is growing uneasiness and debate about changes in medical care delivery. Much of this concern centers on the evolution of organizations and the role of physicians. The emergence of multi-institutional organizations, the rise of investor-owned health care corporations, and the expansion of group medical practice illustrate the increasing organizational influence in medicine. Added to these trends are new financial incentives confronting both physicians and organizations so that the environment increasingly favors conflict. This article reviews the primary strategies for resolving physician-organization conflicts, including cooperation between physicians and organizations, having physician representatives in governance and management, restructuring incentives, and restructuring organizations. Although these strategies have various merits, we suggest that every physician has a personal responsibility to become more involved in organization and management issues. Physicians can play an important role in guiding the evolution of medicine.

Conflict, Psychological↗
PubMed1982

Collaborative practice in obstetrics/gynecology: implications for cost, quality, and productivity.

Rising costs, concern over quality of care, and low worker productivity are some of the factors suggesting a need for revision in the organization of the health care delivery system. Reorganization of the nurse-physician working relationship through the establishment of collaborative practice can serve as the mechanism for improving cost, quality, and productivity outcomes. This analysis evaluates collaborative practice within the disciplines of obstetrics and gynecology.

Cost-Benefit Analysis↗
PubMed1980

Male sexual dysfunction associated with coronary heart disease.

A pilot study of 18 males (age range 38-68) hospitalized for an acute myocardial infarction (MI) revealed that 44% were impotent and 28% had had premature ejaculation prior to the MI. A subsequent research project is the basis of this article. During a 10-month period, 131 male patients (age range 31-86), while hospitalized for an acute MI, were interviewed about their pre-MI sexual functioning. Two-thirds of the males had--by their own definition--a significant sexual problem. Among the sexually dysfunctional group, 64% were impotent, 28% had a significant (greater than 50%) decrease in sexual frequency, and 8% had premature ejaculation. No adverse side effects occurred from a detailed sexual history being taken while the male was recovering from an acute MI. One implication for cardiac rehabilitation is that returning to the pre-MI level of sexual functioning is not enough.

Adult↗
PubMed1980

Von Willebrand's disease complicating second-trimester abortion.

This report describes a patient with Von Willebrand's disease whose second-trimester abortion was complicated by hemorrhage. Factor VIII levels were low and the patient responded well to factor VIII transfusions. The authors believe that abortions can be performed safely in patients with Von Willebrand's disease. If factor VIII is low, prophylactic cryoprecipitate is indicated.

Abortion, Induced↗
PubMed1978

Counseling in gynecologic practice: an overivew.

We live in a turbulant period with regard to interpersonal relationships. Individuals place great emphasis on their ability to form good relationships. It is a time of desiring and searching; desiring to be engaged in a rewarding relationship and searching for any principles which might promote such involvement. Obstetrician-gynecologists are involved because reproduction and sexuality are so basic to dyadic relationship. Few gynecologists have not pondered how they would accomodate new methods of contraception, sterilization, elective abortion, fathers involved in the birth process, and marital conseling. These areas of obstetrics and gynecology have been profoundly altered in what is occurring with respect to women and their dyadic relationships with men. Anyone practicing obstetrics and gynecology, whether specialist, primary care physician, or other professional, has a special role in a woman's life because he or she is there. We have an obligation to acknowledge and take advantage of this unique opportunity.

Anger↗
PubMed1978

Vascular anatomy of the human uterus and pregnancy wastage.

In uteri removed at hysterectomy the uterine arteries were injected with radioopaque media and the vascular configuration was correlated with reproductive histories. Patients whose uteri had two ascending uterine arteries on each side had significantly more abortions and smaller newborn infants than patients with a single ascending branch of the uterine artery.

Abortion, Spontaneous↗
PubMed1977

Safety and efficacy of combining obstetric and noninfectious gynecologic hospital patients.

Unoccupied obstetric beds and unused delivery rooms represent inefficient use of hospital facilities and loss of revenue, both of which adversely affect the quality of care rendered patients. Hartford Hospital has permitted the admission of obstetric and noninfectious gynecologic patients to the same patient care areas of the hospital as well as use of delivery rooms by both groups of patients. Elaborate surveillance of these patients by the epidemiology section for a 1-year period (July 1974-July 1975) demonstrated no increase in the incidence of hospital-acquired infections associated with this combined approach as compared with the more traditional separation system of maternity and nonmaternity patients.

Connecticut↗
PubMed1976

Postpartum and Postabortal Ovarian Vein Thrombophlebitis.

Six cases of ovarian vein thrombophlebitis are reported including one resulting in operative death, a case diagnosed by phlebography, a postabortal case, and a case followed by habitual abortion. An historic review of this disease is presented. It is suggested that the ovarian vein may be the most commonly involved vein in puerperal pelvic thrombophlebitis.

Abortion, Spontaneous↗