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Biomedical subjects

Richard W Schwartz

Publications and source records attributed to Richard W Schwartz.

At least 19 recordsLinked to original sources
PubMed2006

Fundamentals of service lines and the necessity of physician leaders.

In the demanding and unpredictable environment of the health care industry, hospitals and health systems continue to search for ways to improve the efficiency and quality of care provision and, thus, thrive. Service line organization in health care, a concept that was popularized in the past, has recently experienced a resurgence, spanning the gamut from small community hospitals to large academic medical centers. The modern service line has transformed into an organizational tool that provides hospitals and health systems with a novel approach to achieve the goals of efficient and effective care. Physician leaders can play an integral role in the management of service lines, using a combination of management skills and clinical expertise to provide the oversight and direction necessary for assuring excellence in clinical care and value in its delivery. This article presents an overview of service line structure, implementation, implications, and the role of the physician-leader.

Humans↗
PubMed2005

Gaining hospital administrators' attention: ways to improve physician-hospital management dialogue.

BACKGROUND: Despite marked differences in training and professional interests, physicians and hospital managers face similar problems stemming from the unprecedented rate of change in the health care delivery system: failure of reimbursement to keep pace with rising costs, new therapeutic modalities, increasing government and managed care regulations, heightened consumerism, and an aging patient population. In the face of these mounting challenges, both physicians and hospital managers could benefit significantly from a climate of collaboration and interdependence. METHODS: This article presents a "case report" of a community teaching hospital in which practicing physicians and hospital administrators collaborated to develop an operating plan for the next 3 years to improve the practice environment. RESULTS: The physicians recommended new clinical priorities to enhance service to patients and families, to improve physician-physician communication, to develop clinical protocols, and to build coordinated diagnostic treatment centers, which the administration has implemented. SIGNIFICANCE: Physicians and hospital managers can no longer pass on cost increases at will to patients and third-party payers. Nor can physicians and managers ignore the heightened power of patients and third-party payers. Effective dialogue and collaboration are in all parties' interests to optimize patient care and to develop innovative services. Despite the tensions created by competition and rapid change, transformation from a blaming to a learning environment may be a key strategic advantage in today's health care marketplace.

Advisory Committees↗
PubMed2005

A marketing-oriented perspective on physician selection.

The process of selecting a physician is an inherently difficult one for patients. Physician selection is often made from limited information, and in many cases, the information used as the basis for physician selection is obtained indirectly through either medical service providers or other consumers or patients. When selecting a physician, patients tend to rely on personal sources of information and place importance on the reputational aspects of the health-care provider, organization, and experience. Patient expectations for the technical aspects of the health-care experience are stringent and must be met or exceeded by physicians and other health-care providers to compete long-term in the health-care market place. Beyond this, health-care providers can favorably influence patient perceptions of the health-care experience by excelling at the functional aspects of service provision (ie, the interpersonal- and process-oriented attributes). This article examines the physician selection process and provides marketing-oriented recommendations for addressing some of the challenges patients encounter when selecting a physician.

Choice Behavior↗
PubMed2004

Enhancing the clinical skills of surgical residents through structured cancer education.

OBJECTIVE: To assess the short and long-term educational value of a highly structured, interactive Breast Cancer Structured Clinical Instruction Module (BCSCIM). SUMMARY BACKGROUND DATA: Cancer education for surgical residents is generally unstructured, particularly when compared with surgical curricula like the Advanced Trauma Life Support (ATLS) course. METHODS: Forty-eight surgical residents were randomly assigned to 1 of 4 groups. Two of the groups received the BCSCIM and 2 served as controls. One of the BCSCIM groups and 1 of the control groups were administered an 11-problem Objective Structured Clinical Examination (OSCE) immediately after the workshop; the other 2 groups were tested with the same OSCE 8 months later. The course was an intensive multidisciplinary, multistation workshop where residents rotated in pairs from station to station interacting with expert faculty members and breast cancer patients. RESULTS: Residents who took the BCSCIM outperformed the residents in the control groups for each of the 7 performance measures at both the immediate and 8-month test times (P < 0.01). Although the residents who took the BCSCIM had higher competence ratings than the residents in the control groups, there was a decline in the faculty ratings of resident competence from the immediate test to the 8-month test (P < 0.004). CONCLUSIONS: This interactive patient-based workshop was associated with objective evidence of educational benefit as determined by a unique method of outcome assessment.

Breast Neoplasms↗
PubMed2004

A broader view of marketing: implications for surgeons.

The health care sector of the economy is changing. There is unprecedented growth in the health care sector, and competitive forces have a more prominent role. In addition, consumers have become more informed and as a result, more empowered. Patients in the health care sector are no exception to this trend. As patients become more informed, it is imperative that health care providers become more effective at marketing their services. In general, physicians typically have received little training in the field of marketing, which results in potentially limited understanding of the key marketing issues being faced in today's health care environment. We identify and examine several key marketing issues critical to the success of health care providers in today's environment. Further, we offer some managerial recommendations designed to address each of these issues.

Advertising↗
PubMed2003

The next stage in the health care economy: aligning the interests of patients, providers, and third-party payers through consumer-driven health care plans.

This article reviews employers' attempts over the past 25 years to address the cost and accessibility of health care services for their employees and the effect these efforts have had on U.S. health care delivery. The difficulties in aligning the interests of all parties in a third-party health beneficiary contract are examined. Many employers are considering consumer-driven health care plans as an alternative to managed care plans to both control health care costs and improve employee satisfaction. Such plans differ from fee-for-service and managed care models in terms of the economic alignment of the parties. Consumer-driven plans align the employer's economic interest with the employee/patient, and reduce health benefit costs by providing information, tools, and direct economic incentives to employees for self-management of health care dollars. Because these incentives are designed to reduce the consumption of services, providers are the party left out of economic alignment under the consumer-driven model.

Consumer Advocacy↗
PubMed2003

Centralized oversight for clinical performance improvement: a pilot initiative at the Lexington VAMC.

BACKGROUND: In July 2000 the Lexington Veterans Affairs Medical Center (Lexington, Ky) centralized oversight of clinical performance improvement (CPI) activities by creating an office of clinical operations (OCO) to improve patient care and operational efficiency. The OCO was designed to eliminate redundancy of effort, correct resource underuse and overuse, and improve the communication of change initiatives and successes. Before 2000 no formal process existed for creating interdisciplinary CPI teams. Lack of organizational oversight for CPI activities had also led to duplication of effort, mixed accountability, and difficulty in remaining focused on organizational goals. CREATING THE OCO: OCO staff have led and facilitated numerous projects, all of which involved interdisciplinary teams consisting of physician and nurse leaders, users, and support staff. The OCO has also developed a utilization management plan for the entire medical center. The OCO formally interfaces with three major arenas of medical center operation: clinical processes, patient safety, and cost-efficiency. CHALLENGES AND LESSONS LEARNED: A major effort of OCO staff has been to learn about data availability and access and to determine how data can be used in a meaningful way to benefit CPI project teams. The creation of the OCO precipitated the typical cultural integration problems that are often encountered with the introduction of new organizational entities that lack existing turf.

Centralized Hospital Services↗
PubMed2002

Outcome report cards: a necessity in the health care market.

Measuring value (quality and cost) continues to be a major challenge in health care as providers respond to societal pressures (primarily from the payer) to standardize processes and patients assume the role of consumer. Relatively few studies report the extent to which report cards affect patient outcomes of care. Survey results indicate high levels of public distrust in report cards. The information that patients desire often is not what is reported because traditional indicators of quality often serve institutional needs rather than patient needs. Patients understand and value information framed as risk avoidance more so than as an opportunity for better health. Effective report cards are brief and simple. The model surgical report card for patients suggested herein includes ratings for patient satisfaction, functional status and well-being, specific symptom assessment, biologic indicators of disease progress, and costs. Successful report cards strike a balance between quality and cost that meets the needs of the stakeholder for whom they are intended.

Disclosure↗
PubMed2002

The power of servant leadership to transform health care organizations for the 21st-century economy.

Physician leadership is emerging as a vital component in transforming the nation's health care industry. Because few physicians have been introduced to the large body of literature on leadership and organizations, we herein provide a concise review, as this literature relates to competitive health care organizations and the leaders who serve them. Although the US health care industry has transitioned to a dynamic market economy governed by a wide range of internal and external forces, health care organizations continue to be dominated by leaders who practice an outmoded transactional style of leadership and by organizational hierarchies that are inherently stagnant. In contrast, outside the health care sector, service industries have repeatedly demonstrated that transformational, situational, and servant leadership styles are most successful in energizing human resources within organizations. This optimization of intellectual capital is further enhanced by transforming organizations into adaptable learning organizations where traditional institutional hierarchies are flattened and efforts to evoke change are typically team driven and mission oriented.

Delivery of Health Care↗
PubMed2002

Tax planning strategies for physicians.

The development of tax reduction strategies is a critical aspect of both corporate and personal financial planning because taxes represent the largest annual expenditure for the majority of Americans. The categories of tax reduction strategies discussed include charitable-giving techniques, ways to maximize business deductions, shifting income to family members, education tax incentives, retirement planning, and small business tax considerations. One use for these tax savings is the enhancement of a corporation's capabilities to provide services to patients.

Employment↗
PubMed2002

Business plan writing for physicians.

Physicians are practicing in an era in which they are often expected to write business plans in order to acquire, develop, and implement new technology or programs. This task is yet another reminder of the importance of business principles in providing quality patient care amid allocation of increasingly scarce resources. Unfortunately, few physicians receive training during medical school, residencies, or fellowships in performing such tasks. The process of writing business plans follows an established format similar to writing a consultation, in which the risks, benefits, and alternatives to a treatment option are presented. Although administrative assistance may be available in compiling business plans, it is important for physicians to understand the rationale, process, and pitfalls of business planning. Writing a business plan will serve to focus, clarify, and justify a request for scarce resources, and thus, increase its chance of success, both in terms of funding and implementation. A well-written business plan offers a plausible, coherent story of an uncertain future. Therefore, a business plan is not merely an exercise to obtain funding but also a rationale for investment that can help physicians reestablish leadership in health care.

Commerce↗
PubMed2002

The necessity for physician involvement in strategic planning in healthcare organizations.

Strategic planning is necessary in health care organizations to meet the constraints of a lean economy, rapidly changing technologies, and an unprecedented need to provide quality services at affordable prices. It offers a structure for assessing core strengths and environmental conditions and an innovative approach to enhance revenue and minimize costs. During the planning process, organizations define their mission, identify direction, develop a unified approach, prioritize long- and short-term goals, assign accountability, and allocate financial resources. Effective strategic planning is a continuous process and becomes an integral part of an organization's culture. Implementation is a part of strategy formulation, because future insights arise from current operating experiences. Success depends on buy-in from stakeholders, including physicians, nurses, and managers. The invested effort can offer the rewards of management that is proactive rather than crisis driven.

Delivery of Health Care↗