Biomedical subjects

T L Wahls

Publications and source records attributed to T L Wahls.

5 recordsLinked to original sources

PubMed2000

The master clinician project.

This article describes an internal benchmarking process developed and used by the Marshfield Clinic targeting the interface between productivity and service quality. The benchmarking first identified "better performing" physicians using production and service quality measures as benchmarks. This was followed by detailed interviews of "better performers" to discover their "best practices." Based on an analysis of the "best practices" information, a physician curriculum was designed and implemented to improve service quality and provider productivity. Optimal strategies for successful programs are discussed and, finally, recommendations for future research are identified.

Benchmarking↗

PubMed1993

Practice satisfaction and dissatisfaction in general internal medicine departments of large multispecialty clinics.

General internal medicine (GIM) physician practice satisfaction and dissatisfaction in large multispecialty clinics were assessed utilizing a survey designed to elicit physician perceptions of practice. 420 GIM physicians in 22 multispecialty clinics were contacted, and 168 participated in the survey. The most significant positive components of practice satisfaction were patient interactions and favorable physician colleague interactions. The prominent negative components were paperwork hassles and perceived "second-class" physician status. Coping strategies were varied and included increased political involvement, career change, and withdrawal via depression.

Adaptation, Psychological↗

PubMed1987

Coexistent Wegener's granulomatosis and anti-glomerular basement membrane disease.

Wegener's granulomatosis and Goodpasture's syndrome represent two major causes of a pulmonary-renal syndrome. We describe the clinical course and morphologic features of a patient in whom pulmonary manifestations of Wegener's granulomatosis developed and were followed six months later by anti-glomerular basement membrane disease. Although we regard this as a unique and probably fortuitous association, a genetic predisposition or a secondary form of anti-GBM disease cannot be excluded.

Aged↗

PubMedDate not supplied

General internal medicine practice trends in large multispecialty clinics.

OBJECTIVE: To assess practice trends in the general internal medicine departments of large multispecialty clinics. DESIGN: A survey questionnaire addressing the following issues: 1) department size and rate of growth, 2) services provided, 3) patient population, 4) individual clinical workload, 5) call arrangements, 6) time away from practice, and 7) benefits and salary. PARTICIPANTS: 22 multispecialty clinics, with a mean of 279 physicians. MEASUREMENTS AND RESULTS: Mean general internal medicine department physician expansion was 28% over the preceding three years. Primary care, clinic system access, care of patients laterally shifted from subspecialty internists, and preoperative evaluations were the four major services provided. The mix of fee-for-service, Medicare/Medicaid, and prepaid-plan patients was diverse. Mean outpatient clinical scheduling was 35 hours per week exclusive of hospital practice, administrative time, and paperwork. Study of call arrangements revealed a definite trend toward a group practice model of shared responsibility during the day as well as nights and weekends. Mean meeting and vacation time was 35 days per year. Salary was set by committee, formula, or both. Department stresses and dissatisfactions were also reported. CONCLUSIONS: Rapid expansion of general internal medicine departments and services will continue as subspecialists back away from providing primary care. The evolution of general internal medicine practice must be anticipated and managed for optimal patient and departmental outcomes.

Ambulatory Care Facilities↗

PubMedDate not supplied

Short-term medical service in the developing world.

Medicine as it is practiced in the developing world is far removed from medicine as we know it in the United States. It is the authors' opinion that the developing world offers a stimulating environment medically, culturally, and ethically. Those physicians who devote some portion of their careers to practicing in the developing world reap significant rewards. The authors describe how they found and selected medical situations in the developing world and the experiences they had delivering health care in those situations.

Developing Countries↗