Saving shacks and building empires.
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Biomedical subjects
Publications and source records attributed to W F Hejna.
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Hospitals are often faced with the problem of apparent inefficiency or ineffectiveness of operating room management. There can be many contributing factors, and a systematic approach is needed to solve this problem. The article delineates eight management components and suggests that implementation and continuous evaluation of these components will promote the efficient operation of surgical facilities.
Changes in the health care industry and health man-power have had a profound effect on the roles of physicians in hospital and health care management. Modified matrix and team approaches are methods by which physicians can be more effective in a variety of expanded opportunities.
Chemonucleolysis is a promising alternative to open surgical treatment of a herniated lumbar disc. The technique involves injecting chymopapain into the disc under fluoroscopic control. Chymopapain is specific for chondromucoprotein in cartilage. The results of chemonucleolysis in 100 patients are reported; the procedure was successful in 83 percent. This closed procedure has a success rate comparable to that of surgery, but has a lower morbidity, is less costly and is more acceptable to patients.
Contracts such as those at Rush Medical College can help management set goals and evaluate progress, especially in manpower planning.
It is increasingly apparent that there exists a need for academic administrators and an interest in that field on the part of physicians and medical students. In many academic medical centers physicians are called upon to assume administrative responsibilities or have a desire to pursue an administrative career. Medical students also play an important role in their university's governance through their representation on medical school and university committees as well as their participation in various national organizations. In addition, there continues to be a general lack of understanding regarding the nature of the internal and external variables affecting medical education. The course described in this paper is intended to provide students with an understanding of the administrative responsibilities inherent in academic management positions.
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This study examines the relation between the postchemonucleation clinical outcome and changes observed on the lumbar MR scan. Eight of 12 chemonucleated disks showed clinical improvement at the last follow-up, while the other four showed no improvement. In the cases that showed improvement there was a decrease in one or both dimensions of the defect in the thecal sac. Seven of eight showed an increase in the peridisk signal. Where there was no clinical improvement there were fewer decreases in the size of the defect, and three of four showed no increase in the peridisk signal.