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Biomedical subjects

W L Kissick

Publications and source records attributed to W L Kissick.

At least 19 recordsLinked to original sources
PubMed1995

Medicine and management. Bridging the cultural gaps.

Cost-effective health care requires the informed and intensive collaboration of medicine and management. Unfortunately, the two cultures tend to view the health care enterprise very differently. To physicians, the essence is individual physician-patient encounters, patient hospital days, nurse-patient contact hours, diagnoses, and procedures. To managers, the $1 trillion-plus colossus called health care is a challenge to corporate practices of finance, accounting, organization, planning, and personnel. The efforts of these two cultures to face medicine's dilemmas can result in conflict and confrontation--or in collaboration and synthesis.

Cultural Characteristics↗
PubMed1995

To manage or to be managed: that is the question.

As managed care becomes more common, physicians must take part in its evolution or lose their autonomy. The author proposes "the Ben Franklin scenario," which emphasizes six elements: consumer-provider choice, enrolled population, community-weighted capitation, organized practice, prospective budgets, and cost-effective health care. Prototypes for health care reform are also examined.

Cost Control↗
PubMed1994

Fix the healthcare system without making it worse.

President Clinton's prescription for healthcare reform is a social experiment on an unprecedented scale, according to Dr Kissick. As an alternative, he recommends a more measured approach, with incremental steps toward ensuring universal access to healthcare for all Americans. In this commentary, he points out the potential side effects of current reform proposals and explores fundamental issues for Congress to address.

Attitude to Health↗
PubMed1989

Transtracheal oxygen delivery and patients with chronic obstructive pulmonary disease.

A total of 43 severely ill COPD patients already on 24 h, or near 24 h, per day supplemental O2 were randomly assigned to transtracheal oxygen delivery (n = 22) or usual delivery of O2 by nasal cannula or face mask (n = 21). A few important changes were found in pulmonary function over time such as decreases of PEFR, FEF and MVV for both experimental and control groups, and FEV1% and FEV3% in experimental patients. At the same time, there was a significant decrease in both hematocrit and hemoglobin, and per cent shunting for the experimental group and a significant increase in per cent shunting in the control group. Physical, social and psychologic assessments showed significant improvement over time for experimental patients and declines for the control group. Lastly, medical costs were positively affected, as fewer days were spent in hospital post-study enrollment by experimental than control groups, and post-enrollment relative to pre-enrollment by experimental patients.

Activities of Daily Living↗
PubMed1989

Appropriate health care. Setting the limits.

Appropriate is defined by Webster as "especially suitable or compatible". Historically, health care has been appropriate in the eyes of physicians. Now we recognize that health care, like beauty, is in the eyes of the beholder, and the beholders include the consumer and society as well. These two increasingly vigorous players are sensitive to cost and alternative use of their dollars. In fact, a projection of trends over the past 25 years would have us running out of dollars in the middle of the 21st century. My medical colleagues tell me, "No cost is too great to save a human life or treat disease." My Wharton colleagues tell me, "Resources by definition are limited and choices must be made." Therein lies the challenge of "Appropriate Health Care: Setting the Limits."

Health Care Rationing↗
PubMed1989

Health care management according to Ben Franklin.

The evolution of health care management in the 20th century has been from physician/nurse to health administration generalist to management specialist to political leader. I foresee an increase in the number of physicians and nurses in institutional leadership positions; and the increasing concentration of health care resources in multi-institutional systems will facilitate career development in continuing education. The challenge to educational programs will be the synthesis of the health sciences and the management sciences. The health care CEO of the 1990s will learn to behave like a prime minister by the 21st century.

Curriculum↗
PubMed1988

The secularization of health affairs.

Medicine, in Western Civilization, traces its ancestry to the School of Hippocrates on the Isle of Cos in the 5th Century B.C. Its history is intertwined with the Judeo-Christian ethic and manifests a significant ecclesiastical heritage. In the role of healer, the physician has a spiritual as well as a scientific character. Since World War II, health care has experienced vast changes in its cultural, economic, political, social, and technoscientific dimensions. This transition from the temple to the marketplace, characterized as The Secularization of Health Affairs has pervasive societal implications.

Delivery of Health Care↗