Characteristics of hospital care.
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Biomedical subjects
Publications and source records attributed to A Rowe.
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Substantial amounts of soluble wheat antigens have been found in breads sold as "wheat-free" in the San Francisco Bay Area. Physicians with patients on a wheat-free diet are urged to exercise careful supervision over their patients' choice of such breads.
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We studied the impact of converting to an all frozen blood system in a large regional blood center. Several basic assumptions were made including the availability of a sterile docking device which would increase the shelf life of deglycerolized blood to 72 hours. Our study indicated that the most economical manner in which to implement such a program would be to supply deglycerolized blood to all hospitals transfusing more than 500 units per year and to provide frozen units to hospitals transfusing less then this amount (those hospitals would deglycerolize the blood they use). The estimated total cost of the proposed conversion was 3.9 million dollars or a 76 per cent increase over the present operation. Relative to our present fee structure, the average cost of a unit of blood would increase 80 per cent if only frozen or deglycerolized red blood cells were distributed.
The government's vision, reflected in both the white paper The New NHS: Modern, Dependable (Department of Health, 1997) and circulars since is of GPs and community nurses working together in primary care groups to shape services for patients. But the short history of PCGs has seen nurses having to fight for representation. There is also cynicism about the outcome, nurses having a maximum of two members, GPs seven. Is an equal working relationship really possible? This snapshot survey examines professionalism and collaborative working in primary care. The results suggest that without changes in structure, understanding and attitudes by both doctors and nurses a relationship of equality is not likely.
"The trouble with the future is that it usually arrives before we are ready for it." While Arnold H. Glasgow did not have diversity in mind when he made this statement, his thought is relevant to that topic nevertheless. In fact, almost everything in the health care environment of the 1990s is fluid, making the future a question mark. Among these changes is the demographic composition of students entering medical school and of patients. Consider the following. While 14 percent of today's physicians are people of color, that number increases to 25 percent for current medical students. In the past 10 years, the number of female physicians has seen the largest percentage growth, followed by American Indians, Blacks, and Hispanics. Physician executives who have vision and energy can capitalize on this demographic revolution and convert diversity into a competitive advantage once its boundaries are understood.
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