Docs on top.
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Chief Executive Officers, Hospital↗
Biomedical subjects
D E Hough
Publications and source records attributed to D E Hough.
The evolution of primary care networks.
Many physician practices and primary care networks owned by hospital-based healthcare systems have not been successful financially. By investing capital, time, energy, and management expertise in these networks, however, systems can dramatically improve their strategic advantage. A three-stage evolutionary process that is necessary to achieve this strategic advantage comprises practice acquisition, network development, and true integration. Although few primary care networks run by hospitals or systems to date have reached stage three, understanding the evolutionary process is a necessary first step toward success.
Capital Financing↗
Making acquired physician practices profitable.
Many healthcare organizations that acquire physician practices do not realize a return on their investments. Instead, acquisitions often create excess capacity, drive up costs, and reduce an organization's ability to attract managed care contracts. Healthcare systems that acquire physician practices can help ensure that the acquisitions will be profitable by recognizing the benefits and eliminating the barriers to integration, developing a shared strategic vision, developing a progressive governance policy, implementing sound financial management, and achieving critical mass over which to spread fixed costs.
Decision Making, Organizational↗
Frenzy surrounds practice management companies.
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Contract Services↗
Calculating the costs of undergraduate medical education in radiology.
RATIONALE AND OBJECTIVES: The current stringent financial constraints mandate that radiology departments carefully assess the costs involved in undergraduate medical education. We performed a cost-accounting analysis of the radiology department's participation in an introductory clinical medicine course, which could serve as a methodologic model for realistic cost assessment of any new or existing course. MATERIALS AND METHODS: Each day of the 5-week radiology portion of the second-year course consists of 1 hour of lecture and 5 hours of small-group discussions regarding chest, abdominal, and skeletal radiology; neuroradiology; and nuclear medicine. Marginal cost is defined as the additional real cost involved in creating or conducting a course. Opportunity costs represent alternative use of instructional resources. RESULTS: The marginal cost (additional real cost) of providing the course for the first time was $37,475. Subsequent offerings of the course will cost approximately $24,375. CONCLUSION: Resources expended for any instructional purpose must be weighed in terms of marginal and opportunity costs. It is mandatory that adequate cost analysis for undergraduate education in radiology be developed so that sound choices can be made regarding resource consumption.
Costs and Cost Analysis↗
Policy-makers and MDs must work together.
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Health Policy↗
Location of medical education and choice of location of practice.
The geographical distribution of physicians is affected by a number of factors, including the location of their medical education. The authors of the present paper examined the physicians' decisions on where to locate after they completed their training by determining where a state's practicing physicians come from and whether physicians who are trained in a state practice in that state or out of state. The results indicated a positive correlation between location of training and location of practice. Women physicians and general/family practitioners were most likely to remain in the state where they received their graduate medical education. The results also suggested that medical schools and graduate medical education programs are vehicles through which a state can attract physicians who will practice there.
Education, Medical↗
State retention of medical school graduates.
State governments support medical schools in their states for various reasons. A major reason is the perception that graduates tend to practice in the state where they attend medical school. In a study reported here, the authors examined this assumption by investigating the experience of physicians currently active in medical practice. The entire population of active U.S. physicians who graduated from U.S. medical schools was examined, as well as four selected cohorts of U.S. medical school graduates, using the American Medical Associations' Physician Masterfile. The ability of states to retain their medical school graduates is related to physician characteristics (age, medical school, and practice specialty) as well as to state characteristics (population, physician-to-population ratio, and per capita income). The results indicate that, overall, the argument that states should support medical schools in order to ensure an adequate supply of physicians is less compelling than in the past, for reasons often beyond the control of the individual states.
Adult↗
The economic status of resident physicians: results from the survey of resident physicians.
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Internship and Residency↗
Reduction in road fatalities and injuries after legislation for compulsory wearing of seat belts: experience in Victoria and the rest of Australia.
In 1970 the Government of the State of Victoria became the first in the 'western' world to introduce legislation for compulsory wearing of seat belts. Within 14 months the other Australian states followed. Seat belt wearing rates increased to attain 90 per cent in 1977. This paper presents an evaluation of changes during the period 1955--77 in the incidence of road crash fatalities and injuries for vehicle occupants in Victoria and the rest of Australia. The introduction of the legislation in Victoria and subsequently in the other Australian states coincided with significant and marked decreases in driver and passenger fatality and injury rates (numbers per 10 000 registered vehicles). The decreases were enough to reduce the total numbers of vehicle occupant fatalities and injuries for all post-legislation years in Victoria. The improvements have been maintained throughout the entire post-legislation period. The legislation did not apply to child passengers of less than 8 years of age and the frequency of seat belt or harness wearing among them remained low. These children did not share in the overall improvement for passengers. The Australian experience supports the view that legislation for compulsory wearing of seat belts is the single most effective method available for the protection of vehicle occupants in road crashes.
Accidents, Traffic↗
The economic environment of resident physicians.
We examined the financial, working, and educational environment of resident physicians, using mail surveys of residents conducted in 1979 and 1983. Variables examined include annual residency salary, fringe benefits, educational debt, moonlighting income, hours and types of work, and perceived problems with the residency programs. Three conclusions are drawn from the surveys. First, the rapid increases in resident salaries prevalent in the late 1960s and early 1970s have been replaced by more modest advances. Second, resident physicians are not indicating great concern about their current financial status. Third, resident physicians work long hours, but teaching hospitals have not increased their use of residents. These findings illustrate the dual nature of residency training: residents are both students and employees.
Employment↗