Medical staff development: manpower or strategic plan?
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Our central question is how the local public health services can influence urban development and urban renewal policies. The need for a three-way cooperation between departments of urban planning and development, environmental affairs and health is now being widely acknowledged. In practice, however, it has to face manifold and serious problems. We suggest that there are basically three essential "instruments" which could lead to a new and defined role of health departments in urban development: environmental and health audits, local health profiles and "health promotion committees" or similar bodies for closer cooperation at the local level. These three "instruments" are described in terms of the present state of development and dissemination by analysing empirical studies from public health research. The results indicate that the "new role" of local health services in urban planning and development is presently fulfilled only in a few pilot cases. The lack of basic requirements particularly in terms of resources, motivation and qualifications is the main cause for the inability to implement the three "instruments" on a broader level in local health services.
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The Medicare (Title XVIII) program in 1965 began a new era in American medicine. For the first time medical utilization review committees began to monitor medical care. Professional standards review organizations (PSRO's) will not determine if medical care is necessary, up to standards and the most economical. The National Health Planning & Resources Development Act, signed into law in January, 1975, will perform health planning, health regulation and resource development. A National Health Insurance Plan, when passed, will combine all government health agencies into one with complete control of American medicine. This article emphasizes the need for the physician (allergist) to be aware of what is going on and how he should cope with the problems with which he will be faced.
BACKGROUND: This article describes a model used by the Kentucky Breast Cancer Task Force to develop and implement a statewide breast cancer action plan. METHODS: The authors examine the challenges encountered during different phases of plan development and the ways in which these challenges were addressed. CONCLUSIONS: To successfully move from planning to implementation, task forces must have broad-based participation, a "lead organization" to coordinate the planning process, focused work agendas, and firm commitments from cancer-related organizations and groups to spearhead activities in specific implementation areas.
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