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Strategies for clinics. How integrated delivery systems are applying automation at their group practices.

Integrated delivery systems that have created or acquired physician group practices are attempting to determine the best way to apply information technology at these sites. This involves standardizing on one practice management system for all sites, determining the feasibility of installing electronic patient records systems and expanding computer networks to accommodate the exchange of data among outpatient as well as inpatient sites.

Community Networks↗

Health education in medical group practices: promoting health or business?

This article attempts to explain differences in the health education activities of medical group practices. Potential explanatory factors examined include: providing prepaid care, group ownership, group size, and specialty composition and mechanism for making group policy. The data used in this analysis were collected by the American Medical Association through the 1986 National Survey of Medical Groups. Results indicate that the conduct of a variety of health education activities was determined primarily by the group's policy mechanism. That groups with more formal policy mechanisms are more likely to conduct health education activities suggests that the provision of health education is a business decision rather than a medical one. Some implications for health educators of the use of health education to promote a practice are discussed.

Group Practice↗

Group practice.

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Group Practice↗

Group practice.

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Group Practice↗

Procedures performed by family physicians, internists, and a Medex in a small group practice.

Encounter forms for all patient visits to a small group practice (two internists, three family physicians, and one Medex) were examined retrospectively for October 1979 and January, April, and July 1980. A total of 5,694 patient encounters (2,327 male, 3,367 female) were recorded during the four months studied. Diagnostic and therapeutic procedures were performed on 592 patients (9.6 percent), 321 male and 271 female. The family physicians performed fewer procedures on their patients (6.1, 7.5, and 8.6 percent of the total patients seen). The Medex did 18.4 percent of all office procedures for that time period. The ten most commonly performed procedures included electrocardiogram (ECG), rhythm strip or ambulatory ECG, splint application, suture removal, pulmonary function test, suturing, exercise treadmill test, wart removal, removal of skin lesion or punch biopsy, application or removal of plaster cast, and application of ace wrap, sling, or collar. The majority of the procedures performed by the family physicians were also done by the Medex; however, the diversity of the procedures performed by the family physicians was comparable with that of the internists. There were large economic differences between groups, with the internists having the highest total billings and the Medex the lowest average charge per procedure performed.

Adolescent↗

The effects of an experimental prepaid group practice on medical care utilization and cost.

Rates of utilization and costs of medical care by a study group in a prepaid group practice, the Medical Care Group of Washington University (MCG), were compared prospectively over a three-year period with those of a demonstrably similar control group cared for by fee-for-service private physicians. MCG enrollees used twice the ambulatory services control enrollees did (p=less than 0.01), but used 23 per cent fewer hospital days (p=less than 0.01). Cost per diagnostic and therapeutic visit was similar for both groups; MCG preventive visits cost more. Increased numbers of MCG services provided led to increased ambulatory care costs for MCG over controls. Hospital utilization savings did not compensate for these increased costs. Thus prepayment in an organized setting did change hospital and ambulatory care utilization but did not reduce medical care costs. Other changes in medical care besides those which result from a different organization of medical care are discussed which might make control of medical care costs more likely.

Adult↗

Medical group practice and President Clinton's health reform proposals.

Back in 1991, author Thomas Weil, Ph.D., wrote a two-part article discussing the prospect of national health insurance. In his return visit to the subject, Weil has good news for group practice, and hard data to back up his claims. In addition, Austin Ross Jr., FACMGA, offers his many years of group practice experience through a commentary following Weil's article.

Canada↗

Operations improvement. Opportunities for group practices. Part II.

An Operations Improvement system developed by the New York City consulting firm APM, Inc., applies rational analytical processes to streamline daily operational tasks through a team-approach that is democratic and cost-effective. OI was explained in Part I in the March/April 1989 issue of the Group Practice Journal, Vol. 38 No. 2. The second part printed here provides specific group practice examples of application of the system and the results.

Group Practice↗

Strategic business planning for the multispecialty group practice.

A clear plan for guiding the activities of the multispecialty group practice (GP) is critical for ensuring success as the health care industry undergoes profound change. This article describes the process of developing a strategic business plan, and includes examples of pertinent analyses as well as practical considerations for ensuring successful development of a strategic business plan for a GP.

Ambulatory Care Information Systems↗

Contract management: does grafting this hospital concept onto group practice work?

Dramatic changes in the health industry during the past two decades should give physicians cause to look at where they are heading in the 1980s. External factors, such as competition, legislation and regulation, cost and expectations by the public urge serious review of whether group practices are planning effectively for the future and providing essential leadership to meet the challenges ahead. This article presents an innovation for group practices expecting to control rather than to be victims of, change.

Contract Services↗