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At least 397 records · Page 22Linked to original sources
PubMed1996

Creating a group practice? Strategic planning can prevent future problems.

As Michigan physicians have moved to forming group practices, MSMS has worked in a variety of ways to assist them. For instance, MSMS has contracted with some newly-forming groups to provide administrative services and even the administrators. James J. Aluia, senior consultant to Michigan Medical Advantage, and MSMS chief, physician networks and practice management, has served as administrator for newly-forming physician groups in the state and has learned a great deal about what it takes to organize a group. In this article, Michigan Medicine asks Jim what he's learned. His answers may benefit all physician groups.

Group Practice↗
PubMed2004

Cancer prevention services and physician consensus in primary care group practices.

BACKGROUND: We conducted a randomized clinical trial of interventions to achieve physician consensus, practice changes, and patient activation designed to help primary care group practices enhance the delivery of cancer prevention and screening services. METHODS: In each of 42 primary care practices in 1991 to 1994, we studied approximately 60 patients per physician who were between the ages 53 and 64. Data sources included patient and physician questionnaires, medical record audits of consenting patients for evidence of 11 cancer prevention services during the previous 3 years, and telephone interviews with key practice personnel. RESULTS: None of the interventions was associated with significant changes in frequency of services or procedures received or provided. Increased frequencies of services overall and of specific activities were associated with HMO membership or insurance coverage for six screening procedures. Patient reports of clinic staff recommendations to have each of six screening procedures were specifically associated with higher frequencies of services (P = 0.001). CONCLUSIONS: Demonstration of intervention impact may have been limited because the rates of prevention services were significantly higher in this study than have been reported elsewhere. These results might be explained by selection biases inherent in studying patients with a regular provider, overall practice trends for changes in provision of the studied services, and the study methods.

Attitude of Health Personnel↗
PubMed2005

[Characteristics of solo and group practices in Norwegian general practice].

BACKGROUND: The article describes changes in the size of practices after the introduction of the new Norwegian list patient system for general practitioners (GPs) and how length of patient lists, number of consultations, working hours and waiting time for an appointment vary according to the number of physicians in the practice. MATERIAL AND METHODS: The data were collected by a comprehensive questionnaire survey among general practitioners in the autumn of 2002. A total of 2306 physicians took part (response rate: 70%). RESULTS: Before the list patient system was introduced, 18% of GPs worked in solo practices. With the new system in place, the proportion went down to 15%. About 60% of GPs worked in practices with 2-4 GPs. Out of young GPs in solo practices, 78% wished to work in practices with several colleagues, while 26% of GPs in practices with more than six physicians wished to reduce the size of the practice. The number of patients on the list and the number of curative working hours per GP decreased with increasing practice size. The number of consultations per hour did not vary with the number of GPs in the practice. Waiting time for an appointment for non-emergency treatment increased with increasing practice size. INTERPRETATION: A lower service production per physician in large practices may partly be an effect of a relatively high proportion of women wanting to work fewer hours than their male colleagues. Irrespective of gender, group practices also attract GPs who want slightly reduced working hours.

Adult↗
PubMedDate not supplied

Group practice computing: the road to managing information.

Electronic information processing will have major implications for group practices in the near future, according to John T. Douglas, president and CEO of PD Medical Systems. Computer systems must be able to cope with electronic data interchange (EDI), electronic medical records (EMR) and outcome measurements to best serve groups under managed care.

Ambulatory Care Information Systems↗
PubMed1994

Forming large group practices: is it worth it?

OBJECTIVE: To investigate means of successful general practice amalgamation. PARTICIPANTS: Three clusters of Sydney general practitioners who wished to amalgamate their solo or small group practices. DESIGN: Structured interviews were conducted with individual general practitioners and group meetings were held with members of each cluster. RESULT: Successful amalgamation of solo/small practices starts with choosing compatible participants. Next, aims must be agreed upon and clearly spelt out. Commonly expressed goals of amalgamation were to reduce financial overheads, improve the range of patient services and increase opportunities for recreational and study leave. Financial and legal aid is essential for intending amalgamators. "Trial amalgamation" may be a safe option for those uncertain as to whether to commit themselves and their practices. CONCLUSIONS: Practices can successfully amalgamate, but only with a group of like-minded general practitioners who are willing to invest time to achieve mutually agreed objectives. Amalgamation is not always appropriate.

Attitude of Health Personnel↗
PubMed1996

Management services organization for group practices.

This article analyzes why management service organizations (MSOs) have become the major interface between group practices and managed care organizations as well as their advantages and disadvantages. It provides this information in the context of The University of Texas Southwestern Medical Center's development and operation of an MSO in the Dallas/Fort Worth market.

Evaluation Studies as Topic↗
PubMed1987

Use of ambulatory care resources by Medicare-age patients in a primary care group practice.

The increase in the number of persons age 65 and over-the Medicare-age group-and the increasing cost of providing medical care to patients in this group have focused attention on enrollment of these persons in capitated plans as a means of containing costs. Although much is known about resources used for inpatient care for Medicare-age patients, detailed information organized on a per-patient, per-year basis about ambulatory care of these patients is lacking. In order to address this problem and to investigate possible differences in resource use by age groups within the Medicare-age population, a study was made of a primary care group practice in which 523 patients, including 174 patients in the Medicare-age group, were followed for one year to determine their use of ambulatory care resources. A comparison of annual resource use by patients age 75 and over with patients age 65 through 74 showed that patients age 75 and over made more visits for primary care (8.15 vs. 6.46), made more visits to specialty and subspecialty clinics (3.41 vs. 2.33) and had higher total charges for ambulatory care ($749 vs. $623). The pattern of use of specialty and subspecialty clinics suggests that the primary care physicians functioned effectively as gatekeepers because most medical problems were handled without referrals to medical subspecialty clinics. The pattern also suggests that the projected rapid increase between now and the year 2000 in the number of persons age 75 and over may result in a greater than anticipated demand for services provided by ophthalmologists, podiatrists, and otolaryngologists.

Aged↗
PubMed1979

Anticoagulant care in one urban group practice.

A system of supervising anti-coagulant care was introduced to a busy urban group practice. The results of the first two years' operation of this system show that there were 4.4 prothrombin time (PT) assessments per week, about half of which were performed on working patients. The system was acceptable to patients and practitioners and some unexpected advantages were found.

Adolescent↗
PubMedDate not supplied

A prospective study of medical care utilization and morbidity in preschool children belonging to a prepaid group practice: background and methods.

The purpose of this paper is to describe the background and methods of a prospective study of medical care utilization and morbidity in a fixed cohort of over 500 preschool children whose families belonged to a prepaid group practice affiliated with Yale University. Following baseline interviews with their mothers, study children were followed for 12 months between 1981 and 1982. Information concerning the subjects' contacts with the health care facility serving members of the group practice was collected from accompanying adults, attending clinicians, and medical records. Using these data, we were able to identify episodes of care, linking all clinical visits and phone calls for single occurrences of an illness or injury. The major aim of the study is to identify psychosocial determinants of pediatric utilization (for both acute and preventive care) and of childhood morbidity. The possible predictors of principal interest are factors associated with the family environment, such as social stress and strain, family structure, and different aspects of the mother's social network. The dual emphasis on both illness and behavior outcomes is based on the important interrelationship between epidemiologic and health services research, especially when examining psychosocial effects.

Attitude to Health↗