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Structuring group medical practices: tax planning aspects.

This article is the first in a series addressing the structuring of group medical practice entities, shareholder relationships, and general representation factors. In this article, a general background in federal tax planning is provided, including strategies for minimization of income tax payment and the potential problems that may be encountered when a group practice is not carefully structured.

Group Practice↗

Structuring group medical practices: shareholder and partnership agreements.

This article is the second in a series addressing the structuring of group medical entities, shareholder relationships, and general representation factors. In this article, a number of the legal and business considerations for entering into shareholder and partnership agreements are discussed, and various types of practice structures and recommended group practice agreement provisions are described.

Group Practice↗

Physical studies of cell surface and cell membrane structure. Deuterium nuclear magnetic resonance studies of N-palmitoylglucosylceramide (cerebroside) head group structure.

Deuterium Fourier-transform nuclear magnetic resonance spectra of N-palmitoyl[2,3,4,6,6-2H5]glucosylceramide, N-palmitoyl[1-2H]glucosylceramide, N-palmitoyl-[5,6,6-2H3]glucosylceramide, and N-palmitoyl[6,6-2H2]-glucosylceramide have been obtained at 55.3 MHz (corresponding to a magnetic field strength of 8.5 T) for lipids as multilamellar dispersions in excess water at 90 degrees C, above the gel to liquid-crystal phase transition temperature (Tc = 82 degrees C). Spectra were also obtained for these same lipids dispersed with 1,2-dipalmitoyl-sn-glycero-3-phosphocholine, 1,2-dipalmitoyl-sn-glycero-3-phosphoethanolamine, and cholesterol, all in excess water at 90 degrees C. The results are analyzed in terms of a model in which the lipid undergoes fast axial diffusion, together with a "wobbling" of the polar head group, by mathematical methods similar to those used previously for the choline and ethanolamine head groups in phosphatidylcholines and phosphatidylethanolamines [Skarjune, R., & Oldfield, E. (1979) Biochemistry 18, 5903--5909]. However, contrary to the results obtained in the previous study, which indicated many possible conformations for the choline and ethanolamine head groups, results with labeled cerebrosides yield at most a few orientations for the glucose head group in each of the systems studied. Furthermore, where multiple solutions do occur, they fall within a narrow orientational subspace so that all solutions exhibit the same general features. We also show that the order parameter describing the head group wobble is fully determined for each system, and it indicates a rather mobile structure for the cerebroside head group, in a variety of environments. In each system studied the polar head group projects essentially straight up from the bilayer surface into the aqueous region, thereby permitting maximum hydration of the four glucose hydroxyl groups by bulk water molecules.

Cell Membrane↗

Impact of group structure and process on multidisciplinary evidence-based guideline development: an observational study.

RATIONALE, AIMS AND OBJECTIVES: This paper presents selected results from a study investigating the impact of small group processes on the development of clinical practice guidelines by multidisciplinary panels. Observations of one panel developing a guideline for primary care over several months are reported here. METHODS: Non-participant observation with content analy-sis of transcripts aided by field notes. RESULTS: Bales's interaction process analysis was used to categorize interactions in terms of their task-oriented or socioemotional qualities. This revealed a well-functioning, task-oriented group characterized by predominantly positive social behaviours. However, a breakdown of dialogue by speaker indicated a marked effect of professional role and status on the level of contribution to group discussions. This, and marked changes in panel composition across meetings, has implications for the multidisciplinarity of decision-making in such groups and hence for the acceptance and implementation of their outputs. CONCLUSIONS: These findings are likely to generalize to other health care settings in view of the growing emphasis on multidisciplinary decision-making and the clear status hierarchies inherent within the medical and allied fields.

Decision Making↗