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PubMed1983

Group practice.

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Group Practice, Dental↗
PubMed1981

Group practice.

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Group Practice, Dental↗
PubMed1980

Public relations and promotion: a few ideas for group practices.

Public relations is the attempt to influence another's perception of an event, individual or institution by presenting a specific, directed, outward image. In public relations terms, the very worst thing that can happen is for someone to say something bad about you. The second very worst thing is for them to say anything at all about you! Between this Scylla and Charybdis, what can a group practice do to enhance its public image and increase its visibility within its community while, at the same time conducting itself in an appropriate and seemly manner? Some suggestions follow.

Group Practice↗
PubMedDate not supplied

Physician support groups in a multispecialty group practice setting.

With a moderate expenditure of time and energy on the part of a physician executive, the group support concept can be used in any organization to help physicians overcome social obstacles and learn to cope with the disturbing changes that are occurring in medicine. By selecting the most suitable candidates, anticipating obstacles, and simply beginning an effort, one can bring about optimal change for physician members of an organization despite their apparent reluctance. The optimal time for suggesting help in this group support manner is when the problem is acute and significant, i.e., "a crisis."

Group Practice↗
PubMedDate not supplied

Applying geriatric case management in your medical group practice.

One of the biggest questions medical groups will have to answer in relation to America's shifting demographics is how to deal with the diverse needs of the elderly effectively. Authors Candace Bruno and Cheryl Schraeder believe one alternative is a case management approach. Their article presents ways in which other medical groups are using case management to meet the needs of the elderly.

Aged↗
PubMed1986

Setting standards of performance for program evaluations: the case of the teaching hospital general medicine group practice program.

Program evaluation is like research in its use of the scientific method. An important difference is that evaluations result in judgments of merit. What are the standards for making the judgments? Little attention has been paid to their selection and use. This article reports on how standards were set in an evaluation of the structure of fifteen of the nation's university hospitals who participated in the Teaching Hospital General Medicine Group Practice Program (sponsored by the Robert Wood Johnson Foundation). Many sources were used to select standards including a review of the literature, expert advice and actual data from two years of the programs's performance. Also, the standard-setting process was a participatory one in which all potentially competing views were provided with a forum for discussion. Finally, standards were set in advance of the collection of information, facilitating the selection of study designs and analysis techniques. Almost all project directors stated that the process helped them in program planning and gave them ideas for research and evaluation. Because standard-setting has mutual benefits, we recommend that it take place during program planning.

Evaluation Studies as Topic↗
PubMed1998

How far down the managed care road? A comparison of primary care outpatient services in a Veterans Affairs medical center and a capitated multispecialty group practice.

BACKGROUND: Under increasing pressure to provide more efficient, higher-quality care, the Department of Veterans Affairs (VA) is expanding primary care and implementing other managed care techniques. To assess the magnitude of performance improvement possible in the VA and to investigate potential barriers to implementation of new techniques, we compared a VA facility with similar managed care organizations on specific managed care performance benchmarks. METHODS AND DATA COLLECTION: Detailed case studies of a large VA medical center and a large capitated multispecialty group practice in the same region were carried out. Various qualitative and quantitative data were collected between October 1, 1994, and September 30, 1997. Unstructured and semistructured interviews, participant and direct observations, document review, electronic data abstractions, and patient surveys were used to collect the data. RESULTS: Patients in the VA medical center were poorer (average income, $13300 per year), older (36.5% aged 65 years and older), and more likely to be homeless (10.5%). The VA patients saw more specialists and made more emergency department visits than managed care patients. Although the VA had better electronic information flows, its providers saw fewer patients, had more unscheduled visits, and received fewer consultant reports, and its patients waited longer. Inpatient utilization was also higher (length of stay averaged 8 days) among VA primary care patients. CONCLUSIONS: On many dimensions the VA did not compare favorably with the efficiency or lower utilization of the capitated managed care practice. Part of the reason must be attributed to the VA's multiple missions, which include teaching and research; another reason is the VA's role to be a service provider to all eligible veterans regardless of sociodemographic or health characteristics. Whether these differences are also caused by different case mix, or differences in socioeconomic status of patients, surprisingly is not well understood. This hampers future efforts to use managed care techniques to improve the operation of the VA.

Age Factors↗
PubMed1996

[What does the primary care physician now about his deceased patients? A study of deaths in a group practice].

Information about the cause of death is regarded as crucial for quality improvement in medicine. Although patients often consult their general practitioner close to their death, he or she is seldom involved as the attending physician during the terminal stage of life, and is often not told about death and its causes. This study analyses the extent of knowledge among general practitioners about deaths and the causes of death among their patients. Over a 46 month period, 8,627 patients had consulted a suburban group practice outside the city of Oslo, consisting of three general practitioners. 105 patients (0.3%) had died within the period. 40% of the deaths and 65% of the causes of death were unknown to the general practitioners. More than half of the patients died in the local hospital, and one fifth in a nursing home. The general practitioner issued only 7% of the death certificates. Information was lacking in particular on violent deaths and deaths among younger people. A routine should be established to provide general practitioners with information about the death of a patient, and its causes.

Adult↗
PubMed1985

Utilization patterns among long-term enrollees in a prepaid group practice health maintenance organization.

Criteria used in this study established that 13% of long-term adult members of a prepaid group practice health maintenance organization (HMO) were consistently high users of outpatient medical care services. This population accounted for 31% of the total doctor office visits (DOVs), 35% of the hospital admissions, and 30% of the outpatient surgical services for long-term members. The most frequent reason for DOVs in this high user group was treatment and/or follow-up of chronic conditions. Patterns of utilization were unrelated to marital status, income, occupation, and perceived social class. Smoking and alcohol use also were not associated with utilization patterns. However, the consistently high users were more likely to perceive their health status as fair or poor and to report a higher number of physical symptoms. They were also more likely to be characterized by a higher degree of psychological distress, especially depression. Contacts with the HMO's mental health department constituted less than 1% of their total medical care contacts, and only 13% made at least one mental health contact over the study period. The findings are discussed in terms of their health and medical care implications.

Adult↗