Negotiating for successful outcomes in case management practice.
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As the 1990s unfold, the challenges facing medical group practices are not likely to lessen. Traditional territorial boundaries will be blurred, and significant power shifts between physicians, hospitals, and other health care providers will likely occur. The well-managed group will be positioned to anticipate and react to abrupt changes in the rules and to take advantage of opportunities that typically accompany a dynamic market.
The National Dairy Heifer Evaluation Project was a cooperative, USDA-sponsored project involving state agricultural departments, the Cooperative Extension Service, the National Agricultural Statistics Service, and the Animal and Plant Health Inspection Service. A series of retrospective and prospective descriptive surveys using a multiple list and area frame sampling technique were conducted. Information collected pertained primarily to dairy neonates and replacement heifers. Much of the study was related to observational information on health and management characteristics that can be related to the animals' long-term physical and economic performance. The data reflect herds representing 78% of the national dairy cow population. Average herd size was 86 milking and dry cows and 66 heifers. Many characteristics of these herds reflect accepted and recommended practices in the area of dairy replacement management and nutrition. Data summarized in this national study can be utilized to evaluate the impact of management practices on dairy operations.
The purpose of this study was to describe clients' level of compliance with reminders that are computer generated and to identify factors associated with owner response to a recall. Client response to a recall notice revealed that clients responded to reminders for vaccination about 3 times less often than for the other recall codes combined (dental procedures, laboratory tests, medical progress examinations, and neutering). These results suggest that veterinarians need to move away from annual vaccination reminders and toward the promotion of preventive veterinary services, such as annual wellness examinations, screening laboratory testing, and routine dental procedures. Once a practice has committed to and set up the required computer systems to promote preventive veterinary care, the stage is set for the implementation and monitoring of recommendations and reminders. This type of practice philosophy and marketing coincides perfectly with an approach to maximizing compliance in all aspects of veterinary medicine.
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