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In the course of early interviews on the history of psychoanalysis, I saw Michael Fordham in the late summer of 1965. We concentrated primarily on the differences between Freud and Jung, as well as the characteristic distinctions between the two schools that they founded. Fordham also talked about some of his personal contacts with Jung.
Recruitment to general practice is at its lowest level for 30 years, and many vocational training schemes report difficulty in attracting new trainees. Spurred on by the aging population of south London, and with the advantage of pounds 1.3m of development money resulting from the Tomlinson report, the south London organisation of vocational training schemes (SLOVTS) has perhaps been able to cope better than most. Its chair, Richard Savage, a general practitioner and course organiser, and Clare Vaughan, an assistant adviser, have devised and implemented many innovative training posts for general practice over the past two years, and their approach seems to be bearing fruit: most of the doctors who have finished the training scheme are now entering practice in south London. They talked to Douglas Carnall about the causes of the crisis and the measures they have implemented to counter it. Clare Vaughan died in the week following the interview (see obituary, p 555).
Prof. Hans Beger is a worldwide-recognized pancreatologist in the treatment of pancreatic diseases. He led the way in pancreatic surgery with the development of a classic intervention: the Beger procedure for the treatment of chronic pancreatitis. In this interview for Pancreatology Prof. Beger shares his life experiences as a scientist in pancreatic research.
Vay Liang Go is an internationally renowned pancreatic scientist and clinical investigator. Doctor Go's work was fundamental for the understanding of the neuro-hormonal control of gastrointestinal and pancreatic function and metabolism. Additionally, he contributed enormously to the pancreatic community by being one of the founders of the American Pancreatic Association and also co-founder of the journal Pancreas. He trained a large number of fellows and junior faculties, many of whom now are national and international opinion leaders in gastroenterology and pancreatology. In this interview, Doctor Go gives us his views and shares his professional experiences in pancreatic research.
Lucretia W. McClure is one of the most respected figures in the field of medical librarianship. During an interview, she reminisces about important events and changes in librarians' work, users, and services over the past thirty-five years. She also gives her perspective about the impact of computer technology on reference services. Finally, she urges reference librarians to take action to shape their future.
At the National Hospice and Palliative Care Organization's 6th Clinical Team Conference on Hospice and Palliative Care, held April 21-23, 2005, in Atlanta, Georgia, Perry G. Fine, MD, Professor in the Department of Anesthesiology at the University of Utah in Salt Lake City and Vice President of Medical Affairs for the National Hospice and Palliative Care Organization interviewed Louis W. Sullivan, MD, former Secretary of the US Department of Health and Human Services and currently President Emeritus of Morehouse School of Medicine, Chair of the Sullivan Commission-a commission to increase diversity among health professionals, Chair of the National Health Museum, Cochair of the President's Commission on HIV/AIDS, and Chair of the President's Commission on Black Colleges and Universities, as well as Chair of Medical Education for South African Blacks. Dr. Fine and Dr. Sullivan discussed the importance of hospice and palliative care, along with some of the practical issues facing clinicians who wish to use the hospice care system.
This article announces Dr. Scott F. Gilbert as the winner of the Alexander Kowavelsky international prize (2004) and briefly reviews his achievements in developmental biology and evo-devo. Dr. Gilbert replies to the interviewer's questions concerning his personal interest in evo-devo and current controversies within the field. His thoughts and comments represent a unique blend of research talents and skills, curiosity and creativity.
Dr Jean Plouët (Centre de Recherche Cardiovasculaire, INSERM U 689/Institut des Vaisseaux et du Sang) was interviewed by Emma Quigley (Commissioning Editor, Expert Opinion) on 20th June 2006. Born in Brittany, France, Dr Jean Plouët received his MD degree from Nantes University in 1977 and his PhD in Molecular Biology from Paris VII University in 1981. His first research topic, under the supervision of Dr Courtois and Dr Barritault was devoted to the purification and the description of the mechanisms of action of eye-derived growth factor, which turned out to be the retinal fibroblast growth factor (FGF)-2. He was appointed as Charge de Recherche by the Centre National de la Recherche Scientifique in 1981. He later conducted his research on the effect of FGF-2 on light transduction and demonstrated the role of opsin phosphorylation on FGF-2 release from retinal discs in Dr Pouliquen's laboratory. From 1987 to 1989, Dr Plouët worked in the Cancer Research Institute at the University of California, San Francisco, in Dr Gospodarowicz's laboratory where he co-discovered vascular endothelial growth factor (VEGF) with Dr Napoleone Ferrara. He established his own group in Toulouse where he worked on the mechanisms of action of VEGF and vascular targeting by anti-idiotypoc antibodies against VEGF and FGF. In 2005, Dr Plouët moved to Paris where he now works mainly on endogenous inhibitors of angiogenesis acting downstream of VEGF.
Professor Michael P Schön (University of Würzburg) was interviewed by Emma Quigley (Commissioning Editor, Expert Opinion) on 17th October 2006. Professor Michael P Schön currently holds the position of Professor of Dermatology and Experimental Biomedicine at the University of Würzburg. He received his MD degree in 1992 from the University of Ulm in Germany. His internationally successful scientific career has led him to study dermatology and immunology at the University of Berlin, Harvard Medical School, the University of Düsseldorf and the University of Magdeburg. With various research awards and certificates in dermatology, immunology and dermatopathology, Professor Schön has published > 100 papers. He has also been a guest editor and on the Editorial Board of various publications.
Financing a company is more complex than ever-and more important to its economic success. The demands on a CFO are tremendous. Optimizing capital costs requires an unprecedented level of technical sophistication. Yet the best CFOs today are not mere technicians. They are also strategists and innovators. Gary Wilson exemplifies the new CFO. In his 5 years as executive vice president and CFO of the Walt Disney Company and his 12 years at Marriott Corporation, he has shown how the finance function can add value-not just account for it. How does a CFO create value for shareholders? "Just like all the great marketing and operating executives," Wilson says, "by being creative." To Wilson, being creative means rethinking assumptions and finding clever ways to achieve financial and strategic goals. Some of Wilson's innovative deal making-like the off-balance-sheet financing he used at Marriott-is well known. At Marriott, he discovered the power of separating the ownership of an asset from its control. Marriott's strength was in operations, yet the company had a great deal of money tied up in real estate. Growth would require even more investment in real estate. Wilson's solution was to sell the hotels-in effect, removing them and the debt used to finance them from the balance sheet-and contract to operate them. In this interview, Wilson gives his view of the role of finance in today's corporation and explains the thinking behind some of the successful deals he has engineered-including Disney's Silver Screen movie-making partnerships and Euro Disneyland.
Information systems for severity-of-illness measurement and case mix adjustment are at the cutting edge of health care quality technology. The rapid rise of these systems in the past decade has paralleled hospital needs for better data on clinical processes and the burgeoning need among health care customers for better data on clinical outcomes and the relative performance of providers. The dual nature of the demand is fueling what promises to be a decade of growth for the developers of severity systems. To get a better handle on the status of these software-based tools, QMHC interviewed Alan C. Brewster, M.D., Vice Chairman and cofounder of MediQual Systems, Inc., and a principal developer of the widely used MedisGroups system.
For over a decade, Karl Albrecht has helped health care and other organizations focus on creating superior value for customers. In his books Service America! and The Only Thing That Matters, he developed a model of organizational improvement called Total Quality Service that is tailored to service organizations. One of the principles underlying this model is that service industries are fundamentally different from manufacturing industries. Thus, the approach to quality improvement in services should not be based on a manufacturing mentality. QMHC interviewed Karl Albrecht to catch up with his latest thinking on value creation, leadership, and innovation in health care and elsewhere.
Michael Dell started his computer company in 1984 with a simple business insight. He could bypass the dealer channel through which personal computers were then being sold and sell directly to customers, building products to order. Dell's direct model eliminated the dealer's markup and the risks associated with carrying large inventories of finished goods. In this interview, Michael Dell provides a detailed description of how his company is pushing that business model one step further, toward what he calls virtual integration. Dell is using technology and information to blur the traditional boundaries in the value chain between suppliers, manufacturers, and customers. The individual pieces of Dell's strategy--customer focus, supplier partnerships, mass customization, just-in-time manufacturing--may be all be familiar. But Michael Dell's business insight into how to combine them is highly innovative. Direct relationships with customers create valuable information, which in turn allows the company to coordinate its entire value chain back through manufacturing to product design. Dell describes how his company has come to achieve this tight coordination without the "drag effect" of ownership. Dell reaps the advantages of being vertically integrated without incurring the costs, all the while achieving the focus, agility, and speed of a virtual organization. As envisioned by Michael Dell, virtual integration may well become a new organizational model for the information age.
Li & Fung, Hong Kong's largest export trading company, has been an innovator in supply chain management--a topic of increasing importance to many senior executives. In this interview, chairman Victor Fung explains both the philosophy behind supply chain management and the specific practices that Li & Fung has developed to reduce costs and lead times, allowing its customers to buy "closer to the market." Li & Fung has been a pioneer in "dispersed manufacturing." It performs the higher-value-added tasks such as design and quality control in Hong Kong, and outsources the lower-value-added tasks to the best possible locations around the world. The result is something new: a truly global product. To produce a garment, for example, the company might purchase yarn from Korea that will be woven and dyed in Taiwan, then shipped to Thailand for final assembly, where it will be matched with zippers from a Japanese company. For every order, the goal is to customize the value chain to meet the customer's specific needs. To be run effectively, Victor Fung maintains, trading companies have to be small and entrepreneurial. He describes the organizational approaches that keep the company that way despite its growing size and geographic scope: its organization around small, customer-focused units; its incentives and compensation structure; and its use of venture capital as a vehicle for business development. As Asia's economic crisis continues, chairman Fung sees a new model of companies emerging--companies that are, like Li & Fung, narrowly focused and professionally managed.
Leon Davis, founder of District 1199, represents the origin of hospital unionization. Known for his devotion to District 1199, Davis was imprisoned several times as a result of his activities as union president. The following interview with the now retired union activist, traces his impact on the union, discusses conflicts between union and management, changes in today's union, plus other first hand insights regarding this issue.
Iceland has a well established system of socialized medicine and national health insurance. Its small homogeneous population has enabled Iceland to computerize and process data concerning quality of patient care, volume and type of drugs prescribed, and pertinent epidemiological information. In the following interview, Dr. Gudjon Magnusson discusses the development, maintenance, and operational costs of such a health care system.
The United States Congress is currently considering legislation to encourage states to plan, develop, and implement regional trauma care systems. The two bills--S. 10, introduced by Senator Alan Cranston (D-CA), and H.R. 3133, introduced by Representative Jim Bates (D-CA)--would require that these systems comply with the trauma care standards developed by the American College of Surgeons' Committee on Trauma. Significant progress is being made toward enactment of the House bill, H.R. 3133, due in large part to the efforts of the proposal's original cosponsor, Representative Henry A. Waxman (D-CA). Representative Waxman is Chairman of the Energy and Commerce Subcommittee on Health and the Environment, which has jurisdiction over federal programs involving emergency medical services systems, and he has played a key role in shaping and refining the House bill. In recognition of recent Congressional action designating May as National Trauma Awareness Month, Representative Waxman agreed to be interviewed for the Bulletin and to discuss H.R. 3133 and his view of the federal government's role in improving access to expert care for victims of injury.
The topic of empowerment is receiving a lot of attention, but how many employees are truly empowered? At the global electricity giant AES Corporation, the answer is all 40,000 of them. In this interview, chairman Roger Sant and CEO Dennis Bakke reflect on their trials and triumphs in creating an exceptional company and explain how their employee-run company works. When they founded AES in 1981, Sant and Bakke set out to create a company where people could have engaging experiences on a daily basis--a company that embodied the principles of fairness, integrity, social responsibility, and fun. Putting those principles into action has created something unique--an ecosystem of real empowerment. What does that system look like? Rather than having a traditional hierarchical chain of command, AES is organized around small teams that are responsible for operations and maintenance. Moreover, AES has eliminated functional departments; there's no corporate marketing division or human resources department. For the system to work, every person must become a well-rounded generalist--a mini-CEO. That, in turn, redefines the jobs of the people at headquarters. Instead of setting strategy and making the "the big decisions," Sant and Bakke act as advisers, guardians of the principles, accountability officers, and chief encouragers. Can other companies successfully adopt the mechanics of such a system? Not unless they first adopt the shared principles that have guided AES since its inception. "Empowerment without values isn't empowerment," says Sant. "It's just technique," adds Bakke.