The Medical clinics of North America
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The 1990s is truly the era of increased accountability in the practice of medicine. Through the methods of cost and quality measurement and the introduction of a manager (i.e., the MCO), society as a whole will benefit from a medical delivery system that focuses on linking the outcomes of care delivered to the processes of the care provided. Report cards serve an important tool by which information about quality and costs can be quantified and shared with the purchasers and users of the medical delivery system. ⋯ Physicians must provide high-quality care to each patient they see but must also develop the mindset and structures to manage an entire population of patients. The expectations of each of the entities with whom they interact must be understood, and physicians need to develop the skills and infrastructure to put total quality management and information technology to work to help them facilitate the delivery of high-quality care in a cost-effective manner. Everyone involved in the health care system--from purchasers to payers to consumers--shares the same goals as physicians: provide the highest-quality care and achieve the best possible outcomes in the most cost-effective manner.
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Med. Clin. North Am. · Mar 1996
ReviewPreventing complications in diabetes mellitus: the role of the primary care physician.
Many Americans, knowingly or unknowingly, are afflicted with diabetes. Because of a lack of awareness or a disbelief that aggressive treatment benefits patients on the part of both patients and physicians, diabetes, particularly NIDDM, remains underdiagnosed and undertreated despite complications that can dramatically diminish quality of life. Increasing evidence that good glycemic control forestalls if not prevents these outcomes makes it the primary care physician's imperative to diagnose diabetes before complications develop. Physicians, through targeted screening and aggressive treatment of patients in whom they diagnose this chronic disease, can markedly reduce diabetes-related morbidity and mortality.