Physician executive
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Introducing a new column on health policy issues of relevance to physician executives. What are the legislative options to provide children with health care coverage? Federal health initiatives for children have become the next frontier in health care reform. This column defines the problem in the U. S., describes voters' support for a federal initiative, and provides discussion of the options available to federal legislators.
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With the recent changes in the delivery of medical care in the United States, physicians are being thrust into new and unsettling roles. Many are finding themselves for the first time in the role of the follower, subject to myriad types of leadership. Leaders frequently complain that leading physicians is like "herding cats." What are the characteristics of followers? Do physicians make good followers? This article examines the role of the "cats"--what is effective followership, why physicians may fall short in followership skills, and how physicians might become better "followers."
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Which degree should physician executives pursue to enhance their careers--an MBA, MHA, MPH, MS in Administrative Medicine, JD, or other graduate degree? While options abound and the debate continues over which graduate degree physicians preparing for senior management roles in the health field should select, several variables are analyzed in this article that must be considered. Physicians need to be trained to provide leadership in the new, more market-driven environment--their education must focus more on the integration and coordination of clinical and managerial processes. New managerial competencies will be required by the paradigm shift away from simply delivering effective and efficient health services to one that emphasizes improved access, social equity, and particularly on cost containment and quality of care efforts.
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Physician executive · Feb 1997
Reinventing a medical specialty. Using anesthesiology as a model for change.
In only a decade, anesthesiology has reversed its fortunes from an underrepresented specialty in the 1980 Graduate Medical Education National Advisory Committee report to "a specialty in trouble" featured in The Wall Street Journal. This article focuses on anesthesiology and its work force dilemma as an evolving specialist model for change. ⋯ Most specialties will have to reshape curricula and redesign education programs and academic delivery systems concentrating on fewer trainees. What are the options for coping with physicians grieving over lost dreams, such as autonomy and solo practice, while redesigning a medical specialty? The authors untangle fact from fear, mission from myth, and offer strategic thinking and solutions.
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Fraud and abuse, which can occur in all industries, also exist in the health care industry. This problem is compounded by the reality that "American medicine, although undergoing evolution, now faces changes of a magnitude that has never before been encountered." These changes are creating new realities for physician executives and also new challenges. As there are changes in business practices, there will be changes in how fraud occurs in health care. Physician executives need to be sensitive to the possibility of fraud and abuse as an unwanted component in medical losses in managed care systems.