HMO practice / HMO Group
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Tobacco use is the leading cause of preventable mortality in the United States. Therefore, health care organizations have an important role to play in the control of tobacco use both among their plan members and in the communities that they serve. To be effective, they need to adopt a policy that all tobacco users will be identified and provided with advice to quit smoking (or chewing) at each contact with a health care professional. ⋯ The policy can be implemented by defining tobacco use as a "vital sign" and periodically assessing implementation rates with a chart review. Patients who express an interest in quitting should be supported through individual or group follow-up. To make clinical interventions more effective, to counteract tobacco promotion that is directed at youth, and to protect the health of non-smokers, HMOs will want to support local and regional tobacco control coalitions that are taking action against tobacco promotion and are promoting smoke-free public areas.
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What makes doctoring joyful? Important issues may involve the organization and management of the practice setting; the physician needs to focus on the human aspects of doctoring as well.
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HMO practice / HMO Group · Sep 1992
Screening program for colorectal cancer: effect on stage distribution.
The prognosis of patients with colorectal cancer is related to stages of disease at the time of diagnosis. Ultimately, the goal of fecal occult blood test (FOBT) screening programs is to reduce colorectal cancer mortality. ⋯ We observed a favorable shift in the stage distribution of colorectal cancers diagnosed at HCHP after the FOBT screening program began (p less than .05). The shift was not attributable only to FOBT screening. We believe that the educational components of the program were important to its effectiveness. Our results support continued use of FOBT at HCHP.