Medicine as a Profession

Excessive costs obtain given rise to the concept of managed wellness commission. A theme of 61 university-based hospitals known as the University Hospital Consortium (UHC) tardily devised a "market-evolution model to describe the four- peg process by which managed c be becomes the dominant method of delivery and financing in a community" (Iglehart, 1993, pp. 1052-1056). The first stage of the model involves the initial health c ar environment (i.e., unstructured health care and fee-for- assist financing). During the fleck stage of the UHC's model, health maintenance organizations (HMOs) begin to emerge. Eventually, a expel health care framework develops. This can involve, for example, the affiliation of hospitals into provider networks, discounted charges, and per diem payment schemes. Stage three involves a period of turmoil. As HMO enrollment accelerates, greater emphasis is placed on primary care physicians. When these individuals manage health care resources, however, in that respect may be a general decline in the use of specialists. Hence, physicians' fees may become heavily discounted. Eventually, in stage four, "integrated hospital-physician systems compete to provide comprehensive services to delimitate population blocs" (Iglehart, 1993, pp. 1052-1056). This ultimately results in the solidification of alliances between payers and health care providers.

According to this market-evolution model, managed health care i

Japsen, B. (1994, February 7). Teaching hospitals face hard lessons. Modern Healthcare, 24, 36-38.

roughly 60 percent of all major teaching hospitals conk in urban areas with populations of more than 1 million. According to Fishman's (cited in Iglehart, 1993, p. 1053) 1991 data, these facilities are generally larger (average beds equals 563, as compared to 174 for all hospitals), they are more expensive (average costs equal $7,814 per admission, as compared to $4,521 for nonteaching hospitals), and they substantiate higher occupancy rates (78 percent on average, as compared with 55 percent for all hospitals). In addition, hospital corset in teaching hospitals are typically longer (7.7 days, as compared to 6.

9 days for all hospitals) and the facilities have more full-time-equivalent employees per patient (6.9, as compared with 5.4 for all hospitals).

One method by which the various activities of pedantic medical checkup centers might be integrated, however, involves the creation of clinical service organizations or physician-hospital organizations. Such an integrated clinical enterprise consists of both a hospital and a group practice. The clinical role of the organization may exist either within a university, or outside the university as part of a reprinting corporate entity. These associations provide academic medical centers with an increased capacity to respond to market requirements.

Flanigan, J. (1995, June 4). Doctors getting a taste of a new kind of medicine. Los Angeles Times, D1,D6.

In the United States, there are currently 127 academic health centers (Moore, Inui, Ludden, & Schoenbaum, 1994, pp. 595-599). Further, some 388 hospitals--including 72 medical centers operated by the Department of Veterans Affairs--are members of the Council of Teaching Hospitals of the Association of American aesculapian Colleges. In order to be a member on this council, hospitals must sponsor or "participate to a warm degree" in at least 4 sanctioned res
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