Philadelphia Reflections

The musings of a physician who has served the community for over six decades

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Who Needs Hospitals? : Examining the Need for Change of Role.

Introduction

I. WHAT MADE THE MODERN HOSPITAL MODERN?

Lister: The surgeons Endorse Miss Nightingale

Osler: The Internists Bring Teaching to the Almshore

Virchow: Pathologists Create a Temple of Truth

Harkness: Philanthropy Organizes the Medical Center

II. THE GROWTH AND IMPACT OF HEALTH INSURANCE ON THE HOSPITAL

III. THE GREAT TAPESTRY COMES UNRAVELLED

A. Nursing: Destruction of a great Profession

B. Dr. Kildare: Destruction of the Osler system

C. The Plaintiff's Bar: Destruction of the Autopsy

D. Surgeons Consider Whether to Move

E. Hospital Administration Conrad Hilton as Role Model

F. Trustees: The Cowardly Lion

1. Accounting Reports

G. The Blues Start to Fall Apart

IV. THE PUBLIC TRIES TO INTERVENE

GOVERNMENT, Federal

DRGs

Planning

Government, State

Maryland and Massachusetts

Government, Local

The Closing of PGH

Business

Voluntary Effort

Pennsylvania Health Care Cost Commission

V. THE EDGE OF THE ABYSS: CAPITAL COSTS

VI. THE WAY OUT

Shopping Centers, not Department Stores

Corporate Restructuring

Organized Physican Groups

EPILOGUE

Ideas for Chapters

Stockton, California

Young Turks-AAp etc... Gone Are the Days

Lawrenceville 5 miles away from anywhere

Yale Ding Dong

P and S- wards; Sunday Rounds; Establishment Power

NIH- I ain't paid to think; Shirley Temple's slots. That's wont work

Delaware- Mrs. DuP; Trustees/Doctor Hospital

Boston- Lucy Johnston and her sibs

Onicare

Jackson clinic

PSRO

Blue Shield Meeting

 

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