The future management of nephrology and dialysis.

This is a report of a combined experience of a nephrologist, who had been previously working for many years in a public hospital, and a business planning manager coming from a financial administration department of a multinational company. The Istituto Clinico Humanitas is a multi-specialist hospital accreditated with the National Health System, containing 473 beds available: 398 inpatient, 28 intensive care and 47 day hospital beds. Human resources include approximately 250 medical doctors, 500 nurses and ancillary workers. In 2002 the hospital treated about 17,500 inpatients, 18,450 day hospital patients, nearly 18,600 surgical interventions and 470,000 outpatients examinations and tests were performed. The detailed clinical activity of the general medicine and the nephrology units in 2002, the role of the scientific direction and that of the Humanitas Foundation have been presented. The work experience, in particular the advantages and disavantages of public versus private environment, represents another important topic of this paper.