Karp R B
Section of Cardiac Surgery, University of Chicago, IL 60637, USA.
Ann Thorac Surg. 1995 Nov;60(5):1481-5; discussion 1490-3. doi: 10.1016/0003-4975(95)00683-C.
The medical marketplace and various forms of contracted care place academic medical centers at a potential disadvantage. Recruitment of patients and maintenance of the academic mission may at times have disparate agendas. The university surgeon traditionally has embraced patient care, education, research, and administration with relative ease. Major price constraints and new forms of market competition now threaten the centralization of technology, the creativity, and the educational mission of university surgical practices. The university must deal with this new order by being proactive and flexible in negotiation. Faculty should conduct their business among themselves and with outside entities under a practice plan. Business management and physicians must try vigorously to understand each other. Finally, universities should use their expertise to lead in clinical outcomes research. The ideal university practice must show leadership in technological advances, retain the scientific method, and produce useful precise outcomes analysis. The academic surgeon must help solve problems involving excessive costs, assaults on creativity, and the business-medical interface. Time management will be essential.
医疗市场和各种形式的合约医疗使学术医疗中心处于潜在的劣势。患者招募和学术使命的维持有时可能存在不同的议程。传统上，大学外科医生相对轻松地兼顾患者护理、教育、研究和管理。如今，主要的价格限制和新形式的市场竞争威胁着大学外科医疗实践中的技术集中化、创造力和教育使命。大学必须通过在谈判中积极主动和灵活应变来应对这一新局面。教师应根据实践计划在彼此之间以及与外部实体开展业务。商业管理和医生必须大力尝试相互理解。最后，大学应利用其专业知识引领临床结果研究。理想的大学医疗实践必须在技术进步方面发挥引领作用，保留科学方法，并进行有用的精确结果分析。学术外科医生必须帮助解决涉及成本过高、对创造力的冲击以及商业与医疗界面等问题。时间管理将至关重要。
