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Limiting the use of specialists is one of the highest priorities of managed care, which requires patients and their primary care physicians to focus on a health maintenance approach. Preventive medicine programs, encouraged by insurers and HMOs, theoretically reduce the need for expensive specialty care and thus lower overall costs. But where does this leave specialists and their institutions?
Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current era. Using the findings of more than two hundred interviews with physicians, administrators, investigators, and trustees, the author describes in detail these rival organizations, their individual struggles against the economic pressures presented by managed care, and their sometimes bitter competition for patients.
The insights that emerge from this struggle will be of value to anyone interested in how high-profile hospitals and academic medical centers operate, particularly in economically and socially challenging situations.
The Johns Hopkins University Press
A book that sprinkles tantalizing tidbits and provides a clear-eyed view of the inner workings of Cleveland's influential medical institutions.
A truthful and probing account... This book should be required reading for the next class of Leadership Cleveland.
Kastor has provided us with a meticulously researched case study whose lessons provide for a better understanding of the challenges facing all in the health care field.
Meticulously researched and documented case study... Kastor's book is indispensable.
— Diane Solov
— Michael D. Roberts
— Jesse Ballenger
— Pascal James Imperato
Kastor has provided us with a meticulously researched case study whose lessons provide for a better understanding of the challenges facing all in the health care field.
— Pascal James Imperato
A book that sprinkles tantalizing tidbits and provides a clear-eyed view of the inner workings of Cleveland's influential medical institutions.
— Diane Solov
A truthful and probing account... This book should be required reading for the next class of Leadership Cleveland.
— Michael D. Roberts
Meticulously researched and documented case study... Kastor's book is indispensable.
— Jesse Ballenger
| 1 | Cleveland and its medical centers | 1 |
| 2 | Cleveland Clinic : the clinical factory | 5 |
| 3 | University hospitals of Cleveland : turmoil in University Circle | 84 |
| 4 | University hospitals of Cleveland : the Farah Walters years | 120 |
| 5 | University hospitals of Cleveland : new leaders | 174 |
| 6 | The new medical school | 186 |
| 7 | Conclusions | 208 |
| App | Hospitals in Cleveland and Cuyahoga County in 1990 and 2004 |
Overview
Limiting the use of specialists is one of the highest priorities of managed care, which requires patients and their primary care physicians to focus on a health maintenance approach. Preventive medicine programs, encouraged by insurers and HMOs, theoretically reduce the need for expensive specialty care and thus lower overall costs. But where does this leave specialists and their institutions?
Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland ...