Word: doctor
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Dates: during 1990-1999
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...session on how heart-failure drugs should be studied. As director of the Duke Clinical Research Institute, he is charged with doing whatever he can to take the guesswork out of medical care, and he has a specific statistic he wants to change. "Only 15% of the decisions a doctor makes every day are based on evidence," he recites...
That's how Snyderman has to think. As Duke's CEO, he's both doctor and businessman. More than that, he's the chief visionary behind Duke's risky refashioning of itself as a health "system," one he's gambling will prove profitable enough to subsidize Duke's money-losing missions in teaching and research. Once, Medicare payments and privately insured patients paid for everything, no questions asked. Now HMOs question everything. The Balanced Budget Act, passed by Congress last year, will mean big cuts in Medicare payments, which, when added to the pervasive weight of managed care, threaten...
...doubt that Duke needed to change in order to survive, but to some doctors Snyderman represents a shift of power from the stethoscope to the calculator. In 1993, he replaced a longtime department chair with a doctor who also held an M.B.A. A group of dissidents petitioned Duke's board of trustees protesting the changes. But Snyderman survived, and last May his contract was extended again for five years...
...last year of residency in internal medicine, he spends two afternoons each week at the clinic, seeing patients under the supervision of an attending physician who must approve every medical decision he makes. Only the short length of his white coat betrays his status as a doctor-in-training--an M.D. after four years of medical school, he examines patients, writes prescriptions, orders tests and fills out insurance forms...
...happen. Her doctor called Peter Jacobi, medical director of PrimaHealth, and Jacobi authorized an additional day. Thompson's saga sounds like one of those sepia-toned HMO commercials: dub in the triumphant music, fade out with mother embracing child. But this is no ad, nor is PrimaHealth an HMO. It's a rarer species in the managed-care jungle, called an independent-practice association. IPAs are groups of doctors who band together to act like HMOs. Some medical observers believe that if IPAs like PrimaHealth spread, they could make managed care a lot more patient-friendly...