A model for merging vascular surgery and interventional radiology : Clinical and economical implications. Discussion.
Annual Meeting of the Eastern Vascular Society. Newport, RI, USA, 1998/05/01.
The traditional separation of vascular surgery and interventional radiology into distinct units is associated with inefficiencies in patient care, practice management, and training.
Traditional departmental politics, discrepant clinical backgrounds and philosophies, fear of decreasing remuneration, and basic differences in education, training, and practice have all rendered mergers difficult.
We have implemented a model that incorporates all the clinical, fiscal, and educational activities of the 2 former entities into a single unit.
A 5-physician vascular surgery group, its noninvasive laboratory, and a 3-physician interventional radiology group were unified.
The revenue was deposited into a single account from which all the expenses were paid.
The net income of the joint unit was apportioned on a predetermined pro rata basis, with scaled percentages for each practitioner.
In an effort to separate clinical decision making from economic pressures, the individual physician remuneration was not on the basis of productivity.
Clinical volume, gross revenue, and remuneration were compared with the 12-month period that immediately preceded the merger and contrasted to the previous 3-year historical trend (HT).
The number of vascular surgical procedures fell after the merger (-9.3% ; HT, 4.7%). By contrast, the number of interventional radiology procedures rose (+56.1% ; HT, 15.2%), as did the number of noninvasive testing (+9.2% ; HT, 3.5%). (...)
Mots-clés Pascal : Traitement instrumental, Chirurgie, Vaisseau sanguin pathologie, Homme, Etude comparative, Pratique professionnelle, Médecin, Rémunération, Coût, Economie santé, Fusion, Exploration, Activité professionnelle, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Instrumentation therapy, Surgery, Vascular disease, Human, Comparative study, Professional practice, Physician, Remuneration, Costs, Health economy, Melting, Exploration, Professional activity, Cardiovascular disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0050802
Code Inist : 002B26E. Création : 31/05/1999.