Physician manpower expansionism: a policy review.

Abstract:

:A lack of national health goals has allowed physician manpower policy to be dominated by an expansionist philosophy. Scarce resources have been channeled into the production of specialist physicians trained to provide complex and expensive care for uncommon diseases, using other scare and expensive resources and adding to the steep rise in medical care costs. Society seems to want access to primary care--a lack it views with dismay--and simultaneously fears increasing costs of care. Lack of access plus high cost might lead to rash implementation of other inappropriate policies. Success of policy decisions is pure serendipity if made without reliable and relevant information or based on inappropriate data, such as opinions alone. If information is unavailable, then physician manpower decisions should be delayed or, if made, implemented cautiously.

journal_name

Ann Intern Med

authors

Bloom BS,Peterson OL

doi

10.7326/0003-4819-90-2-249

subject

Has Abstract

pub_date

1979-02-01 00:00:00

pages

249-56

issue

2

eissn

0003-4819

issn

1539-3704

journal_volume

90

pub_type

杂志文章,评审
  • Systemic lupus erythematosus in pregnancy.

    abstract::A retrospective analysis of the course of systemic lupus erythematosus in pregnant patients hospitalized at UCLA during a 15-year period provided important prognostic information. Women with systemic lupus erythematosus became pregnant if renal function was reasonably well preserved. Pregnancy infrequently posed a ser...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-94-5-667

    authors:

    更新日期:1981-05-01 00:00:00

  • Risk factors for group B streptococcal disease in adults.

    abstract:OBJECTIVE:To determine risk factors for community-acquired and nosocomial group B streptococcal disease in adults. DESIGN:Case-control study. SETTING:3 metropolitan areas in the United States with an aggregate population of 6.6 million persons. PATIENTS:219 nonpregnant adults with invasive group B streptococcal infe...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-123-6-199509150-00003

    authors: Jackson LA,Hilsdon R,Farley MM,Harrison LH,Reingold AL,Plikaytis BD,Wenger JD,Schuchat A

    更新日期:1995-09-15 00:00:00

  • Occupational exposures to body fluids among medical students. A seven-year longitudinal study.

    abstract:BACKGROUND:Medical students may be at high risk for occupational exposures to blood. OBJECTIVE:To measure the frequency of medical students' exposure to infectious body substances, to identify factors that affect the probability of such exposure, and to suggest targets for the prevention of such exposure. DESIGN:Revi...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-130-1-199901050-00009

    authors: Osborn EH,Papadakis MA,Gerberding JL

    更新日期:1999-01-05 00:00:00

  • Systemic lupus erythematosus during penicillamine therapy for rheumatoid arthritis.

    abstract::Six patients with rheumatoid arthritis developed a syndrome resembling lupus erythematosus while being treated with penicillamine. All patients had previous mucocutaneous reactions to chrysotherapy. Manifestations included pleurisy in five of six patients, rashes in three, nephritis in two, and neurologic disturbances...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-97-5-659

    authors: Chalmers A,Thompson D,Stein HE,Reid G,Patterson AC

    更新日期:1982-11-01 00:00:00

  • A randomized, double-blind, placebo-controlled trial of rifaximin to prevent travelers' diarrhea.

    abstract:BACKGROUND:Travelers' diarrhea causes substantial morbidity and postinfectious irritable bowel syndrome. OBJECTIVE:To evaluate nonabsorbable rifaximin for prevention of travelers' diarrhea. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Guadalajara, Mexico. PARTICIPANTS:U.S. students. ...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-142-10-200505170-00005

    authors: DuPont HL,Jiang ZD,Okhuysen PC,Ericsson CD,de la Cabada FJ,Ke S,DuPont MW,Martinez-Sandoval F

    更新日期:2005-05-17 00:00:00

  • Hypophosphatemic osteomalacia: association with prostatic carcinoma.

    abstract::Hypophosphatemic osteomalacia that remits after resection of a coexisting tumor has been described in 35 patients. Because the associated neoplasms have been of mesenchymal origin, it has been inferred that this tumor-induced osteomalacia syndrome is uniquely related to tumours of this derivation. However, in the pres...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-93-2-275

    authors: Lyles KW,Berry WR,Haussler M,Harrelson JM,Drezner MK

    更新日期:1980-08-01 00:00:00

  • Support for physician deception of insurance companies among a sample of Philadelphia residents.

    abstract:BACKGROUND:Some physicians seem to be willing to sanction deception of insurance companies. Little is known about public attitudes regarding this practice. OBJECTIVE:To assess public attitudes regarding physician deception of insurance companies. DESIGN:Cross-sectional survey using clinical vignettes. SETTING:Philad...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-138-6-200303180-00011

    authors: Alexander GC,Werner RM,Fagerlin A,Ubel PA

    更新日期:2003-03-18 00:00:00

  • Biological basis for cancer treatment.

    abstract::The new knowledge of the regulation of cell growth and the genetic and biochemical changes that lead to malignancy have created many new opportunities for cancer drug discovery. These new targets include oncogenes, growth factors and their receptors, signal transduction pathways, and cell differentiation signals. Atte...

    journal_title:Annals of internal medicine

    pub_type: 评论,杂志文章,评审

    doi:10.7326/0003-4819-118-8-199304150-00011

    authors: Chabner BA

    更新日期:1993-04-15 00:00:00

  • Issues for American internal medicine through the last century.

    abstract::The content, role, and purpose of internal medicine, organized as an American specialty 100 years ago, have been marked by ambivalence from the beginning. Nevertheless, molded to a large extent by external events, including the strategic and symbolic importance of surgery in American medicine, the rise of university m...

    journal_title:Annals of internal medicine

    pub_type: 历史文章,杂志文章

    doi:10.7326/0003-4819-105-4-592

    authors: Stevens R

    更新日期:1986-10-01 00:00:00

  • Autoantibodies to platelet glycoprotein IIb/IIIa and to the acetylcholine receptor in a patient with chronic idiopathic thrombocytopenic purpura and myasthenia gravis.

    abstract::The coexistence of chronic idiopathic thrombocytopenic purpura and myasthenia gravis has been infrequently reported. We report another case and show the coexistence of autoantibodies to the platelet glycoprotein IIb and IIIa complex and the acetylcholine receptor. Autoantibody levels were followed during 8 weeks of tr...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-100-6-829

    authors: Anderson MJ,Woods VL Jr,Tani P,Lindstrom JM,Schmidt D,McMillan R

    更新日期:1984-06-01 00:00:00

  • The association between cardiorespiratory fitness and impaired fasting glucose and type 2 diabetes mellitus in men.

    abstract:BACKGROUND:Several studies show an inverse association between self-reported physical activity and type 2 diabetes. It is not known whether physical activity or cardiorespiratory fitness is associated with the onset of objectively determined impaired fasting glucose and type 2 diabetes. OBJECTIVE:To determine whether ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-130-2-199901190-00002

    authors: Wei M,Gibbons LW,Mitchell TL,Kampert JB,Lee CD,Blair SN

    更新日期:1999-01-19 00:00:00

  • Adenosine for paroxysmal supraventricular tachycardia: dose ranging and comparison with verapamil. Assessment in placebo-controlled, multicenter trials. The Adenosine for PSVT Study Group.

    abstract:OBJECTIVE:To assess the safety and efficacy of intravenous adenosine in terminating acute episodes of paroxysmal supraventricular tachycardia. DESIGN:Two prospective, double-blind, randomized, placebo-controlled trials to evaluate dose response in patients receiving adenosine and to compare the effects of adenosine wi...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.7326/0003-4819-113-2-104

    authors: DiMarco JP,Miles W,Akhtar M,Milstein S,Sharma AD,Platia E,McGovern B,Scheinman MM,Govier WC

    更新日期:1990-07-15 00:00:00

  • Differences in metabolism of sulfonamides predisposing to idiosyncratic toxicity.

    abstract::Individual differences in metabolism of the sulfonamides may predispose patients to idiosyncratic reactions. Sulfonamides are metabolized by N-acetylation (mediated by a genetically polymorphic enzyme) and oxidation to potentially toxic metabolites. We examined 6 patients who had severe reactions to sulfonamides and c...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-105-2-179

    authors: Shear NH,Spielberg SP,Grant DM,Tang BK,Kalow W

    更新日期:1986-08-01 00:00:00

  • Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis.

    abstract:BACKGROUND:Because psychological approaches are likely to produce sustained benefits without the risk for tolerance or adverse effects associated with pharmacologic approaches, cognitive behavioral therapy for insomnia (CBT-i) is now commonly recommended as first-line treatment for chronic insomnia. PURPOSE:To determi...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,meta分析,评审

    doi:10.7326/M14-2841

    authors: Trauer JM,Qian MY,Doyle JS,Rajaratnam SM,Cunnington D

    更新日期:2015-08-04 00:00:00

  • Drugs five years later: acyclovir.

    abstract::In the 5 years since its release for clinical use, acyclovir (9-[2-hydroxyethoxymethyl]guanine) has proved to be a safe and effective agent for therapy of herpes simplex and varicella-zoster infections. The drug's availability in topical, oral, and intravenous preparations has allowed its use in a range of clinical si...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-107-6-859

    authors: Dorsky DI,Crumpacker CS

    更新日期:1987-12-01 00:00:00

  • Achieving Gender Equity in Physician Compensation and Career Advancement: A Position Paper of the American College of Physicians.

    abstract::Women comprise more than one third of the active physician workforce, an estimated 46% of all physicians-in-training, and more than half of all medical students in the United States. Although progress has been made toward gender diversity in the physician workforce, disparities in compensation exist and inequities hav...

    journal_title:Annals of internal medicine

    pub_type: 指南,杂志文章

    doi:10.7326/M17-3438

    authors: Butkus R,Serchen J,Moyer DV,Bornstein SS,Hingle ST,Health and Public Policy Committee of the American College of Physicians.

    更新日期:2018-05-15 00:00:00

  • Incompetent patients with limited care in the absence of family consent. A study of socioeconomic and clinical variables.

    abstract::To understand the factors that distinguish terminally ill, incompetent patients who are given do-not-resuscitate status by physicians against the wishes of the patient's family, I reviewed the charts of 20 such patients (cases) seen in consultation by the ethics committee at the Massachusetts General Hospital over 10 ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-109-10-819

    authors: Brennan TA

    更新日期:1988-11-15 00:00:00

  • Cyclophosphamide in the management of advanced Graves' ophthalmopathy. A preliminary report.

    abstract::Three patients with advanced Graves' ophthalmopathy were treated with cyclophosphamide. All had proptosis and diplopia. One patient had disabling iatrogenic Cushing's syndrome from steroid treatment of the ophthalmopathy and had undergone bilateral orbital decompression before cyclophosphamide therapy; steroids could ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-90-6-921

    authors: Bigos ST,Nisula BC,Daniels GH,Eastman RC,Johnston HH,Kohler PO

    更新日期:1979-06-01 00:00:00

  • Transaminase elevations in patients receiving bovine or porcine heparin.

    abstract::Eighty-six patients who required heparin therapy were randomly assigned to receive bovine or porcine heparin. Abnormal concentrations of alanine transaminase and aspartate transaminase developed during treatment in 59.3% and 26.7% of patients, respectively. Patient characteristics that significantly influenced the dev...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-100-5-646

    authors: Dukes GE Jr,Sanders SW,Russo J Jr,Swenson E,Burnakis TG,Saffle JR,Warden GD

    更新日期:1984-05-01 00:00:00

  • Risk factors for Helicobacter pylori resistance in the United States: the surveillance of H. pylori antimicrobial resistance partnership (SHARP) study, 1993-1999.

    abstract:BACKGROUND:Pretreatment antimicrobial resistance has an important impact on the efficacy of many Helicobacter pylori treatment regimens. OBJECTIVE:To estimate the prevalence of H. pylori resistance to antimicrobials in the United States, to characterize risk factors associated with H. pylori antimicrobial resistance, ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,meta分析

    doi:10.7326/0003-4819-136-1-200201010-00008

    authors: Meyer JM,Silliman NP,Wang W,Siepman NY,Sugg JE,Morris D,Zhang J,Bhattacharyya H,King EC,Hopkins RJ

    更新日期:2002-01-01 00:00:00

  • Contributions of obesity and weight loss to gallstone disease.

    abstract:OBJECTIVE:To examine the relation of obesity and weight loss to the formation of gallstones according to pertinent clinical and research issues. DATA SOURCES AND EXTRACTION:Original reports obtained through a MEDLINE search from 1966 to 1992 on gallstones plus obesity or reducing diets, supplemented by a manual search...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-119-10-199311150-00010

    authors: Everhart JE

    更新日期:1993-11-15 00:00:00

  • Cytomegalovirus retinitis in immunosuppressed hosts. II. Ocular manifestations.

    abstract::We observed the course of cytomegalovirus (CMV) retinitis in 21 eyes of 14 immunosuppressed patients. In two patients, other organisms, specifically Toxoplasma and Candida, also appeared to be causing retinal disease simultaneously. Post-mortem examination was done on 10 eyes from seven patients. At initial presentati...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-93-5-664

    authors: Egbert PR,Pollard RB,Gallagher JG,Merigan TC

    更新日期:1980-11-01 00:00:00

  • Identification of K-ras mutations in pancreatic juice in the early diagnosis of pancreatic cancer.

    abstract:OBJECTIVE:To develop an early diagnostic test for pancreatic cancer based on the identification of K-ras mutations in pure pancreatic juice collected during endoscopic retrograde pancreatography. DESIGN:Prospective study with masked comparison. The standard criteria for the diagnosis of pancreatic cancer were pancreat...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章

    doi:10.7326/0003-4819-123-3-199508010-00005

    authors: Berthélemy P,Bouisson M,Escourrou J,Vaysse N,Rumeau JL,Pradayrol L

    更新日期:1995-08-01 00:00:00

  • Screening for testicular cancer: U.S. Preventive Services Task Force reaffirmation recommendation statement.

    abstract:DESCRIPTION:Reaffirmation of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for testicular cancer. METHODS:The USPSTF performed a targeted literature search for benefits and harms of screening for testicular cancer in asymptomatic males and found no new studies. RECOMMENDA...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,实务指引

    doi:10.7326/0003-4819-154-7-201104050-00006

    authors: U.S. Preventive Services Task Force.

    更新日期:2011-04-05 00:00:00

  • Poststreptococcal acute glomerulonephritis: fact and controversy.

    abstract::Poststreptococcal acute glomerulonephritis is prototypic of the immunologic glomerulonephritides. It most commonly follows streptococcal infection of the pharynx or skin. The diagnosis is usually not difficult when a nephritic clinical presentation (with such manifestations as hematuria, edema, and hypertension) is as...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,评审

    doi:10.7326/0003-4819-91-1-76

    authors: Nissenson AR,Baraff LJ,Fine RN,Knutson DW

    更新日期:1979-07-01 00:00:00

  • Exogenous insulin administration and cardiovascular risk in non-insulin-dependent and insulin-dependent diabetes mellitus.

    abstract:PURPOSE:It is currently unknown whether intensive insulin treatment of diabetes decreases the risk for cardiovascular complications by lowering glucose levels or increases the risk by postulated direct atherogenic effects. This article reviews published data from two long-term, randomized clinical trials that compared ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章,meta分析

    doi:10.7326/0003-4819-124-1_part_2-199601011-00005

    authors: Genuth S

    更新日期:1996-01-01 00:00:00

  • Hydroxychloroquine in decompensated, treatment-refractory noninsulin-dependent diabetes mellitus. A new job for an old drug?

    abstract:STUDY OBJECTIVE:To evaluate the usefulness and safety of hydroxychloroquine in patients with decompensated, treatment-refractory noninsulin-dependent diabetes mellitus. DESIGN:Prospective, randomized, placebo, double-blind 6-month trial. PATIENTS:Thirty-eight patients with noninsulin-dependent diabetes resistant to c...

    journal_title:Annals of internal medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.7326/0003-4819-112-9-678

    authors: Quatraro A,Consoli G,Magno M,Caretta F,Nardozza A,Ceriello A,Giugliano D

    更新日期:1990-05-01 00:00:00

  • Internists' attitudes about clinical practice guidelines.

    abstract:OBJECTIVE:To assess internists' familiarity with, confidence in, and attitudes about practice guidelines issued by various organizations. DESIGN:Cross-sectional, self-administered survey. PARTICIPANTS:Questionnaires were mailed to a stratified random sample of 2600 members of the American College of Physicians (ACP) ...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-120-11-199406010-00008

    authors: Tunis SR,Hayward RS,Wilson MC,Rubin HR,Bass EB,Johnston M,Steinberg EP

    更新日期:1994-06-01 00:00:00

  • Cases in Precision Medicine: A Personalized Approach to Stroke and Cardiovascular Risk Assessment in Women.

    abstract::Cardiovascular disease is the leading cause of death among women in the United States, and stroke is third. This article uses a case scenario to examine female sex-specific cardiovascular risk factors across the lifespan and describes a precision medicine-based approach to risk factor modification and primary preventi...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/M19-1601

    authors: Bello NA,Miller EC,Cleary KL,Wapner R

    更新日期:2019-12-03 00:00:00

  • Procurement of cadaveric kidneys for transplantation.

    abstract::Kidney transplantation is safe, cost-effective, and beneficial for patients with end-stage renal disease. The number of patients who can receive transplants is severely limited by the availability of donor organs. Because most patients do not have a suitable living, related donor, transplant programs now rely on the u...

    journal_title:Annals of internal medicine

    pub_type: 杂志文章

    doi:10.7326/0003-4819-98-4-536

    authors: Waltzer WC

    更新日期:1983-04-01 00:00:00