Weighing the views of a university hospital and medical school regarding an HMO

After 14 years of study, the University of Michigan decided to terminate development of a health maintenance organization (HMO). The process was long and difficult because of the university's need to consider the HMO from the university's perspective of both an employer and a provider. As an employer, the university's early view was favorable and then declined when employee interest was found to be weak and the HMO's impact on the rapidly rising cost of the university's health insurance benefit was determined to be modest. As a provider, the university's view was mixed. In regard to its hospitals, the university's judgment was positive largely because it hoped that HMO incentives might help the hospitals remain viable in the health care delivery environment that was becoming increasingly competitive. From the Medical School's point of view, an HMO was felt not to be desirable because it could put in jeopardy the professional fee revenue used by the school to help underwrite its academic programs, which are the primary source of faculty pride and recognition.

Impairment prevention in the training years. A new mental health program at UCLA

The new Mental Health Program for Physicians in Training, at UCLA, offers free psychiatric evaluation and short-term psychotherapy to UCLA medical students and house officers, utilizing a large group of physician volunteers from the clinical and regular faculties. The program features complete confidentiality and an off-campus setting and provides help in a number of specialized areas. It also conducts research on stress in medical education. A basic aim is to promote a sense of community in the medical profession by demonstrating the concern of mature practitioners for their young colleagues. It also seeks to foster greater sensitivity among young physicians by educating them about the importance of their own psychological needs. The UCLA program provides a model for mental health services that are low in cost, both to medical trainees and to the training institution, at a time of severe budget shrinkage.

University of Manchester sports injury clinic

This paper reviews the work of the sports injury clinic based at the Student Health Centre, University of Manchester during its first eighteen months. A total of 852 patients including 46 Centre of Excellence athletes were treated. The results indicate that the establishment of such a specialised clinic is worthwhile, that the injured sportsmen should be treated by individuals trained and interested in the treatment of injured patients in general and that the commonest injuries are soft tissue injuries to the knee of ankle joint. A record card, designed for future computer analysis, is illustrated. It includes details of the sport, training, mechanism of injury, pathology and treatment.