Index
Abdelhak, Sharif, 160
Adams, John, 214
adult care, 96
AFL-CIO, 194
African Americans, 47, 61–64, 127, 141, 179, 190, 194, 205, 216; discrimination against, 66, 160, 211; education of, 151–52, 154, 196–98; HIV/ AIDS among, 188; in northern New England, 69, 112, 117, 121; medical experiments on, 43–44; in south, 116. See also civil rights movement
Agency for Health Care Policy and Research, 57
Agency for Healthcare Research and Quality, 57
AIDS. See HIV/AIDS
Albert Einstein Medical Center Northern Division (Philadelphia), 155
Albion College, 196
Allegheny Health Education and Research Foundation (AHERF), 159–60
allergists, 157
alternative medicine, 15
Alzheimer's disease, 71
Amalgamated Clothing and Textile Workers Union, 49
Ambulatory Pediatric Association (APA), 56
American Academy of Family Physicians, 11, 18, 26; Reporter, 38
American Academy of General Practice (AAGP), 11, 17, 18, 26; Willard Committee, 10
American Association of Colleges of Medicine, 10
American Association of Colleges of Osteopathic Medicine, 202
American Board of Family Practice, 11
American Board of Medical Specialties, 202
American Journal of Public Health, 119
American Medical Association (AMA), 14, 18, 186; Journal of, 97; Millis Commission, 10; Sawyer Committee, 11
American Osteopathic Association, 202
American Psychological Association, 186
Amherst College, 61
amyotrophic lateral sclerosis, 167
Anabaptists, 208
Anaconda American Brass, 194
Angoff, Kris, 88
Annals of Internal Medicine, 161
Annie E. Casey Foundation, 73
Anthony L. Jordan Health Center (Rochester, New York), 127
antisepsis, 9
Apollo project, 125
Area Health Education Center (AHEC), 122
Arizona State University, 102
Asian Americans, 141
Association for Ambulatory Pediatric Services, 56
AT&T, 65
Augusta General Hospital (Maine), 129
Austria, 31
AZT, 188–90
Ball State Teacher's College, 209
Bangor Theological Seminary, 122
Batalden, Paul, 79
Baty, James Marvin, 87–88
Bay Area Physicians for Human Rights, 186
Bell's palsy, 156
Berrigan, Daniel, 32
Berwick, Donald, 79
Beth Israel Hospital (New York), 51
Beverly, Edmond, 204
Black Panthers, 141
Boston Floating Hospital, 86–87
Boston University School of Theology, 168
Boufford, Jo Ivey, 45–47
Bradley, Bill, 201
Brigham Hospital (Boston), 61
Britain, health care system in, 230
Bronx Lebanon Hospital Center, 48–51
Brown, Rita Mae, 163
Burroughs Wellcome, 190
Butler, Ruth, 90
Caen, Herb, 185
California Pacific Medical Center, 190
Campbell, James, 43
cancer research, 41
capitation, 230–31
carditis, 87
Carnegie Institution, 76
Carter, James, 78
Case Western Reserve University Medical School, 58, 74, 77–79
Cebul, Randall, 79
Center for Comprehensive Health Practice (New York), 46–47
Centers for Disease Control (CDC), 59, 65–66. See also Epidemic Intelligence Service
Centers of Osteopathic Research and Education (CORE), 203
Chávez, Cesar, 44
Chestnut Hill College, 153–54
Chicago riots (1968), 211
Child Health Services (Manchester, New Hampshire), 83–85, 90–93
child psychiatry, 88
Children and Youth (C and Y) clinics (New Hampshire), 89
Children's Defense Fund, 90
Chillicothe County (Ohio) Veterans' Administration, 203
Chinese Americans, 140
chloramphenicol, 86
cholera, 60
Church of the Brethren, 208
City College of New York, 115
cleft palate, 89
Cleveland Metropolitan General Hospital, 77
Colombia, health care system in, xiii
Columbia Road Health Service (Washington, D.C.), 207, 213, 214, 216, 218–19
Committee on the Costs of Medical Care, 9
communications policy, 236
Community Family Practice (Detroit), 199–200
compensation policy, 231–32
Comprehensive Health Manpower Training Act (1971), 97
congenital heart defects, 34
Conger, Beach, 57–73
Congo, 209–10
contagious diseases, 24
contraceptives, 65
counseling, family, 34
Country Doctor Clinic (Seattle), 30
Coyote, 128
Crippled Children's Clinic (New Hampshire), 89
Cultural Revolution, Chinese, 140
cystic fibrosis, 89
Dartmouth Medical School, 22–23, 33–34, 79; Mary Hitchcock Clinic, 27, 68
Darwinism, 17
Davidoff, Frank, 57
DDI, 189
Dead Sea Scrolls, 42
death and dying, dealing with, 190
Delbanco, Thomas, 57
DeLee, Joseph Bolivar, 23
dermatology, 157
Detroit News, 198
Detroit riots (1967), 197–98
diagnosis, 151, 155, 156, 199–200; of AIDS, 188, 189; genetics and, 225; nursing versus medical, 126–27; technological innovation and, 222, 223
Donabedian, Avedis, 5
Drexel University, 160
Dritz, Selma, 185
drug abuse, 27, 215, 218; children and, 84, 85, 92; treatment of, 66; violence and, 93
Drug Enforcement Administration (DEA), 105
Duke University, 99, 112, 113, 115–19, 122; Medical Center, 97; School of Medicine, xviii
dysfunctional families, 92
ear infections, 223
early-childhood education, 88
echocardiography, 223
Edelman, Marian Wright, 29
educational policy, 232–34
elderly, care of. See geriatric care
Ellis Island, xiv
Ellwood, Paul, 135
El Salvador, war in, 214
Emory University, 118–19
Empty Closet (publication), 128
epidemiology, 10, 56, 59, 60, 65; of AIDS, 187; of sexually transmitted diseases, 185
epiglottitis, 86
Eschtruth, Glen, 210
Evanston Hospital (Illinois), 210
evidence-based medicine, 223
Family Medical Leave Act, 201
family practice, 2, 4, 18, 19, 76–77, 81, 82, 103, 139, 210, 234, 235; admitting privileges of, 47, 48; general practice transformed into, 26; HMOs and, 142–43; nurse practitioners and, 96, 109, 129–30; physician assistants and, 117–18; and referrals to specialists, 70; residency programs for, 11, 18, 45–48, 50–51, 141, 169, 170, 232, 233; rural, 125; technology and, 223. See also Adler, Connie; Calman, Neil; Halaas, Gwen Wagstrom; Kapla, William; Ross-Lee, Barbara
Farrakhan, Louis, 63
Faverman, Gerald, 202
Federal Health Professions Act, 11
fetal monitoring, 26
Flexner, Abraham, 20
Ford, Loretta, 96
Ford Hospital (Detroit), 204
foreign medical graduates, 120
fractures, 67–68
France, 31
Franklin Memorial Hospital (Farmington, Maine), 30
Gay and Lesbian Medical Association, 163
gay men and women, 34, 128, 133, 162–64, 181–85; AIDS epidemic and, 180, 186–92
Geiger, Jack, 62
genetics, 225–26
Georgetown University Hospital, 212
Georgia Department of Human Resources, Primary Health Care Section, 120
Georgia Office of Rural Health, 120
Georgia State University, 119
germ theory of disease, 9
Gilbertson, Reid, 169
Golden Gate University, 66
Gomez, Maria, 216
Gorgas Hospital (Panama), 24
Gottlieb, Michael, 187
graduate medical education (GME), 234
Grady Hospital (Atlanta), 118
Great Britain, health care system in, 4
Great Society programs, 89
Greece, life expectancy in, xiv
Group Health, 173
Gruber, May, 90
Guatemala, 31
gynecology, 33, 65; nurse practitioners in, 96; physician assistants in, 118
Haggerty, Robert, 92
Hahnemann Medical School, 149, 155–57; see also MCP-Hahnemann Medical School
hantavirus, 60
Harvard University; Medical School, 61, 165, 168, 171; School of Public Health, 88
Hawaiians, 140
Health Care Reform Task Force, xii, 12
health insurance, 21, 25, 36; catastrophic, 49; employment-based, 10, 13, 17, 136; loss of, and AIDS, 188; single-payer, 36, 230; universal coverage, 231. See also health maintenance organizations; Medicaid; Medicare
Health Insurance Portability and Accountability Act (1996), 232
Health maintenance organizations (HMOs), 4, 13, 28, 93, 110, 135–39, 142–48, 156; community health center contracts with, 50; family practice and, 172; not-for-profit, 157, 165, 166, 173–74; nurse practitioners and, 97, 110–11, 132; physician assistants and, 132; systems reform and, 230. See also names of specific companies
Health Partners (Philadelphia), 157–59
health policy, 201–2, 229–37; communication of, 236; on compensation, 231–32; on education, 232–34; leadership in, 236–37; on professional structure, 234–36; systems reform of, 229–31
Health Professions Educational Assistance Act (1976), 56
Health Resources and Services Administration Bureau of Health Professions, 50
Health Right, 217
Health Security Act, xii
health service research, 56
heart defects, congenital, 34
heart disease, 175
Hennikoff, Leo, 42
Hickey, James Cardinal, 213
Hippocratic tradition, 139
Hispanics, 35, 47, 127, 190, 214, 216;
― 251 ―discrimination against, 101–2; HIV/AIDS among, 188HIV/AIDS, 50–53, 60, 65, 216, 218, 219, 223; among gay men, 163, 179, 180, 186–92; managed care and, 159; prevention of, 121, 188; as policy issue, 201
Ho, Sam, 137–48
Holocaust, 54
homebound patients, primary care for, 51–52
hospitals, 25, 34, 200; admitting privileges at, 47, 48; HMOs and, 155; pediatrics in, 86, 88, 91, 111; rural, 103–4; segregated, 62. See also names of specific hospitals
Howard County (Maryland) Hospital, 212
Hudson, Charles, 97
Human Genome Project, xii, 225
hypothyroidism, 155
Iceland, life expectancy in, xiv
Indiana University Medical School, 209
inpatient versus outpatient medicine, 14
Institute for Child Health and Development (Manchester, New Hampshire), 90
Institute for Healthcare Improvement (IHI), 79
insurance. See health insurance
internists, 2, 4, 9, 55–57, 103, 234–36; physician assistants and, 119; residency programs for, 11, 76–77, 156–57, 183, 223, 233; technology and, 223. See also Bowman, Sallyann; Conger, Beach; Headrick, Linda
Iran, Shah of, 64
Irene, Sister, 212
Irish Americans, 151
iron lung, 222
IUDs, 65
Japan, life expectancy in, xiv
Jewish Memorial Hospital (New York), 40
Johnson, Bob, 213
Johnson, Lyndon Baines, 89
Joy, Margie, 30
Kapla, William, 179–92
Kaposi's sarcoma, 186–87
Keane, Vince, 216
Keene, Friedman, 186–87
Kennedy-Kassebaum Act (1996), 232
King, Angus, 132
Kingston (New York) Hospital, 47
Ku Klux Klan, 195
Lawrence, Robert, 57
lawsuits, 27
leadership, strategic, 236–37
leprosy, 24
lesbians. See gay men and women
Life magazine, 40
litigiousness, 27
Littleton (New Hampshire) Hospital, 26
Loeb, John, 115
Look magazine, 97
Lou Gehrig's disease, 167
Luther College, 178
Luther Seminary, 170
Lyme disease, 167
Maine Advanced Practice Law, 132
Maine Council of Churches, 133
Maine Department of Health, 112; HIV/STD Prevention Program, 121
Maine Medical Center (Portland), 117
malnutrition, 60
mammography, 173
managed care, 13–14, 21, 36–37, 51–53, 68, 149–50, 161, 166–67, 175–77; allocation of medical resources in, 150–51; capitation in, 230–31; financial constraints of, 191; Medicaid, 51, 53, 142, 157–59, 172, 217. See also health maintenance organizations
Marion Hospital (Indiana), 210
Martin Luther King Hospital (Los Angeles), 154
mastectomy, 153–54
Maternal and Child Health (MCH) Program, 89
McDade, Harry, 26
McEachern, Edward, 79
McKinney Act (1987), 215
MCP-Hahnemann Medical School, Institute for Women's Health at, 159
Medalie, Jack, 74
MedCenters, 173
Medicaid, 25, 50, 103, 199, 230; bookkeeping requirements for, 28; managed care and, 51, 53, 142, 157–59, 172, 217; obstetrics and, 36; osteopathic medicine and, 202; reform of, 201, 232
MediCal, 142
Medical Committee for Human Rights, xvi, 62
medics, 113–14; training as physician assistants, 98, 112, 115–17
meningitis, 86
Mennonites, 208
mentoring, 105
Mesches, David, 47
methadone maintenance, 66
Metropolitan Hospital (New York), 47
Mexican Americans, 36
Michigan State University, 193, 196, 202, 204; College of Osteopathic Medicine, 198, 200–201
Mid-Hudson Consortium for the Development of Family Practice, 47, 48
Montefiore Hospital (New York) Social Medicine Residency Program, 45–47
Moorhead State University, 167
Morocco, health care system in, xiii
Moses, John, xvii–xviii
multiple sclerosis, 167
Mundinger, Mary, 14
muscular dystrophy, 111
Muslims, 211
National Academy of Sciences, xvi; Institute of Medicine, 3
National Guard, 197–98
National Health Service Corps (NHSC), xii, 29, 33, 118, 120, 139, 141, 142, 229, 234
National Institutes of Health (NIH), 97
National Labor Relations Board, 46
National League for Nursing, 97
National Library of Medicine, Primary Care Oral History Collection, xvii
Neuropsychiatric Institute (Fargo, North Dakota), 167
New England Medical Center (Boston), 87
New Hampshire Department of Health, 88–89
New Mexico Board of Nursing, Advanced Practice Committee, 105
New Mexico Nurse Practice Act, 105
New York Daily News, 38
New York Herald Tribune, 61
New York Hospital, 114
New York University Dental School, 39
Nicaragua, socialized medicine in, 133
Noble, John, 57
North Dakota State University, 167
Northwestern University, 140–41; Garrett Theological Seminary, 210
nurse practitioners, 2, 4, 11, 19, 95–98, 217, 234, 235; expanding role of, 14–15; managed care and, 52; pediatric, 96; political organization of, 132; training programs for, 12, 95–96, 104–6, 126–27, 223, 234; in urban community practices, 38, 48. See also Gerlaugh, Holly; Hidalgo, Therese
Nurse Training Act (1971), 96
obstetrics, 21, 37, 102–4; in family practice, 30, 33–36, 48, 168, 170; in general practice, 24, 26; managed care and, 156; nurse practitioners in, 96; services for poor, 23, 43–44
occupational health, 119
Office of Economic Opportunity (OEO), 62
Optima Health Care, 91
orthopedic surgery, 68
outpatient versus inpatient medicine, 14
Pakistan, 211
Panama, 24
Pan American Airways, 115
Pap smears, 173
Parke-Davis, 197
patient education, 230
payment policy, 231–32
Payne-Whitney Psychiatric Clinic (New York), 114
Peace Corps, 197
pediatrics, 2, 4, 55–57, 68, 81, 103, 234–36; in family practice, 34, 35; history of, 83; hospital, 86, 88, 91, 111; managed care and, 156; nurse practitioners in, 96; residency programs for, 11, 223, 233. See also Deitch, Selma
Pelligrino, Ed, 213
penicillin, 86
Penn State University Medical School, 154
Pennsylvania Department of Welfare, 157
perinatology, 34
Pew Charitable Trust, 214
pharmacists, 105
Philadelphia College of Pharmacy and Science, 153
Philadelphia Inquirer, 161
physician assistants, 2, 4, 11, 81, 95, 97–98, 217, 234, 235; managed care and, 52; political organization of, 132; in rural medicine, 35, 130; training programs for, 12, 97, 110, 115–18, 223, 234. See also Gerlaugh, Holly; Toney, Carl
Piedmont Hospital (Atlanta), 119
Planned Parenthood, 91
Poitier, Sidney, 61
poverty: dysfunctionality and, 92, 93; in Guatemala, 31; managed care and, 159; rural, 35, 62, 69, 120, 122; urban, 23, 43, 53, 62–65, 140, 211–19
PPOs, 28
prenatal care, 168, 216; incentive program for, 173. See also obstetrics
Presbyterian Health Services (Belen, New Mexico), 103–4
Presbyterian Hospital (San Francisco), 183
preventive services, 173
primary care, 1–2; definitions of, 2–3; future of, 220–38; and generalism in human enterprise, 5–8; history of, 8–16; technology and, 221–24; values of, 3–5
Primary Care Organizations Consortium, 57
professional structure policy, 234–36
proprietary health care, 135
protease inhibitors, 189
Protestant ethic, 75
Protestants, 216. See also specific denominations
psychoanalysis, 31
public health, 59–66, 228; HIV/AIDS and, 180, 186; HMOs and, 138, 142–44, 175; pediatrics and, 83, 84, 88–90; STDs and, 185–86. See also National Health Service Corps (NHSC); U.S. Public Health Service
Public Health Service Act, Title VII of, 11
radiation treatment, 154
Ramsey Faculty Associates, 173
record keeping, 158
Regions Hospital (Minnesota), 173
replacement transfusions, 86
rheumatic fever, 86
rheumatology, 155
Rh incompatibility, 86
Rhode Island Department of Children's Services, 73
risk allocation, 230–31
Robert Wood Johnson Foundation, 11, 57, 96, 117, 214; Advances, 38; Health Policy Fellowships, 201
Rockridge Health Plan, 142
Rogers, David, 57
Rouse, Jim, 211
Rowland, Mike, 32–34
rubella, 205
rural medicine, 29–37, 65, 125; nurse practitioners in, 100, 101, 105, 109, 129, 130; physician assistants in, 117, 120, 122, 130
Rutgers Medical School, 41–43
safe sex guidelines, 188
St. Francis Hospital (San Francisco), 185
St. Luke's Hospital (San Francisco), 142
St. Paul Family Physicians, 169
St. Vincent Hospital (Santa Fe), 100
Samoans, 140
San Francisco Chronicle, 185
San Francisco Family Health Programs, 141–42
San Francisco Health Department, 185
Sauder, Kenan, 74
Schumann, Hy, 86
Senge, Peter, 8
sexual abuse, 92
sexually transmitted diseases (STDs), 180, 185–88. See also HIV/AIDS
sigmoidoscopy, 223
Silver, Henry, 96
Simmons College, 24
Smith, Isabella, 24–26
Smith, Richard, 97
Society for Research and Education in Primary Care Internal Medicine, 57
So Others May Eat (SOME), 214
Soundview Health Center (New York), 47–48
South of Market Health Center (San Francisco), 66
specialists, 5–7, 45, 68, 130, 155, 220; in community health centers, 48–50; compensation of, 231–32; history of, 8–12, 17, 20, 55; in internal medicine and pediatrics, 55–57; managed care and, 13–14, 36, 146, 150, 176–77; medical schools and, 33; physician assistant, 118; primary care and, 157; referrals and, 26, 69–70, 77, 110, 143, 199–200, 230–31; rural medicine and, 34; scientific information and, 224; technology and, 222–24, 229; volunteer, in innercity clinics, 213
spina bifida, 91
State Child Health Insurance Program, 232
Stehling, Barbara Salas, 104
Streat, Toussaint, 141
surgery, 9, 10, 77, 103; in family practice, 35; in general practice, 21, 26, 85; oral, 38, 39; philosophical differences between medicine and, 55; referrals for, 68; technology and, 224; unnecessary, 49
Switzerland, health care spending in, xii
systems reform, 229–31
“Take Back the Night” campaign, 128
teenagers, and pregnancy, 84. See also adolescent health care
Teen Options, 91
Tenet Corporation, 160
Thomas, Clarence, 202
Tougaloo University, 62
transfusions, replacement, 86
typhoid, 24
UCare, 172–73
ultrasound, 223
United Auto Workers, 194
United Farm Workers (UFW) Health Clinics, 44–45
U.S. Bureau of Maternal and Child Health, 90
U.S. Bureau of Primary Health Care, 120
U.S. Marine Corps, 184
U.S. Navy, 183
U.S. Public Health Service, xi–xiii, 65, 234; Primary Care Policy Fellowship, 57, 113, 121
University of California, Berkeley, 147
University of Maine at Farmington, 35
University of Maryland, 77
University of Michigan, 205
University of Missouri, 76; Agricultural Extension Service, 75, 76
University of New Hampshire, 22
University of New Mexico, 100–102, 106; Medical School, 104, 110
University of Pennsylvania: Hospital, 162; Medical School, 152, 162; Student Health Services, 161–62
University of Pittsburgh, School of Public Health, 62
University of Washington, Medical Extension (MEDEX) Program, 97
urology, 28
vaccines, 222
Valley News, 72
Vermont Law School, 67
Veterans' Affairs, Department of, 234
Vietnamese immigrants, 214
Visa Physician Placement Program, 120
Visiting Nurse Service, 51
Volunteer Health Care Network, 213
Wall Street Journal, 156
Weather Underground, 41
weight management, 108
Weir, Reginald, 114
wellness care, 71
Werdegar, Dave, 143
White, Bernie, 164
White, Kerr, 10
Wiggins, Roy, 119–20
W. K. Kellogg Foundation, 214
women doctors, 24; in family medicine, 171; nurse practitioners and, 109; before World War II, 23. See also names of specific doctors
Women's Hospital (Detroit), 194
World Health Organization (WHO), xiii
Yale University, 32
Zuni Indians, 34