1887

Chapter 6 : The Changing Practice of Medicine

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in
Zoomout

The Changing Practice of Medicine, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817695/9781555812799_Chap06-1.gif /docserver/preview/fulltext/10.1128/9781555817695/9781555812799_Chap06-2.gif

Abstract:

Societal changes, changes in technology, and changes in expectations have all come together to create a landscape vastly different for both practitioners and consumers of healthcare over the last two decades. The practice of medicine has changed in response to new discoveries in medicine and science but is being shaped by external pressures such as rising costs, increasing competition, and a new emphasis on customer satisfaction in the informationsavvy patient. The training programs that educate future physicians have been restructured to prepare students for the practice environment they will soon enter. The laboratory, always at the forefront of quality issues, is the perfect paradigm of changes going on at a more global level in healthcare. The chapter identifies the changes in medical school and residency curricula intended to prepare physicians for medical practice in the 21st century. New medical discoveries are made at a dizzying pace. Keeping up with these changes has always been challenging for physicians. The development of clinical practice guidelines is prioritized based on the prevalence of the clinical problem, burden of illness imposed, cost, variability in practice, potential to improve healthcare outcomes, and potential to reduce cost. The laboratory is usually just a small segment of the hospital’s business overall and is lumped into other reports. Finally, the laboratory is usually a part of a larger organization that may not keep their laboratory data separated. The major cost containment and medico-legal issues faced by physicians and laboratorians are outlined.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6

Key Concept Ranking

Nucleic Acid Amplification Techniques
0.44367644
Hepatitis C virus
0.416061
0.44367644
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

References

/content/book/10.1128/9781555817695.chap6
1. Albert, T. 2002. House bill recognizes crisis, revitalizes tort reform. AMA Newsl. 45(18): 1 2.
2. Anderson, F. P.,, M. L. Fritz,, M. C. Kontos,, R. A. McPherson,, and R. L. Jesse. 1998. Cost-effectiveness of cardiac troponin I in a systematic chest pain evaluation protocol: use of cardiac troponin I lowers length of stay for low-risk cardiac patients. Clin. Lab. Manag. Rev. 12: 63 69.
3. Anderson, M.,, B. Salmon,, J. O’Malley,, A. Fox,, and B. J. Youngberg. 1993. Legislative, Regulatory and Legal Issues in the Clinical Lab: a Resource Guide, p. 1 42. University Health System Consortium, Oakbrook, Ill.
4. Berwick, D. 2000. Knowledge always on call: for docs, practicing medicine will mean providing information more than providing care. Clin. Lab.Manag. Rev. 14: 250 252.
5. Bickford, G. R. 1994. Decentralized testing in the ’90’s: a survey of US hospitals. Clin. Lab.Manag. Rev. 8: 327 338.
6. Bloom, S.W. 1989. The medical school as a social organization: the sources of resistance to change. Med. Educ. 23: 228 241.
7. Blumenthal, D.,, and S.O. Their. 1996. Managed care and medical education. The new fundamentals. JAMA 276: 725 727. (Editorial.)
8. Brennan, T. A. 1995. Methods for setting priorities for guidelines development: medical malpractice, p. 99 110. In Committee on Methods for Setting Priorities for Guidelines Development (M. J. Field, ed.), Division of Healthcare Services, Institute of Medicine, Setting Priorities for Clinical Practice Guidelines. National Academy Press, Washington, D.C.
9. Buckman, R. 1992. How To Break Bad News: a Guide for Health Care Professionals. The Johns Hopkins University Press, Baltimore, Md.
10. Campbell, E. G.,, J. S. Weissman,, J. Ausiello,, S. Wyatt,, and D. Blumenthal. 2001. Understanding the relationship between market competition and students’ ratings of the managed care content of their undergraduate medical education. Acad. Med. 76: 51 59.
11. Carroll, R. (ed.). 2001. Risk Management Handbook for Healthcare Organizations, 3rd ed. Jossey-Bass, Inc.Publishers, San Francisco, Calif.
12. Clancy, C. M.,, and D. B. Kamerow. 1996. Evidence-based medicine meets cost-effectiveness analysis. JAMA 276: 329 330. (Editorial.)
13. Committee on Medicare Payment Methodology for Clinical Laboratory Services (D. M. Wolman, A. L. Kalfoglou, and L. LeRoy, ed.), DivisionofHealthCareServices, InstituteofMedicine. 2000. Medicare Laboratory Payment Policy: Now and in the Future. National Academy Press, Washington, D.C.
14. Committee on Methods for Setting Priorities for Guidelines Development (M. J. Field, ed.), DivisionofHealthcareServices, InstituteofMedicine. 1995. Setting Priorities for Clinical Practice Guidelines. National Academy Press, Washington, D.C.
15. Committee on Quality of Health Care in America (L. T. Kohn, J. M. Corrigan, and M. S. Donaldson, ed.), 2000. To Err Is Human: BuildingaSaferHealthSystem. National Academy Press, Washington, D.C.
16. Conner, C.,, and N. Hershey. 2001. Hospital Law Manual, vol. 2, p. 1 68. Health Law and Compliance Center. Aspen Publishers, Inc., Gaithersburg,Md.
17. Dickler, R. G.,, and G. Shaw. 2000. The Balanced Budget Act of 1997: its impact on U.S. teaching hospitals. Ann. Intern. Med. 132: 820 824.
18. DiLima, S.,, N. Frye,, and C. Frye (ed.). 1997. Hospital Risk Management: Forms, Checklists & Guidelines, vol. II, p. 44:I 44:34. Aspen Publishers, Inc., Gaithersburg,Md.
19. Donoghue, G.D. 2000. Women’s health: a catalyst for reform of medical education. Acad. Med. 75: 1056 1060.
20. Epstein, A. M. 1995. U.S. teaching hospitals in the evolving health care system. JAMA 273: 1203 1207.
21. Epstein, R. M.,, and E. M. Hundert. 2002. Defining and assessing professional competence. JAMA 287: 226 235.
22. Felder, R. A.,, S. Graves,, and T. Mifflin. 1999. Reading the future, the increased relevance of laboratory medicine in the next century. MLO Med. Lab. Obs. 31: 20 26.
23. Ferrara, K.,, S. Mitchell,, C. Price,, M. Schneider,, and B. J. Youngberg. 1995. Legal Issues Associated with the Use and Development of Practice Guidelines. UHC Services Corporation, Oakbrook, Ill.
24. Food and Drug Administration. September 1998. Guidance for industry; current good manufacturing practice for blood and blood components: (1) quarantine and disposition of units from prior collections from donors with repeatedly reactive screening tests for antibody to hepatitis C virus (anti-HCV); (2) supplemental testing, and the notification of consignees and blood recipients of donor test results for anti-HCV. Food and Drug Administration, Rockville,Md.
25. Frenkel, M.,, and E. B. Ayre. 2001. The growing need to teach about complementary and alternative medicine: questions and challenges. Acad.Med. 76: 251 254.
26. Friedman, B. A. 1998. Integrating laboratory processes into clinical processes, web-based laboratory reporting and the emergence of the virtual clinical laboratory. Clin. Lab. Manag. Rev. 12: 333 338.
27. Glenn, G. C., and Laboratory Testing Strategy Task Force of the College of American Pathologists. 1996. Practice parameter on laboratory panel testing for screening and case finding in asymptomatic adults. Arch. Pathol. Lab.Med. 120: 929 943.
28. Golden, W. E.,, A. A. Pappas,, and R. C. Lavendar. 1987. Financial unbundling reduces outpatient laboratory use. Arch. Intern. Med. 147: 1045 1048.
29. Goodman, M. L. 19 April 2002. Medical Malpractice and the Legal Process Goodman. Allen & Filetti, PLLC, Richmond,Va.
30. Greenfield, S.,, C. E. Lewis,, S. H. Kaplan,, and M. B. Davidson. 1975. Peer review by criteria mapping: criteria for diabetes mellitus, the use of decision-making in chart audit. Ann. Intern.Med. 83: 761 770.
31. Grol, R. 2001. Improving the quality of medical care, building bridges among professional pride, payer profit, and patient satisfaction. JAMA 286: 2578 2585.
32. Grundman, J. A.,, R. S. Wigton,, and D. Nickol. 2000. A controlled trial of an interactive, web-based virtual reality program for teaching physical diagnosis skills to medical students. Acad.Med. 75S: S47 S49.
33. Hoffman, E.,, D. Magrane,, and G. D. Donoghue. 2000. Changing perspectives on sex and gender in medical education. Acad.Med. 75: 1051 1055.
34.H. R. 4600. 2002. Help Efficient, Accessible, Low Cost, Timely Health Care (HEALTH) Act of 2002 (introduced in House April 25, 2002). 1 07th Congress, 2nd Session, in U.S. House of Representatives.
35. Hume, H. A.,, A. M. Ali,, F. Décary,, and M. A. Blajchman. 1991. Evaluation of pediatric transfusion practice using criteria maps. Transfusion 31: 52 58.
36. Iserson, K.V. 1999. Simulating our future: real changes in medical education. Acad.Med. 74: 752 754.
37. Katon, W.,, M. Von Korff,, E. Lin,, E. Walker,, G. E. Simon,, T. Bush,, P. Robinson,, and J. Russo. 1995. Collaborative management to achieve treatment guidelines, impact on depression in primary care. JAMA 273: 1026 1031.
38. Katz, D. A.,, J. L. Griffith,, J. R. Beshansky,, and H. P. Selker. 1996. The use of empiric clinical data in the evaluation of practice guidelines for unstable angina. JAMA 276: 1568 1574.
39. Keiser, J. F.,, and B. J. Howard. 1998. Critical pathways: design, implementation, and evaluation. Clin. Lab.Manag. Rev. 12: 317 332.
40. Kelly, C. S.,, C. L. Anderson,, J. P. Pestian,, A. D. Wenger,, A. B. Finch,, G. L. Strope,, and E. F. Luckstead. 2000. Improved outcomes for hospitalized asthmatic children using a clinical pathway. Ann. Allergy Asthma Immunol. 84: 509 516.
41. Kurec, A. S. 1998. Telemedicine: emerging opportunities and future trends. Clin. Lab.Manag. Rev. 12: 364 374.
42. LaRosa, J. C.,, P. Whelton,, and M. S. Litiwin. 1999. Academic medicine and managed care: seeking common ground. Acad. Med. 74: 488 492.
43. Larson, D.,, and L. A. Straub. 1996. Clinical data repository, a solution for outcomes assessment. Clin. Lab.Manag. Rev. 10: 107 114.
44. Leach, D. C. 2002. Competence is a habit. JAMA 287: 243 244. (Editorial.)
45. Leibman, B.D.,, O. Dillioglugil,, F. Abbas,, S. Tanli,, M.W. Kattan,, and P. T. Scardino. 1998. Impact of a clinical pathway for radical retropubic prostatectomy. Urology 52: 94 99.
46. Maudsley, R. F. 1999. Content in context: medical education and society’s needs. Acad. Med. 74: 143 145.
47. McPherson, R. A. 2001. Blood sample volumes: emerging trends in clinical practice and laboratory medicine. Clin. Lab. Manag. Rev. 15: 3 10.
48. McPherson, R. A. 1998. Robotics, automation, and the new role of process control. Clin. Lab. Manag. Rev. 12: 339 346.
49. Medical School Objectives Writing Group. 1999. Learning objectives for medical student education—guidelines for medical schools: report I of the Medical Schools Objectives Project. Acad. Med. 74: 1318.
50. Medical School Objectives Writing Group. 1999. The Informatics Panel and the Population Health Perspective Panel. Contemporary issues in medicine—medical informatics and population health: report II of the Medical School Objectives Project. Acad. Med. 74: 130141.
51. Mennemeyer, S. T. 1998. Should laboratories be judged by patient outcomes? Clin. Lab. Manag. Rev. 12: 57 62.
52. Meyer, G. S.,, and D. Blumenthal. 1996. TennCare and academic medical centers. The lessons from Tennessee. JAMA 276: 672 676.
53. Morse, R. M.,, G. S. Plungas,, D. Duke,, L. K. Rollins,, V. Barnes,, B. K. Brinson,, J. R. Martindale,, and D. W. Marsland. 1999. The Virginia Generalist Initiative: lessons learned in a statewide consortium. Acad. Med. 74S: S24 S29.
54. Narayanan, S. 2000. Technology and laboratory instrumentation in the next decade. MLO Med. Lab. Obs. 32: 24 31.
55. Nease, R. F.,, T. Kneeland,, G. T. O’Connor,, W. Sumner,, C. Lumpkins,, L. Shaw,, D. Pryor,, and H. C. Sox. 1995. Variation in patient utilities for outcomes of the management of chronic stable angina, implications for clinical practice guidelines. JAMA 273: 1185 1190.
56. Neville, A. J.,, H. I. Reiter,, K.W. Eva,, and G. R. Norman. 2000. Critical appraisal turkey shoot: linking critical appraisal to clinical decision making. Acad. Med. 75S: S87 S89.
57. Office of Inspector General. 1997. Publication of the OIG model compliance plan for clinical laboratories. Fed. Regist. 62: 94359441.
58. Papa, F. J.,, and P. H. Harasym. 1999. Medical curriculum reform in North America, 1765 to the present: a cognitive science perspective. Acad.Med. 74: 154 164.
59. Paris, J. J.,, and J. Ferranti. 2001. The changing face of medicine: health care on the internet. J. Perinatol. 21: 34 39.
60. Parmley, W. W. 1994. Clinical practice guidelines, does the cookbook have enough recipes? JAMA 272: 1374 1375. (Editorial.)
61. Pearlman, E. S.,, M. S. Wolfert,, R. Miele,, L. Bilello,, and J. Stauffer. 2001. Utilization management and information technology: adapting to the new era. Clin. Lab.Manag. Rev. 15: 85 88.
62. Philibert, I. (ed.). 2001. AAMC releases report on core competencies. In ACGME Bulletin,March 2001.
63. Plapp, F. V.,, C. I. Essmyer,, A. B. Byrd,, and M. L. Zucker. 2000. How to successfully influence laboratory test utilization. Clin. Lab. Manag. Rev. 14: 253 260.
64. Plaushin, C. 1997. Microscope on Washington. Federal funding of graduate medical education. Lab. Med. 28: 627 628.
65. Plebani, M. 1999. The changing face of clinical laboratories. Clin. Chem. Lab.Med. 37: 711 717.
66. Pritts, T. A.,, M. S. Nussbaum,, L. V. Flesch,, E. J. Fegelman,, A. A. Parikh,, and J. E. Fischer. 1999. Implementation of a clinical pathway decreases length of stay and cost for bowel resection. Ann. Surg. 230: 728 733.
67. Rabinowitz, H. K.,, D. Babbott,, S. Bastacky,, J. M. Pascoe,, K. K. Patel,, K. L. Pye,, J. Rodak, Jr.,, K. J. Veit,, and D. L. Wood. 2001. Innovative approaches to educating medical students for practice in a changing health care environment: the national UME-21 project. Acad.Med. 76: 587 597.
68. Reddick, R. L.,, and W. W. McLendon. 1995. Pathology and laboratory medicine. JAMA 273: 1707 1708.
69. Rich, E. C.,, M. Liebow,, M. Srinivasan,, D. Parish,, J. O. Wolliscroft,, O. Fein,, and R. Blaser. 2002. Medicare financing of graduate medical education. J. Gen. Intern.Med. 17: 283 292.
70. Robinson, J.C. 1996. Decline in hospital utilization and cost inflation under managed care in California. JAMA 276: 1060 1064.
71. Sass, P.,, and P. Edelsack. 2001. Teaching community health assessment skills in a problem-based format. Acad. Med. 76: 88 91.
72. Schoenbaum, S. C.,, and D. N. Sundwall. 1995. Using Clinical Practice Guidelines to Evaluate Quality of Care, vol. 1. Issues. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Rockville, Md.
73. Schoenbaum, S. C.,, and D. N. Sundwall. 1995. Using Clinical Practice Guidelines to Evaluate Quality of Care, vol. 2. Methods. U.S. Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research, Rockville, Md.
74. Schoenfeld, P.,, D. Cruess,, and W. Peterson. 2000. Effect of an evidence-based medicine seminar on participants’ interpretations of clinical trials: a pilot study. Acad. Med. 75: 1212 1214.
75. Shaneyfelt, T. M. 2001. Building bridges to quality. JAMA 286: 2600 2601. (Editorial.)
76. Shaneyfelt, T. M.,, M. F. Mayo-Smith,, and J. Rothwangl. 1999. Are guidelines following guidelines? The methodological quality of clinical practice guidelines in the peer-review medical literature. JAMA 281: 1900 1905.
77. Singer, P. A.,, D. S. Cooper,, E. G. Levy,, P. W. Ladenson,, L. E. Braverman,, G. Daniels,, F. S. Greenspan,, I. R. McDougall,, and T. F. Nikolai. 1995. Treatment guidelines for patients with hyperthyroidism and hypothyroidism. JAMA 273: 808 812.
78. Snyder, J. R.,, and D. S. Wilkinson,. 1998. The nature of management in laboratory medicine, p. 1 15. In J. S. Snyder, and D. S. Wilkinson (ed.), Management in Laboratory Medicine, 3rd ed. Lippincott, Philadelphia, Pa.
79. St.Peter, R. F.,, M. C. Reed,, P. Kemper,, and D. Blumenthal. 1999. Changes in the scope of care provided by primary care physicians. N. Engl. J. Med. 341: 1980 1985.
80. Strickland, B. J.,, and W.O. Quiery. 17 May 2002. HIPAA Patient Rights, State Law and You. Reciprocal of America, Glen Allen, Va.
81. Trosty, S. R. 2002. Future looks bleak as malpractice premiums continue upward spiral. Health. Risk Manag. 24: 1 12.
82. Tunis, S. R.,, R. S. A. Hayward,, M. C. Wilson,, H. R. Rubin,, E. B. Bass,, M. Johnston,, and E. P. Steinberg. 1994. Internists’ attitudes about clinical practice guidelines. Ann. Intern. Med. 120: 956 963.
83. Van Walraven, C.,, V. Goel,, and B. Chan. 1998. Effect of population- based interventions on laboratory utilization. JAMA 280: 2028 2033.
84. Veloski, J.,, B. Barzansky,, D. B. Nash,, S. Bastacky,, and D. P. Stevens. 1996. Medical student education in managed care settings: beyond HMOs. JAMA 276: 667 671.
85. Weisman, C. S. 2000. The trends in health care delivery for women: challenges for medical education. Acad. Med. 75: 1107 1113.
86. Wilkinson, D. S. 2000. Technology assessment: measuring the outcomes of laboratory practice. Clin. Lab. Manag. Rev. 14: 267 271.
87. Wilkinson, D. S. 1997. The role of technology in the clinical laboratory of the future. Clin. Lab. Manag. Rev. 11: 322 330.
88. Wilson, I. B.,, and P. D. Cleary. 1995. Linking clinical variables with health-related quality of life, a conceptual model of patient outcomes. JAMA 273: 59 65.
89. Winkelman, J.W.,, and S. T. Mennemeyer. 1996. Using patient outcomes to screen for clinical laboratory errors. Clin. Lab. Manag. Rev. 10: 134 142.
90. Young, D. S.,, V. S. Sachais,, and L.C. Jefferies. 2000. Laboratory costs in the context of disease. Clin. Chem. 46: 967 975.

Tables

Generic image for table
Table 6.1

Themes of change

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.2

Impact of the internet

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.3a

Pros and cons of clinical practice guidelines and clinical pathways

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.3b

Pros and cons of clinical practice guidelines and clinical pathways

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.4

Elements for developing clinical pathways

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.5

Highlights of the Help Efficient, Accessible, Low Cost, Timely Health Care Act of 2002

See reference 34.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.6

Program oversight functions from the Medicare Integrity Program

See reference 11.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.7

Framework for federal privacy legislation (HIPAA)

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.8

Requirements of written request for confidential patient information

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.9

Essential elements of a legal contract

See reference 11.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
Table 6.10

Ethical principles and moral obligations governing the patient and healthcare organization's relationship

See reference 11.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
APPENDIX 6.2a Example of a Clinical Pathway: Community-Acquired Pneumonia Clinical Pathwaya

Provided courtesy of Stephen Sigworth,Virginia Commonwealth University Health System.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6
Generic image for table
APPENDIX 6.2b Example of a Clinical Pathway: Community-Acquired Pneumonia Clinical Pathwaya

Provided courtesy of Stephen Sigworth,Virginia Commonwealth University Health System.

Citation: Roseff S, Nichols B, Grimes M. 2004. The Changing Practice of Medicine, p 135-159. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch6

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error