Implications of Health Care Reform (Medical Ethics Series, 2011)

A video of a panel discussion on how Obama's Health Care Reform would affect Texas Medical Center institutions and health care in general.Speakers include Tom Cole (moderator), Roberta Schwartz (Methodist Hospital), Pauline Rosenau (UT-Houston School of Public Health), and Laurence McCullough (Baylor College of Medicine).

1906 Polk's Medical Register and Directory of North America (Texas Portion Only)

List of Physicians and Surgeons arranged by location, giving post office address with population and location, the School practiced, date and college of graduation, all the existing and extinct medical colleges in North America, with locations, officers, number of professors, lecturers, demonstrators, etc., the various medical societies, penal, reformatory and charitable state institutions, hospitals, sanitariums, dispensaries, asylums and other medical institutions, boards of health, boards of medical examiners, health officers at principal points, the laws of registration and other laws relating to the profession, medical journals with names of editors, frequency of publication and subscription rates, medical libraries, a therapeutic classification of American health resorts, mineral springs, official list of officers of the medical departments of the U.S. Army, Navy and Marine Hospital Service, the U.S. Indian Service, roster of examining surgeons of the U.S. Pension Department, a descriptive sketch of each state, territory and province, embodying such matters as location, boundary, extent in miles and acres, latitude and longitude, statistics relating to climate, temperature, rate of mortality, etc. Full particulars of all national and inter-state associations and societies relating to medicine and surgery, and an INDEX TO THE PHYSICIANS OF THE UNITED STATES. Arranged alphabetically, with the number of the page and column in which the name appears.

1902 Polk's Medical Register and Directory of the United States and Canada (Texas portion only)

List of Physicians and Surgeons arranged by states and provinces, giving post office address with population and location, the School practiced, date and college of graduation, all the existing and extinct medical colleges in the United States and Canada, with locations, officers, number of professors, lecturers, demonstrators, etc., the various medical societies, state prisons, hospitals, sanitariums, dispensaries, asylums and other medical institutions, boards of health, boards of medical examiners, a synopsis of the laws of registration and other laws relating to the profession, medical journals with names of editors, frequency of publication and subscription rates, medical libraries, mineral springs, official list of officers of the medical departments of the U.S. Army, Navy and Marine Hospital Service, roster of examining surgeons of the U.S. Pension Department, a descriptive sketch of each state, territory and province, embodying such matters as location, boundary, extent in miles and acres, latitude and longitude, statistics relating to climate, temperature, rate of mortality, number of deaths from consumption, etc. full particulars of all national associations and societies relating to medicine and surgery, and an INDEX TO THE PHYSICIANS OF THE UNITED STATES. Arranged alphabetically, with the number of the page on which the name appears.

Estimates of hospital and physician costs of epilepsy in the United States for 1995 comparing the provider -based survey method and a patient -based medical charts and billing method

This investigation compares two different methodologies for calculating the national cost of epilepsy: provider-based survey method (PBSM) and the patient-based medical charts and billing method (PBMC&BM). The PBSM uses the National Hospital Discharge Survey (NHDS), the National Hospital Ambulatory Medical Care Survey (NHAMCS) and the National Ambulatory Medical Care Survey (NAMCS) as the sources of utilization. The PBMC&BM uses patient data, charts and billings, to determine utilization rates for specific components of hospital, physician and drug prescriptions. ^ The 1995 hospital and physician cost of epilepsy is estimated to be $722 million using the PBSM and $1,058 million using the PBMC&BM. The difference of $336 million results from $136 million difference in utilization and $200 million difference in unit cost. ^ Utilization. The utilization difference of $136 million is composed of an inpatient variation of $129 million, $100 million hospital and $29 million physician, and an ambulatory variation of $7 million. The $100 million hospital variance is attributed to inclusion of febrile seizures in the PBSM, $−79 million, and the exclusion of admissions attributed to epilepsy, $179 million. The former suggests that the diagnostic codes used in the NHDS may not properly match the current definition of epilepsy as used in the PBMC&BM. The latter suggests NHDS errors in the attribution of an admission to the principal diagnosis. ^ The $29 million variance in inpatient physician utilization is the result of different per-day-of-care physician visit rates, 1.3 for the PBMC&BM versus 1.0 for the PBSM. The absence of visit frequency measures in the NHDS affects the internal validity of the PBSM estimate and requires the investigator to make conservative assumptions. ^ The remaining ambulatory resource utilization variance is $7 million. Of this amount, $22 million is the result of an underestimate of ancillaries in the NHAMCS and NAMCS extrapolations using the patient visit weight. ^ Unit cost. The resource cost variation is $200 million, inpatient is $22 million and ambulatory is $178 million. The inpatient variation of $22 million is composed of $19 million in hospital per day rates, due to a higher cost per day in the PBMC&BM, and $3 million in physician visit rates, due to a higher cost per visit in the PBMC&BM. ^ The ambulatory cost variance is $178 million, composed of higher per-physician-visit costs of $97 million and higher per-ancillary costs of $81 million. Both are attributed to the PBMC&BM's precise identification of resource utilization that permits accurate valuation. ^ Conclusion. Both methods have specific limitations. The PBSM strengths are its sample designs that lead to nationally representative estimates and permit statistical point and confidence interval estimation for the nation for certain variables under investigation. However, the findings of this investigation suggest the internal validity of the estimates derived is questionable and important additional information required to precisely estimate the cost of an illness is absent. ^ The PBMC&BM is a superior method in identifying resources utilized in the physician encounter with the patient permitting more accurate valuation. However, the PBMC&BM does not have the statistical reliability of the PBSM; it relies on synthesized national prevalence estimates to extrapolate a national cost estimate. While precision is important, the ability to generalize to the nation may be limited due to the small number of patients that are followed. ^

Raising the bar: the importance of hospital library standards in the continuing medical education accreditation process*

The Connecticut State Medical Society (CSMS) reviews and accredits the continuing medical education (CME) programs offered by Connecticut's hospitals. As part of the survey process, the CSMS assesses the quality of the hospitals' libraries. In 1987, the CSMS adopted the Medical Library Association's (MLA's) “Minimum Standards for Health Sciences Libraries in Hospitals.” In 1990, professional librarians were added to the survey team and, later, to the CSMS CME Committee. Librarians participating in this effort are recruited from the membership of the Connecticut Association of Health Sciences Librarians (CAHSL). The positive results of having a qualified librarian on the survey team and the invaluable impact of adherence to the MLA standards are outlined. As a direct result of this process, hospitals throughout the state have added staffing, increased space, and added funding for resources during an era of cutbacks. Some hospital libraries have been able to maintain a healthy status quo, while others have had proposed cuts reconsidered by administrators for fear of losing valuable CME accreditation status. Creating a relationship with an accrediting agency is one method by which hospital librarians elsewhere may strengthen their efforts to ensure adequate library resources in an era of downsizing. In addition, this collaboration has provided a new and important role for librarians to play on an accreditation team.

John Warren's copy of votes from a meeting of the Boston Medical Society, 1784 May 3

This document lists the eleven votes cast at a meeting of the Boston Medical Society on May 3, 1784. It was authorized as a "true coppy" by Thomas Kast, the Secretary of the Society. The following members of the Society were present at the meeting, all of them doctors: James Pecker, James Lloyd, Joseph Gardner, Samuel Danforth, Isaac Rand, Jr., Charles Jarvis, Thomas Kast, Benjamin Curtis, Thomas Welsh, Nathaniel Walker Appleton, and doctors whose last names were Adams, Townsend, Eustis, Homans, and Whitwell. The document indicates that a meeting had been held the previous evening, as well (May 2, 1784), at which the topics on which votes were taken had been discussed. The votes, eleven in total, were all related to the doctors' concerns about John Warren and his involvement with the emerging medical school (now Harvard Medical School), that school's relation to almshouses, the medical care of the poor, and other related matters. The tone and content of these votes reveals anger on the part of the members of the Boston Medical Society towards Warren. This anger appears to have stemmed from the perceived threat of Warren to their own practices, exacerbated by a vote of the Harvard Corporation on April 19, 1784. This vote authorized Warren to apply to the Overseers of the Poor for the town of Boston, requesting that students in the newly-established Harvard medical program, where Warren was Professor of Anatomy and Surgery, be allowed to visit the hospital of the almshouse with their professors for the purpose of clinical instruction. Although Warren believed that the students would learn far more from these visits, in regards to surgical experience, than they could possibly learn in Cambridge, the proposal provoked great distrust from the members of the Boston Medical Society, who accused Warren of an "attempt to direct the public medical business from its usual channels" for his own financial and professional gain.

Cases copied by James Lloyd from Mr. Steed, apothecary in Guy's Hospital, London, 1751-1787 (inclusive)

Contains medical cases copied by James Lloyd (1728-1810), primarily between 1751 and 1754, from Mr. Steed, an apothecary at Guy's Hospital in London, England. The volume has additional medical cases dating from 1780 to 1787. Lloyd transcribed the names, ages, and symptoms of the patients, as well as the medicines and medical care delivered to them. The volume is divided into chapters based on the type of case, which included vision loss; fluor albus, or leucorrhoea; diabetes; and dysentery. There is also a letter pasted into the volume addressed to Dr. Brigham of the Boston Medical Library Association from Lloyd's great-grandson, dated 4 November 1887.

Student notes from medical lectures by Benjamin Rush, undated

The volumes contain student notes on a course of medical lectures given by Dr. Benjamin Rush (1746-1813) while he was Professor of the Institutes of Medicine and Clinical Practice at the University of Pennsylvania Medical School, likely in circa 1800-1813. The notes indicate Rush often referenced the works or teachings of contemporaries such as Scottish physicians William Cullen, John Brown, John Gregory, and Robert Whytt, and Dutch physician Herman Boerhaave. He frequently included anecdotes and case histories of his own patients, as well as those of other doctors, to illustrate his lecture topics. He also advised students to take notes on the lectures after they ended to allow them to focus on what they were hearing. Volume 1 includes notes on: physician conduct during visits to patients; human and animal physiology; voice and speech; the nervous system; the five senses; and faculties of the mind. Volume 2 includes notes on: food, the sources of appetite and thirst, and digestion; the lymphatic system; secretions; excretions; theories of nutrition; differences in the minds and bodies of women and men; reproduction; pathology; a table outlining the stages of disease production; “disease and the origin of moral and natural evil”; contagions; the role of food, drink, and clothing in producing disease; worms; hereditary diseases; predisposition to diseases; proximate causes of diseases; and pulmonary conditions. Volume 3 includes notes on: the pulse; therapeutics, such as emetics, sedatives, and digitalis, and treatment of various illnesses like pulmonary consumption, kidney disease, palsy, and rheumatism; diagnosis and prognosis of fever; treatment of intermitting fever; and epidemics including plague, smallpox, and yellow fever, with an emphasis on the yellow fever outbreaks in Philadelphia in 1793 and 1797.

Homeopathic (School) College

Originally West Professor's house on North University. Became Homeopathic Hospital. Wing added in rear of building in 1879. School of Dentistry 1875-1877. Psychological Lab 1903-1914. Building razed in 1914. On verso: Homeopathic Dept. from 1875-1877. In another hand: School & Dental School (Dr. M. Ward's corrections 3-25-35)

Color aerial view of Medical campus, incl. "Old Main" Hospital, mid 1960s?

side 2

Review of the Government's rights and practices concerning recovery of the cost of hospital and medical services in negligent third-party cases /

"May 1960."