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This paper explores problems in delegating aspects of the physician's work to others. The relative merits of using assistants vs. associates is discussed in terms of productivity, legal issues, role relationships and training programs. Also considered are the quality of care and its evaluation, future manpower pools, and consumer acceptance. [ABSTRACT FROM AUTHOR]

The article presents the second part of the paper on tuberculosis (TB) program and the channel for patient/consumer advocacy on Alumni-Patient Council that was organized to help TB patients in the U.S. It explores the role and goal of patients/consumers group in the delivery of health services, the onset of different mode of treatment for tuberculosis, and the representation of the voice of patients/consumers group over the method of treatment for tuberculosis. The role of patients/consumer group in health services is deemed necessary in improving the effectiveness of the country's health care delivery system.

The article presents the first part of the paper on a tuberculosis (TB) program and the channel for patient/consumer advocacy on Alumni-Patient Council in the U.S. It offers information about the history of the Council and discusses the purpose of its creation. The Council was organized in 1967 with the help of a social worker and a small group of tuberculosis patients from Herman Kiefer and Maybury Sanatoria. It was aimed to share patient's knowledge about tuberculosis and to create a better program for its treatment. The patients/consumers group was able to change health service programs by educating themselves about their rights, dignity and major role in the delivery of health services.

ABSTRACT The purpose of this study is to develop economic incentives for consumers of health care services that win lead to efficient delivery of health care of any specified quality. The importance of this investigation derives from the rising cost of health services and the resulting quest for new organizational structures for their delivery. These new structures are supposed to utilize resources more efficiently than current institutions and thereby make health services available to a broader class of consumers. The authors posit a health care delivery that provides two kinds of services--preventive care and treatment. Provision of each kind of care is costly. The individual selects a level of preventive care that maximizes expected utility, where utility is a function of disposable income. It is shown that the level of preventive care chosen by the individual will not in general be appropriate for the 'minimization o[ the total costs of health care. The possibility of selecting a payment scheme for health services is investigated, ranging from full prepayment to fee-for-service compatible with minimization of expected total cost. The main result is the development of such a payment plan. [ABSTRACT FROM AUTHOR]

A system involving a family doctor-nurse team was put into operation in an Israeli town in 1967. New tasks were involved for the nurse. These are described. The number of patients seen by the physician have been reduced, greater satisfaction among patients, physicians and nurses has been created, and there has been improved medical care for the community. [ABSTRACT FROM AUTHOR]

In order to evaluate the effect of better medical care on poor people, the authors of this report examined the effect of a comprehensive medical care program on the behavior of elementary school children from low income families by measuring improvement in school attendance. Improvement was produced, but the effect was small, compared to other variables. These factors are discussed. [ABSTRACT FROM AUTHOR]