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4. How to fix the primary care crisis

Author

Schimpff, Stephen C.

Subjects
Demographic aspects, Training, Medical students -- Training, Medical specialties -- Demographic aspects, Primary health care -- Training
Abstract

A recent article by Victoria Knight of Kaiser Health News chronicled the declining interest in primary care (i.e., general internal medicine, family medicine and pediatrics) by medical school graduates. Of [...]

Published
2020

7. Solving the crisis in primary care

Author

Schimpff, Stephen C.

Subjects
Practice, Analysis, Reports, Physicians -- Practice, Primary health care -- Analysis -- Reports
Abstract

Direct pay models could buy physicians more time with patients to improve care and reset a fractured payment system There is a crisis in the provision of primary care in [...]

Published
2014

18. Organs for transplantation

Author

Lopez-Navidad, Antonio, Caballero, Francisco, Bartlett, Stephen T., Oldach, David, Schimpff, Stephen C., Selby, Rick, Genyk, Yuri, Jabbour, Nicolas, Hilbrands, Lukas B., Hordijk, Willem, Vliet, J. Adam van der, Remuzzi, Giuseppe, Gridelli, Bruno, Kahn, Jeffrey, and Matas, Arthur

Subjects
Donation of organs, tissues, etc. -- Analysis
Published
2000

19. Direct primary care does not lead to patient abandonment

Author

Schimpff, Stephen C.

Subjects
Practice, Analysis, Services, Health care costs -- Analysis, Physicians -- Practice, Primary health care -- Services, Physician-patient relations -- Analysis
Abstract

I frequently hear the lament that when a primary care physician converts to direct primary care (DPC)/retainer-based/concierge care models, a lot of patients get left out, equating to patient abandonment. [...]

Published
2018

21. Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever

Author

Hughes, Walter T., Armstrong, Donald, Bodey, Gerald P., Feld, Ronald, Mandell, Gerald L., Meyers, Joel D., Pizzo, Philip A., Schimpff, Stephen C., Shenep, Jerry L., Wade, James C., Young, Lowell S., and Yow, Martha D.

Subjects
Antibiotics -- Usage, Neutropenia -- Drug therapy, Fever -- Causes of, Neutropenia -- Complications, Health, Infectious Diseases Society of America -- Reports
Abstract

Neutropenia is an abnormal drop in the number of neutrophils, a type of white blood cell involved in fighting off infection. Patients with neutropenia who have fever are likely to have a bacterial infection in their blood. Typical signs of infection such as swelling may be reduced or absent in neutropenic patients, which tends to make diagnosis complicated. The infectious organisms in neutropenic patients are typically gram-negative bacilli and gram-positive cocci, which are generally restricted to just a few sites on the body, primarily the intestinal tract and skin. Treatment of neutropenic patients is complicated because excessive antibiotic therapy can predispose these patients to other types of infections (secondary infections), and it can make bacteria resistant to treatment, have adverse affects and cost a great deal of money. Since untreated infections can be life-threatening in the neutropenic patient, careful diagnosis and treatment are essential. The medical management of neutropenic patients having an unexplained episode of fever is reviewed. Although specific antibiotic plans cannot be determined in advance, a set of guidelines recommended by a committee working for the Infectious Diseases Society of America is presented. A four-star rating system was used to evaluate the validity of each antibiotic treatment for each type of bacterial infection. All patients with unexplained fever and a neutrophil count of less than 500 cells per microliter should be placed on a broad spectrum antibiotic. Specific antibiotic regimens are selected based on the type of bacteria, how often the infection occurs and the susceptibility of the bacteria to that particular antibiotic. The specific recommendations for antibiotic therapy, which is based on the committee's consensus, are not intended to be steadfast rules but a reasonable approach to the management of neutropenic patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

36. The future of health care delivery

Author

Schimpff, Stephen C.

Subjects
Health care industry, Entrepreneurship
Abstract

We have a real paradox in American health care. We have superb medical schools and exceptionally well-trained physicians who are committed to our care. America is the envy of the [...]

Published
2013

37. Dealing with disease: combating chronic diseases such as cardiovascular and lung disease requires a transformation of our healthcare delivery system

Author

Schimpff, Stephen C.

Subjects
Health care industry, Chronic diseases, Medical equipment, Lung diseases, Physiological apparatus
Abstract

In 1900, the three most common causes of death in the United States were typhoid, tuberculosis and pneumonia--all infectious diseases. In 2010, the three most common causes of death in [...]

Published
2013

38. The Hospital of the Future. Megatrends, Driving Forces, Barriers to Implementation, Overarching Perspectives, Major Trends into the Future, Implications for TATRC And Specific Recommendations for Action

Author

ARMY MEDICAL RESEARCH AND MATERIEL COMMAND FORT DETRICK MD TELEMEDICINE AND ADVANCED TECH RESEARCH CENTER, Schimpff, Stephen C., ARMY MEDICAL RESEARCH AND MATERIEL COMMAND FORT DETRICK MD TELEMEDICINE AND ADVANCED TECH RESEARCH CENTER, and Schimpff, Stephen C.

Abstract

In the coming five to fifteen years we can expect that medicine will change dramatically such that it will become custom tailored [also known as 'personalized medicine']; there will be greater emphasis on prevention; medicine's ability to repair, restore or replace organs, tissues and cells will markedly advance; medical information will finally become fully digitized with instant access, anytime and anyplace; healthcare quality and safety will improve dramatically; and, in a all likelihood, there will be realistic attempts to address the rapidly rising costs of medical care. These changes are being driven by advances in biomedical research such as the advent of the genomics era with targeted drugs, drug prescribing with assured efficacy and safety, disease prediction and disease prognostication and improved diagnostics; the developing understanding of stem cells; the improved understanding of immunology that is leading to the creation of vaccines for both infections and chronic diseases such as atherosclerosis and Alzheimer's and to methods for improved transplantation including xenotransplantation; and the advances arising from the pharmaceutical and biotechnology industries with new drugs. Less appreciated are the advances in medicine that derive from engineering and computer science. These include vastly improved anatomic imaging and the beginnings of functional or molecular imaging; medical devices such as pacemakers, stents, bioengineered tissues and nanotechnology devices; improvements in the operating room such as new instruments but also the advent of simulation for training, practice and certification, the use of robots for surgery and surgical assistance, and new approaches such as natural orifice surgery.

Published
2008

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