Teaching Hospitals Today and the Challenge for Excellence

PEDIATRICS ◽  
1983 ◽  
Vol 71 (6) ◽  
pp. 978-979
Author(s):  
JOSEPH W. ST. GEME
Keyword(s):  
Hospital Care ◽  
Academic Medical Centers ◽  
Teaching Hospitals ◽  
Biomedical Researcher ◽  
Academic Leaders ◽  
Teaching Institution ◽  
Medical Centers ◽  
Academic Medical ◽  
Secondary Hospital ◽  
Administrative Leader

The contemporary pediatric chairman exists in an extraordinary professional milieu. The challenge for academic leaders in this deacde becomes more rigorous with each passing day. No longer will the traditional attributes of teacher, clinician, and biomedical researcher suffice. The chairman must also become a competitive academic-administrative leader with additional skills in personnel management and entrepreneurial business pursuits. At the same time, the arena in which he or she toils, the teaching hospital, has become an economic battle-ground. Competition for patient population and teaching material in our academic medical centers is intense. Can we meet it? Nonteaching community hospitals surround every teaching institution. These hospitals provide primary and secondary hospital care with much less fuss.

In Search of Wonder and Wisdom: Pediatrics in Transition

PEDIATRICS ◽  
1985 ◽  
Vol 76 (2) ◽  
pp. 308-310
Author(s):  
JOSEPH W. ST GEME
Keyword(s):  
Health Care ◽  
Academic Medical Centers ◽  
Teaching Hospitals ◽  
Group Practice ◽  
Medical Systems ◽  
Men And Women ◽  
Pediatric Residents ◽  
Medical Centers ◽  
Academic Medical ◽  
Fierce Competition

Pediatrics has become more complex in the last two decades, matched by similar sophistication throughout all of medicine. We have more medical schools, more students, and more physicians, and teaching hospitals are corporate academic medical centers engaged in fierce competition with community hospitals and innovative medical systems for the health care dollar. New, expanded 3-year curricula for pediatric residents are firmly set, but some pediatricians and, unfortunately, some medical students are skeptical about the future of the discipline and wonder appropriately what kind of pediatrics these young men and women will practice. Pediatric subspecialization has increased, particularly in neonatology, yet more than half of recently surveyed residents will engage in private or group practice.1

Unplanned Reoperation and Implant Revision After Total Wrist Arthroplasty

Hand ◽  
2020 ◽  
pp. 155894471989881 ◽  
Author(s):  
Taylor M. Pong ◽  
Wouter F. van Leeuwen ◽  
Kamil Oflazoglu ◽  
Philip E. Blazar ◽  
Neal Chen
Keyword(s):  
Risk Factors ◽  
Implant Removal ◽  
Academic Medical Centers ◽  
Implant Design ◽  
Factors Associated ◽  
Medical Centers ◽  
Total Wrist Arthroplasty ◽  
Academic Medical ◽  
Related Risk ◽  
Wrist Arthroplasty

Background: Total wrist arthroplasty (TWA) is a treatment option for many debilitating wrist conditions. With recent improvements in implant design, indications for TWA have broadened. However, despite these improvements, there are still complications associated with TWA, such as unplanned reoperation and eventual implant removal. The goal of this study was to identify risk factors for an unplanned reoperation or implant revision after a TWA at 2 academic medical centers between 2002 and 2015. Methods: In this retrospective study, 24 consecutive TWAs were identified using CPT codes. Medical records were manually reviewed to identify demographic, patient- or disease-related, and surgery-related risk factors for reoperation and implant removal after a primary TWA. Results: Forty-six percent of wrists (11 of 24 TWAs performed) had a reoperation after a median of 3.4 years, while 29% (7 of 24) underwent implant revision after a median of 5 years. Two patients had wrist surgery prior to their TWA, both eventually had their implant removed ( P = .08). There were no risk factors associated with reoperation or implant removal. Conclusion: Unplanned reoperation and implant removal after a primary TWA are common. Approximately 1 in 3 wrists are likely to undergo revision surgery. We found no factors associated with reoperation or implant removal; however, prior wrist surgery showed a trend toward risk of implant removal after TWA.

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