Evolving a Culture of Medical Excellence offers a carefully researched, unvarnished history of the Hawaii Permanente Medical Group in honor of its sixtieth anniversary. Author Dr. Albert J. Mariani describes how this medical group, now the largest in Hawaii with 650 doctors, a democracy with principled leadership evolved a successful and durable culture of medical excellence that could serve as a model for similar doctor groups. Real life examples from the author's extensive experience illustrate that the good and bad of human nature can often be successfully approached by aligning interests. It is a study of how decades ago the very dissimilar cultures of medicine and business were reconciled in the traditional Kaiser Permanente program to the benefit of patients and society. It could have been a model for healthcare everywhere. Deviations from the traditional model - especially those that compromised the partnership - resulted in failure.
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Chapter 1 Sidney Garfield, MD: Visionary ......................................... 1 Chapter 2 Henry J. Kaiser: Entrepreneur Extraordinaire ................... 18 Chapter 3 Mr. Kaiser Establishes His Hawaii Health Plan ................ 25 Chapter 4 The Genetic Code and the Kaiser Permanente Golden Age .................................................................... 51 Chapter 5 Philip Chu, MD: The First President of the HPMG ......... 62 Chapter 6 Are Physicians Governable? ............................................... 87 Chapter 7 William M. H. Dung, MD: The Second President of HPMG .........................................................103 Chapter 8 Quality Assurance-Fixing the Jet While It's Flying .......149 Chapter 9 How Much Is a Doctor Worth? .......................................163 Chapter 10 Michael Chaffin, MD: The Third President of HPMG ... 186 Chapter 11 Why Do It Their Way When We Should Do It Our Way? ....................................................................... 238 Chapter 12 Chaos Theory as Applied to Physician Performance ........ 249 Chapter 13 Change to What? The Nineties ....................................... 286 Chapter 14 The Case For KP Regions Outside of California ............. 307 Chapter 15 Geoffrey Sewell, MD: The Fourth President of HPMG .. 338 Epilogue: Will Kaiser Permanente Survive? ....................................... 373 Glossary: