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Specialty Care in the Era of Managed Care
Cleveland Clinic versus University Hospitals of Cleveland

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Table of Contents
John A. Kastor, M.D.

$50.00 hardcover
978-0-8018-8174-9 (24 ctn qty)
2005 288 pp. 24 halftones
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Description

Limiting the use of specialists is one of the highest priorities of managed care, which requires patients and their primary care physicians to focus on a health maintenance approach. Preventive medicine programs, encouraged by insurers and HMOs, theoretically reduce the need for expensive specialty care and thus lower overall costs. But where does this leave specialists and their institutions? Dr. John A. Kastor has studied two leading centers in specialty care, the Cleveland Clinic and the University Hospitals of Cleveland, to learn what these institutions are doing to survive in the current era. Using the findings of more than two hundred interviews with physicians, administrators, investigators, and trustees, the author describes in detail these rival organizations, their individual struggles against the economic pressures presented by managed care, and their sometimes bitter competition for patients. The insights that emerge from this struggle will be of value to anyone interested in how high-profile hospitals and academic medical centers operate, particularly in economically and socially challenging situations.

Reviews

"Kastor has created a very unique window on our era of hospitals in a time of transition. An intriguing and highly important work."—Duncan Neuhauser, Case Western Reserve University

"A book that sprinkles tantalizing tidbits and provides a clear-eyed view of the inner workings of Cleveland's influential medical institutions."—Diane Solov, Plain Dealer

"A truthful and probing account . . . This book should be required reading for the next class of Leadership Cleveland."—Michael D. Roberts, Inside Business

"Kastor has provided us with a meticulously researched case study whose lessons provide for a better understanding of the challenges facing all in the health care field."—Pascal James Imperato, Pharos

"Meticulously researched and documented case study . . . Kastor's book is indispensable."—Jesse Ballenger, Bulletin of the History of Medicine

Author Information

John A. Kastor, M.D., is former chair of the Department of Medicine and a cardiologist at the University of Maryland School of Medicine. He is the author of two editions of Arrhythmias; Mergers of Teaching Hospitals in Boston, New York, and Northern California; and Governance of Teaching Hospitals: Turmoil at Penn and Hopkins, which is also available from Johns Hopkins.
For more information, visit Dr. Kastor's website.


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