Growth Trends in Dental Service Organizations.

There are a number of factors fueling the growth of large group practices managed by corporations across the U.S., including California. These evolving trends are shaping the dental profession and practice models in a variety of ways.

Will Large DSO-Managed Group Practices Be the Predominant Setting for Oral Health Care by 2025? Two Viewpoints: Viewpoint 1: Large DSO-Managed Group Practices Will Be the Setting in Which the Majority of Oral Health Care Is Delivered by 2025 and Viewpoint 2: Increases in DSO-Managed Group Practices Will Be Offset by Models Allowing Dentists to Retain the Independence and Freedom of a Traditional Practice.

This Point/Counterpoint article discusses the transformation of dental practice from the traditional solo/small-group (partnership) model of the 1900s to large Dental Support Organizations (DSO) that support affiliated dental practices by providing nonclinical functions such as, but not limited to, accounting, human resources, marketing, and legal and practice management. Many feel that DSO-managed group practices (DMGPs) with employed providers will become the setting in which the majority of oral health care will be delivered in the future. Viewpoint 1 asserts that the traditional dental practice patterns of the past are shifting as many younger dentists gravitate toward employed positions in large group practices or the public sector. Although educational debt is relevant in predicting graduates' practice choices, other variables such as gender, race, and work-life balance play critical roles as well. Societal characteristics demonstrated by aging Gen Xers and those in the Millennial generation blend seamlessly with the opportunities DMGPs offer their employees. Viewpoint 2 contends the traditional model of dental care delivery-allowing entrepreneurial practitioners to make decisions in an autonomous setting-is changing but not to the degree nor as rapidly as Viewpoint 1 professes. Millennials entering the dental profession, with characteristics universally attributed to their generation, see value in the independence and flexibility that a traditional practice allows. Although DMGPs provide dentists one option for practice, several alternative delivery models offer current dentists and future dental school graduates many of the advantages of DMGPs while allowing them to maintain the independence and freedom a traditional practice provides.

[Potentials of cooperative quality management initiatives: BQS Institute projects, January 2010 - July 2013]. / Bericht aus der Praxis: Möglichkeiten einrichtungsübergreifender Qualitätsinitiativen. QS-Projekte des BQS-Instituts Januar 2010 bis Juli 2013.

Alongside the projects of internal quality management and mandatory quality assurance there is a variety of quality driven projects across institutions initiated and run by various partners to continuously improve the quality of care. The multiplicity and characteristics of these projects are discussed on the basis of projects run by the BQS Institute between 2010 and 2013. In addition, useful interactions and linking with mandatory quality benchmarking and with internal quality management are discussed. (As supplied by publisher).

The evolution of dental group practices.

Dentists and the dental profession are changing. One significant change in the deliver of dental care is the evolution of group practices to include networks of dental practices with central management by various service organizations that are owned or financed by private equity firms. This article discusses their evolution and potential advantages and disadvantages for dentists who join them. The article concludes with a prediction about the future heterogeneity of the dental care system.

The citizen physician: governance principles make the difference.

Until recently, medicine was one of the few areas in which an individual could practice a profession as a citizen member of the organization. However, in the last 15 years as dramatic reductions have occurred in outpatient reimbursement, physicians have moved from self-governing organizations with the rights of citizen participation to autocratic, centrally controlled organizations with little offered to physicians other than to provide high-quality manual labor. The principles of prosperity and choice espoused in The Federalist Papers are governance principles that can reestablish citizenship in medical groups no matter who owns them.

Mejoramiento del proceso de atención del parto en el centro quirúrgico obstétrico del Hospital José María Velasco Ibarra / Improvement of the process of attention of the childbirth in the obstetric surgical center of the Hospital José María Velasco Ibarra

Este trabajo investiga la situación actual del proceso de atención del parto, sus debilidades, limitaciones y en base a este, proponer acciones que tienda a fortalecer esta atención en el Centro Quirúrgico Obstétrico del Hospital José María Velasco Ibarra de Tena, ubicado en la amazonía ecuatoriana.El objetivo principal planteado fue el investigar la siutación actual del proceso de atención del parto desde su inicio al ingresar a emergencias hasta su culminación al egresar del Centro Quirúrgico Obstétrico del Hospital José María Velasco Ibarra de Tena y proponer el establecimiento de mecanismos o estándares de calidad que permitan mejorarlo considerando la inclusión del acompañamiento familiar

Gestión de Políticas Públicas y Salud / Management of public policies and health

En nombre del proyecto Gestión de Políticas Publicas y Salud liderado en Antioquia por la Dirección Seccional de Salud y la Facultad Nacional de Salud Pública, agradezco a los organizadores la invitación que nos han hecho para que compartamos con ustedes hoy algunos de los conceptos y experiencias relacionados con la gestión de políticas públicas en salud. Los organizadores me han pedido especialmente retomar algunos conceptos básicos relacionados con el tema que hemos trabajado en otros espacios y que podrían facilitar el trabajo interinstitucional. Por eso he estructurado esta ponencia en cuatro partes. En la primera retomaré brevemente, a manera de glosario algunos conceptos básicos relacionados con la comprensión y gestión de las políticas públicas, cuya revisión podría facilitarnos lacomprensión del resto de la ponencia. A continuación desarrollo algunas reflexiones sobre las preguntas que podrían o deberían hacerse los agentes interesados por las políticas públicas de salud y sobre los métodos que podrían ayudarles a resolver sus inquietudes. La presentación termina con una conclusión que podría ser objeto de debate a lo largo del evento. Esta ponencia defiende tres ideas centrales: En primer lugar, que las políticas públicas que afectan la salud son siempre complejas y suelen ser principalmente extra-sectoriales. Por esta misma razón deben ser enfocadas interdisciplinaria y trans- sectorialmente. En segundo lugar, que la gestión de políticas públicas es el reflejo de intereses con frecuencia opuestos y por ello mismo debería incluir la participación de los afectados. Y finalmente, que los alcances de la participación de lasociedad civil pueden ser muy limitados si ésta no se organiza de manera efectiva.

On behalf of the Public Policies Development and Health Project led by the Divisional Management of Health an the National Faculty of Public Health in Antioquia, I thank the organizers for the invitation they made us to share some of the concepts and experiences related to the Public Policies Development in Health. The organizers have especially asked me to review some basic concepts related to the topic we have worked before, which could facilitate interinstitutional work. Due to what was mentioned above, this presentation has been divided in four parts. In the first part, I will briefly mention some basic concepts related to the comprehension and development of public politics, to facilitate the understanding of the rest of the presentation. The concepts are distributed in a glossary. Following this, I present some thoughts on the questions that individuals, interested in public policies of health and in methods that could be of help when answering inqueries, could or should ask themselves. This presentation defines three main ideas: firstly, the public policies that affect the health sector are always complex and tend to cover multiple sectors. Due to this, they should have an interdisciplinary and trans-sectoral focus. In second place, the development of public policies is the reflection, usually, of opposite interests, and therefore, should include the participation of those involved. Finally, the range of the civilian participation could be very limited, if this part of society doesn't become organized in an effective manner