Institute for the Study of
Healthcare Organizations & Transactions


Healthcare is no longer a matter of physicians and their patients.  The changing organization of the healthcare industry means that healthcare consumers routinely interact with many kinds of  professionals. However, consumers are not alone in coping with the changes that are occurring in healthcare today. Many professionals have experienced changes in their traditional roles as well.  For example:

Nurse practitioners may increasingly provide primary care services largely independent of physicians. 
Pharmacists now do more than dispense medications prescribed by physicians.  They are now asked to provide "cognitive services" to insure that patients understand their medicines. 
Clinical psychologists, once trained to perform psychotherapy, may now practice behavioral medicine as well. (Click on the Clinical Psychology page to read about training issues that are facing this profession.)


TREND 1:  Increasingly, healthcare providers of all types no longer practice alone or in small groups.  Rather, they are members of large corporate enterprises, sometimes operating for profit.  In these enterprises, diagnosis and treatment are not  medical "arts", where intuition and creativity can play a large part.

TREND 2:  Providers must diagnose their patients according to predetermined categories, conform their treatments to practice guidelines and other standards of care, and prescribe drugs within the constraints of institutional formularies.

TREND 3:  Prescribed treatments must have demonstrated efficacy. And, selection among effective treatments must be guided by considerations of cost and efficiency.


Patients are no longer passive recipients of healthcare services. These changes mean that healthcare providers of all types need to learn more than anatomy, physiology, pharmacology, and surgical techniques.

The advertisement of drugs in the popular press and electronic media, and the widespread availability of medical information on the Internet, mean that patients may be armed with more information (including misinformation) about their conditions than ever before. 
Consumers are, now more than ever, more capable of challenging diagnoses and prescriptions, more inclined to obtain second opinions, and more likely to seek nontraditional treatments as complements or alternatives to established ones.  Click on our Herbals & Dietary Supplements pages to read more about this.
Physicians, whose training currently emphasizes the biological sciences, need to appreciate the contributions of the behavioral and social sciences to health and healthcare. Click on the NRC Report (release date: August 1, 2000) to read about what a committee of the National Research Council had to say about this.
Providers of all sorts need to learn how to evaluate and weigh the outcomes and costs of the interventions and techniques. 

They need to learn more about the contributions that other professions make to the total healthcare enterprise. 

And they need to learn more about the environment and organizations in which they will practice their professions.    

Accordingly, the curricula of professional schools and continuing-education programs must be revised and expanded in order to convey to healthcare providers the new knowledge and attitudes they will need to practice appropriately in the new environment.

We welcome you to this portion of our Web site and invite you to read, download, and comment on what you find.  Thank you for clicking on.

John F. Kihlstrom, PhD

Copyright 2000 Institute for the Study of Healthcare Organizations & Transactions

Last modified:   04.08.2010 02:58 PM