Health Care: Pressure for Change

August 10, 1984

Report Outline
New Era in Health Care
Responses to High Costs
Cost Containment's Impact
Long-Term Reform Issues
Special Focus

New Era in Health Care

Innovative Service Changing Profession

The family doctor, carrying his black bag on house calls and caring for everything from mother's delivery to junior's measles, has long been a thing of the past. The tools of his trade grew so in size and complexity after World War II that house calls became all but out of the question. No matter how ill, most patients must get to a doctor's office, clinic or hospital for diagnosis and treatment. Once there, the patient is likely to be treated by doctors he has never met. The trusted, if somewhat paternalistic, family physician has been replaced by a myriad of specialists whose interests appear confined to individual organ systems and methods of treatment.

But recent trends indicate changes in America's health care system. The family doctor may be on his way back. The steady concentration of medical and surgical services in large hospital centers is slowing. Free-standing, or independent, clinics are springing up in shopping malls and other unlikely places as private practitioners compete aggressively for patients. By offering prompt attention to a wide variety of ailments at all hours and at relatively low cost, these walk-in “emergicenters” or “surgicenters” provide an attractive alternative to the hospital emergency room or Monday-through-Friday-only doctor's office. Called “docs-in-the-box” by their detractors, emergicenter physicians are accused of conducting their profession as they might a fast-food franchise.

When hospitalization is necessary, inpatient stays are becoming shorter and shorter. A woman whose mother might well have spent a full week in the hospital at her birth can expect to stay only one to three days for a normal delivery today. Many relatively simple surgical procedures, such as tonsillectomies, are conducted on an “in-and-out” basis. Pre-operative preparation, surgery and postoperative care are all completed within hours, with no overnight stay.

ISSUE TRACKER for Related Reports
Health Insurance
Oct. 23, 2020  The U.S. Health Insurance System
Oct. 18, 2019  Health Care Debates
Sep. 21, 2012  Assessing the New Health Care Law
Jun. 11, 2010  Health-Care Reform Updated
Aug. 28, 2009  Health-Care Reform
Mar. 30, 2007  Universal Coverage
Jun. 14, 2002  Covering the Uninsured
Apr. 16, 1999  Managing Managed Care
Apr. 12, 1996  Managed Care
Mar. 17, 1995  Primary Care
Nov. 23, 1990  Setting Limits on Medical Care
Oct. 14, 1988  The Failure to Contain Medical Costs
Aug. 10, 1984  Health Care: Pressure for Change
Apr. 08, 1983  Rising Cost of Health Care
Jan. 28, 1977  Controlling Health Costs
Aug. 09, 1974  Health Maintenance Organizations
Jun. 13, 1973  Health Care in Britain and America
Jan. 18, 1970  Future of Health Insurance
Jun. 20, 1962  Health Care Plans and Medical Practice
May 28, 1958  Health Insurance Costs
Feb. 17, 1954  Government Aid for Health Plans
Nov. 22, 1949  Compensation for Disability
Aug. 30, 1946  Public Medical Care
Jan. 25, 1944  Medical Insurance
Sep. 16, 1938  Health Insurance in Foreign Countries
Mar. 06, 1937  Toward Health Insurance
Jul. 09, 1934  Sickness Insurance and Group Hospitalization
Health Insurance and Managed Care
Medicaid and Medicare
Medicaid and Medicare