Utilization and productivity of the Duke physician's associate

The objectives of this study were as follows: (1) Formulate a theoretical model of the typical medical practice as a system for producing medical care, with particular attention to the role of middle-level health workers such as graduates of Duke University's Physician's Associate Program. (2) Develop a methodology for collecting data necessary to estimate the relevant parameters in the model, and to describe current patterns of utilization of Duke PA's. (3) Draw substantive conclusions, insofar as the model and data collection methodology permit, about the actual and potential productivity of Duke PA's.As of October 1971 Duke University had graduated 68 PA's from its Physician's Associate Program. Of these, 34 are employed as assistants in family practice or general medicine in a variety of private and institutional settings. Data were collected on eleven of these 34 PA's. No attempt was made to study the other 34 graduates engaged in clinical specialties, administration, or other functions. Neither was any attempt made to collect data on or draw inferences about the utilization and productivity of graduates of any other program such as the MEDEX Program.⁴     

Economic growth and environmental impact: evaluating alternatives

The environment is no longer to be considered a free good, whether it is utilized for economic growth or is affected by it.This is an exploratory paper attempting to depict a conceptual framework for policy planning embodying growth, environmental and societal variables. The aim is to identify a comprehensive framework and suggest an operationally feasible set of methodologies and processes. In view of the limitations of the current theoretical andmethodological framework, the suggested heuristic approach is an attempt to develop and specify a realistic and convenient process for operational purposes. Moreover, any future developments in theory, methodology, measurement and information is considered to be complementary to, rather than competing with, the proposed framework. The contention is that while the on-going research undertakings are expected to improve the theoretical and methodological framework of the existing body of doctrine, there appears to be a need for a systematic operational framework for policy planning keeping in prospects realism, reasonableness andcertain balances. Sufficient flexibility should be maintained to adjust the particular aspects of the system in light of new information and experience.In summary, the issues of growth and the resultant environmental and societal implications are expounded upon and a conceptual framework is suggested for the process of national priority setting.The desirability of continued growth for the developed and developing countries is predicated upon the premise that environmental and societal variables are to be explicitly embodied in the allocation process so that the composition, structure and the rates of economics growth are compatible with the quality of life (Q/L).