Exam Questions and CORRECT Answers
What is Ambulatory Care? - CORRECT ANSWER - Ambulatory care is a personal health
care consultation, treatment, or intervention using advanced medical technology or procedures
delivered on an outpatient basis.
Examples of ambulatory care settings - CORRECT ANSWER - Private Medical Office
Practice
Other (non-physician) ambulatory care practitioners
Ambulatory care services of hospitals
Hospital emergency services
Free-standing (non-hospital based) facilities
overview of ambulatory care - CORRECT ANSWER - medical care not requiring
overnight hospitalization
an increase in ambulatory care increased in the 80s due to what - CORRECT ANSWER -
Advanced technology → safety improvements for procedure
Payer incentives to decrease inpatient stays
Consumer and physician preferences
1990s: increasing number of outpatient/ambulatory care facilities owned and operated by
hospitals, physicians, independent corporate chains. - CORRECT ANSWER - Cancer
treatment, diagnostic imaging, renal dialysis, pain management, physical therapy, cardiac and
other rehabilitation, eye, plastic and other surgery, etc.
Physicians and hospitals compete for patient business, altering prior relationships
what is the Predominant mode of health care services - CORRECT ANSWER - Private
Medical Office Practice
, Private Medical Office Practice visits - CORRECT ANSWER - 929 million visits per year
56% of visits to general internal medicine and family practice, pediatrics, Ob/gyn
17% of visits to orthopedic surgeons, ophthalmology, dermatology, psychiatry
27% of visits to an array of other physician specialists
The first major group practice, The Mayo Clinic group practice of salaried MDs began in late
1800s (see note below), was seen as - CORRECT ANSWER - controversial and a new
way of practicing medicine as a cooperative science
Until 1930's solo practice predominant - CORRECT ANSWER - 1932 Committee on the
Costs of Medical Care* report recommended group practice as economically efficient, promoted
insurance as a means to improve access.
Reactions to Committee Reporton the Costs of Medical Care: 1930s-1950s - CORRECT
ANSWER - AMA condemned the recommendations for group practice and salaried
physicians as "unethical"
GHI establishment (1937) erupted legal battle; AMA expelled GHI-salaried physicians and
"blacklisted" them with hospitals
D.C Medical Society and AMA indicted and found guilty of conspiracy to monopolize medical
practice
Next few decades spawned controversy about MD participation in group health plans
Continuing Opposition to Group Practice - CORRECT ANSWER - Physicians sought
membership in evolving group health plans as local medical societies attempted and failed at
obstructing group practices
Group physicians were ostracized and denied hospital privileges
Opposition subsided by 1950s due to legal challenges and physician shortage
Transition from Solo to Group Practice- 1960s - Changes occurring - CORRECT
ANSWER - Social and lifestyle changes
Medical specialization