Plan (FHP), the first and largest Utah HMO, began operations in Utah
in 1976 and by 1992 cared for 140,000 patients annually. HMOs are attractive
to the employer who pays much of the cost of employees' health insurance
because of their generally lower rates and broader coverage. The patient
chooses a primary-care physician--internist, family practitioner, or
pediatrician. These doctors see the patients first and decide on procedures
and, if necessary, refer them to specialists. Another physician is frequently
substituted, particularly when a patient is hospitalized, since the
physician is obligated to work only 40 to 44 hours per week. Physicians
are on salary but are rewarded for keeping costs down. The average age
of patients covered by HMOs is significantly lower than that of the
population at large.
Research Accomplishments Utah physicians and medical researchers have
made many important contributions, locally, nationally, and internationally.
A few significant landmarks are mentioned here.
In 1900 the major
causes of death were infectious diseases such as pneumonia, tuberculosis,
and the childhood diseases. By mid-century heart disease, stroke, and
cancer had climbed to the top of the list, with infectious diseases
at the bottom. Technological advances in public health (such as water-
and sewage-treatment plants) played a major role in nearly eliminating
intestinal infections in the United States, and vaccination accomplished
wonders in reducing childhood diseases. Simultaneously, however, increased
tobacco and alcohol use, and other lifestyle changes, as well as rapidly
increasing pollution by chemicals and radiation, contributed to the
increase in cancer and heart disease.
In the 1940s
and 1950s, a concerted effort by several cooperating departments of
the University of Utah Medical Center, under the leadership of Dr. Leo
Samuels, resulted in significant new knowledge concerning the chemistry
and physiology of the adrenal glands.