in the culture of medicine, and they saw their mission as a generation of profit for stockholders, not necessarily medical care for clients. Cost-effective medicine was the goal in the context of a profit-making enterprise. Although preventive health care programs were promised, very few were realized and they were not nearly comprehensive. The definition of unnecessary testing slowly expanded to mean virtually any high-cost test requiring the service of a medical specialist, and low priced generalist physicians with limited diagnostic and therapeutic skills were made available to patients with the instruction they should limit their access to high-cost specialists. Managed care organizations tended to re ward primary care physicians who avoided specialty referrals, and severed contracts with those who persisted in sending their patients to outside consultants. Most notoriously, managed care organizations maintained veto authority over the provision of complex and expensive care, and that veto was often wielded in defiance of a physician's recommendation by managed care employees without medical training or experience. Managed care did indeed slow the rate in increase of medical costs, but not without limitations on the care provided to patients and the professional integrity of physicians. Managed care organizations were so successful that they could provide extremely high salaries to their executives even in the context of limiting cost and care. It is these developments that the papers of this symposium addressed. The most fundamental ethical issue is posed in the first paper by Dr."

This collection provides a philosophical and historical analysis of the development and current situation of managed care. It discusses the relationship between physician professionalism and patient rights to affordable, high quality care. Its special feature is its depth of analysis as the philosophical, social, and economic issues of managed care are developed. It will be of interest to educated readers in their role as patients and to all levels of medical and health care professionals.

The author joined the Fleet Air Arm in December 1950. During his 13+ years of service, he worked on many interesting Naval aircraft. A few years later, the 'jet' propelled aircraft would make their appearance, and to make room for those, his beloved piston-engine aircraft would have to go. By chance, the author spent a comparatively short time on aircraft carriers, due to his rapid selection for regular higher maintenance training, rising from Air Mechanic (2nd Class) to the top as Chief Petty Officer (Air Mechanician 1st Class). As his career drew to a close, larger Naval aircraft were entering service, and helicopters were becoming larger. Those marvellous aircraft, and talented pilots, were unable to fly without the efforts of maintenance personnel; the author's role was to assist in 'Keeping Them Flying'. His career finalised taking charge of a maintenance crew for a helicopter unit at the Dartmouth Britannia Naval College.

If you enjoy the country-side, reading or poetry, you will find 40 poems in this book that will interest you, which are enjoyable to read, covering topics that many readers will relate to. The collection has been written over the past 50 years whilst the author dwelt in rural surroundings, which inspired him to put into verse life as he witnessed it. If an interest in poetry has escaped you, this book will allow an ideal opening to the genre. Each poem, or verse, has been written in a manner that makes reading them a pleasure for all age groups. They span a variety of themes as diverse as the 'Trials of an Umpire' to a visit to 'Stow Horse Fair' or from a 'February Freeze' to a 'Summer's Dream'. Give in to temptation and open the book and begin reading to-day.

After the devastating loss of the Civil War in 1865 Confederate Captain Gregory D. Stewart searches for a new life in the Northwest Territories. Accompanied by a former slave who becomes his best friend, Stewart finds success in gold mining until the relationship with the local Nez Perce tribe goes awry. While running for his life, Stewart's journey takes a strange turn when he is inadvertently abducted and transported through time into the modern era. As they both struggle to adapt to American life in 2008, Stewart matches wits with the strange man from the future who is trying to return Stewart to his correct time after being mind wiped where he will almost certainly be killed by the dozens of Nez Perce warriors he'd left behind.

All twins are EXACTLY alike, aren't they? Meet Mitty and His Sister who are fraternal twin Siamese kittens who couldn't be more different than night and day In this picture-based tale of two kittens, you'll follow Mitty through some of his favorite adventures. You'll see how very different a set of twins can be, and how, at the end of the day, their friendship is what matters most. If you've ever had a sibling, a twin, a friend or a doppelganger, you will relate to this story. This is the first published story by Seattle area artist, Kristol Jones, and it reflects her slightly warped sense of humor while still being appropriate for kids ages 4 and up.

A Translation of All the Greek, Latin, Italian, and French Quotations By J.W. Jones

The Making of the Modern Law: Legal Treatises, 1800-1926 includes over 20,000 analytical, theoretical and practical works on American and British Law. It includes the writings of major legal theorists, including Sir Edward Coke, Sir William Blackstone, James Fitzjames Stephen, Frederic William Maitland, John Marshall, Joseph Story, Oliver Wendell Holmes, Jr. and Roscoe Pound, among others. Legal Treatises includes casebooks, local practice manuals, form books, works for lay readers, pamphlets, letters, speeches and other works of the most influential writers of their time. It is of great value to researchers of domestic and international law, government and politics, legal history, business and economics, criminology and much more.++++The below data was compiled from various identification fields in the bibliographic record of this title. This data is provided as an additional tool in helping to insure edition identification: ++++Harvard Law School Libraryocm12618115Philadelphia: T. & J.W. Johnson, 1889. 129 p.; 24 cm.