[…] face,” 3e:ms, P.O. Bcix 1026, Salc[na Beach,
CA 92075.

AIl of us at Chicago had been asked to

spillourgutsaboutwhatwaswrongin
our projects. Both Dr. Sylvia Micik and I
fellforitandactuallytoldthewhole

truth. I don‘t remember Dr. Micik’s con–
fessions, but among nine was

admissionofagrowingfeelingonmy

Somethingwasmisstng.

part that there was something very very
wron8inthewaywewereloohingatthe

prehorfutal care industry – […]

[…] “fix it when it

breaks” approach, though too many pro-
viders can honestly claim little more. But
I’vemetownersandmanagersoflargeand

well established ambulance operations
who were actually proud of a preventive

maintenance program that, if they ran a
taxi company or a trucking firm, would be

just fine. If they only knew the differences
between […]

[…] patients whose medical
histories meet defined criteria. Outcome standards are results the system intends to
achieve by meeting its input and perform ­
ance standards.
Wh en the system’s actual perform ance is not in compliance with its perform ance standards, corrective action usually re­
quires modification of, or better adherence to, the system’s input standards, or clari­ […]

[…] by various Emergency Extension Acts
and COBRA (the 1985 budget bill)
through December 31, 1986. Then,
under the Omnibus Reconciliation
Act of 1986 (OBRA ). a maximum
allowable actual charge restriction was placed, not on Medicare reim­
bursement, but on the amounts
non-participating physicians would
be allowed to charge Medicare pa­ tients. Still further, physician […]

[…] well-documented

clinical algorithms not only help

paramedics retain their technical
skills, but actually can be traced with
statistical significance to changes in

patient outcome.
Gradually, very gradually, we are
learning what some have […]