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A case study in
corporate resuscitation
Managed-care
executive Norman C. Payson, M.D., described “The Rise, Collapse
and Resurrection of Oxford Health Plans Inc.” for graduates
of the Yale Management Course for Physicians in April. The Connecticut-based
health insurer “is off the ventilator, it is out of the
ICU, but it is still an inpatient,” said Payson, who was
brought in to revive the ailing company as its CEO last year.
He was a fitting
choice for the graduation ceremony, which marked the end of a course designed
to impart management skills so doctors may better cope with medicine’s new
regulatory and financial environment. Payson started his career as a physician,
became CEO of a 120-physician group practice, then headed a managed care company
before taking over as CEO of Oxford. The company became the darling of Wall Street
in the early 1990s as it offered customers a choice of insurance plans and sought
affiliations with top doctors and hospitals. After a series of poor business decisions,
its quarterly profits of $34 million, Payson said, fell to quarterly losses of
$45 million a year later. Its stock plummeted, investors sued and regulators intervened.
To survive, the company jettisoned its management, secured new investments and
pulled out of unprofitable markets. Now, Payson said, Oxford’s recovery is
a work in progress. “Hopefully,” he said, “the patient will be
able to go home soon.”
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Shades
of gray in the human genome
Nobel
laureate Baruch S. Blumberg, M.D., Ph.D., discussed environmental
and genetic factors of the hepatitis B virus and related liver
diseases during a talk on May 24. “It is very difficult,
if not impossible, to assign a value to a gene in terms of good
or bad,” Blumberg said. “Those terms are polarized
and very often they can only be used in the context of other
factors that are involved.”
His talk, “DNA
Polymorphisms and Clinical Phenotypes: A New Era for Genome Epidemiology,”
was the second annual Genaissance Pharmacogenetics Lecture. Blumberg shared the
1976 Nobel Prize in Medicine with D. Carleton Gajdusek, M.D., for their discoveries
concerning new mechanisms for the origin and dissemination of infectious diseases.
Blumberg was honored for his discovery of the hepatitis B virus.
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“Lost
Boys” author weighs in on Littleton
Access
to weapons, violent role models in the media, spiritual emptiness
and a history of trouble are among the risk factors that can
precipitate teen violence, said James Garbarino, Ph.D., director
of the Family Life Development Center and professor of human
development at Cornell University. Garbarino’s talk on May
6, “Lost Boys: Pathways to Violence,” came two weeks
after the high-school massacre in Littleton, Colo., that left
15 dead, including two high-school gunmen.
“[The cause]
is not one thing, it’s an accumulation of risk factors,” Garbarino said
during the second in a series of lectures marking the opening this fall of the
Neison and Irving Harris Building of the Child Study Center. “With one or
two risk factors, kids do fine. With three or four risk factors they go over the
line.” But Garbarino saw cause for optimism in the tragedy. “This is
obviously a time of despair, but also an opportunity to help people mobilize in
caring, thoughtful ways,” he said.
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Biology’s
new world
DNA
sequencing and genome-mapping have moved biology into a new world
where researchers try to keep pace with the explosion of information
and ideas, Nobel laureate Walter Gilbert, Ph.D., told a standing-room-only
audience of graduate students, postdocs and researchers in May.
“By
the time you start graduate school,” he said, “there
is only 10 percent of the information about DNA that will be
known by the time you get your Ph.D. A few years ago it was possible
to get a thesis by cloning a gene. Today it is impossible. You
have to do something more.”
Gilbert,
a microbiologist at Harvard who invented DNA sequencing, delivered
the seventh annual Edward A. Adelberg Lecture in Genetics. He
shared the 1980 Nobel Prize in chemistry with Frederick Sanger
for their work in determining base sequences in
nucleic acids. |
