Seven deadly assumptions for new physician managers.

You've just been, or are about to be, named to a management position, your first. Success will not be easy, but it can be achieved. Just avoid seven common assumptions that are the chief culprits in the demise of many a physician executive: All human beings make rational decisions, so the way to resolve conflicts is by giving people more data. Clinical teams are the same as management teams. Your new title confers all the decision-making authority, trust, and power needed to do the job. Bedside communication techniques are the same ones used in the board room. A financial statement is pretty much the same as a checking account statement. There are no politics in management. Just reading every important management text will make you a great manager.

Merging medical groups.

One of the trends of the past 10 years that has marked the way physicians practice medicine is growth in the size and complexity of group practice. The reasons for these changes (better patient coverage, within-the-group referral, a larger financial base, a collegial environment, shared overhead, professional management, and packaged negotiation) are clear and are certainly valid. This trend shows few signs of slowing and may be accelerating. Indeed, most of the proposals for national health care reform seem likely to put larger groups at a competitive advantage. We have developed a highly effective procedure that helps improve the efficiency and the success of the merger process.

Infarction of the superior temporal gyrus: a description of auditory evoked potential latency and amplitude topology.

P1 and N1 of the cortical auditory evoked potential (AEP) were studied with multiple electrodes in 10 normal subjects and 6 patients with left middle cerebral artery infarction. Patients were selected based on neurological examination and on CT scans showing both (1) infarction limited to the vascular territory and (2) involvement of posterior portion of superior temporal gyrus. Waveforms recorded from C3, Cz, and C4 were examined for peak latency and amplitude of P1 and N1 on all subjects. Topographic displays of amplitude over P1 and N1 latency ranges were also examined. In normals, P1 was identified in 9 of the 10 subjects at all three electrode sites. In patients, P1 was identified at C3 in only 1 of the 6. N1 was present at all three electrodes in the 10 normal subjects and in 5 of the 6 patients. The remaining patient had N1 at C4 and Cz only. Examination of amplitude topology showed as asymmetric evolution of P1 and N1 in the patients. This asymmetry was not present in normals. The results of this study are consistent with theory that P1 arises from primary auditory cortex. Results further suggest multiple generators for N1. Additional study correlating topographic display from multichannel recordings with CT or MRI in brain-injured patients may bring more insight into N1 generators.