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EUGENE L. ALFORD, MD Book Review Editor
BOOK REVIEWS EUGENE L. ALFORD, MD Book Review Editor
***
Grabb's Encyclopedia of Flaps, edited by Berish Strauch, Luis O. Vasconez, and Elizabeth J. Hall-Findlay. 2272 pages. Lippincott-Raven, Philadelphia, 1998. 475.00. This book is actually a 3-volume text, of which only the first volume, "Head and Neck Reconstruction," is of interest to the otolaryngologist-head and neck surgeon. This volume is divided into different sites of reconstruction: (1) scalp, forehead, and nape of neck; (2) eyelid and orbit; (3) nose; (4) ear; (5) cheek and neck; (6) lip; (7) intraoral structures; and (8) pharyngeal esophageal structures. Those flaps applicable to reconstruction of each site are delineated within that individual section. Short, concise chapters describe the flaps, beginning with local rotational flaps and ultimately progressing to regional flaps, distant flaps, and microvascular free tissue transfers. Each chapter is arranged in a similar fashion, which provides uniformity throughout the text. A short editorial comment begins the chapter, followed by indications, anatomy, flap design, operative technique, and clinical results. Fairly simple line drawings in each chapter are complemented by an example of a clinical case. One objective of this encyclopedia is to provide choices for the closure of particular defects that will fulfill the requirements of the reconstruction, even though it may be the most complex method. Multiple authors contribute to this text, often the originator of the flap, so that unique perspectives are described for similar defects. Volume 1 of this text clearly has a place in the library of every otolaryngologist-head and neck surgeon who makes head and neck reconstruction part of his or her practice. It allows the surgeon faced with a particular defect to look at the variety of options available and to choose the appropriate reconstructive technique. This book is not meant to be an exhaustive description of each particular flap; however, pertinent references are listed that will provide the reader with full descriptions of each flap and its uses. Residents-in-training will also find this encyclopedia very useful for the reasons mentioned above. This text presents one of the best broad overviews of head and neck reconstruction. Neal D. Futral!, MD, DMD
*****
Managed Care, Outcomes, and Quality. A Practical Guide, by Steven F. Isenberg. 366 pages. Thieme Medical Publishers, Inc, New York, 1997. $59.00.
*****
The rating scale is as follows: Outstanding, a classic, should be on the shelf of anyone interested in the subject; Strong, well-written book with major contributions in some areas; Informative book that should be read. if not owned, by indiSome worthwhile informaviduals with interest in the field; tion, but with deficiencies in writing style or completeness; Major shortcomings, not recommended.
***
**
450 Otolaryngology-Head and Neck Surgery
****
*
This handbook discusses the current medical practice environment, which is dominated by managed care either in reality or by the physician's economic concern. Because the managed care environment is relatively new and constantly changing, this text presents the historic facts, definitions of terms, and current state of affairs in 4 major sections. It begins by addressing the basics of capitation, referral guidelines, negotiation of contracts, profiling, and legal issues of managed care contracting. Wilmes details the intricacy of capitation by giving multiple real-life examples. Dagi explains the fine points of negotiating techniques including "Enlarge the Pie" and the "Four Quadrant Analysis." Neal discuses all the legal fine points of managed care contracts. Section 2 reviews outcomes in a managed care environment. Definitions of outcomes research are discussed by Stewart. Meaningful outcomes research and how to implement changes are dealt with in detail. Multiple otolaryngology examples are used throughout, culminating with a chapter on project Solo, which gives specific information on the patient satisfaction survey that Isenberg spearheaded in 1994. Flow charts on improving office efficiency and staffing requirements are discussed by Toth to begin the third section on quality in the front and back offices. Total quality management, marketing of one's practice, managing of referral services, and employee and operation costs are all dissected in detail. Discussion of information systems in managed care and capitation by Hudson gives very useful benchmarks on hardware, software, maintenance, and support services, which are invaluable. Kidder amplifies important points of contract language such as "hold-harmless" clause and safeguarding the patients' best interests. The last section deals with physicians' responses to managed care. In general, mergers, IPAs, single-specialty networks, or groups have resulted. Techniques of mergers, acquisitions, and group formations were also discussed in detail and included a very specific real-life example of multiple actual projects. Overall, this book is exactly what it claims to be-a practical guide. Above all, it contains all the wisdom and insights of the 26 combatants in this war-like business world, which has dominated our health care scene. The multiple checklists, actual documents, and real-life experiences of the authors truly qualify this as an invaluable handbook in the daily chaotic life of managed care. In the world of evolve or perish, this handbook provides some of the major landmarks and defines the obstacles in navigating through this complex environment in which we all have to function. Whether a physician, administrator, nurse, or third-party payer, or in any way remotely related to health care delivery, the reader undoubtedly will find vast golden morsels of knowledge in this comprehensive text. This book is a must read! Jimmy W. C. Lee, MD March 1999
***
Grabb's Encyclopedia of Flaps, edited by Berish Strauch, Luis O. Vasconez, and Elizabeth J. Hall-Findlay. 2272 pages. Lippincott-Raven, Philadelphia, 1998. 475.00. This book is actually a 3-volume text, of which only the first volume, "Head and Neck Reconstruction," is of interest to the otolaryngologist-head and neck surgeon. This volume is divided into different sites of reconstruction: (1) scalp, forehead, and nape of neck; (2) eyelid and orbit; (3) nose; (4) ear; (5) cheek and neck; (6) lip; (7) intraoral structures; and (8) pharyngeal esophageal structures. Those flaps applicable to reconstruction of each site are delineated within that individual section. Short, concise chapters describe the flaps, beginning with local rotational flaps and ultimately progressing to regional flaps, distant flaps, and microvascular free tissue transfers. Each chapter is arranged in a similar fashion, which provides uniformity throughout the text. A short editorial comment begins the chapter, followed by indications, anatomy, flap design, operative technique, and clinical results. Fairly simple line drawings in each chapter are complemented by an example of a clinical case. One objective of this encyclopedia is to provide choices for the closure of particular defects that will fulfill the requirements of the reconstruction, even though it may be the most complex method. Multiple authors contribute to this text, often the originator of the flap, so that unique perspectives are described for similar defects. Volume 1 of this text clearly has a place in the library of every otolaryngologist-head and neck surgeon who makes head and neck reconstruction part of his or her practice. It allows the surgeon faced with a particular defect to look at the variety of options available and to choose the appropriate reconstructive technique. This book is not meant to be an exhaustive description of each particular flap; however, pertinent references are listed that will provide the reader with full descriptions of each flap and its uses. Residents-in-training will also find this encyclopedia very useful for the reasons mentioned above. This text presents one of the best broad overviews of head and neck reconstruction. Neal D. Futral!, MD, DMD
*****
Managed Care, Outcomes, and Quality. A Practical Guide, by Steven F. Isenberg. 366 pages. Thieme Medical Publishers, Inc, New York, 1997. $59.00.
*****
The rating scale is as follows: Outstanding, a classic, should be on the shelf of anyone interested in the subject; Strong, well-written book with major contributions in some areas; Informative book that should be read. if not owned, by indiSome worthwhile informaviduals with interest in the field; tion, but with deficiencies in writing style or completeness; Major shortcomings, not recommended.
***
**
450 Otolaryngology-Head and Neck Surgery
****
*
This handbook discusses the current medical practice environment, which is dominated by managed care either in reality or by the physician's economic concern. Because the managed care environment is relatively new and constantly changing, this text presents the historic facts, definitions of terms, and current state of affairs in 4 major sections. It begins by addressing the basics of capitation, referral guidelines, negotiation of contracts, profiling, and legal issues of managed care contracting. Wilmes details the intricacy of capitation by giving multiple real-life examples. Dagi explains the fine points of negotiating techniques including "Enlarge the Pie" and the "Four Quadrant Analysis." Neal discuses all the legal fine points of managed care contracts. Section 2 reviews outcomes in a managed care environment. Definitions of outcomes research are discussed by Stewart. Meaningful outcomes research and how to implement changes are dealt with in detail. Multiple otolaryngology examples are used throughout, culminating with a chapter on project Solo, which gives specific information on the patient satisfaction survey that Isenberg spearheaded in 1994. Flow charts on improving office efficiency and staffing requirements are discussed by Toth to begin the third section on quality in the front and back offices. Total quality management, marketing of one's practice, managing of referral services, and employee and operation costs are all dissected in detail. Discussion of information systems in managed care and capitation by Hudson gives very useful benchmarks on hardware, software, maintenance, and support services, which are invaluable. Kidder amplifies important points of contract language such as "hold-harmless" clause and safeguarding the patients' best interests. The last section deals with physicians' responses to managed care. In general, mergers, IPAs, single-specialty networks, or groups have resulted. Techniques of mergers, acquisitions, and group formations were also discussed in detail and included a very specific real-life example of multiple actual projects. Overall, this book is exactly what it claims to be-a practical guide. Above all, it contains all the wisdom and insights of the 26 combatants in this war-like business world, which has dominated our health care scene. The multiple checklists, actual documents, and real-life experiences of the authors truly qualify this as an invaluable handbook in the daily chaotic life of managed care. In the world of evolve or perish, this handbook provides some of the major landmarks and defines the obstacles in navigating through this complex environment in which we all have to function. Whether a physician, administrator, nurse, or third-party payer, or in any way remotely related to health care delivery, the reader undoubtedly will find vast golden morsels of knowledge in this comprehensive text. This book is a must read! Jimmy W. C. Lee, MD March 1999