The health care crisis - Impact of surgery from a chief executive officer's perspective

Kaiser Permanente, in conjunction with the surrounding academic institution s, trains 64 surgical residents annually in Northern California. Although t he current health care crisis has made resident education increasingly diff icult, we are committed to maintaining and expanding our programs. The curr ent health care crisis reflects the effect that for-profit health plans, ho spitals, and pharmaceutical groups have had on medicine. Their negative imp act has not been simply the extraction of resources from the delivery syste m to their equity shareholders, but the implementation of an authorization process designed to frustrate and deny. As executive director and chief exe cutive officer of the Permanente Medical Group, I believe that resident tra ining allows us to attract outstanding clinicians, train the physicians of the future, and improve the clinical care of our patients. The multispecial ty nature of our medical group and our size allows us to work collaborative ly, offer evidence-based approaches, preserve professional independence, an d implement innovative programs to increase quality and service. Although i t is uncertain how health care will evolve in the future, we at Kaiser Perm anente are committed to maintaining and expanding our involvement in the ed ucation of the next generation of surgeons.