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WARREN UTICA TROY BLOOMFIELD ROCHESTER CANTON PLYMOUTH LIVONIA Venus Plaza 6046 Rochester Rd. At Sq. Lake Rd. 879-1010 Canton Corners 42775 Ford Rd. At Lil ley 981-7400 Fashion With Value Always! db Dr. Norman Bolton cause they are going to give up autonomy," he said. But Sinai Hospital President and CEO Phil Schaengold said the doctors' loss of autonomy would not occur as a result of the development of PHOs. "The loss would result from the increasing impact of man- aged-care plans in the market- place. The managed-care plans (HMOs, PPOs, etc.), in order to contain costs, will dictate the network of providers that pa- tients use, will alter the refer- ral patterns that primary-care physicians use. and in the long run, will probably also dictate certain practice patterns as a means to control costs," he said. One independent physician explains why he opposes PHOs. Joseph Weiss, a rheumatolo- gist with a private practice in Livonia, believes doctors have little autonomy to give up. PHOs will only worsen the sit- uation, he said. Although its board is composed of physicians and hospital officials, he said the PHO is likely to negative- ly impact doctors. "Driving the PHO is the fear of being left out." Dr. Steven Widlansky U) LU ROLLS-ROYCE... • 1 Mile if nellig WO Ma IVA lin#11 THE SUPREME MOTORING. EXPERIENCE. ~Vllppl Cr) LLI . CC LU MICHIGAN'S EXCLUSIVE BENTLEY ROLLS ROYCE DEALER 40475 ANN ARBOR RD., PLYMOUTH, MICHIGAN 20 (313) 453-7500 LOTTERY WINNER SPECIALS CO ROLLS-ROYCE MOTOR CARS INC., 1993. THE NAME "ROLLS-ROYCE - AND THE MASCOT, BADGE AND RADIATOR GRLLLE ARE REGIS1TiRED TRADEMARKS. "As soon as you sign a con- tract, someone is going to be asking you to do things you don't want to do," he said. "(In contracts) there are an awful lot of strictures and re- strictions about which patients you agree to take on. You will probably be under a utilization review. You may or may not be paid if the PHO fails to make budget. I have stayed away from PHOs. Physicians who get involved in this may spend more time in courts than in clin- ics." Said Mr. Schaengold: "That is the extreme position. In reality, if a PHO is to be suc- cessful, then it must do those things that benefit the physi- cian and the hospital. It is not in the interest of the PHO to negatively impact the physi- cian, although the PHO must implement a set of guidelines and protocols to control utiliza- tion and assure high-quality care." For instance, a physician- run committee will decide on criteria for when to use expen- sive high-tech medical equip- ment and which antibiotics are cost effective in treating certain infections, he said. Dr. Weiss also said PROs might fall through because President Bill Clinton's health- care package is doomed. "What the Clinton adminis- tration is trying to do is marry government regulation with free-market ventures. It can't be done because the detail of government bureaucracy won't mix with the ruthlessness you've got to use when you're venturing out into the market- place." Dr. Bolton and Dr. Steven Widlansky served on the com- mittee to form Sinai's PHO. The latter said PROs are necessary — but not necessarily optimal — choice for doctors. "Driving the PHO is the fear of being left out," he said. "Sinai's PHO (eventually) will join with Beaumont's PHO, which will join with others. They'll cover the whole south- eastern region of Michigan. What will happen is the PHO will take over the whole mar- ket and anyone who is not a member of the PHO is out of the market. I think that doctors are sort of trapped." ❑ Comedy Benefit At The Fisher Forgotten Harvest, a non- profit organization working to relieve hunger in the Detroit metropolitan area, will pre- sent native Detroiter Tim Allen, star of ABC's "Home Improvement," at Comedy Night II For Action Against Hunger Sept. 11 at the Fisher Theatre. Tim will headline this even- ing of comedy along with master of ceremonies Mark Ridley. They will be joined by comedians Jim McLean, Keith Ruff and Jill Washburn. Proceeds will go to benefit Forgotten Harvest. Tickets will be available at the Fisher Theatre box office and TicketMaster. Seven pits lie open before the good, and he escapes; before the wicked there is only one, and he falls into it. Talmud: Sanhedrin, 7a