2 Aniyan Warns U.S* Hospitals Don't Get Stuck with 'Halfway Technologies' By Joe Sigler American hospitals: Don't get rigid and locked into "half-way technologies.” Your survival may depend on your flexibility. That was part of the message prepared for an American Hospital Association symposium in Warrenton, Va., yesterday and today by Dr. William G. Aniyan, vice president for health affairs. Aniyan said that changes in attitudes and habits by the American people, coupled with better health education, also could have a significant impact on tomorrow's hospitals. Half-Way Technologies Aniyan calls the whole collection of expensive patient maintenance and repair programs, such as kidney dialysis and cardiac by-pass surgery, "half-way technologies" because they are high-cost, aftermath treatments of disease that neither prevent nor control the disease itself. For illustration, Aniyan noted that before research produced a vaccine for polio and antibiotic control of tuberculosis, polio and TB were both half-way technology diseases. If hospitals in the 1940s had been so inflexible as to have planned only for iron lungs and sun rooms, he said, much time, money and personnel would have been wasted. Hospital programs, he cautioned, "should be reviewed annually with a five-year roll forward for constant updating." With rapidly developing changes such as ultrasound and computerized tomography, Aniyan said, "no plans should be set in concrete." Health Education Needs In health education, Aniyan said the United States needs programs on a national basis, "tailored to the needs of every age group." The country, he noted, "is spending a mere $l-$3 million in federal expenditures this year in public education in health." Touching on some of the areas where education is needed, Aniyan said that "alcoholism, drug abuse, obesity and accidents prevail at the same time as we spend millions of dollars on cirrhosis of the liver, crime resultant from drug addiction, managing arteriosclerosis- hypertensioh-diabetes resultant from obesity and accepting premature death or major disability as a result of accidents." Changes in health habits, attitudes and behavior through education could alter the hospital patient makeup of the future, he said. Who Does What One of the key issues facing hospitals is what Aniyan calls "the at least 225 different catiegories of health care personnel who interface with the patient." It raises the question, he said, of "who does what to whom, where and when?" Cost also is a factor because as each "new, ill-defined health profession" is organized, Aniyan said, "a new guild is born to protect Trading Post You may send ads to "Trading Post," Box 3354, Hospital, no later than one week prior to publication. Ads are printed free, but we do not advertise real estate, personal * services or commercial enterprises. Please give your home telephone number. Duke extensions will not be listed. FOR SALE-1971 Grand Prix Model J. Navy blue with white vinyl top. Blue interior. Automatic transmission. Air condition, full p>ower — steering, brakes, windows, seats. AM-FM stereo radio and built-in eight-track player. New shocks and tires. Recently married, must sell. Will take first reasonable offer. Call 383-4363 weekdays after 5 p.m. and anytime on weekends. FOR SALE-1974 Jensen-Healey, 1,500 miles, must sell, leaving country. Call 683-6810 Monday-Friday. Ask for Micki Helms. Call 929-1468 in Chapel Hill after 6 p.m. FOR SALE-1971 AMC Gremlin, 41,000 miles, four-speed, air cond., great vondition; must sell immediately, $990. Intercom is published weekly for Duke Uni versity Medical Center employees, faculty, staff, students and friends by the medical center's Office of Public Relations, Joe Sigler, director; David Williamson,' medical writer; William Erwin, Comprehensive Cancer Center medical writer; Miss Annie Kittrell, secretary. Editor Mrs. Ina Fried Public Relations Assistant John Becton it. New associations, academies, societies, certifying boards and accrediting groups emerge and the cost is ploughed somewhere into the health care system." Certifying the competence of these groups as well as physicians will increasingly affect hospital costs in the future, he predicted. Continuing Evaluation "With the rapid turnover in pertinence and validity of medical information," Aniyan said, "it becomes imperative that continuing evaluation of competence become a way of doing business, similar to the recertification of airline pilots." Hospitals will have to provide facilities for expanding continuing education programs to meet those needs, Aniyan said, and health professionals may have to spend as much as a month a year in advanced clinical study. In his symposium paper, Aniyan lamented the absence of a separate cabinet-level Secretary of Health and the absence of a long-term national health policy which has resulted in "180-degree swings of the pendulum in directional guidance." A strong supporter of research, the doctor advised that "the best prescription for good health and cost containment of health care will be a continued modest investment of public and private monies in biomedical research." co^ by the Camera Call 682-8109 before 5 p.m. (ask for Tim) or 383-2680 after 5 p.m. FOR SALE —Play pen, umbrella stroller, training chair, car seat, all in excellent condition. Call 383-2934 after 4 p.m. FOR SALE —AKC wire-haired fox terriers. Must have fenced yard or keep inside. Call John Mauney, 688-6597 after 5p.m. WANTED —Room to rent or house to share near Duke for Florida State University senior doing internship in hospital recreation. Dates needed Jan. 2-March 25 (12 weeks). Call 471-1710 after 7 p.m. or contact recreation staff in psychiatry, third floor, red zone. FOR SALE —Peke-a-poos. Males, white and black and white. Phone 688-0883 after 6 p.m. or anytime weekends. FOUND—Silver hoop earring found in area of blood drive at Eye Center, Nov. 17. CaH Jane Mahoney, 6M-3511. FOR SALE—1974 Olds Vista Cruiser, 31,000 miles, AM-FM, AC, nine passenger, $3,500. Call 688-6813 Monday-Friday, and after 6 p.m. call 929-146>8 in Chapel Hill. Ask for Ms. Helms. WANTED-Used set of World Book Encyclopedia or Encyclopedia Britannica. Call collect, Hillsborough, 732-4586 after 5:30 p.m. FOR SALE —1969 Buick Skylark, 2-door, hard top, new tires; $995. Call 682-1005, days; ^9-2021, nights. FOR SALE—Firewood, $30 per load. Call Hillsborough, 732-7194, anytime. SKIING IN VERMONT - Group of Duke fjersonnel are going to Burke Mnt., Vt., leaving Jan. 1, 1977, returning Jan. 9; second year offered; 6 days skiing, lesson and equipment available. We share cooking and expenses. Cost about $200. Call 286-7180 or 929-5930 (Chapel Hill). LIQUID LUNCH—Pharmacist Daryl Blackburn checks the prescription for a Total Parenteral Nutrition (TPN) intravenous (IV) solution. "A pharmiacist and surgeon can decide what formula to be used on each individual patient to provide complete nutrition," he explained. Blackburn rotates with other personnel in the Central Pharmacy in checking regular and TPN IV's, filling and checking unit dose carts with patient medications and staffing a drug information service. A graduate of the pharmacy school at the University of North Carolina at Chapel Hill, Blackburn has worked here for two years. He and his wife enjoy traveling, camping, fishing and playing tennis. (Photo by Ina Fried)

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