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Appendix D Biographies of Committee Members JEROME H. GROSSMAN, M.D., is the chairman and chief executive of- ficer of the New England Medical Center, Inc. He is also chairman of the Institute for the Advancement of Health and Medical Care and pro- fessor of medicine at lefts University School of Medicine. He selves as trustee/director of several corporations and institutions, including the Fed- eral Reserve Bank, the Boston Private Industry Council, lefts Associated Health Plan, Wellesley College, and Arthur D. Little, Inc. Dr. Gross- man joined the staff of Massachusetts General Hospital in 1966, where he served in a variety of positions. He came to the New England Medical Center in 1979. Dr. Grossman was one of the original staR of the Harvard Community Health Plan, where he developed the world's first automated medical record system, known today as COSTAR. From 1982 to 1987 Dr. Grossman served as program director of the Commonwealth Fund Task Force on Academic Health Centers. He is a member of the Institute of Medicine. HUGH P. lI. BOWER, M.D., was trained in England and has practiced medicine in four countries. For the last 25 years he has been a family physician in rural New Hampshire and Vermont He is on the board of the American Academy of Family Physicians (AAE;P) and three years ago helped to start their Task Force for Clinical Policies. He is also on the Task Force for Clinical Policies for the Council of Medical Specialties Society. He has been chairman of the Committee on Aging of the AAFP for the last two years. 151

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152 CLINICAL PRACTICE GUIDELINES ROBERT H. BROOK, M.D., Sc.D., F.A.C.P., is deputy director of the Health Program and a corporate fellow at the RAND Corporation and chief of the Division of Geriatrics and Professor of Medicine and of Public Health at the UCLA Center for the Health Sciences. At RAND he was the leader of the Health and Quality Group on the $80 million RAND Health Insurance Experiment and was the co-principal investigator on the Health Services Utilization Study, which both developed a method to as- sess appropriateness of care and then applied it to carotid endarterectomy, coronary angiography, and endoscopy. He was the co-principal investi- gator on the only national study that has investigated, at a clinical level, the Impact of DRGs on quality and outcome of acute hospital care. At UCLA he is the director of the Robert Wood Johnson Clinical Scholars Program. Dr. Brook's special research interests include quality assessment and assurance; the development and use of health status measurements in health policy; the efficiency and effectiveness of medical care; and the variation in use of selected seIvices by geographic area. He is a member of the Institute of Medicine, the American Society for Clinical Investigation, and the American Association of Physicians. He recently was awarded the Baxter Foundation Prize for excellence ~ health services research and the Rosenthal Foundation Award of the American College of Physicians for contributions lo improving the health of the nation. He is the author of more than 250 articles on quality of care. ARTHUR J. DONOVAN, M.D., is professor and chairman of the department of surgery at the University of Southern California in Los Angeles. A graduate of Thfts University School of Medicine, he received his education in surgery at Yale University. Prior to his present appointment, he seated on the facula in surgery at lefts University School of Medicine, the University of Southern California, and the University of South Alabama in Mobile. At that institution, he was also acting dean and vice president for health affairs. Dr. Donovan has served on the American Board of Surgery, the American Board of Family Practice, and the Residency Review Committee for Surgery. He was chairman of the American Board of Surgery from 1986 to 1988. Dr. Donovan was chairman of the board of governors of the American College of Surgeons from 1987 to 1989. He represented the American Surgical Association on the Council of Academic Societies of the American Association of Medical Colleges from 1979 to 1984. He served from 1982 to 1987 on the Task Force on Academic Health Centers of the Commonwealth Fund. DAVID M. EDDY, M.D., Ph.D., is the J. Alexander McMahon Professor of Health Policy and Management at Duke University. He received his M.D. degree from the University of Virginia and a Ph.D. in engineering-economic systems (applied mathematics) at Stanford. After serving on the faculty

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APPENDIX D 153 at Stanford as professor of engineering and medicine, in 1981 he went to Duke University to set up the Center for Health Policy Research and Education. Dr. Eddy's research has focused on developing and applying methods for evaluating health practices and designing practice policies. He has developed policies for a number of organizations, including the American Cancer Society, the National Cancer Institute, the World Health Organization, the Congressional Office of Technology Assessment, the Blue Cross and Blue Shield Association (BCBSA), and the American Medical Association. His mathematical model of cancer screening was awarded the Lanchester Prize, the top award in the field of operations research. He recently completed a manual on methods for designing practice policies, a book that describes a new set of statistical methods for synthesizing experimental and nonexperimental evidence to estimate the effect of medical interventions on health outcomes. Dr. Eddy is the methodological consultant to the BCBSAs medical advisory panel, which recommends coverage policies to the BCBSA plans, and is scientific director of the Association's new program to promote quality of care. He serves on the Board of Mathematics of the National Academy of Sciences and is a member of the National Academy of Sciences and the Institute of Medicine. RICHARD D. FLOYD, M.D., is a general, vascular, and thoracic surgeon at the Lexington Clinic in Lexington, Kentucly. He was chairman of the Lexington Clinic Board of Directors for 12 years. He is a clinical associate professor of surgery at the University of Kentucly. He served as a director of the American Board of Surgery and governor of the American College of Surgeons and has been a member of the board of trustees at ~ansylvania University for 19 years. He is a member of many surgical societies including the American College of Surgeons and the Southern Surgical Association. ALICE G. GOSFIELD, J.D., is an attorney from Philadelphia who has worked on legal aspects of utilization management, quality assurance, and peer review issues since 1973. She has been a public member of a statewide Professional Standards Review Council and a consultant to state and fed- eral regulatory agencies on health law issues. She lectures widely on these issues for various organizations including the National Health Lawyers Association, American Medical Association, American Medical Peer Re- view Association, Blue Cross and Blue Shield Association, and others. A member of the executive committee of the National Health Lawyers Asso- ciation, she has chaired their programs on utilization management, PROs, and quality assurance and is on the planning committee for their jointly sponsored programs with the American Medical Association on physician legal issues. Ms. Gosfield has published a book on PSROs, numerous articles on utilization management and quality assurance topics, and is a

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154 CONICAL PRACTICE GUIDELINES contributing editor of the 1989 Heath Law Handbook and the forthcoming l 990 Health Law Handbook, published by Clark Boardman Co., Ltd. She is also the consulting editor to Clark Boardman Co., Ltd.'s, health law series. She was a member of the Institute of Medicine Committee on Utilization Management by Third Parties. MICHAEL A.W. HA0WICK, M.D., is a practicing physician with Wood- burn Internal Medicine Associates, Ltd., a five-physician pruna~y care internal medicine practice that he founded in Fairfax County, Virginia, in 1977. He was born in Illinois, raised in Texas, and educated at Harvard, Georgetown, and the University of London. He is board certified in in- ternal medicine and in preventive medicine, with a subspecialty interest in preventive cardiology. He is currently a clinical assistant professor of the Departments of Medicine and Community and Family Medicine of George- town University School of Medicine, a member of the governing council of the Virginia chapter of the American College of Physicians, a trustee of the Virginia Society of Internal Medicine, and a member of the American Medical Association. Since 1978, he has been actively using computers to implement preventive medicine guidelines in his clinical practice. Prior to entering full-time medical practice, he served as chief medical advisor and director of the Health Examination Survey of the National Center for Health Statistics, director of the Surveillance and Assessment Center of the National Influenza Immunization Program, director of the Special Pathogens Branch of the Viral Disease Division Epidemiology Program at the Centers for Disease Control, and registrar and visiting lecturer at St. Thomas' Hospital Medical School. CLARK C. HAVIGHURST, I.D., is William Neal Reynolds Professor of maw at Duke University. He Is also professor of community health sciences at the Duke University Medical School. During the 1989-1990 academic year, he was on sabbatical at the firm of Epstein, Becker ~ Green in Washington, D.C. Mr. Havighurst received his undergraduate degree from Princeton University and his law degree from Northwestern University. He is the author of a leading law school casebook, Health Case Law and Policy (Foundation Press, 1988), and Dereg~laiing the Health Care Indzls~y (13allinger, 1982~. He will shortly publish a major article on practice guidelines in the Saint Louis University Law Journal. His other writings include numerous articles on health insurance, professional liability, and competition and antitrust issues in the health care field. On earlier sabbaticals, he served as consultant to the U.S. Federal Trade Commission (1988-1989) and as a scholar-in-residence at the IOM (1972-1973~. He has been an IOM member since 1982.

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APPENDIX D 155 ADA SUE HINSHAW, Ph.D., Rot., F.A.A.N., has been director of the National Center for Nursing Research at the National Institutes of Health since June 1987. Prior positions included professor and director of research at the University of Arizona College of Nursing while concurrently serving as director of nursing research at University Medical Center. Dr. Hinshaw received her Ph.D. in sociology from the University of Arizona, holds two master's degrees-in sociology, from the University of Arizona, and nursing, from Yale University-and earned her undergraduate degree in nursing from the University of Kansas. Dr. Hinshaw has published widely. Her honorary and professional affiliations include the American Nurses Association, Council of Nurse Researchers, Sigma Xi, American Academy of Nursing, Sigma Theta Tau, Inc. the National Academies of Practice, and the Institute of Medicine. She has conducted numerous extramurally funded studies focused on nursing systems and nursing administration research. JOHN T. KELLY, M.D., Ph.D., has been director of the American Medical Association's (AMA) Office of Quality Assurance since June 1988. He coordinates the AMA/Specialn,r Society Practice Parameters Forum and is the editor of the AMA's quality assurance newsletter. Formerly, he was as- sociate medical director of California Medical Review, Inc., the California peer review organization; chairman of the Quality Assurance Committee of the American Medical Peer Review Association; and a practicing emer- gency physician. He has also seIved as president of the San Francisco Emergency Physicians Association. He received his undergraduate training from Amherst College, his doctorate in the history of science from Harvard University, and his medical degree from Harvard Medical School. His residency training was in internal medicine and radiology. DONALD G. IAN GSLE:Y, M.D., is executive vice president of the American Board of Medical Specialties and professor of psychiatry and behavioral sciences at Northwestern University School of Medicine. He was formerly professor and chairman of psychiatry at the University of Cincinnati and, for nine years previously, the first chairman of the Psychiatry Department at the University of California, Davis, School of Medicine. He has also been president of the American Psychiatric Association and of the National Resident Matching Plan. He is a member of the board of trustees of the Educational Commission for Foreign Medical Graduates and a member of the National Board of Medical Examiners. Dr. Langsley was a director of the American Board of PsychiatIy and Neurology and a member of the Residency Review Committee in Psychiatry and Neurology

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156 CLINICAL PRACTICE GUIDELINES LAWRENCE C. MORRIS is a consultant in health care finance, based in Wilmette, Illinois. Before becoming a consultant, he spent 23 years with the Blue Cross and Blue Shield Association, the majority of that time as senior vice president for professional affairs and health benefits management. Previously, he was for 10 years executive director of the Medical Society of Delaware. Mr Morris was an originator of the Blue Cross and Blue Shield Medical Necessity Program, the first collaborative effort among national medical specialty societies and a payment agency to establish guidelines for cost-effective practice. He was a member of the Institute of Medicine's Council on Health Care Technology and chair of its Infonnation Panel. JOACHIM L. OPITZ, M.D., is professor of physical medicine and rehabil- itation, Mayo Medical School, Rochester, Minnesota. His medical degrees are from the University of Goettingen (West Germany) and the University of Minnesota, and he is board certified in physical medicine and rehabili- tation. Dr. Opitz has been president of the American Academy of Physical Medicine and Rehabilitation and is its current delegate to the Council of Medical Specialty Societies. Among other professional society activities, he chairs the Task Force on Practice Guidelines and Standards of the Ameri- can Spinal Injury Association. He is the author of numerous articles in the field of rehabilitation medicine and professional education. JOHN C. PETERSON III, M.D., is the chairman of the Medical Directors Section of AMPRA, the American Medical Peer Review Association. He is also director of medical affairs for the Professional Review Organization for Washington, Alaska, and Idaho. He has served in that position since 1986. Dr. Peterson has had an active clinical practice in internal medicine and family practice in Seattle, Washington, since 1972 and serves as clinical associate professor of family practice at the University of Washington School of Medicine. Dr. Peterson joined the Stan of Northwest Hospital in Seattle, Washington, in 1972, where he has served in various positions, including chairman of the Credentials Committee. He is a fellow of the American Academy of Family Practice and a member of the American College of Physicians. ELLISON C. PIERCE, JR., M.D., is associate clinical professor of anaes- thesia at Harvard Medical School and chairman of the Department of Anaesthesia at the New England Deaconess Hospital. He was the 1984 president of the American Society of Anesthesiologists and is a current chairman of its Committee on Patient SafeW and Risk Management. In 1985 he founded and became president of the Anesthesia Patient Safety Foundation, a multidisciplinary organization dedicated to all facets of pa- tient safeW in anesthesia. Dr. Pierce is chairman of the Ask Force on Practice Policies of the Council of Medical Specialty Societies, a member

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APPENDI)f D 157 of the American Medical Association Practice Parameters Forum, a mem- ber of the Joint Commission of Anesthesia Care's Clinical Indicator Ask Force, and a member of the World Federation of Societies of Anesthesiolo- gists' Committee on Safety in Anaesthesia. He is an authority on anesthesia patient safety and risk management and has lectured and written on anes- thesia in the diabetic patient, the medical liability crisis, and patient safely and risk management. Dr. Pierce is president and chief executive officer of Anaesthesia Associates of Boston, P.C., a group practice providing services to two major Boston teaching hospitals and several other Massachusetts hospitals and surgicenters. BRENDA RICHARDSON, M.D., is a practicing physician in Massachusetts. She is the president of the Massachusetts Peer Review Organization, a wholly owned subsidiary of the Massachusetts Medical Society. Dr. Richardson graduated from McMaster Medical School and the Harvard School of Public Health. In addition to her PRO activities, she maintains a consulting practice in nutrition, is the school physician for the city of Gloucester, and is the medical director of quality assurance and utilization review at the Addison-Gilbert Hospital in Gloucester, Massachusetts. Dr. Richardson is board certified by the American Board of Quality Assurance and Utilization Review Physicians. She is a past president of the local chapter of the American Cancer Society and a current member of the Pro- fessional Advisory Board of the Visiting Nurses Association of the North Shore. LOUISE RUSSELL, Ph.D., is research professor of economics at the In- stitute for Health, Health Care Policy, and Aging Research, Rutgers Uni- versi~, and a professor in the Department of Economics. Before joining Rutgers in 1987, Dr. Russell was a senior fellow at the Brookings Institution for 12 years. Her most recent Brookings book is Medicare's New Hospital Payment System: Is It Working? (1989~3, an evaluation of the success of Medicare's DRG-based payment rates for hospitals. Her Brookings pub- lications also include Evaluahng Preventive Care: Report on a Workshop (1987), Is Prevenuo~z Better Than Cure? (1986), The Baby Boom Generation and the Economy (1982), and Technology in Hospitals: Medical Advances and Their Division (1979~. She has written numerous journal articles as well as chapters in several editions of Brookings' regular volumes on the federal budget Dr. Russell is a member of the Institute of Medicine. She served on the Institute's Committee for the Study of the Future of Public Health (1986-1987) and currently selves on its Board on Health Sciences Policy. She was also a member of the U.S. Preventive Services Thsk Force of the Department of Health and Human Services (1984-1988~.

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158 CLINICAL PRACTICE GUIDELINES WILLIAM STASOtI, M.D., M.S., received his M.D. degree, cum laude, from the Haward Medical School in 1960 and his master of science degree in epidemiology from the Harvard School of Public Health in 1975. He trained in internal medicine and cardiology at the Massachusetts General Hospital, Boston, Massachusetts, and Columbia Presbyterian Hospital, New York, New York. He has been a member of the Harvard faculty since 1970 and is currently lecturer in health policy and management at the Harvard School of Public Health and lecturer in medicine at the Harvard Medical School. For the past 20 years, Dr. Stason has been involved in planning, managing, and evaluating health care services. He is currently director of the Department of Veterans Affairs Northeast Health Sentences Research and Development Field Program located at the West Roxbury, Massachusetts, Medical Center and vice president of Health Economics Research, Inc., of Needham, Massachusetts. MICHAEL A. STOCKER, M.D., M.P.H., has been executive vice president and general manager of the Greater New York Marketplace since May 1989 and senior vice president and general manager of the Greater New York Marketplace since July 1987. Since November 1986 he has been president of U.S. Healthcare, Inc. (New York), and from October 1985 to October 1986 he was vice president and medical director of the same subsidiary. From 1980 to 1985 he was medical director of the Anchor Organization for Health Maintenance of the Rush Presbyterian St. Luke's Medical Center in Chicago. Prior to that he was associate chairman of the Department of Family Practice at Cook County Hospital in Chicago from 1975 to 1980. Dr. Stocker was educated at the University of Notre Dame and received his M.D. degree from the Medical College of Wisconsin in 1968. He received his postgraduate training at the Mayo Clinic and the University of California, Davus, and is board certified in internal medicine and family practice. Dr. Stocker also received a master's degree in public health from the University of Michigan in 1978. JAMES J. STRAIN, M.D., is professor and director of the Division of Behavioral Medicine and Consultation Psychiatry at the Mount Sinai School of Medicine. He is president of the Society of Liaison Psychiatry, co- chairman of the MICRO-CARES Consultation/Liaison Consortium for computerized data management systems and collaborative studies, and scientific advisor to the European Consultation/Liaison Work Group. He is a former chairperson of ethics at the Mount Sinai School of Medicine. Under National Institute of Mental Health contracts and grants, he has pioneered models of mental health training for primary care physicians and cost-ofLet evaluation for psychiatric interventions in the medical setting. Funded by the National Cancer Institute, he has developed models to examine physician adherence to protocols and thereby provided schema

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APPENDIX D 159 to reduce error measurement secondary to noncompliance. The MICRO- CARES computer program to document psychiatric interventions in the medical setting was offered to 100 medical schools through an education grant. This program was designed to enhance clinical care, administration, research, and education in the psychiatric consultation setting. LINDA JOlINSON WHITE is director of the Department of Scientific Policy of the American College of Physicians in Philadelphia. She oversees the policy development and research activities of the college, including the clinical privileges project; the quality assurance, medical ethics, and adult immunization initiatives; other health promotion/disease prevention programs; and activities in geriatrics, health care organization, and financ- ing. In 1982, when Ms. White became research associate to the Clinical Efficacy Assessment Project (CEAP) of the American College of Physi- cians, she was instrumental in establishing this program as the premiere private-sector technology assessment activity in the country. CEAP reports are published in the Annals of Internal Medicine as educational resources for physicians, and they are used by others in the development of appropri- ate utilization and reimbursement policies. Originally with the Council of Medical Specialty Societies in Lake Forest, Illinois, Ms. White developed council policies on the impaired physician, consultations, criteria for inter- preting computed tomography scans, guidelines for physician advertising, and effective peer review. Ms. White's involvement in medical practice guidelines development began with the initiation of the Medical Necessity Project by the Blue Cross and Blue Shield Association and the formation of process and procedures for the Council of Medical Specialty Societies Program on Clinical Procedure Review in 1976. Ms. White is a graduate of Northwestern University. CONSTANCE M. VVINSLOW, M.D., M.B.A., is head of research and pro- gram development in AEtna's Employee Benefits Division, a department responsible for the development and implementation of health care utiliza- tion management and quality assurance programs for health maintenance organizations, physician provider organizations, and indemnity business. Prior to coming lo AEtna, Dr. Winslow was a research scientist at the RAND Corporation and assistant professor of medicine at UCLN Her research at RAND was on geographic variations in the use of health ser- vices and the evaluation of the impact of the NIH consensus conferences on physician practice patterns. Her current work at AEtna utilizes health services research as a basis for the development of operational programs. A board-certified internist, she graduated from the University of California, San Francisco, School of Medicine and completed both her internship and residency at the Hospital of the University of Pennsylvania. Her fellowship

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160 Cr rNICAL PRACTICE GUIDELINES training was in health policy as a Robert Wood Johnson Clinical Scholar at the UCLA Department of Medicine, and she received her M.B.N degree from UCLN Her research has been published in the New England Journal of Medicine, the Journal of the American Medical Association, and others. She is a member of the American College of Physicians, the Association of Health Services Research, the American Medical Association, and the Society for General Internal Medicine.