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March 4, 1992

My Pulse Is Not What It Used to Be: The Leadership Challenges in Health Care

Author Affiliations

University of Oklahoma College of Medicine Oklahoma City

JAMA. 1992;267(9):1275. doi:10.1001/jama.1992.03480090123043

Many readers will be familiar with volumes that deal with leadership issues in industry and society in general.1-6 But, to my knowledge, this is the first book to deal specifically with the challenges presented to physician leaders of physician organizations.

Developing a frame of reference to help physician leaders understand the tasks at hand is a major challenge in itself. Rubin, a highly respected organizational development consultant, and Fernandez, a physician executive, have collaborated to present an actual case history with commentary and analysis. The book is small but well done and succeeds admirably both in presenting fundamental knowledge of physician organization development and in providing encouragement and support for physician leaders involved in helping these unique organizations achieve their purposes.

The case involves the responses of the multispecialty clinic at which Dr Fernandez presides to the changes occurring in health care. (The case narrative is complete with clinical