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Pa- tients shoidd l)e cautioned to follow the dosage schedule strictly. .'\n addi- tional contraceptive method is recommended for the first 7 tablet days of the first cycle of Oracon usage. It is also interesting to note that not all atypical mycobacteria are innocuous. AUGUST, 1968, MICHIGAN MEDICINE 963 The Programmatic Aspects of The Michigan Regional Medical Program BY ALBERT E. Mich- igan Health Planning, Detroit, February 23, 1968. While the University of Michigan initiated activity in July, other j^articipants and the Central Office itself did not get staffed until the last quar- ter of 1967. The University of Michigan has been doing cen- tral planning and coordination, trying to plan a Cancer Chemotherapy project, developing a pro- gram for Post Graduate Education of Nurses, es- tablishing a Drug Therapy fnfonnation and Drug- Therapy Analysis Reporting System and has start- ed to plan for the training of non-professional per- sonnel. Administration: Counting onset of menses as Day 1, the patient starts medication on Day 5 of the cycle and takes one white tablet daily liom Day 5 through Day 20, then one pink tablet daily from Day 21 through Day 25 . How'ever, the atypical mycobacteria can still be a fooler. This partnership should make it possible for ever)’ commu- nity’s practicing physicians to share in the diagnostic, therapeutic and consultative re- sources of major medical institutions.” Then, in the opening section of Public Law 89- 239 itself, we find the purposes of the legislation defined as follows: “Sec. The Purposes of this title are — (a) “Through grants, to encourage and assist in the establishment of regional cooperative arrangements among medical schools, research institutions, and hospitals for research and training (including continuing education) and for related demonstrations of patient care in the fields of heart disease, cancer, stroke, and related diseases; (b) “To afford to the medical profession and the medical institutions of the Nation, throutth such cooperative arrangements, the opportu- Presented at the First Annual Conference for . CURRENT STATUS The Michigan Association for Regional Medical Programs has operated under a planning grant since June 1, 1967 — a relatively short period of time. The Michigan Department of Public Health has made a start on planning and developmental work and is developing a system of coordinated data collection and anaylsis to insure the comparability of all data collected in the region.

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Be- cause of the common occurrence of increased cervical mucus, it is recommended that the patient be apprised of this possibility. to guide her in understanding and using conception control A discussion of conception con- trol for brides, “To Plan for a Life- time, Plan with Your Doctor,” is one of several booklets available through your Mead Johnson representative or directly from Mead Johnson Laboratories. JACKSON (Note: This editorial first appeared in a recent issue of the Foote Hospital Pathological News Ptullctin and is reprinted ivith permission of Doc- tor Ahronheini, who is also the editor. Titus, a well organized district hospital (with a specialist staff ancf director of medicaf education) functioning as a training and serv- ice center will serve as a communication link between university and community hosjtitals, lessening the gap between knowledge in uni- versity medical centers and practice in com- munity hospitals. In all programs designed to improve patient care in order to have maximum impact, the effort should ideally be multi-disciplinary, providing for interrelated training of physi- cians, nurses and other personnel. All a]3plications must include specific assur- ances that continuing education offerings will be available to all medical and osteopathic physicians in the area regardless of hospital affiliation.

Therefore, if such tests are abnormal in a patient taking Oracon, it is recommended that they be repeated after the drug has been withdrawn for two months.

Endocrine and possibly liver function tests may be affected by treatment with Oracon.

For those few occasions when breakthrough bleeding occurs, the fol- lowing recommendations are made: (a) Spotting. Discontinue medication and begin a new medication cycle on the fifth day. They should have some immediate impact in communities and hos- pitals not now affiliated with the medical schools and should be programmed to be geo- graphically inclusive with an indication of the phasing anticipated for total coverage. Projects must identify specific working inter- relationships and cooperative arrangements that have been developed or anticipated xvith other agencies. Patient care demonstration jjrojects must ci- ther be replicable elsewhere in the region or have a clearly defined impact throughout the region on physician cajjability through train- ing. Projects will be concerned with those aspects of the subject diseases and of the health care system in which input of funds will result in maximum benefit in improving the care of individual patients. Funding of projects relating to the care of low income urban groups will be encouraged.

However, preg- nancy should be suspected at the first missed period if the patient has deviated from instructions. These are presented here as an integral part of the emerging plan for Michigan’s Regional Medical Program. The goal of the Michigan Regional Medical Program is to advance the accessibility and tite quality of health sendees available to in- dividual patients throughout the region through regional arrangements designed to stimulate new patterns of cooperative action among physicians, hospitals, university medi- cal centers, public health and voluntary health agencies. In addition to universities, a wide range of health related community, district and state- wide agencies will be encouraged to develop projects with the proxision that applicants must have the ability to take full fiscal and operational responsibility for projects devel- oped and have recognized competence in the area of concern or a demonstrable potential. Projects to be considered for funding cannot be isolated activities but must relate to the overall development of Michigan’s Regional Program. In general, projects must provide for some im- mediate relevance for the imjirovement of pa- tient care or for better utilization of man- power. Projects must have as an objective the making of a practical contribution to the effective dif- fusion of knowledge throughout the region and to the lessening of the gap between knowledge and practice as it affects the care of individual patients.

Haagensen, MD, Columbia University Extrication of Injured from Auto Wrecks Col. Kossuth, MC, USAE, ENT, Air Force Base, Colorado Relief of Pain John W. Brosin, MD, University of Pitts- burgh Calcium — Too Much, Too Little L. bulgaricus in a standardized viable culture, with the naturally occurring metabolic products produced by these organisms. Tablets LABOR ATO RIBS l»«8 MEAD JOHNSON ft COMPANY • EVANSVILLE, INDIANA 47721 59S6S VIEWPOINTS Where Are We Heading? Whichever it may be, the AMA is aware ol a problem which is becoming increasingly more serious, and of which there is little hope in siglit that it will improve. Each district hospital or dis- trict hospital center will be encouraged and other- wise assisted in reviewing current practices regard- ing the handling of patients with acute coronary disease and wherever indicated will be assisted in developing and implementing an adequate concept of cardio-vasctdar care which will fit into its par- ticidar circumstances, with said district hospital or district hospital center and the medical staff there- of (with needed assistance from a medical school) accepting the responsibility of working with the smaller or community hospitals within its referral area, so tliat available new knowledge may be re- ceived in a fashion that will facilitate the improve- ment of patient care at the community level.