Family Health Plan (FHP), the first and largest Utah HMO, began operations in Utah in 1976 and by 1992 cared for 140,000 patients annually. HMOs are attractive to the employer who pays much of the cost of employees' health insurance because of their generally lower rates and broader coverage. The patient chooses a primary-care physician--internist, family practitioner, or pediatrician. These doctors see the patients first and decide on procedures and, if necessary, refer them to specialists. Another physician is frequently substituted, particularly when a patient is hospitalized, since the physician is obligated to work only 40 to 44 hours per week. Physicians are on salary but are rewarded for keeping costs down. The average age of patients covered by HMOs is significantly lower than that of the population at large.

Some Outstanding Research Accomplishments Utah physicians and medical researchers have made many important contributions, locally, nationally, and internationally. A few significant landmarks are mentioned here.

In 1900 the major causes of death were infectious diseases such as pneumonia, tuberculosis, and the childhood diseases. By mid-century heart disease, stroke, and cancer had climbed to the top of the list, with infectious diseases at the bottom. Technological advances in public health (such as water- and sewage-treatment plants) played a major role in nearly eliminating intestinal infections in the United States, and vaccination accomplished wonders in reducing childhood diseases. Simultaneously, however, increased tobacco and alcohol use, and other lifestyle changes, as well as rapidly increasing pollution by chemicals and radiation, contributed to the increase in cancer and heart disease.

In the 1940s and 1950s, a concerted effort by several cooperating departments of the University of Utah Medical Center, under the leadership of Dr. Leo Samuels, resulted in significant new knowledge concerning the chemistry and physiology of the adrenal glands.