T. Hershel Gardin, Ph.D. | Wayne State University (original) (raw)
Dr. Gardin began his professional career teaching Introductory Psychology and more advanced Social Psychology courses at Wayne State University in Detroit. He then moved into a clinical and research practice focusing on substance abusers and substance abuse and from there to a major health care system where he rose from research staff to corporate officer and vice president of Medicare Operations. Beginning in 1982 he was also personally responsible for the then novel and innovative introduction of desktop computing throughout the above mentioned health care system, one of the very first corporations in metropolitan Detroit to do so.
After retiring from the health care industry and taking a year-long sabbatical, he accepted an unsolicited offer to act as “Interim” Senior Vice President and Dean of Academic Administration at Michigan Jewish Institute, a four-year college offering degrees in IT and business amongst others. Eleven years later he resigned and moved into independent consulting and semi-retirement.
In addition to his formal university undergraduate and graduate education at Wayne State University, Dr. Gardin spent more than a half dozen years as a rabbinical seminary student. Here, he began a life-long interest in and study of medical and business ethics. He has been and continues to be a regular participant in a series of biannual conferences focusing on contemporary medical ethical issues.
Over a period of more than 45 years, Dr. Gardin has honed his skills as: a prolific social scientist; clinician; post-secondary educator; executive manager; grant writer; and, a strategic and business planner. He has authored dozens of peer-reviewed journal articles on a variety of topics and been invited to address numerous scientific and scholarly conferences, including the: American Association of Health Plans, American Psychological Association, American Public Health Association, the Association of Information Management, Group Health Association of America, the National Association of Urban Based HMOs, the National Managed Health Care Congress, and most notably, the W.H.O.’s World Federation of Public Health Associations, IVth International Triennial Congress, Tel Aviv, Israel.
Dr. Gardin continues to be active in professional and charitable consulting related to grant seeking, advanced education, ethical behavior and business operations.
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Papers by T. Hershel Gardin, Ph.D.
Journal of Personality and Social Psychology, Jul 1, 1973
The New England Journal of Medicine, Feb 19, 1987
American Journal of Obstetrics and Gynecology, Aug 1, 1984
This study compares the quality of obstetric care provided for patients in two distinct groups: a... more This study compares the quality of obstetric care provided for patients in two distinct groups: a federally-qualified health maintenance organization and a private fee-for-service practice. Patients of both groups were delivered in the same hospital with resident coverage equally accessible to both groups. From January, 1979, through December, 1981, the period of the study, the physician group delivered 2385 patients, 57% of them from the health maintenance organization and 43% from the fee-for-service practice. Not only were comparisons of maternal and fetal outcomes available for the two patient groups, but the yearly trends and individual performances of the physicians were available as well. This paper addresses the question, all other things being equal, is the level of care and ultimate outcome the same for both groups of patients? The results in some instances showed surprising differences. (AM. J. OBSTET.
Archives of physical medicine and rehabilitation, 1991
In their article “Nerve Conduction Studies: Orthodromic vs. Antidromic Latencies (Arch Phys Med R... more In their article “Nerve Conduction Studies: Orthodromic vs. Antidromic Latencies (Arch Phys Med Rehabil 1990;71:579-82), Cohn. Wertsch and associates point out that distance between the reference and active electrodes can change the configuration and thus-possibly-the latency of the evoked response. The authors quoted two of our studies’.2 and a study by Murai and Sanderson’ all of which indicated that there is a statistically significant difference between the orthodromic and antidromic latencies. Murai also standardized the distance between the active and reference electrodes, as did Cohn and colleagues. In our second study, we demonstrated that colder temperature also increased the difference between the antidromic and orthodromic latencies. Although electrode distance can, as Cohn pointed out, affect the peak latency, this is only one of several parts of the total explanation for the differences between antidromic and orthodromic latencies. In analyzing Cohn and colleagues’ study, we see in table 1 that there was, in fact, a mean difference between the peak latencies of almost .lmsec in the median nerve and .128msec in the ulnar nerve. This compares with onset latency differences of essentially zero in the median nerve, and .071 and .040 in the ulnar nerve. This indicates a greater latency difference between peak latencies than between onset latencies. The authors did not state whether the peak latency of the orthodromic or the peak latency of the antidromic was always the longer; it was the antidromic latency that was longer in both our studies and Murai’s study. Also, in our second study we demonstrated an increase in the difference between the orthodromic and antidromic latencies with cold temperatures which still requires an explanation, since even if the distances between the electrodes were not the same when performed ortho- and antidromic, the difference in the electrode distance was held constant while the temperature was altered. This temperature effect must be considered although the electrode distance difference and the changing temperature may indeed represent a confounding of two variables. There may be several explanations for the differences between our studies. One may be the statistical methodology; in our first study we used .52 subjects using the student f-test for related measures. Cohn and associates used 25 subjects, which would require a larger difference between anti- and orthodromic latencies to approach statistical significance. Another possible explanation: the electrode separation did seem to cause temporal displacement of the measured peak latency. Murai noted that the anti- and orthodromic peak latency became similar at an electrode distance of lcm. This effect was not present on the onset latency. They postulated that because of the increased amplitude of the antidromic vs. orthodromic response, the peak latency became more displaced, and hence the antidromic peak latency was always a little longer. This would help to explain the effect of cold since the amplitude of the antidromic evoked response increases much more with cooling than does the orthodromic response;’ therefore, the displacement of the peak of the antidromic evoked response would be expected to be greater, thereby producing a larger latency. Finally, the hand temperature in Cohn’s study ranged from 30” to 34°C. This would minimize the difference between the anti- and orthodromic peak latencies. After reading Cohn’s article, we performed median conduction studies on a 24-year old woman at room temperature, keeping the
American Journal of Obstetrics and Gynecology, 1984
This study compares the quality of obstetric care provided for patients in two distinct groups: a... more This study compares the quality of obstetric care provided for patients in two distinct groups: a federally-qualified health maintenance organization and a private fee-for-service practice. Patients of both groups were delivered in the same hospital with resident coverage equally accessible to both groups. From January, 1979, through December, 1981, the period of the study, the physician group delivered 2385 patients, 57% of them from the health maintenance organization and 43% from the fee-for-service practice. Not only were comparisons of maternal and fetal outcomes available for the two patient groups, but the yearly trends and individual performances of the physicians were available as well. This paper addresses the question, all other things being equal, is the level of care and ultimate outcome the same for both groups of patients? The results in some instances showed surprising differences. (AM. J. OBSTET.
International Journal of the Addictions, 1981
Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, g... more Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, given that premature termination is the norm. Previous literature indicted a negative association between elevation on various MMPI scales and dichotomized measures of retention, as well as other outcome indices. The present study examined the predictive relationship between pretreatment MMPI scores and a continuous measure of retention. Results indicated that the MMPI could significantly differentiate groups staying less than and more than 20 d in treatment, but had no power to predict to more precise ranges of retention.
International Journal of the Addictions, 1980
Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an i... more Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an indirect method of indicator analysis. Medical and legal indicators are assumed to be related to each other and to prevalence in specific directions. The present study tests the relationship between six commonly used indicators. The results indicate that not all assumed relationships are obtained in the predicted direction and implications of this for future prevalence study are discussed.
Journal of Personality and Social Psychology, 1973
New England Journal of Medicine, 1987
With Charles H. Wright, now deceased
Journal of Personality and Social Psychology, 1973
Substance Use & Misuse, 1981
Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, g... more Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, given that premature termination is the norm. Previous literature indicted a negative association between elevation on various MMPI scales and dichotomized measures of retention, as well as other outcome indices. The present study examined the predictive relationship between pretreatment MMPI scores and a continuous measure of retention. Results indicated that the MMPI could significantly differentiate groups staying less than and more than 20 d in treatment, but had no power to predict to more precise ranges of retention.
Substance Use & Misuse, 1982
Substance Use & Misuse, 1980
Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an i... more Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an indirect method of indicator analysis. Medical and legal indicators are assumed to be related to each other and to prevalence in specific directions. The present study tests the relationship between six commonly used indicators. The results indicate that not all assumed relationships are obtained in the predicted direction and implications of this for future prevalence study are discussed.
Journal of Personality and Social Psychology, 1973
The present study investigated the effects of two proxemic factors-seating arrangement and availa... more The present study investigated the effects of two proxemic factors-seating arrangement and availability of eye contact-on the cooperation, interpersonal attitude, and approach-avoidance tendencies shown by the two players in a Prisoner's Dilemma game. As expected, significant interactions emerged between these two proxemic factors on all three of the above outcomes. In data consistent with role-play findings, more positive cooperation and attitudinal outcomes tended to be associated with the more proximal side-by-side seating arrangement
Conference Presentations by T. Hershel Gardin, Ph.D.
Because of its emphasis on man•s phenomonal world, Kurt Lewin's conception of 'life space' may ha... more Because of its emphasis on man•s phenomonal world, Kurt Lewin's conception of 'life space' may have inadvertently led to a disregard for the role of physical setting in determining interpersonal behavior. The aggressiveness, crime and indifference-syndrome currently prevalent in many of our high density urban areas, however, has brought home with a vengeance the dangers of ignoring such spatial considerations in planning human activities. It has led to the resurgence of ethology and the development of a new breed of anthro-psychologists devoted to the study of proxemics, a term originated by the anthropologist
Edward Hall
The literature on alcoholics has suggested that alcoholics, as a group may require and make use o... more The literature on alcoholics has suggested that alcoholics, as a
group may require and make use of, more medical services than the general population. Therefore, it is hypothesized that the rehabilitation of alcoholics should reduce this excessive use of medical services. 259 subscribers of Comprehensive Health Services of Detroit, a medium sized HMO, were identified as having problems with alcohol abuse. Of these, 60 subscribers self-selected to make use of a newly developed Alcohol Treatment Unit within the HMO . Consequently, three general categories of subscribers were available for examination: I) those identified alcoholics who received rehabilitative treatment; 2) those identified alcoholics who did not receive treatment; and 3) a control sample of the general subscribership. The primary data collected include: basic demographics for matching purposes; number of hospitalizations during specified pre and post treatment time periods; and number of days spent in hospital during the pre-post periods. Hospitalization rates during the pre-treatment period were higher for the alcoholics than the general population. Further, during the post treatment period, hospitalization rates for the treated alcoholics declined while the rates increased for the other two untreated groups.
Journal of Personality and Social Psychology, Jul 1, 1973
The New England Journal of Medicine, Feb 19, 1987
American Journal of Obstetrics and Gynecology, Aug 1, 1984
This study compares the quality of obstetric care provided for patients in two distinct groups: a... more This study compares the quality of obstetric care provided for patients in two distinct groups: a federally-qualified health maintenance organization and a private fee-for-service practice. Patients of both groups were delivered in the same hospital with resident coverage equally accessible to both groups. From January, 1979, through December, 1981, the period of the study, the physician group delivered 2385 patients, 57% of them from the health maintenance organization and 43% from the fee-for-service practice. Not only were comparisons of maternal and fetal outcomes available for the two patient groups, but the yearly trends and individual performances of the physicians were available as well. This paper addresses the question, all other things being equal, is the level of care and ultimate outcome the same for both groups of patients? The results in some instances showed surprising differences. (AM. J. OBSTET.
Archives of physical medicine and rehabilitation, 1991
In their article “Nerve Conduction Studies: Orthodromic vs. Antidromic Latencies (Arch Phys Med R... more In their article “Nerve Conduction Studies: Orthodromic vs. Antidromic Latencies (Arch Phys Med Rehabil 1990;71:579-82), Cohn. Wertsch and associates point out that distance between the reference and active electrodes can change the configuration and thus-possibly-the latency of the evoked response. The authors quoted two of our studies’.2 and a study by Murai and Sanderson’ all of which indicated that there is a statistically significant difference between the orthodromic and antidromic latencies. Murai also standardized the distance between the active and reference electrodes, as did Cohn and colleagues. In our second study, we demonstrated that colder temperature also increased the difference between the antidromic and orthodromic latencies. Although electrode distance can, as Cohn pointed out, affect the peak latency, this is only one of several parts of the total explanation for the differences between antidromic and orthodromic latencies. In analyzing Cohn and colleagues’ study, we see in table 1 that there was, in fact, a mean difference between the peak latencies of almost .lmsec in the median nerve and .128msec in the ulnar nerve. This compares with onset latency differences of essentially zero in the median nerve, and .071 and .040 in the ulnar nerve. This indicates a greater latency difference between peak latencies than between onset latencies. The authors did not state whether the peak latency of the orthodromic or the peak latency of the antidromic was always the longer; it was the antidromic latency that was longer in both our studies and Murai’s study. Also, in our second study we demonstrated an increase in the difference between the orthodromic and antidromic latencies with cold temperatures which still requires an explanation, since even if the distances between the electrodes were not the same when performed ortho- and antidromic, the difference in the electrode distance was held constant while the temperature was altered. This temperature effect must be considered although the electrode distance difference and the changing temperature may indeed represent a confounding of two variables. There may be several explanations for the differences between our studies. One may be the statistical methodology; in our first study we used .52 subjects using the student f-test for related measures. Cohn and associates used 25 subjects, which would require a larger difference between anti- and orthodromic latencies to approach statistical significance. Another possible explanation: the electrode separation did seem to cause temporal displacement of the measured peak latency. Murai noted that the anti- and orthodromic peak latency became similar at an electrode distance of lcm. This effect was not present on the onset latency. They postulated that because of the increased amplitude of the antidromic vs. orthodromic response, the peak latency became more displaced, and hence the antidromic peak latency was always a little longer. This would help to explain the effect of cold since the amplitude of the antidromic evoked response increases much more with cooling than does the orthodromic response;’ therefore, the displacement of the peak of the antidromic evoked response would be expected to be greater, thereby producing a larger latency. Finally, the hand temperature in Cohn’s study ranged from 30” to 34°C. This would minimize the difference between the anti- and orthodromic peak latencies. After reading Cohn’s article, we performed median conduction studies on a 24-year old woman at room temperature, keeping the
American Journal of Obstetrics and Gynecology, 1984
This study compares the quality of obstetric care provided for patients in two distinct groups: a... more This study compares the quality of obstetric care provided for patients in two distinct groups: a federally-qualified health maintenance organization and a private fee-for-service practice. Patients of both groups were delivered in the same hospital with resident coverage equally accessible to both groups. From January, 1979, through December, 1981, the period of the study, the physician group delivered 2385 patients, 57% of them from the health maintenance organization and 43% from the fee-for-service practice. Not only were comparisons of maternal and fetal outcomes available for the two patient groups, but the yearly trends and individual performances of the physicians were available as well. This paper addresses the question, all other things being equal, is the level of care and ultimate outcome the same for both groups of patients? The results in some instances showed surprising differences. (AM. J. OBSTET.
International Journal of the Addictions, 1981
Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, g... more Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, given that premature termination is the norm. Previous literature indicted a negative association between elevation on various MMPI scales and dichotomized measures of retention, as well as other outcome indices. The present study examined the predictive relationship between pretreatment MMPI scores and a continuous measure of retention. Results indicated that the MMPI could significantly differentiate groups staying less than and more than 20 d in treatment, but had no power to predict to more precise ranges of retention.
International Journal of the Addictions, 1980
Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an i... more Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an indirect method of indicator analysis. Medical and legal indicators are assumed to be related to each other and to prevalence in specific directions. The present study tests the relationship between six commonly used indicators. The results indicate that not all assumed relationships are obtained in the predicted direction and implications of this for future prevalence study are discussed.
Journal of Personality and Social Psychology, 1973
New England Journal of Medicine, 1987
With Charles H. Wright, now deceased
Journal of Personality and Social Psychology, 1973
Substance Use & Misuse, 1981
Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, g... more Prediction of dropout from therapeutic community treatment for heroin addiction is of interest, given that premature termination is the norm. Previous literature indicted a negative association between elevation on various MMPI scales and dichotomized measures of retention, as well as other outcome indices. The present study examined the predictive relationship between pretreatment MMPI scores and a continuous measure of retention. Results indicated that the MMPI could significantly differentiate groups staying less than and more than 20 d in treatment, but had no power to predict to more precise ranges of retention.
Substance Use & Misuse, 1982
Substance Use & Misuse, 1980
Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an i... more Recent substance abuse literature discusses the measurement of heroin abuse prevalence using an indirect method of indicator analysis. Medical and legal indicators are assumed to be related to each other and to prevalence in specific directions. The present study tests the relationship between six commonly used indicators. The results indicate that not all assumed relationships are obtained in the predicted direction and implications of this for future prevalence study are discussed.
Journal of Personality and Social Psychology, 1973
The present study investigated the effects of two proxemic factors-seating arrangement and availa... more The present study investigated the effects of two proxemic factors-seating arrangement and availability of eye contact-on the cooperation, interpersonal attitude, and approach-avoidance tendencies shown by the two players in a Prisoner's Dilemma game. As expected, significant interactions emerged between these two proxemic factors on all three of the above outcomes. In data consistent with role-play findings, more positive cooperation and attitudinal outcomes tended to be associated with the more proximal side-by-side seating arrangement
Because of its emphasis on man•s phenomonal world, Kurt Lewin's conception of 'life space' may ha... more Because of its emphasis on man•s phenomonal world, Kurt Lewin's conception of 'life space' may have inadvertently led to a disregard for the role of physical setting in determining interpersonal behavior. The aggressiveness, crime and indifference-syndrome currently prevalent in many of our high density urban areas, however, has brought home with a vengeance the dangers of ignoring such spatial considerations in planning human activities. It has led to the resurgence of ethology and the development of a new breed of anthro-psychologists devoted to the study of proxemics, a term originated by the anthropologist
Edward Hall
The literature on alcoholics has suggested that alcoholics, as a group may require and make use o... more The literature on alcoholics has suggested that alcoholics, as a
group may require and make use of, more medical services than the general population. Therefore, it is hypothesized that the rehabilitation of alcoholics should reduce this excessive use of medical services. 259 subscribers of Comprehensive Health Services of Detroit, a medium sized HMO, were identified as having problems with alcohol abuse. Of these, 60 subscribers self-selected to make use of a newly developed Alcohol Treatment Unit within the HMO . Consequently, three general categories of subscribers were available for examination: I) those identified alcoholics who received rehabilitative treatment; 2) those identified alcoholics who did not receive treatment; and 3) a control sample of the general subscribership. The primary data collected include: basic demographics for matching purposes; number of hospitalizations during specified pre and post treatment time periods; and number of days spent in hospital during the pre-post periods. Hospitalization rates during the pre-treatment period were higher for the alcoholics than the general population. Further, during the post treatment period, hospitalization rates for the treated alcoholics declined while the rates increased for the other two untreated groups.
A relatively new approach in the search for a measure of true heroin prevalence is the Heroin Pro... more A relatively new approach in the search for a measure of true
heroin prevalence is the Heroin Problem Index. This particular
approach attempts to combine several variables assumed to be related in some indirect manner to prevalence. Theoretically, if a set of independent variables (or indicators) can first be shown to be related to each other, then it may be assumed that all are tapping some underlying common variable, prevalence. That is, the Heroin Problem Index is a measurement model containing multiple indicators of a single underlying latent variable, with the original model or Index incorporating six different variables as prevalence indicators.
The Medicare rlsk contract represents an opportunity for HMOs to expand their membership ... more The Medicare rlsk contract represents an opportunity for HMOs to expand their membership by enrolling Medicare beneficiaries on a rlsksharing, prospective basis. Thls opportunity, however, Is not without pitfalls for prepaid health plans. Several HMOs have canceled their risk contracts with HCFA as a result of adverse selection prob-
lems as well as inadequate capitation rates stemming from the insufficiency of the adjusted average per capita cost (I.e., .AAPCC). Consequently, prior to an HMO establishing a risk contract It Is advisable for the
health plan to examine the practicality of such an arrangement.
The purpose of this paper Is to provide HMOs with a method for assesslng the feasibility and financial impact of establishing a Medicare risk contract. The method entails the following steps: Evaluating the Medicare market within a plan's service area, developing a proposed
benefit package, determining the capitation requirement for the package, estimating payment from HCFA and determining the beneficiary premium.
The draft Medicaid HEDIS was developed to provide a standardized perfonnance measuring tool for b... more The draft Medicaid HEDIS was developed to provide a
standardized perfonnance measuring tool for both State
Medicaid agencies and the Managed Care entities with
which they contract. The final version of Medicaid HEDIS
1Jl is intended to relate well with the current HEDIS 2.5
and be a harbinger of a considerable portion of HEDIS 3.0.
Although developed by a collaborative effort on the part of
some managed care entities, State Medicaid agencies,
HCFA, NCQA and others, it is not yet ready for
implementation by States
This project was undertaken to determine the extent to which the Community Services Data System (... more This project was undertaken to determine the extent to which
the Community Services Data System (CSDS) of the Michigan Department of Mental Health might be used by the Detroit/Wayne County Community Mental Health Board (Board). The Analysis was made as an initial response to the need of the Board to determine its
options for achieving standardized documentation of program
activities across all agencies.