The idiocy of productivity measures

Stimulate them to work harder? Yep. To generate more income.

WHEN will bean counters learn that you can count the number of lug nuts an assembly line worker tightens in a given time period. but you CAn NOT apply this to cognitive professions? My answer: Never.

Medicine has been taken over by MBAs, Wall Street, etc. Even in academics.

dr. centor-i was the one who asked the questions you kindly answered regarding relationships between attendings and trainees. it is my opinion that the relationships are strained to the point of breaking. i do not hear recently graduated residents sing the praises of their attendings-note i say attendings and not mentors. i hear the recently graduated physicians complain that they weren’t taught properly, that their attendings were not engaged in preparing to teach them things, that focus was on rvu’s, or research etc. additionally, as attendings are increasingly hired to do the ‘clinical’ work and given titles such as acting instructor or some such insulting position of decreased recognition and pay, the age and experience differential decreases dramatically. lastly, these acting instructors seem to be quite miserable. they feel that the senior attendings don’t support them. they feel underpaid. the system is too competitive. the residents don’t appreciate them. the medical students grade them, so if you give an honest assessment that someone is deficient, that can come back to haunt you during your own evaluation. that misery is transmitted quite clearly to the trainees. that, imo, is why people don’t go into primary care.
as for academic primary care, why would they? the specialists do most of the clinical research in the 3 institutions i trained at. the academic primary care groups started requiring general internal medicine fellowships and mph’s to join. what sense does it make? they turned away their own chief residents who subsequently went on to do specialty fellowships instead. instead of nurturing those with interest, they just cut them the off at the knees with unrealistic demands that the attendings themselves had never achieved.
i am pleased you manage to continue to treat your students and residents in such a caring fashion. i would respectfully submit that yours is an unusual situation, rather than the norm. possibly your longstanding experience and success has allowed you to carve out a niche that today’s young attendings may not be able to. especially since in contrast to Erik above, you have just a few clinical months a year. how good would you be if you were following his schedule? it is clear from the description, that Erik’s mentor’s did not have his long term career interests in mind when they created his schedule. imho, that is the typical experience.

respectfully submitted.