Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
Nov - 15
Dec - 19
Jan - 21
Feb - 7
Mar -
Let’s be careful about residency reform
26 Jun2009
Again tip of hat to FutureDoc – House Reform Bill Would Redistribute GME Positions, Assess Curricula
Health care reform legislation proposed by Democratic leaders of the three committees of jurisdiction in the US House of Representatives would mandate a study of residency education and faculty expertise in subjects including patient care coordination, costs and benefits of diagnostic and treatment options, and work in inter-professional teams. The bill would also (1) redistribute unused residency positions to hospitals that agree to expand and maintain primary care training as well as (2) provide legislative authority for graduate medical education payments from the Medicaid system.
The curricular assessment is the most troubling aspect of the bill. The legislation articulates seven goals for physician training, including working effectively in non-hospital settings, implementing solutions to health care systems errors, and being “meaningful [electronic health record] users.” The bill does not mention development of medical knowledge or skills as goals for training. According to the bill, the aforementioned study, to be conducted by the Comptroller General, would include recommendations in two areas. First, the report would discuss if making curricula in the seven goal areas mandatory for Medicare graduate medical education payments would be effective in changing medical education. Second, the report would discuss if existing accrediting processes are effective in changing curricula to meet the goals outlined in the bill.
Policy wonks and politicians know less about medical education than they know about the automobile industry. Letting the Comptroller General influence graduate medical education is an idea whose time should never come.
But we do need more primary care physicians.
But more important we need to reform our payment system to encourage physicians to do true complex primary care.
Related posts:
- Some early inclusions in the House bill
- Reform residency but intelligently
- Some thoughts on health care reform
- HR 2350
- No opinion yet on health care reform
Related posts brought to you by Yet Another Related Posts Plugin.
- In: Medical Rants
1 Response to Let’s be careful about residency reform
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June 26th, 2009 at 7:52 am
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