Can We Squeeze the Waste Out Of Medical Education

Patricia Salber

Posted 4/04/12 on The Doctor Weighs In

I had a chance to “moonlight” in the internal medicine “drop-in” clinic at the Kaiser Medical Center in San Francisco while I was finishing my residency and endocrinology fellowship at UCSF.  I was superbly trained in in-patient care and there was no IV or PA line that I couldn’t put in with my eyes closed.  I was comfortable taking care of really sick people and thrived on complex, acute cases.  I knew how to work up a VIPoma (vanishingly rare endocrine tumor), but, I didn’t know how to treat a paronychia (a skin infection around the nails) and I was bored silly by colds and sore throats – the run of the mill cases that filled up the Kaiser clinic.  I used to daydream about building a machine that would grab (gently) the patient by the neck, insert a throat swab, and then spit out a prescription for penicillin.   Nine years of training for this!  What a waste of all that training!

Continue reading “Can We Squeeze the Waste Out Of Medical Education”

Residents and Medical Students Should Support Efforts to Revalue Cognitive Services

Kevin Bernstein

First posted 9/17/11 on The Future of Family Medicine

The numbers do not lie.  As stated in a previous post and its referenced links, the payment gap between primary care and specialists has increased since the American Medical Assocation started the Resource-Based Relative Value Scale (RVS) Update Committee (“RUC”) in the early 1990s.  It is difficult to separate the two when the Center for Medicare and Medicaid Services (“CMS”) has accepted over 90% of the RUC’s recommendations throughout the years.  This can be interpreted in a number of different ways but let’s be honest – I am a current intern and do not have enough time to go through the different interpretations –  I will leave that up to your comments.

Continue reading “Residents and Medical Students Should Support Efforts to Revalue Cognitive Services”

Bach and Kocher In the NYTs: Good try. Wrong plan.

Paul Levy

First published 5/30/11 on Not Running a Hospital 

Peter Bach and Robert Kocher offer an intriguing but wrong-headed approach to expanding the roster of primary care doctors in America. In a New York Times op-ed entitled, “Why medical school should be free,” the authors note:

Fixing our health care system will be impossible without a larger pool of competent primary care doctors. . . . [T]he American Academy of Family Physicians has estimated a shortfall of 40,000 primary care doctors by 2020.

Continue reading “Bach and Kocher In the NYTs: Good try. Wrong plan.”