Intro -- FrontMatter -- Reviewers -- Foreword -- Acknowledgments -- Contents -- Boxes, Figures, and Tables -- Summary -- 1 Introduction -- 2 Background on the Pipeline to the Physician Workforce -- 3 GME Financing -- 4 Governance -- 5 Recommendations for the Reform of GME Financing and Governance -- Appendix A: Abbreviations and Acronyms -- Appendix B: U.S. Senate Letters -- Appendix C: Public Workshop Agendas -- Appendix D: Committee Member Biographies -- Appendix E: Data and Methods to Analyze Medicare GME Payments -- Appendix F: Illustrations of the Phase-In of the Committee's Recommendations.
Graduate medical education (GME) is critical to the career development of individual physicians, to the functioning of many teaching institutions, and to the production of our physician workforce. However, recent reports have called for substantial reform of GME. The current lack of established GME outcome measures limits our ability to assess the impact of individual graduates, the performance of residency programs and teaching institutions, and the collective contribution of GME graduates to the physician workforce. To examine the opportunities and challenges in measuring and assessing GME outcomes, the National Academies of Sciences, Engineering, and Medicine held a workshop on October 10â€"11, 2017, in Washington, DC. Workshop participants discussed: meaningful and measurable outcomes of GME; possible metrics that could be used to track these GME outcomes; possible mechanisms for collecting, collating, analyzing, and reporting these data; and further work to accomplish this ambitious goal. This publication summarizes the presentations and discussions from the workshop.
Tomorrow's best physicians will be those who continually learn, adjust, and innovate as new information and best practices evolve, reflecting adaptive expertise in response to practice challenges. As the first volume in the American Medical Association's MedEd Innovation Series, The Master Adaptive Learner is an instructor-focused guide covering models for how to train and teach future clinicians who need to develop these adaptive skills and utilize them throughout their careers. - Explains and clarifies the concept of a Master Adaptive Learner: a metacognitive approach to learning based on self-regulation that fosters the success and use of adaptive expertise in practice. - Contains both theoretical and practical material for instructors and administrators, including guidance on how to implement a Master Adaptive Learner approach in today's institutions. - Gives instructors the tools needed to empower students to become efficient and successful adaptive learners. - Helps medical faculty and instructors address gaps in physician training and prepare new doctors to practice effectively in 21st century healthcare systems. - One of the American Medical Association Change MedEd initiatives and innovations, written and edited by members of the ACE (Accelerating Change in Medical Education) Consortium – a unique, innovative collaborative that allows for the sharing and dissemination of groundbreaking ideas and projects.
A citizen's guide to America's most debated policy-in-waitingAfter languishing for decades on the fringes of political discussion, Medicare-for-All has quickly entered the mainstream debate over what to do about America's persistent healthcare problems. But for most informed Americans, this surge of public and political interest in Medicare-for-All has outpaced a strong understanding of the issues involved. This book seeks to fill this gap in our national discourse, offering an expert analysis of the policy and politics behind Medicare-for-All for theinformed American.
Evaluates Medicare's policy regarding graduate medical education (GME) & addresses concerns about federal budget spending. Provides an overview of the changing physician work force & the effects of Medicare's GME policy on residency training & teaching hospitals at which such training is based. Presents various options for GME policy & explores their implications. Charts & tables.
Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Introduction: The house of medicine and medical prices -- The enduring influence of the house of medicine over prices -- The science of work and payment reform -- How doctors get paid -- Conflicts of interest and problems of evidence -- Complexity, agency capture, and the game of codes -- Fixing medical prices
Provides a highly engaging, richly contextualized account of the residency system in all its dimensions and analyzes the mutual relationship between residency education and patient care in America.
