Preparing the New Generation of Doctors

I read this stupid article in the NEJM Catalyst, whatever that is, called “Preparing a New Generation of Physicians for a New Kind of Health Care”.   It’s one of those “we predict the future” and “have all the answers” kind of thing that is easy to get published because it is edgy.  Here are some of their observations:

  • Today’s physicians differ markedly from those who came out of medical school 30 years ago. (That is me and no sh%t).
  • These generational changes in the physician workforce have implications for medical schools and policymakers. Health care’s new payment models, such as population-based risk-sharing, episodic payments, and care bundles, require physicians to change how they deliver care. These models reward teamwork, care coordination, and leveraging data to improve quality and lower costs. (There is no proof this is beneficial or works but who needs evidence in an evidence-based profession?).
  • Medical schools have both a responsibility and an opportunity to prepare their students for success under new value-based payment models. (Great idea. Let’s change curriculums to follow the newest fad which changes every two years or so).
  • For example, under the Medicare Access and CHIP Reauthorization Act (MACRA), most physicians who see Medicare patients now have a portion of their payments tied to quality measures and cost considerations. This new paradigm emphasizes a different set of priorities, including team-based care, addressing patients’ social determinants of health, reducing extensive utilization of expensive tests and procedures, and developing relationships with a wider variety of providers. (Brilliant. By the time the medical schools figure out their syllabus this crap will be gone).
  • Medical schools will need to look beyond undergraduate GPA and MCAT scores and identify candidates who will work most effectively in a team-based environment, who will be able to best address social determinants of health, develop novel care coordination programs, and thrive in an increasingly complicated care delivery system.(I just vomited in my mouth a little).

I have some ideas on preparing the next generation of doctors. How about they:

  • Learn how to look at someone in the eye.
  • Stop staring at the computer.
  • Learn how to do a real physical exam.
  • Have social skills.
  • Stop staring at their phones.
  • Stop complaining about work hours.
  • Care about people.
  • Dress professionally.

Any more recommendations from you guys?

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