Dumb It Down
Here is an editorial about a JAMA article which makes the claim that one way to cut healthcare costs would be to….wait for it…..ready?…..here it comes:
CUT MEDICAL TRAINING!
Wow. These people are brilliant. We are already cutting resident work hours. Now they figure they can just move them through medical school quicker. How about skipping medical school altogether? Child, please. I have always felt that LELTs (less education/experience and less training) are not what makes our field better. Now, amazingly enough, physicians may become LELTs. I am sick to my stomach.
Did anyone miss this precious part? “It could also have the effect of driving down American doctors’ salaries…” It’s always about paying the person who actually does the work less.
How about we get rid of the lawyers, and the other pencil pushers with nursing and business (JCAHO, et al) and then see how inexpensively medicine can run before we start cutting physician education (which is probably too short rather than too long…as the original H said: “Life is short, art long, opportunity fleeting, experience treacherous, judgment difficult.” ) or (well deserved) physician salaries!
All this plus less moonlighting ( which also counts to resident work hours)
Many docs out there gained a lot of experience working in nonacademic settings that they will not have now.
I am a non-physician, working in an academic hospital, and I have to say, the residents coming out of a traditional program are scary enough!! Cut their training? That means the hospital staff would have to teach them even more…
Where are the University presidents? Shouldn’t they speak out in favor of a more highly educated work force, including physicians? Having a shortened educational experience (medical school and residency, 80-hour limit per week, etc.), but demanding periodic recertification in your speciality seems schizophrenic to me. After practicing family medicine/ob-gyn/surgery/psychiatry/etc. for 10, 20, or 30 years, you have seen a lot, done a lot, and the MOC or Recertification exams seem superfluous.
Oh, wait. You have to keep paying your specialty Board $1k-$2k to take the exam, not to mention buy their study book beforehand to prepare (and, by the way, take time from your practice and/or family). But do not cut down on college — we need more touchy, feely physicians with a background in the humanities for patients to better relate to us.
Seems to me these people need a psych consult with their bipolar approach. Or, are they just throwing thoughts on the wall and seeing what sticks? The cynic in me thinks they may just like to see their name in print.
Or, just maybe, it will make primary care physicians more level with NPs, PAs, and the like, so follow up studies will show no advantage in physicians and they can all be replaced by less expensive mid-levels.
Pardon me, I need to go vomit.
I pulled up the article in JAMA and I agree 50% with it and 50% with you. Reflecting on my own premedical training, I don’t remember half the stuff I learned in college, other than that it was utterly irrelevant to the preclinical medical curriculum. One semester of biology and one semester of chemistry–or better yet, take the classes in high school–is really all you need. There you go, cut out 4 years of tuition going nowhere. Sure, we technically need O-chem to understand biochem, but most biochemists don’t care about teaching mechanisms as much as they care about the big picture stuff (how much NADH is produced in one go of the Krebs cycle, etc). And then most pharm teachers don’t care about biochem! So what’s the point?
But then they start talking about cutting the preclinical years just because Harvard and Duke do it–well that’s because they’re Harvard and Duke students who are brilliant enough that they can pull it off. Peons like me needed a little more time.
As for shortening residencies and fellowships…sounds like bad news to me.