Physician Education / Maldistribution Flashcards
Specialty maldistibution
60% of US physicians are specialists, the amount of specialist is growing while PCP shrinks
This is an issue in other countries but not as pronounced
Reasons for Specialty Maldistribution of Physicians
- Medical technologies
- Reimbursement / renumeration
- Specialty oriented education
Medical Technology
Large hospitals are focusing on adding specialists, as patients prefer care performed with the most advanced technologies
Reimbursement & Renumeration
Specialist make more and have more favorable hours
Specialty oriented education
Medical education is oriented around specialist, PCP fight stigma of being less intelligent
Consequences of Specialty Maldistribution
- Rise in health care expenditures
2. Financing of medical training is biased
Rise in health care expenditures
High volume of expensive and invasive procedures
More expensive medical tech doesn’t mean better results, and PCPs are cheaper
Biased financing
Financing for training is based on number of trainees which favors specialists
Geographic maldistribution of physicians
Rural / non-urban areas under 50,000 residents have a shortage of PCPs, despite having sicker populations
Reasons behind geographic maldistributions
- higher income in urban areas
- more modern facilties
- living standard
- continuing education
Policy solutions to geographic maldistribution
- Expand scope of health care professionals (more responsibility for NP)
- Increase reimbursement in rural areas
- Targeted programs
NRMP
National resident matching program
Est. 1952, matches med-students to residency programs
Since 1998 they have been using a new algorithm
Resident Matching
4th year med students, ranked on ordered list by their application
Hippocratic Oath
Med-student binding document
“Do no harm”
Minimize harm to patient and avoid overtreatment, through emphasis on sympathy
Prevention > care
