摘要:

The academic medical center is currently being affected by major changes in the national health care delivery system. These changes include the rapid growth in prepaid health plans, the emerging surplus of physicians, and the continued escalation of health care costs. The potential effects of these changes are only now becoming appreciated and may have significant ramifications for the entire medical education system. In this article, the author traces the impact of these changes on one major academic medical center. He presents a methodology for pinpointing other centers that may soon be affected and discusses ways to minimize the undesirable consequences of these changes.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Increased competition among hospitals is a potential threat to teaching hospitals. The growing cost of medical education and the provision of care to the indigent can be endangered by the dilution of revenue sources which traditionally have been available to the academic health centers but which now are being taken over by suburban hospitals. As an example of such a threat, the authors in this paper relate a case study regarding the expansion of open heart surgery programs in St. Louis, Missouri.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

In this paper, the authors report on a nationwide study that examined continuing medical education (CME) “programmatic linkages” between medical schools and community hospitals. Data were gathered to answer two major questions. To what extent are U.S. medical schools currently involved with community hospitals in providing cosponsored, accredited CME programs on an ongoing basis for hospital staffs? How do such programs differ one from the other? Data obtained indicated that a majority (70 percent) of the medical schools have CME programmatic linkages with community hospitals and that these relationships were viewed as very positive and beneficial.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

While older applicants have traditionally had difficulty being admitted to medical schools, they slowly are gaining easier acceptance at some institutions. Little is known, however, about whether or not older medical students experience the same professionalization process as younger ones and whether or not the extensive literature developed over the past 40 years is useful in understanding older students' developmental processes. Structured interviews were conducted with 26 University of Cincinnati students who were 28 or older when they matriculated as freshmen in medical school. The findings indicated not only that these students experienced different stresses from their younger classmates but also that they cope with problems and view the professionalization process differently. These results are discussed in relation to the literature. Some suggestions for educational and counseling policies are offered.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The authors discuss ways to increase the funding base of a family medicine residency program through the appropriate use of procedures related to patient care and the provisions of service. Following a commitment of cooperation by residents and faculty members, certain principles of a business practice management curriculum were expanded and applied to a residency program. A written procedure manual describing the intricacies of the fee-for-service system was prepared for interns. Mechanisms for the review of patient care productivity and educationally productive incentives were developed. All of these steps were helpful in achieving improvement in the funding base for the residency. Areas for potential expansion in training programs and financial and staffing strategies to increase revenues are discussed. Although administrative decisions regarding fees and collection mechanisms are mentioned, this discussion focuses on educational and patient care activities that also produce revenue.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

An adviser program has been instituted at Rush Medical College which utilizes specially selected and trained faculty members and provides comprehensive counseling with continuity of contact between adviser and student through the four years of medical school. In this paper, the authors describe the development of the program and the evaluations used to determine its efficacy. The authors conclude that the personal characteristics and time commitment of the advisers are of primary importance rather than their training discipline, that continuity of contact between student and adviser fosters the development of the most beneficial relationships, that advisers require special training during the entire time of their service as advisers, and that the program and the advisers require continual monitoring so that deficient performance and changing needs can be promptly identified.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The study reported here revealed a very high incidence of unrecognized feelings toward the patient (“countertransference”) and potentially harmful associated behaviors in a group of medical students at the midpoint of their training. Fifteen students were studied individually by the author during a clinical interview each student conducted with a patient. Typically, unrecognized feelings were fear of harming the patient, fear of loss of control, performance anxiety, and fears unique to the individual student (such as fear of cancer in self). One or more of these feelings were present in 14 of the students. Interview behaviors that were potentially deleterious were present in 13 students; avoidance and/or overcontrol of the psychosocial aspects of the interview accounted for 11 of these instances, while two students exhibited behaviors unique to the student. Although these students all had demonstrated adequate interviewing skills previously, the unrecognized feelings were, in each of the 13 instances, related to impaired interview performance. These data suggest the need for interviewing instructors to teach medical students about the concept of counter-transference in addition to interviewing techniques.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

No abstract available.

ISSN:0022-2577    

出版商:OVID    

年代:1984

数据来源: OVID