Quality of U.S. Medical Residents is In Steady Decline – What Must Be Done!

 

Guest Post From David R Schwartz MD:

As a physician educator practicing in the ICU/hospital environment for >15 years, I have noted a steady decline in the average resident’s knowledge base, clinical skill and efficiency, bedside manner and overall motivation. I am a harsh critic with extremely high standards, though I’ve supervised and been responsible for student/resident/fellow ICU rotations from an educational standpoint throughout.  The vast majority of my colleagues throughout the nation have supported this observation. More telling, daily report from the ICU nurses has chronicled a perennial erosion of their confidence in housestaff!

If true, this poorly documented but worrisome phenomenon combined with the anecdotal, but near universal, acceptance of increasing complexity and acuity of hospitalized patients is a prescription for failure. Explanations are numerous and pervasive.

THE STUDENTS

1) The public regard and economic rewards classically afforded physicians have dwindled dramatically.  While this may select for a less gifted cohort entering our medical schools, I believe the effect on the finished “product” far exceeds any deterioration in raw materials. Our new medical students and young physicians are still gifted.  Continue reading

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Letter to AOA President on AOA plan for ACGME takeover of OGME

Dr. Juhasz,

Just when did AOAs dues paying osteopathic physician membership and societies get to feedback alternative ideas and weigh in on OGME funding options as you stated in your Med Ec interview below? Not at all. The AOA trustees unilaterally make the decision some time ago. Many DOs and many component specialty societies like AOCD were dead set against the ACGME takeover, or, at least wanting defined terms and conditions set like ACOFP, otherwise bail out. Never did the AOA solicit member opinions or allow input, let alone dissent against the preset policy OGME sellout to ACGME takeover. AOA top-down propaganda are not grass-roots fact. Has the AOA administration learned nothing from the failed AMA takeover in California in 1960?

Quote: Juhasz says AOA members have had ample time to consider the agreement and offer input. “We’ve been having an ongoing dialogue with ACGME since 2012 that’s been reported to the membership,” he says. Since arriving at the agreement in February, “there have been multiple opportunities for dialogue with the profession at state and specialty society meetings to help them understand how we’ve moving forward.” http://medicaleconomics.modernmedicine.com/medical-economics/news/allopathic-osteopathic-graduate-training-programs-unify-accreditation-process

We’re being forceably strapped into AOA’s leftist liberal agenda “moving forward” off the government debt cliff, like the current US administration. No, thank you. As a private practice DO and AOA member for 20 years, I protest. And if you think I’m the only one… You will see.

After twenty years of increasing AOA corporatization and weak physician leadership, now is your chance at the helm. Steer our 140 year old brave physician profession into independence and freedom for the betterment of the patient-physicians relationship, away from government, hospital health system and special interest dependence. The choice is yours. We are all making ours.

Best wishes for good health,
Craig M. Wax, DO
Family physician, Editorial Board of Medical Economics
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM
http://wgls.rowan.edu/?feed=YOUR_HEALTH_MATTERS
Twitter @drcraigwax
Independent Physicians For Patient independence @IP4PI
IP4PI.wordpress.com

We cannot give in.

Dr. Gina Reghetti responds to the events at last week’s AOA House of Delegates meeting in Chicago where the HOD approved the GME merger and brazenly blocked a resolution in opposition to OCC/MOL.

Unbelievable!

They are cowards. They all go with the flow in fear of consequences that would threaten their medical licenses. What good is it being a doctor when non-doctor providers practice medicine and are not bound by the same laws as doctors? We aren’t permitted to do anything anymore due to government and insurance regulations, and now the powers are fighting to take away self-pay for medical services.

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AOA HOD Delegates afraid to speak up. Why?

One cry from several peers on the floor of the HOD at AOA this week was where was the support from within. People were afraid to stand up for their rights because they “get silenced while speaking, cut off by chairs that use Robert’s Rules to funnel dissent to the sidelines indefinitely or terminate discussions so that members are not permitted to explore the issues more fully”. Once their opposition has been registered ” They are often not invited back to sit as delegates.” In that environment compromise is not an option.

In order to have an organized mechanism we need to make a space available where people can speak freely and not have their opinions subject to scrutiny by their national organizations. “There are multiple examples of our professional organizations actually working toward academic censure over the past 20 years with individuals who speak out against current policy.”

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JAOA’s One-Sided View of ACGME Takeover

Dr Juhasz,

The newest JAOA is below with two articles supporting the ACGME takeover of OGME. There seemed to be no article on or credence paid to the work of Dr. Norman Gevitz and his well researched, valid & logical argument that the ACGME takeover would sell out and dismantle the DO profession and its schools.

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Paging Congress: Don’t Cut GME Funding

Guest post from Jason Fodeman, MD

This summer new doctors will start their residency training in a host of hospitals across Arizona and across this great nation. These new doctors are entering medicine at a time when uncertainty about the future of medical practice is at an all-time high. Much of this is a result of the Affordable Care Act, yet other uncertainties remain; including ambiguities about the future of the very funding that supports residency training.

As Congress looks to curtail out of control government spending and rising deficits, one expenditure that has repeatedly drawn interest is funding for Graduate Medical Education (GME). The Super Committee, the Simpson-Bowles Commission, and the Medicare Payment Advisory Commission have all paid particular attention to this funding that supports the mandated training doctors must complete at regular intervals in the years after graduation from medical school.  While budgets must be tightened, cuts to GME would endanger patients.

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Saddened by the seriousness of the AOA’s path

Dr. Gina Reghetti asks American Osteopathic Board of Family Physicians Executive Director Ms. Carol Thoma, MBA for a reply to her previous letter dated May 21.

June 29th, 2014
RE: Certified Article # 7012-3050-0000-2628-9885

Dear Ms. Thoma:

To date, I have not received a response back from the letter that I initially sent in May via email, and certified mail. It was signed for by S. Burnett on May 27th, 2014. We are nearing July. I would like answers to my many concerns. I would appreciate it very much if you would make this priority or forward it to someone that can answer my concerns.

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