by Travis G. Bias, DO
Throughout my involvement in organized medicine, I’ve met friends who I hold in high regard, and colleagues for whom I hope to one day work. One of my favorites, a neurosurgery resident buddy of mine, claims specialists should be paid more than primary care physicians. But, I am a third-year family medicine resident, preparing to enter the practicing world. And …
How to meet the primary care demand in the next decade
Recent rules issued by the Accreditation Council for Graduate Medical Education (ACGME) for resident work hours have further limited the consecutive and total number of hours that medical trainees may work. These measures, originally created because of safety concerns, are intended to decrease the number of fatigue-related errors made by physicians in training. They have received broad support within the medical community.
A recent story published by Mike Lillis in The …
Should OSHA create work rules for physicians in training?
A guest column by the American College of Physicians, exclusive to KevinMD.com.
by John Tooker, MD, MBA, MACP
The Annals of Internal Medicine recently published an article by Mullan and colleagues on the social mission of medical schools. In the article, medical schools were ranked on their record of educating and training physicians …
ACP: Primary care education and training: Time for change?
A guest column by the American Medical Association, exclusive to KevinMD.com.
by J. James Rohack, MD
This year marks the 100th anniversary of the landmark Flexner Report that standardized medical education in North America. Now, during this historic time of health system change, medical education reforms on the scale of those enacted a century ago are needed …
AMA: Ensuring medical education best prepares future physicians
Recently, I had the opportunity to decamp from the friendly confines of GlassHospital and trek a few miles to the north.
GlassHospital has brokered a teaching and patient-sharing agreement with a nearby religiously-affiliated community hospital I’ll call Our Lady of Blessed Proximity.
Our Lady has a residency training program, just like ours, with the major difference being that nearly all of the doctors come from foreign lands.
Something you should know about medicine in America …
Leading a hospital team of foreign trained doctors
According to an article published in the Journal of General Internal Medicine, counties with teaching medical hospitals experienced a 10% increase in fatal medication errors as compared to counties without teaching medical hospitals.
First, what is the July Effect? It represents an entire transition in the hospital, during which medical students become interns, interns become senior residents, and second or third-year residents become chief residents. …
Fix the July Effect for incoming interns and residents
“An apple a day keeps the doctor away,” or so goes the old adage.
People who believe there’s some truth behind the saying are crunching on a great big Macintosh right now, or at least they will be once they hear about the results of a study from UC-San Diego which showed that every July, there’s a 10% spike in fatal medication errors in hospitals.
The scientists behind the study suggested that …
The July Effect and causes of the spike in medication errors
Can the field of family medicine truly become monotonous?
I never thought I’d ever find myself in a repetitive routine when selecting family medicine as my specialty. I spent eleven years after high school studying what I know. How can eleven years of material really become mundane? In a way, it’s a great thing – it means I am feeling comfortable and confident in my job.
And I am fortunate enough to …
Teaching family practice residents is rewarding
One of the mantras of performance improvement is that caregivers and provider organizations should learn from their experiences. That’s all well and good, but how about policy-setting organizations?
Recently, in the New England Journal of Medicine, two of the Biggest Kahunas in the safety and quality worlds – the Joint Commission (TJC) and the Accreditation Council for Graduate Medical Education (ACGME) – announced bold new policies. To their credit, both organizations …
Will the new resident duty hour rules improve patient safety?
How many hours can a doctor work?
The residency regulators are back. About ten years ago, the national organization that accredits residency programs (ACGME) set out its first guidelines about how many hours a doctor-in-training can work. Interns and residents finally achieved the vaunted 80-hour workweek. New York State was 15 years ahead on this, having mandated an 80-hour work week in 1989, stemming from the Libby Zion case.
Every patient wants …
The 80 hour resident work week balances fatigue and independence
It has been 10 years since the landmark Institute of Medicine report “To Err is Human” uncovered disturbing deficiencies in the quality of our nation’s medical care.
Progress in correcting these deficiencies remains frustratingly slow, and it has become clear that achieving the quality and safety improvements we seek will require us to examine our approach to medical education.
Although today’s newly minted physicians are well prepared in the science of medicine …
Today’s new physicians are unable to improve patient safety
A recent article in US News and World Report, Most U.S. Physicians Practicing Defensive Medicine, claims that physicians are ordering more tests and escalating the work-up of sick patients, all in the name of defensive medicine.
Is it true? Absolutely.
It is especially true in the emergency department, where we have one shot to get things right, or else. Ironically, by practicing defensive medicine we are not practicing …
Defensive medicine forces residents to use test oriented care
by Michael Smith
Life is better but the quality of surgical training has gone down in the wake of a Swiss law restricting surgical residents’ hours.
That was the view of both the residents and the surgical consultants who supervise them in a survey conducted by Daniel Oertli, MD, of University Hospital Basel in Basel, Switzerland, and colleagues.
Less than 9% of residents and less than 5% of surgical consultants saw the change …
Does restricting work hours hurt surgical training?
ADVERTISEMENT
At a recent meeting I attended, a vigorous discussion broke out about what medical students, residents and attendings should wear, and more importantly what they should not wear.
Interestingly, patients have been asked to weigh in on this discussion. What to wear is also on the mind of many current second year medical students who may find themselves trying to take study breaks from USMLE 1 to go buy …
What residents and medical students should wear in the hospital
by Kristina Fiore
Deaths from medication mistakes appear to spike in July, when medical residencies begin, researchers say.
Over nearly a 30-year period, fatal medication errors appear to jump 10% solely in that summer month in U.S. counties with teaching hospitals, David P. Phillips, PhD, of the University of California San Diego and Gwendolyn E.C. Barker, BA, of the University of California Los Angeles, reported online in the Journal of General Internal …
Medication errors spike when new residents start in July
by Emily P. Walker
A majority of the American public doesn’t approve of doctors working 24 hours straight and supports tougher work hour regulation for resident physicians, according to a new public opinion survey.
The survey, published in the online journal BMC Medicine, is the first to assess the public’s perceptions about the controversial issue of medical residents’ work hours.
The survey found that 90% of Americans believe the maximum shift duration should …
The public wants resident physicians to work less
A version of this op-ed was published on June 2nd, 2010 in USA Today.
During medical training, I routinely stayed awake for more than 30 hours straight to care for my patients in the hospital. I strove to be the tireless physician who would be with his patients until they went home. It turns out I may have jeopardized their safety instead.
For many years, the medical field has been rightfully …
Op-ed: Restrictions on physician hours may not improve patient safety
On a recent Saturday, I rounded in the hospital. I met up with Zainab, the president of the minority premed association for the University of Chicago, who asked to shadow me. While she was doing research at the hospital, she had not ever rounded in the hospital before. It was Saturday so our team was mostly off so it was just me and my very capable resident who is about …
Tips for students who want to shadow doctors
A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.
The American Board of Internal Medicine (ABIM) is sending a clear message to doctors this week: Compromise the integrity of the certification process and face swift and serious penalties.
ABIM is sanctioning 139 physicians for sharing, buying, or soliciting confidential, copyrighted questions that were part of the exam …
ABIM responds to doctors sharing board certification questions
What is “MRI Abuse”? This is when the health care provider orders MRIs (Magnetic Resonance Imaging) in excess or for the wrong reasons. There are many causes of MRI abusive behavior but most evolve out of a significant misunderstanding of how to properly utilize this diagnostic tool. MRI imaging has a high sensitivity to detect anatomic abnormalities, does not expose the patient to high doses of radiation like a CAT …
MRI abuse can be dangerous and expensive for patients
Get free updates delivered free to your inbox.
