Comments on: Non-teaching services: A threat to medical education? http://www.kevinmd.com/blog/2007/07/non-teaching-services-threat-to-medical.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Mikehttp://www.kevinmd.com/blog/2007/07/non-teaching-services-threat-to-medical.html#comment-78156 Mike Wed, 25 Jul 2007 00:53:00 +0000 http://clients.emmense.com/kevinmd/2007/07/non-teaching-services-a-threat-to-medical-education.html#comment-78156 This is garbage.<br/><br/>First off, the patients assigned to the Non teaching service typically arent spearated by insurance status. They are just in a queue with the on call residents and the ER just doles em out.<br/><br/>Secondly, the real danger is that all the non teaching cases are probably lower acuity, so the few "easy ones" that interns and residentts (and their attendings) get are plucked away in favor of those that are sick as hell. So the floor team gets crushed. Its just like with mid level run clinics.<br/><br/>NO WAY would hospitals get rid of residency programs, if Medicare gives the hospital 150K per resident for GME, then the hospital would be pissing away MILLIONS of dollars.<br/><br/>These non teaching prgrams are a byproduct of JCAHO 405 regulations (in NYC anyway) that put caps on resident admissions and census. Administrators are in constant jeopardy of being cited by JCAHO so they are desperate to ease the burden on the housestaff placed there by the ever increasing use of the ER/hospital as a primary care source and hotel. This is garbage.

First off, the patients assigned to the Non teaching service typically arent spearated by insurance status. They are just in a queue with the on call residents and the ER just doles em out.

Secondly, the real danger is that all the non teaching cases are probably lower acuity, so the few “easy ones” that interns and residentts (and their attendings) get are plucked away in favor of those that are sick as hell. So the floor team gets crushed. Its just like with mid level run clinics.

NO WAY would hospitals get rid of residency programs, if Medicare gives the hospital 150K per resident for GME, then the hospital would be pissing away MILLIONS of dollars.

These non teaching prgrams are a byproduct of JCAHO 405 regulations (in NYC anyway) that put caps on resident admissions and census. Administrators are in constant jeopardy of being cited by JCAHO so they are desperate to ease the burden on the housestaff placed there by the ever increasing use of the ER/hospital as a primary care source and hotel.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/non-teaching-services-threat-to-medical.html#comment-78141 Anonymous Tue, 24 Jul 2007 23:37:00 +0000 http://clients.emmense.com/kevinmd/2007/07/non-teaching-services-a-threat-to-medical-education.html#comment-78141 Teaching services can never be as efficient at utilization as those run by mature clinicians, if they are optimal teaching experiences. Good training requires that residents be given leeway to make clinical judgement which means they have to have responsibility for making decisions without a lot of interference and find their clinical comfort level--sometimes that takes and extra day or two in the hospital. Teaching services can never be as efficient at utilization as those run by mature clinicians, if they are optimal teaching experiences. Good training requires that residents be given leeway to make clinical judgement which means they have to have responsibility for making decisions without a lot of interference and find their clinical comfort level–sometimes that takes and extra day or two in the hospital.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/07/non-teaching-services-threat-to-medical.html#comment-78122 Anonymous Tue, 24 Jul 2007 17:42:00 +0000 http://clients.emmense.com/kevinmd/2007/07/non-teaching-services-a-threat-to-medical-education.html#comment-78122 Isn't this a re-hash of age old HAVEs [those who go into hospitalist service] and HAVE-NOTs [those that are in the teaching service]. The latter maybe assigned to attendings who are so busy trying to see enormous numbers of patients with minimal to no compensation? Isn’t this a re-hash of age old HAVEs [those who go into hospitalist service] and HAVE-NOTs [those that are in the teaching service]. The latter maybe assigned to attendings who are so busy trying to see enormous numbers of patients with minimal to no compensation?

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