There is a tremendous amount of handwringing among students, workforce researchers, and medical school deans about the record amount of debt that medical students incur -- more than $175,000, according to the Association of American Medical Colleges. This has unintended consequences, including student selection of more lucrative specialties and placing medical education beyond the reach of low-income and minority students. The average household income for a matriculating medical student is ...

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I always believed that, if we could harness the entrepreneurial spirit of the American physician, we could be capable of great things. Physician decisions drive much of what is good and bad about our health care system. Their pens are the biggest driver of cost and their vigilance is the most significant driver of quality. It is a shame that physician-owned hospitals are accelerating the creation of a two-tier system ...

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I am old enough to remember when physicians did not advertise. It was considered a professional ethical issue. Hospital advertising consisted of institutional “We’re here” ads.  Anything aggressive by docs or hospitals was considered bad taste… but that was before health care became as competitive as any other type of business. I have been barraged, as have many of you, by a wave of hospital advertisements as our health care marketplaces ...

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Predicting the next 4 years of health reform Although members of the Obama team are now celebrating their election victory, the next four years will not be smooth sailing. Ignoring the campaign rhetoric, there is still much more work to be done in order to reshape our health care system; the effect on academic medical centers and teaching hospitals will be significant. The political conscience is still being driven by ...

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The Dartmouth Atlas Project released a study on October 30, 2012, entitled, “What Kind of Physician Will You Be? Variation in Health Care and Its Importance for Residency Training.” The data, and the conclusions of the report’s authors, bear closer examination. The data set focuses on the differences in the intensity of services that Medicare patients receive, and highlights the academic medical centers rated by U.S. News and World ...

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Stranded capital is a new term, a derivation of the term stranded costs that emerged from the deregulation of electric companies. It refers to “the existing investments in infrastructure for the incumbent utility which may become redundant in a competitive environment.” Many academic medical centers are weighing the importance of meeting current demand while considering the risk that, in a future competitive environment, dramatic declines could occur in the need ...

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In 2003, authors Warshaw and Bragg published a paper that reported on three decades of progress in creating a workforce to care for our aging population. They noted that, as of academic year 2001-2002, 120 geriatric medicine fellowships were training 338 fellows. U.S. medical schools had 869 full-time equivalent (FTE) geriatrics faculty members teaching in IM residency programs and FP residency programs. From 1988-2002, more than ten thousand Certificates of ...

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