Everyone in the world is talking about “value-driven health care.” Or so it might seem if you pick up a medical journal or attend a lecture about health care here in Boston. “Maximizing value for patients” is on the tip of every administrator’s tongue and an interest in cost containment is de rigueur for young physicians who aspire to leadership positions in medicine. For those of us who are intimate with the ...
Nathan Favini
How to address the mistreatment of medical students
How to address the mistreatment of medical students is a hot topic in medical education right now. The LCME, the body that accredits medical schools, is interested in this and their attention seems to be lending credibility to the issue and leading to some soul searching. It’s a difficult topic to approach for many reasons, especially since defining it is incredibly difficult. Medical training is notorious for its hierarchical culture and ...
Medical school debt only partly explains the primary care shortage
Pauline Chen had a compelling piece in the New York Times recently about medical student debt and it’s unappreciated costs. It draws on a recent publication in Academic Medicine which highlights the diverse drivers of medical student indebtedness. These include an expansion of the medical school’s research enterprise, a lack of accountability on the part of medical school administrators, who can increase tuition to support the research mission, ...
Walking out of the hospital for the last time as a third year student
On our first day of the Cambridge Integrated Clerkship, every student had a pager on their desk. We knew they would be there—the central idea of the clerkship was that students could be reached at any time when our patients came to the hospital. Still, it seemed to me a strange and antiquated device, only slightly less odd than a typewriter or rotary phone, and it was hard ...
The older generation of physicians may disapprove of social media
In the last three years, less than fifteen minutes of the formal medical school curriculum at my school has been dedicated to social media.During our orientation, a faculty member showed us a series of images that she had found online, publicly available on Facebook, that showed what she considered to be inappropriate behavior: students drinking, dancing and in revealing clothing. She warned us about the impact that images ...
Burning your short white coat after medical school graduation
Eastern Virginia Medical School held it’s "White Coat Retirement Ceremony" recently. In photos from the event, graduating medical students are shown throwing their short white coats into a fire. I thought to myself, "what in the world is going on?"When I was presented with my short white coat at the start of my first year of medical school, I was told that ...
The problem of healthcare costs is deeply political and cultural
Below are the rates for my student health insurance coverage for the coming year.I’m newly married, so my spouse and I will be enrolling together. That means that the total cost of health insurance for our family of two will be $7,522. Even though I’ve been paying $3,000 a year for my own insurance, $7,522 inspired some sticker shock. Our care is pretty heavily “managed” in this plan, allowing only ...
Balanced living for medical students
As a third-year medical student, I sometimes felt like a hypocrite.I spent much of my time advising my patients on how to take care of themselves, discussing in depth the best ways to care for our bodies and relationships. And yet, the schedule and intensity of my work often prevented me from following my own advice. I was not getting recommended levels of exercise or sleep and I was substituting ...
Why do medical students find primary care so boring?
There was a New York Times piece recently about a young doctor from northeastern Pennsylvania, not far from my hometown.Dr. Kate Dewar speaks with the NY Times about her decision to not join the primary care practice of her father and grandfather. I don’t have an issue with her choice to enter emergency medicine instead ...
