Physician Education / Maldistribution

Question 1

Specialty maldistibution

Answer 1

60% of US physicians are specialists, the amount of specialist is growing while PCP shrinks

This is an issue in other countries but not as pronounced

Question 2

Reasons for Specialty Maldistribution of Physicians

Answer 2

1. Medical technologies
2. Reimbursement / renumeration
3. Specialty oriented education

Question 3

Medical Technology

Answer 3

Large hospitals are focusing on adding specialists, as patients prefer care performed with the most advanced technologies

Question 4

Reimbursement & Renumeration

Answer 4

Specialist make more and have more favorable hours

Question 5

Specialty oriented education

Answer 5

Medical education is oriented around specialist, PCP fight stigma of being less intelligent

Question 6

Consequences of Specialty Maldistribution

Answer 6

1. Rise in health care expenditures

2. Financing of medical training is biased

Question 7

Rise in health care expenditures

Answer 7

High volume of expensive and invasive procedures

More expensive medical tech doesn’t mean better results, and PCPs are cheaper

Question 8

Biased financing

Answer 8

Financing for training is based on number of trainees which favors specialists

Question 9

Geographic maldistribution of physicians

Answer 9

Rural / non-urban areas under 50,000 residents have a shortage of PCPs, despite having sicker populations

Question 10

Reasons behind geographic maldistributions

Answer 10

1. higher income in urban areas
2. more modern facilties
3. living standard
4. continuing education

Question 11

Policy solutions to geographic maldistribution

Answer 11

1. Expand scope of health care professionals (more responsibility for NP)
2. Increase reimbursement in rural areas
3. Targeted programs

Question 12

NRMP

Answer 12

National resident matching program

Est. 1952, matches med-students to residency programs

Since 1998 they have been using a new algorithm

Question 13

Resident Matching

Answer 13

4th year med students, ranked on ordered list by their application

Question 14

Hippocratic Oath

Answer 14

Med-student binding document

“Do no harm”

Minimize harm to patient and avoid overtreatment, through emphasis on sympathy

Prevention > care