Managed care and medical education: hard cases and hard choices

Academic Medicine : Journal of the Association of American Medical Colleges
E Friedman

Abstract

As managed care becomes more and more dominant in U.S. health care, it is coming into conflict with medical education. There are historical reasons for this: medical education traditionally excluded physicians who chose to work in health plans, and for profit managed care has tended to avoid subsidizing medical education. In order to improve the climate, three changes are necessary: medical education must understand the tense history of discord between the two; distinctions must be made between responsible and irresponsible managed care plans; and medical educators should not assume they own the moral high ground. Arrogance, a gross oversupply of physicians and especially specialists, scandals and fraud, an often callous attitude toward the poor, and other sins can be laid at medical education's door. The worse threat for both sides is that the public and payers could simply abandon both, leading to underfunding for health professions education, a society that does not trust its health care system, and the loss of superb teaching organizations. To prevent this, managed care and medical education should work together to solve several difficult problems: how to shrink the medical education infrastructure; how to report honestly t...Continue Reading

Citations

Jun 13, 2001·Academic Medicine : Journal of the Association of American Medical Colleges·H K RabinowitzD L Wood
Feb 14, 2002·Academic Medicine : Journal of the Association of American Medical Colleges·Allan S Berger
Aug 27, 2009·Academic Medicine : Journal of the Association of American Medical Colleges·Mitesh S PatelMatthew M Davis

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