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1. Concerns About Primary Care Residency Trainin
Pages 15-34

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From page 15... ... Although the content of primary care residency training is not the focus of these last two topics, they discussed here because they are topics of national importance that can be influenced by the financing of primary care residencies. New Directions for Primary Care Residencies are The education of primary care physicians being prepared to work in the late twentieth and early twenty-first century must respond to changes that have occurred and are occurring in the organization and delivery of health care. Read the entire page →
From page 16... ... This survey of 2,000 office-based non-governmental physicians, collects data about the ambulatory patients encountered during a randomly selected study week. Regarding the patient problems seen in ambulatory practice, 15 diagnostic clusters in 1978 accounted for 50 percent of the half billion annual ambulatory care visits. Read the entire page →
From page 17... ... Pre and Post natal care (3) 1 ~ general practice and family practice internal general obstetrics medicine pediatrics and gynecology breast Dis (58) Read the entire page →
From page 18... ... . Many sites that are used for ambulatory care training of primary care residents do not meet the description of the recently approved Special Requirements for Residency Training Programs in Internal Medicine, which state that "the conditions under which ambulatory patients are managed should be similar to those of office practicet' (Accreditation Council for Graduate Medical Education, 1988~. Read the entire page →
From page 19... ... Thus, despite mounting concern about the amount of ambulatory care training, and the quality of training in the most frequently used ambulatory care sites, change has been slow to occur. The ways in which current financing mechanisms make the transition difficult is the subject of Chapter 2. Read the entire page →
From page 20... ... Even in traditional solo practice or group fee-for-service practices, the primary care physician makes decisions concerning testing and referral that have major cost implications. In addition, some of the attributes emphasized in primary care, such as preventive care, health education and counseling are thought to be useful in forestalling more costly episodes of illness. Read the entire page →
From page 21... ... Taking into account such variables as the ratio of physicians to population, the Council on Graduate Medical Education (COGME) concluded that there is a current or impending undersupply of family practice and general internal medicine physicians, but there is likely to be an oversupply of pediatricians. Read the entire page →
From page 22... ... % of All MDs 485,123 100.0 585,597 No. % of All MDs 100.0 Total Physicians Family 31,195 6.4 44,944 7.7 44.1 Practice General 28,027 5.8 34,669 5.9 23.6 Pediatrics General 60,118 12.4 72,038 12.3 19.8 Internal Medicine Total 119,340 24.6 151,165 25.8 26.7 Source: American Medical Association, Physician Characteristics and Distribution, 1982 Edition and Forthcoming 1988 Edition. Read the entire page →
From page 23... ... Table 1.2 Projected Change in Number of Professionally Active Physicians, General and Family Practice, General Internal Medicine and General Pediatrics 1986, 2000 and 2020 Percent Percent Change Change Specialty 1986 2000 2020 1986-2000 1986-2020 All 521,780 667,370 757,130 27.9 45.1 Physicians General 71,320 81,660 95,100 14.5 33.3 and Family Practice General Internal Medicine 76,260 91,440 105,930 19.9 38.9 General 34,530 46,040 51,520 33.3 49.2 Pediatrics Primary Care 182,110 Physicians 219,140 252,550 20.3 38.7 U.S. Department of Health and Human Services, Sixth Report to the President and Congress on the Status of Health Personnel in the United States. Read the entire page →
From page 24... ... cD ~14 a a a no ec ~ hi ~ - ~ ~ ME ~x'o on-. Read the entire page →
From page 25... ... Data from the National Resident Matching Program also highlight the fact that the number of available primacy care residencies is not necessarily the determinant of the number of primary care physicians that enter the workforce. Between 1983 and 1989, the number of residency positions in primary care offered to physicians in their first year after medical school increased faster than the positions were filled. Read the entire page →
From page 26... ... Family Medicine 20~41:250-254; National Resident Matching Program, Evanston, Illinois. Read the entire page →
From page 27... ... Washington, D.C.: Association of American Medical Colleges. Read the entire page →
From page 28... ... Nevertheless, rational economic decisionmaking would steer physicians away from primary care specialties; the return on the educational investment is lower for the primary care specialties than for all other specialties except psychiatry (Marder, 1988) ; the incomes of primary care specialties are low compared with other specialties, and the income differential between the highest-paid specialties and the lowest-paid specialties (pediatricians, general and family practitioners, and psychiatrists) Read the entire page →
From page 29... ... When state or local governments pay for such care, the financial difficulties of the programs can be eased. Such a proposal is spelled out by Reiselbach (19861: " a linkage between the funding of graduate medical education and care of the indigent may be an effective means of accomplishing the changes in clinical education and indigent care necessitated by major problems in these areas". Read the entire page →
From page 30... ... 369 hospitals provided 40 percent of uncompensated care and received only 29 percent of net patient revenues (Association of American Medical Colleges, 1988b) Read the entire page →
From page 31... ... Chicago: Accreditation Council for Graduate Medical Education. American Medical Care and Review Association, Council of Medical Specialty Societies. Read the entire page →
From page 32... ... Presented at the workshop of the Institute of Medicine Committee to Study Strategies for Supporting Graduate Medical Education in Primary Care. April 17-18. Read the entire page →
From page 33... ... Prepared for the Institute of Medicine, Committee to Study Strategies for Supporting Graduate Medical Education in Primary Care. See Appendix B Read the entire page →
From page 34... ... In Medical Education and Societal Needs: A Planning Report for the Health Professions. Institute of Medicine. Read the entire page →

From page 15...

... Although the content of primary care residency training is not the focus of these last two topics, they discussed here because they are topics of national importance that can be influenced by the financing of primary care residencies. New Directions for Primary Care Residencies are The education of primary care physicians being prepared to work in the late twentieth and early twenty-first century must respond to changes that have occurred and are occurring in the organization and delivery of health care.

1. Concerns About Primary Care Residency Trainin Pages 15-34

1. Concerns About Primary Care Residency Trainin
Pages 15-34