Moving the Financing of Graduate Medical Education Into the 21st Century

[elementaryschooleconomics]

"Residents slow attendings down"

"Training residents costs money"

"We expanded the number of Radiation Oncology residents to fill a looming shortage, certainly not because we make a ton of money off of them and an oversupply lowers attending salaries"

Financing Graduate Medical Education In the 21st Century

This Viewpoint challenges US hospital claims that government funding to train physicians is necessary to offset costs, maintain physician supply, and keep costs low for other payers, and proposes reforms to use the monies to target known problems, such as geographic disparities in physician...

jamanetwork.com

---

Members don't see this ad.

 

[Chartreuse Wombat]

Below is a report from RAND that was mischaracterized by Mike Steinberg at an ASTRO panel in 2019 (or 2018).

Does It Cost More to Train Medical Residents or to Replace Them?

If a hospital has service needs, adding a resident presents a marginal benefit. This is especially true for more-lucrative specialty and subspecialty programs, before considering the additional benefits of any Medicare revenues related to graduate medical education.

www.rand.org

TBL

"If the hospital has service needs, there is a marginal benefit to adding a resident, particularly in the more-lucrative specialty and subspecialty programs, before considering the additional benefits of any Medicare GME-related revenues."

 

[scarbrtj]

Unsure M4

Psych HCA hospital in FL where I interviewed.... heard from a very reputable source that some non-physician suit from HCA came and overturned the PD and program's rank list. The rank list was redone by this HCA non-physician and stratified by step scores (>230 to play). PD and residents felt steamrolled and annoyed after spending tons of time reviewing applications and conducting interviews. HCA suit even chastised program about why they interviewed some candidates. Oh, they also suddenly took away the residents free food a few weeks ago without warning after interview season. And supposedly were supposed to compensate for residents' lower stipend with travel funds for conferences, which also never materialized. This program went from top 5 to maybe DNR for me. Also all research is required to be approved by HCA corporate first, and there has to be an HCA person listed as an author on all research projects even though they took no part in it. Was going to rank this program in top 5, now its DNR for me.

I think it's starting to be accurate to say that in the corporate world... which is in essence the world in which a lot of medicine now lives... doctors are second-class citizens and will never be quite "equal" much less in charge (like they used to be, and should be). A lot of the stuff the corporate world now does is what I'd describe as autonomy tokenism.

 

[Radonky]

"Residents slow attendings down"

"Training residents costs money"

"We expanded the number of Radiation Oncology residents to fill a looming shortage, certainly not because we make a ton of money off of them and an oversupply lowers attending salaries"

Financing Graduate Medical Education In the 21st Century

This Viewpoint challenges US hospital claims that government funding to train physicians is necessary to offset costs, maintain physician supply, and keep costs low for other payers, and proposes reforms to use the monies to target known problems, such as geographic disparities in physician...

jamanetwork.com

It is wonderful to hear physicians who aren't invertebrates.

 

[seper]

Wonder if that HCA admin is doing fine. Working on ranking medstudents, that's like the definition of pathological micromanagement

Unsure M4

Psych HCA hospital in FL where I interviewed.... heard from a very reputable source that some non-physician suit from HCA came and overturned the PD and program's rank list. The rank list was redone by this HCA non-physician and stratified by step scores (>230 to play). PD and residents felt steamrolled and annoyed after spending tons of time reviewing applications and conducting interviews. HCA suit even chastised program about why they interviewed some candidates. Oh, they also suddenly took away the residents free food a few weeks ago without warning after interview season. And supposedly were supposed to compensate for residents' lower stipend with travel funds for conferences, which also never materialized. This program went from top 5 to maybe DNR for me. Also all research is required to be approved by HCA corporate first, and there has to be an HCA person listed as an author on all research projects even though they took no part in it. Was going to rank this program in top 5, now its DNR for me.