Health Affairs is highly esteemed in both the medical and governmental communities as one of the finest and most reputable periodical sources for health policy news and commentary. The publication's blog of the same title continues that commitment to health policy for a web-enabled audience. Medical students and professionals alike should consider this site to be regular, mandatory reading, if only to stay at the forefront of the most salient news affecting their industry.
When Less Is More: Issues Of Overuse In Health Care
Editor’s Note: This post is part of an ongoing Health Affairs Blog series on palliative care, health policy, and health reform. The series features essays adapted from and drawing on an upcoming volume, Meeting the Needs of Older Adults with Serious Illness: Challenges and Opportunities in the Age of Health Care Reform, in which clinicians, researchers and policy leaders address 16 key areas where real-world policy options to improve access to quality palliative care could have a substantial role in improving value. About 18 months ago, Daniel Wolfson, president of the American Board of Internal Medicine (ABIM) Foundation began asking audiences of clinicians if any of them had ever seen a patient subjected to unnecessary medical care. As one of the architects of the Choosing Wisely campaign, an initiative of the ABIM Foundation intended to reduce overuse of medical services, Wolfson had a particular interest in the answer to this question. He was surprised to find that in some of his audiences, a majority of clinicians have personal experience with overuse. Clinicians’ newfound willingness to concede that overuse is a problem comes as good news for people who have long labored to increase awareness of this aspect of medicine in America, including the authors of this blog and many of the readers of Health Affairs. Overuse is costly, pervasive, and causes harm to patients, yet it has been remarkably difficult to get the medical profession, health care industry, and general public to take note of it, much less take steps to reduce it. Today, however, there are multiple efforts underway that offer hope for real change, including Choosing Wisely, the growth of palliative care, and the Lown Institute’s Right Care Alliance; but until now, the most difficult step has been the first: for patients, payers, physicians and policymakers to acknowledge the scope of the problem.
The 2014 GME Residency Match Results: Is There Really A “GME Squeeze”?
Each spring thousands of seniors at medical and osteopathic schools and other physicians apply for positions in graduate medical education (GME) training programs; simultaneously, thousands of training programs rank their preferred candidates. Based on the preferences of the medical student/physician applicants and the training programs, the two are matched by a sophisticated computer program. Since GME is a prerequisite to becoming licensed and practicing medicine in the US, this is a critical juncture in the education – training pipeline and provides a spotlight on the future physician workforce. There are two matching systems: one administered by the National Residency Match Program (NRMP) for allopathic training positions, accredited by the Accreditation Council for Graduate Medical Education (ACGME), that matches medical doctors (MDs), doctors of osteopathic medicine (DOs) and graduates of schools outside of the US, known as international medical school graduates (IMGs); and one for GME programs accredited by the American Osteopathic Association (AOA) that is limited to DOs. The following are among the highlights of the results of this year’s matches. First year positions (PGY 1 positions) for entrants into GME reached an all-time high and the number continues to grow. This year, a record 26,678 first year positions were offered by the NRMP and an additional 2,988 first year positions were offered in the AOA sponsored match, for a total of 29,666 positions offered in 2014. (See Note 1) This represents an overall increase of 2.2 percent from 2013. (See Note 2) However, some of the NRMP increase may reflect the “all in” policy instituted by the NRMP effective in 2013. (See Note 3) Entry level GME positions far outnumber the number of US medical and osteopathic graduates seeking a residency position. Despite a lot of rhetoric and fear that new US graduates are facing a lack of training slots, overall, there were about 22,300 US MD and DO seniors competing for the 29,666 first year positions.
Health Affairs Briefing: Hospital Productivity And The Standardization Of Care
Hospital organizational form, practices, and procedures all affect outcomes and costs. These topics and the exploration of cost-saving potential within the hospital sector were the subject of a National Bureau of Economic Research conference held last fall. The May 2014 issue of Health Affairs, "US Hospitals: Responding To An Uncertain Environment," features four of the papers presented at that conference, as well as several other papers that take up issues surrounding the financial health of hospitals and outcomes for the populations they serve. Please join Health Affairs Founding Editor John Iglehart on Wednesday, May 7, at the National Press Club in Washington, D.C., for a Health Affairs briefing marking the release of the May issue where the authors will present their work.
WHEN: Wednesday, May 7, 2014 10:00 a.m. - Noon
WHERE: National Press Club 529 14th Street NW Washington, DC 13th Floor (Metro Center)
REGISTER NOW!Follow live Tweets from the briefing @HA_Events, and join in the conversation with the hashtag #HA_HospitalProductivity.
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