Our ailing public hospitals: cure them or close them?

Article Abstract:

The cost and value of public hospitals need to be assessed on a national scale as these facilities continue to close, leaving the poor and uninsured people they serve with few health service options. Approximately 21% of US hospitals are public and they are largely funded by Medicare, Medicaid, local governments, and medical-education subsidies. As these sources of money are threatened these public hospitals will be forced to close or greatly reduce their services. These hospitals provide care to underinsured and uninsured people, people with ordinary diseases, and people with particularly taxing illnesses such as AIDS and drug addiction. They also provide various social services and contain special-care facilities such as burn units. As these hospitals close, private hospitals may be able to provide beds for appropriate patients, but not provide necessary outpatient and emergency care. The federal government must resume its attempt to create a health policy that provides care for all people.

Public health, Hospitals, Public, Public hospitals

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Tribulations and rewards of academic medicine - where does teaching fit?

Article Abstract:

Efforts must be made to provide financial support to faculty members at academic medical centers for their teaching, as sources of educational funding are cut and faculty jobs change. A 1996 study found that faculty members in an academic department of medicine were not paid for the 10% to 15% of their professional time spent teaching medical students and house staff. Financial support is threatened by decreases in professional income, and reduced funding for medical research and graduate education. The other responsibilities of faculty members are also likely to increase, leaving less time for teaching. Academic physicians will be spending more time managing care and delivering care, and seeking additional income through work outside of the medical center. However, teaching continues to provide other rewards, including prestige and the opportunity to work with students and tackle challenging clinical problems. Furthermore, faculty and students remain enthusiastic about medical education.

Finance, Hospitals, Teaching, Teaching hospitals

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Teaching problem-solving - how are we doing?

Article Abstract:

Technical and diagnostic advances cannot replace the critical thinking inherent in the problem-solving abilities of a physician. Diagnostic inference and eventual identification of the disease at hand requires practice, knowledge, and the ability to comprehensively combine all known aspects of a patient. It is more crucial than ever to reduce the financial expense of elaborate testing in favor of clinical problem-solving and diagnosis. To this end, medical education has attempted to include group problem-solving techniques and decision analysis. However, neither approach seems to address all aspects of the diagnostic process. The discussion of medical errors, as offered in the Journal, may prove a valuable learning tool.

Methods, Analysis, Study and teaching, Problem solving, Medical errors, Diagnosis, Critical thinking

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