The leadership crisis in internal medicine: What can be done?

Article Abstract:

Internal medicine needs leaders; in a time of great professional turmoil, this lack is the one that most threatens the specialty's identity. Ideas concerning the ways leaders can be identified and developed are presented and evaluated. Internal medicine is beset by problems resulting from practitioners' disillusionment, the imposition of control over their methods by outside agencies and interests, the loss of patient-oriented physicians to universities, and patients' unmet needs. Eighteen areas that represent both problems of special concern and challenges for the future are listed and briefly discussed. Geriatrics, moral and ethical issues, evaluation of new technology, interpersonal communication, medical informatics (management of the growth in medical information), the preparation of physicians for primary care, and health policy analysis, are a few of these topics. Roles that internists can play in these arenas are reviewed. The lack of leadership in the medical profession is a reflection of the lack of a national health care policy in the US. Medical associations, in general, do not have authority to implement desired actions. Specific suggestions for chairpersons of medical schools and for professors of medicine are presented. These revolve around the profession's taking an active role in educating students, defining curricula, improving the health care system, and encouraging research. The Association of Professors of Medicine, composed of these chairpeople, is the one group with the power to effect change. Leadership should be provided by the members of this group, who must now, in contrast to the past, encourage action in accordance with public concerns, not those of physicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

College faculty, Medical colleges, Medical school faculty, Leadership, Internal medicine

---

Clinical peer review: burnishing a tarnished icon

Article Abstract:

Clinical peer review may not be the most effective method for evaluating the treatment received by hospital patients. A research study found that physician peer review was unreliable in evaluating the quality of care received by hospital patients in a general medicine ward. The physicians who performed the review were internists who had been trained in an implicit criterion approach. The reviewers were often unable to agree on the quality of treatment received by single patients. The widespread use of the implicit criterion approach raises many concerns. Different measures may be taken to improve the reliability of peer review. One measure would be the recognition and use of techniques developed by scientists in other disciplines. Another would be to improve the education of residents and fellows in peer review with the use of a computer tracking system. A third would be to improve the identification and assistance available to substandard doctors.

Editorial, Medical care, Quality management, Medical care quality, Peer review

---

Improving the statistical approach to health care provider profiling

Article Abstract:

A hierarchical statistical model for evaluating quality health care may provide more complete information than previous models have. Hierarchical models include calculations that can predict the likelihood of quality performance regardless of the provider's sample size. These calculations are based on a provider's patient mix and past performance and are made in reference to identifiable standards. Producing meaningful results with this method can be limited by poorly defining the essential variables.

Hospitals, Medical statistics

Similar abstracts:

• Abstracts: The HIV epidemic and training in internal medicine: challenges and recommendations. Infections with Cryptococcus neoformans in the acquired immunodeficiency syndrome
• Abstracts: The HIV epidemic and training in internal medicine: challenges and recommendations. part 2 Sexual harassment in medical training
• Abstracts: The temporal relationship between maternal blood and amniotic fluid glucose levels. Exercise prescription in pregnancy: weight-bearing versus non-weight-bearing exercise
• Abstracts: The incidence of significant fetomaternal hemorrhage in patients undergoing cesarean section. The effect of mode of delivery on the perinatal outcome in fetuses with abdominal wall defects
• Abstracts: Depression in medical outpatients: underrecognition and misdiagnosis. Depression: underrecognition and undertreatment by psychiatrists and other health care professionals

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.