MEDICAL SCHOOLS: Not Preparing Docs For Managed Care
One of the problems with the managed care system is that medical schools do not teach their students how to practice medicine in a "budgeted environment," top medical directors said at a Boston conference yesterday. Sponsored by the Pew Charitable Trust's Partnerships for Quality Education, the conference hosted medical directors from Harvard Pilgrim, PacifiCare Health, Oxford and Humana to discuss "strategies for improving managed care performance." Medical schools should update their curricula "so doctors understand that the nation has 'finite resources in the face of seemingly unlimited demand,'" the directors recommended. Dr. Gordon Moore, director of Partnerships for Quality Education, said that "most medical schools still prepare graduates for a world that no longer exists." The Boston Globe reports that the delegates "seemed to be saying that if doctors -- and their patients -- understood better the limits of resources, there would be less complaining by both groups about the restrictions HMOs put on access to care." However, one HMO official, Dr. Robert Jacobs of Oxford Health, said most of HMO grievances "are caused by gaps in the system" like failure to provide follow-up care or delayed diagnosis. He said, "It's the simple grunt work that's killing you guys."
Reporting For Duty
The officials recommended that medical schools teach future doctors to "value teamwork with nurses, pharmacists, social workers, and clerks; streamlin[e] procedures; and [redirect] money from 'heroic' measures to preventive programs." Other officials recommended more quality measurements. "If you don't measure, you don't manage. If you don't manage, you don't improve," said PacifiCare's Dr. Sam Ho. The Globe reports that some directors "said that public backlash against HMOs might diminish if all parts of the health industry followed the HMO practice of publicizing at least portions of their 'report cards' on cost, health outcomes and consumer satisfaction" (Sanchez, 6/16).