B Ross-Lee, LE Kiss, MA Weiser. Transforming osteopathic medical education. J Am Osteopath Assoc 1996;96(8):473. doi: 10.7556/jaoa.19220.127.116.113.
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The evolution of the healthcare marketplace to a managed care-based system requires dramatic changes in the fragmented medical education infrastructure and curricula to more adequately train the physician workforce needed to staff and support the new system. Graduating physicians, in large numbers, feel poorly prepared to function effectively in the very areas adjudged to be essential to a successful transition, such as cost-effective care and caring for patients in outpatient settings. Managers of the new systems, such as health maintenance organizations, have expressed dissatisfaction with the skill levels of many of the practitioners whom they are hiring. Many physicians who have made the transition to a new practice paradigm by restructuring their practices are dissatisfied with several aspects of the new practice environment and equally concerned about the quality of care they can deliver. The conflict between rhetoric and incentives, and the difficulty of reforming a fragmented academic system pose barriers to effective change as the nation's academic health centers prepare to respond. Osteopathic medicine is better positioned to change because of its community-based education, its track record in primary care, and its national move to create a vertically integrated continuum of education from undergraduate through graduate study. Medical education and workforce issues are essential components of the cost, quality, and access triad. Without reform in medical education, the ability of the new paradigm to adequately address these other issues is critically compromised.
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