Doctors Minus The Bedside Manner

The New York Times has put up an article concerning the increasing rudeness of doctors towards patients. This post goes along with the earlier one on concierge medicine and the effects of increasing patient loads for future doctors. The article states how neglectful and rude doctors are becoming more common in the United States. Also, it seems that most of these unsympathetic doctors do not even recognize the problems they are causing for their patients.
The cases in the article seem mighty extreme such as one doctor chastising a woman for being sexually active and not married. Another, where a doctor says to an overweight woman, "I could wire your jaws shut so tight that you can't move your jaws to talk, and if you can't talk you can't eat." Though these are pretty crazy (and hopefully rare) cases, it does seem from the explanations in the articles that doctors today have to carry a more time consuming role at the office. The article proposes some solutions for current doctors:

At the Rochester Independent Practice Association in New York, with 3,000 doctors, patients are surveyed, and their satisfaction scores can account for 20 percent of a doctor's pay. At Tufts Health Plan, 3,000 to 4,000 doctors had all or part of their bonuses withheld last year because their patients did not rate them highly, said Richard Lynch, the plan's vice president of network contracting.

In California, said Dr. Ronald Bangasser, the past president of the California Medical Association, eight major health insurers have a new program in which they divide $30 million among 35,000 physicians depending on how their patients rate them. "It could be $3,000, $4,000 or $5,000 per physician," Dr. Bangasser said. "That would get their attention."

As for doctors in training, it seems that many residency programs are teaching doctors how to be "nice" and they are also reviewed by a fake patient's feedback. Something as simple as teaching doctors to nod and say, "uh huh," made a dramatic difference.

There is one last thing to be noted from the article that is HUGE for future doctors and how they will be practicing medicine. The article highlights the increasing use of physician's assistants in hospitals and offices. The medical system seems to be going in the direction of separating out the work over different tiers, with the doctors overseeing the final findings of physician's assistants and nurses. Patients and I think a lot of pre-med students are dismayed by this, but it seems to be where this overly strained field is headed.

Summer Medical Education Program Has Changed

The Summer Medical Education Program (SMEP) provided by AAMC is no longer available in the form it once was. It has now changed to SMDEP. The program still has a lot of similarities to the old one, but to some people's dismay or happiness it only accepts freshmen and sophomores now. I feel that they should have had a transitional period for a couple of years to let some of the older kids that did not know about the change, get an opportunity too. According to the website some of offerings are:

• Academic enrichment in the basic sciences (organic chemistry, physics, biology, pre-calculus/calculus) and key elective courses (writing, oral presentations, current topics in health)
• Learning-skills seminars, including study skills and methods of individual and group learning
• Limited clinical exposure through small-group clinical rotations and full-group clinician seminars
• Career development, including the exploration of the medical and dental professions and an individualized education plan to identify other appropriate summer experiences
• A financial-planning workshop

Looks like a solid setup, plus it's free. That includes tuition, meals and even housing. The app will be open in December and is due on March 1, 2006. The program uses rolling admissions, so apply as soon as possible.

Forgot to Introduce Myself

My name is Nirav Patel. I currently attend the University of Arizona.I am the creator of this blog and also the main writer for it. My goal for this blog is a simple one, to provide a blog for pre-medical students that is informative and useful. This means that I hope it will include study tips from real professors, news on the ever changing state of medicine that will affect future doctors, and anything else that is possibly relevant to a pre-med student. We here at PreM.D. are always open to suggestions. Everyone is able to contribute and we would love help from all areas.

Hello from Varun

My name is Varun Rajendran. I will be an occasional writer for this blog. I hope to bring new ideas and thoughts to here and this is my first entry. I attend the University of Texas at Austin.

Medicine for the Rich?

The New York Times has posted an interesting article on boutique or concierge doctors. A concierge doctor is basically one that sees fewer patients in exchange for much higher fees. Some of these fees surmount to 10,000 dollars a year or even higher. The doctors do and explain everything to the patients for as long as it takes. Some will even make house calls. Other doctors have even chosen to include “scholarships” for patients that cannot afford the extrememly high fees (the exact number of patients that receive these I am assuming is low).

To me this basically amounts to greed and only greed. There is enough of a disparity between the rich and the poor in the country. All concierge doctors will do is widen the gap that is already present. When did “regular medicine” in this country turn into the equivalent of buying a KIA? In my opinion, a doctor should offer equal treatment to everyone that he or she sees. With a doctor shortage in this country already present the last thing needed doctors taking less patients. What is going to happen if one day 50% of medical students become concierge doctors? How will people who cannot afford treatment get proper medical care? There should not be a luxury model on medicine. Giving patients the right attention, calling them with results, and checking up on them should not be an extra charge, it should be a duty. Every patient has the right to all those things and shouldn’t have to save up so that they can get good medical care. The doctors in the article complain of having too large a number of patients. Why not reduce the number patients? The doctors see more patients to make more money. Doctors deserve a good salary for the work that they do, but there is a line where one will eventually cross from being a caregiver to a businessman. That is the line I believe these boutique doctors have not only crossed, but ran miles past. This is an article that everyone pre-med student should take a close look at.