4 Years In Medical School Is Wasting HealthCare Resources

Ezekiel J. Emanuel MD, PhD and Victor R. Fuchs PhD want to speed up the clock in medical school and residency.

If you think 10 to 15 years of training to become a doctor is nuts but decided to go for it regardless, I have some bad news. According to recently published article in JAMA, you where right, it is nuts! More than that, it may be a place to look for cutting unnecessary costs in healthcare. This article calls to question some of the most basic assumptions central to becoming a physician.

The Death of The All Knowing All Powerful Physician

The picture of the lone physician hero fighting off death and disease may seem inspiring but is really just ignorant and impossible in healthcare today. No matter how many of your internal medicine attendings puff up their chest and say "I don't need to get consults" it does not change the fact that we can no longer effectively practice medicine in a vacuum. Learning to work closely with our colleges is something that competition in medical school has suppressed but it is a skill that future physicians need to develop.

The consequence [of trying to train one all knowing doctor] is a broad training regimen... [it] emphasizes the autonomy of the physician rather than team-based care. The new model recognizes that with increasing clinical and scientific complexity, no physician can be a competent triple threat; that few clinicians will also be investigators; that no single clinician can know everything even in his or her own specialty; and that effective care requires collaborative, multidisciplinary teams.*

Less Time In Medical School and Residency Makes Better Doctors

At first this seems like a paradox, but when you consider the time spent learning outdated and extraneous facts or working hard to efficiently take care of more and more useless paper work, it begins to make sense. What if the right of passage was something besides showing how well one can fill out reams of paper work on patients. I guarantee any intern will tell you this takes up most of there waking moments during the first year of training. The current system has evolved to fit this waste and has little reason to correct course because, "that's what interns and medical students are for". However this drives up education costs for new physicians and increasing educational debit also limits the career options for graduating doctors. We are all inherently practical and when faced with a mountain of debt, grabbing a job with the highest pay and benefits will win. Following your desires to work in an undeserved area or taking a risk on a new business venture is a cost that many will not take.

There is substantial waste in the education and training of US physicians. Years of training have been added without evidence that they enhance clinical skills or the quality of care. This waste adds to the financial burden of young physicians and increases health care costs. The average length of medical training could be reduced by about 30% without compromising physician competence or quality of care.*

Read the full article here: Shortening Medical Training By 30%

*Emanuel EJ, Fuchs VR. Shortening Medical Training by 30%. JAMA. 2012;307(11):1143-1144. doi:10.1001/jama.2012.292.

Comments

[am]

I also wonder why med students need a 4yr degree before going to Med school. In other countries this is not required. That shaves a good 4 years off the program.