Category Archives: Pattern Analysis

Top 10 Posts of 2013

In case you missed them, here is a roundup of our Top 10 Most Popular Posts of 2013:

pattern_anlysis1. Proposed U.S. Allopathic and Medical Schools, by James E. Lewis, Ph.D.

???2. Matching the Unmatched: The Role of the Medical Student Career Advisor, by Marlene Welch, M.D.

3. The Primary Care Shibboleth: Debunking the Myth, by Robert E. Harbaugh, M.D. (cross-post)

Procrastinating4. Meet Our New Cartoonist: Dalya Munves

Bonham Ann5. How Will We Treat This Generation’s Henrietta Lacks? by Ann Bonham, Ph.D.

6. Health Wonk Review: Rhetorical Question Edition, by Sarah Sonies and Jennifer Salopek

Low Res Gloria Ohmart, Ed.D., MN, APRN, Assoc Dean, Simulations7. Empowered Nurse Advocates Build Effective Patient-Centered Care Teams, by Gloria Ohmart, Ed.D, MN, APRN

brainstorms8. Time’s Brill Persuasive but “Bitter Pill” Misdiagnoses Health Care Ills, by Joanne Conroy, M.D.

socialized_medicine9. Five Topics I Avoid as a Social Physician, by Bryan Vartabedian, M.D.

10. Assessing Med School Applicants’ Digital Footprints, by Bryan Vartabedian, M.D.

“Inextricably Intertwined:” Income Streams in Academic Medicine

pattern_anlysisBy James E. Lewis, PhD 

In the past four decades, many people have said that the triple missions of academic medicine—education, research, and patient care—are “inextricably intertwined.” I even visualize them as the sides of an “eternal triangle” that maps to a mirror image for health care whose sides are “quality,” “cost,” and “access.”

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Wing of Zock Featured in This Week’s Health Wonk Review

InsureBlog’s Hank Stern has posted the “Pre-Thanksgivukkah” edition of Health Wonk Review, which includes the November Pattern Analysis column by Dr. Jim Lewis, “The Medical School Class of 2025.” Stern writes,

Something that a lot of folks haven’t really thought through is “Where are all the new docs going to come from?” After all, these newly-insured folks will need someone from whom to actually receive care. Over at Wing of Zock, Jim Lewis notes that students just entering high school would graduate from medical school in 2025, and they’ll have access to diagnostic and clinical tools likely even unimagined today. But where will they complete their residency training? The answers may surprise you.

The Medical School Class of 2025

pattern_anlysisBy James E. Lewis, Ph.D. 

The members of the U.S. medical school class of 2025 entered high school this fall. Shocking to think of, isn’t it? More shocking is to wonder what and how to teach when they enter medical school in just eight years? And how will they complete their training—will there be enough residency positions for them? These questions can and should keep medical educators awake at night.

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Medical School Admissions and Deming’s Parable of the Red Beads

pattern_anlysisBy James E. Lewis, PhD 

I used to think I was the only one who thought that the root cause of many problems in the American health care delivery system, particularly those associated with quality, safety, and cost, would be found in the decisions made by medical school admissions committees. I don’t feel so alone now that bloggers and others are suggesting that a lottery for selecting among academically qualified medical school candidates would be as good as thirty-minute interviews, or that pre-application counseling and grooming will improve the overall quality of the students admitted.

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Will Technology Make Primary Care Doctors “Whole?”

By James E. Lewis, Ph.D.

My July column focused on what I see as the adverse effects of academic medical faculty practice fund flows on primary care training and on academic and community primary care practice. I used the phrase “whole doctor” to describe the primary care practitioner (PCP) and the nature and style of primary care practice that the literature reports patients, physicians, analysts, and policy makers find desperately lacking in primary care as it is commonly practiced today.

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Do Academic Medical Practice Financial Structures Inhibit Primary Care Training and Practice?

pattern_anlysisBy James E. Lewis, Ph.D. 

Peer-reviewed literature, blogs, the popular media, and professional medical meetings are replete with pleas, complaints, laments, and even some good ideas about primary care medicine. How to deliver it, where to deliver it, and what to deliver as primary care are commonly explored areas by both physicians and the media. In the thousands of primary care-related articles that I have read since the IOM defined “primary care” in 1977, I have never seen mention or discussion of the possible effects of academic medical financial structures on primary care training or the subsequent practice of primary care in the community (or academic) setting. In my opinion, their importance cannot be overestimated.

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Life in the “Crease”: Academic Medicine–Where the Knowledge Industry and the Health Industry Meet

pattern_anlysisBy James E. Lewis, Ph.D.

The “crease” is what I call the interface between the academic world (part of the “knowledge industry”) and the health care delivery world (part of the “health industry”). It is where academic medicine lives and, in my opinion, misunderstanding of that fact is the root cause of many conflicts between medical schools and their clinician faculty, and the teaching hospital. Those conflicts arise when medical schools and teaching hospitals seek individual greatness for the clinical and academic enterprises rather than greatness for the academic medical center in which they are inextricably intertwined. I stress, “inextricably intertwined.”  Nearly everything done in the academic medical center, whether teaching, research, or clinical care, is a “joint product” created through inseparable efforts and components.

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