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Biomedical subjects

Jordan J Cohen

Publications and source records attributed to Jordan J Cohen.

At least 19 recordsLinked to original sources
PubMed2006

Health industry practices that create conflicts of interest: a policy proposal for academic medical centers.

Conflicts of interest between physicians' commitment to patient care and the desire of pharmaceutical companies and their representatives to sell their products pose challenges to the principles of medical professionalism. These conflicts occur when physicians have motives or are in situations for which reasonable observers could conclude that the moral requirements of the physician's roles are or will be compromised. Although physician groups, the manufacturers, and the federal government have instituted self-regulation of marketing, research in the psychology and social science of gift receipt and giving indicates that current controls will not satisfactorily protect the interests of patients. More stringent regulation is necessary, including the elimination or modification of common practices related to small gifts, pharmaceutical samples, continuing medical education, funds for physician travel, speakers bureaus, ghostwriting, and consulting and research contracts. We propose a policy under which academic medical centers would take the lead in eliminating the conflicts of interest that still characterize the relationship between physicians and the health care industry.

Academic Medical Centers↗
PubMed2006

The role and contributions of IMGs: a U.S. perspective.

At 25% of the nation's physician workforce, international medical graduates (IMGs) contribute significantly to the U.S. health care system. Beyond their sheer numbers, however, IMGs have played critically important roles, both in aggregate and as individuals. By choosing to pursue specialties less attractive to U.S. medical graduates, IMGs have filled important gaps that otherwise would have seriously compromised the effectiveness of the U.S. health care system. Moreover, individual IMGs have made notable contributions to the improvement of clinical practice, to biomedical and health services research, and to medical education. The Educational Commission for Foreign Medical Graduates (ECFMG), through its certification process, has enabled the best and the brightest medical students from other nations to train in the United States and can take justifiable pride in the undeniably positive impact IMGs have had on U.S. health care. It is imperative to note, however, that while the United States and other developing nations have benefited enormously from this "medical migration," there is considerable concern about the damaging effects on many countries in the developing world. Among the options to consider in offsetting the negative consequences of this so-called brain drain is working to improve the medical education available to aspiring physicians in "donor" countries. In facilitating such a process, the ECFMG and its partner, the Foundation for Advancement of International Medical Education and Research, have the opportunity to amplify their contributions significantly by building on their established programs of international assistance in improving medical education.

Biomedical Research↗
PubMed2006

Professionalism in medical education, an American perspective: from evidence to accountability.

CONTEXT: Professionalism is central to sustaining the public's trust in the medical profession; it is the essence of the doctor-patient relationship. Evidence exists that public trust is waning and that doctors are facing powerful contemporary threats to their professional values. The role of medical education is paramount in preparing future doctors to recognise and overcome these threats; to do so will require substantial change in the culture and environment of medical education. OBJECTIVES: The aims of this paper are to provide a definition and framework for professionalism in the context of medical education, describe current threats to medical professionalism, and detail the role medical schools and academic medical centres can play in preparing tomorrow's doctors to recognise and resist these threats. Additionally, the paper reviews established and potential methods for measuring professionalism and thus assuring public accountability. Finally, specific recommendations are offered for medical schools and teaching hospitals to nurture and sustain professionalism. DISCUSSION: The progressive intrusion of commercialism into the realm of medicine is threatening to replace the ethics of professionalism with the irreconcilable ethics of the marketplace. Academic medicine must assume greater responsibility and accountability for strengthening the resolve of future doctors to sustain their commitment to the ethics of professionalism. It can do so by improving the medical school admission process, enhancing both formal and experiential teaching of professionalism, and purging the educational environment of unprofessional practices. Ten approaches that academic medicine might adopt to achieve these goals are provided.

Biomedical Research↗
PubMed2005

Academic medical centers and medical research: the challenges ahead.

Although the present era offers more promise for medical research progress than ever before, academic medical centers also face more daunting challenges for the conduct of medical research: high expectations by the public for a steady stream of lifesaving discoveries, news about financial conflicts of interest and scientific misconduct by researchers that threatens to erode public trust in academic institutions, tensions between the cultural norms of academe and industry that cloud their growing partnerships, obstacles to recruiting and retaining physician-scientists, constrained funding sources and increasing costs of research, and the need to transform the academic reward structure and culture to encourage collaboration and adapt to the new "team science." The interconnectedness of these challenges magnifies their difficulties and importance. Maintaining academic medicine's integrity and effectiveness in pursuing its vital research mission will be a crucial challenge for medical schools and teaching hospitals in the years ahead.

Academic Medical Centers↗
PubMed2004

Realizing our quest for meaning.

The author asks whether the quest for growth in academic medicine has begun to obscure the quest for meaning-the deep-seated aspiration of those in academic medicine to contribute in meaningful ways to the improvement of the human condition. He describes the unprecedented growth in medical schools and teaching hospitals over the last few decades, and then offers suggestions for how these institutions, through each of their missions (education, research, and improving health), can make meaningful contributions without spending so much energy trying to get even bigger. Throughout these suggestions runs the common thread of collaboration: the need for academic medicine's institutions to coordinate their efforts, give up just a little of their independence, and join forces to achieve goals beyond their individual reach. With collaboration, like-minded institutions might be able to (1) form a nationwide clinical research collaborative to translate basic knowledge into better health; (2) transform this country's ineffective continuing medical education enterprise; and (3) partner with public and private payers of health care services to rationalize our irrational system of health care. He acknowledges that such goals would be difficult to accomplish, but that academic medicine's quest for meaning can be best realized only when its institutions shift from a paradigm of individualism to one of collaboration, all seeking to maximize the societal benefits for which they are responsible.

Cooperative Behavior↗
PubMed2003

The consequences of premature abandonment of affirmative action in medical school admissions.

The US Supreme Court recently accepted on appeal 2 cases from the University of Michigan regarding the constitutionality of race-conscious decision making in higher education admissions. The consequences of the Court's decision will directly affect the future of medicine in the United States. Medical schools have a societal obligation to select and educate the physician workforce of the future. To outlaw the use of affirmative action in the admissions process would cripple the profession's ability to achieve racial and ethnic diversity. Preserving this diversity in medical school admissions programs is important for 4 major reasons (1) adequate representation among students and faculty of the diversity in US society is indispensable for quality medical education; (2) increasing the diversity of the physician workforce will improve access to health care for underserved populations; (3) increasing the diversity of the research workforce can accelerate advances in medical and public health research; and (4) diversity among managers of health care organizations makes good business sense. This article explores these reasons in detail, reviews the history and effectiveness of affirmative action in medical school admissions programs, and explains why alternatives to affirmative action are unworkable.

College Admission Test↗