While there is good evidence that decisions regarding practice site are influenced by experience in medical school and residency, medical education constitutes only one of a complex set of factors that have made it difficult to recruit physicians to rural America. A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location, but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity by leaders of the medical profession to the needs of rural areas and rural practitioners.

Attitude of Health Personnel↗

PubMed1986

The impact of competitive health care systems on professional education.

The development of competitive markets for health services as a cost containment strategy and the attendant shift to the provision of services through large-scale organizations are having a profound effect on academic health sciences centers. At the University of Minnesota, where this transition is firmly in place, the teaching programs based at the University of Minnesota Hospital and Clinic are threatened as health maintenance organizations and similar provider systems restrict referrals to these institutions and limit lengths of stay. Moreover, large-scale provider organizations are becoming more influential in determining the content of the training programs. The University of Minnesota Health Sciences Center is attempting to improve its competitive position in health care delivery and reshape its teaching programs to reflect this new environment through strategic planning.

Academic Medical Centers↗

PubMed1984

Price competition and the teaching hospital.

Explore the source record for details and available documents.

Costs and Cost Analysis↗

PubMed1983

Indigent care limitation in university-owned hospitals.

In recent years the ability of teaching hospitals to finance the expenses associated with the provision of medical care to the indigent has come increasingly into question. Such concerns develop because of the burden cost shifting places on other patients and the potentially adverse market position resulting for the hospital. The University of Nebraska's experience in care for the indigent has been an economic success. The social, political, educational and ethical aspects of policies in this area, however, have not yet permitted definitive assessment.

Costs and Cost Analysis↗

PubMed1978

Experience with college of medicine departmental reviews.

Departmental review are a means of assessing quality in administrative and academic functions. Policies and guidelines have been established. The review processes are time consuming and costly. However, the goals for such reviews are achievable. Guidance to improve department head performance is provided, and search for new leadership when indicated is enhanced.

Arizona↗

PubMed1976

A senior-year experience similar to an internship.

A senior year experience similar to an internship was initiated in community hospitals. It is designed to shorten the overall length of training and to restore a broad-based clinical experience to the period of "intermediate patient care responsibility" in the training of new physicians. The program provides students with an opportunity to observe and practice in a primary care setting and expands the clinical resources of the medical school. Analysis of the performance of students in the class of 1974 indicates that they perform on a level comparable with first-year house officers. This program provides a general clinical experience for those students who have not yet decided on future training plans or who are going into primary care fields.

Clinical Competence↗

PubMed1976