scholarly journals Plug the Leak: Align Public Spending With Public Need

2012 ◽  
Vol 4 (3) ◽  
pp. 293-295 ◽  
Author(s):  
Donald E. Girard ◽  
Patrick Brunett ◽  
Andrea Cedfeldt ◽  
Elizabeth A. Bower ◽  
Christine Flores ◽  
...  

Abstract We explore the history behind the current structure of graduate medical education funding and the problems with continuing along the current funding path. We then offer suggestions for change that could potentially manage this health care spill. Some of these changes include attracting more students into primary care, aligning federal graduate medical education spending with future workforce needs, and training physicians with skills they will require to practice in systems of the future.

2020 ◽  
Vol 15 (4) ◽  
pp. 278-288
Author(s):  
Wade Green ◽  
Eric Sauers

Context Review of the origins, history, and attributes of primary care demonstrates continued challenges for the future of primary care and care delivery. The profession of athletic training may benefit from a critical self-review to examine its readiness to assist in reinventing primary care. Objective To explore parity between primary care attributes and athletic training practice and promote a timely and relevant discussion of primary care and public health integration native to athletic training practice, competency-based education with an emphasis on milestones, and the development of clinical specialists to prepare a well-trained workforce. Background General practitioners developed educational reforms through graduate medical education that resulted in primary care as it is known today. Graduate medical education has refined its assessment of students to include milestones for the purpose of describing the progression of clinical competence with identifiable behaviors. The development of future clinical specialists in primary care will also involve competence in public health. Recommendation(s) Practicing clinicians and educators should begin to critically explore the congruencies between the primary care attributes and athletic training practice. It is important to conceptualize traditional models of care within the frameworks of primary care and public health, given that athletic training practice routinely engages patients at personal, community, and environmental levels. The athletic training skill mix should be purposefully presented within interprofessional health care teams in primary care so that stakeholders can appropriately integrate athletic trainers (ATs) at the point of first contact. It is plausible that continued structural changes in the traditional practice settings will be required to facilitate integration of ATs into primary care. Conclusion(s) The impact of ATs in ambulatory settings and primary care possesses a foundation in the current literature. The ATs are uniquely suited to create a symbiotic pattern of care integrating both primary care and public health for improved outcomes.


2013 ◽  
Vol 5 (2) ◽  
pp. 195-200 ◽  
Author(s):  
Sawsan Abdel-Razig ◽  
Hatem Alameri

Abstract Many nations are struggling with the design, implementation, and ongoing improvement of health care systems to meet the needs of their citizens. In the United Arab Emirates, a small nation with vast wealth, the lives of average citizens have evolved from a harsh, nomadic existence to enjoyment of the comforts of modern life. Substantial progress has been made in the provision of education, housing, health, employment, and other forms of social advancement. Having covered these basic needs, the government of Abu Dhabi, United Arab Emirates, is responding to the challenge of developing a comprehensive health system to serve the needs of its citizens, including restructuring the nation's graduate medical education (GME) system. We describe how Abu Dhabi is establishing GME policies and infrastructure to develop and support a comprehensive health care system, while also being responsive to population health needs. We review recent progress in developing a systematic approach for developing GME infrastructure in this small emirate, and discuss how the process of designing a GME system to meet the needs of Emirati citizens has benefited from the experience of “Western” nations. We also examine the challenges we encountered in this process and the solutions adopted, adapted, or specifically developed to meet local needs. We conclude by highlighting how our experience “at the GME drawing board” reflects the challenges encountered by scholars, administrators, and policymakers in nations around the world as they seek to coordinate health care and GME resources to ensure care for populations.


2021 ◽  
Vol 3 (2) ◽  

Introduction: The COVID-19 pandemic has driven many health care institutions in the United States beyond their capacity. Physicians-in-training in graduate medical education programs have suffered the strain of providing patient care during this unprecedented time of crisis. The significant prevalence of pre-existing resident and fellow burnout and depression makes the need for action by institutions to support the well-being of residents and fellows even more urgent. We aim to describe innovative adaptations our Office of Graduate Medical Education implemented with the support of institutional leadership as responses to promote the well-being of residents and fellows on the frontlines during the COVID-19 pandemic. Methods: The Office of Graduate Medical Education (GME), in collaboration with the Office of Well-being and Resilience, developed a set of resources and interventions to support trainees during the pandemic based on four major categories: workplace culture, personal factors and health, mental health support, and workplace efficiency and function. Examination of the capacity of existing services and gaps that needed to be filled in the rapidly evolving early days of the COVID pandemic led to a robust growth in resources. For example, the already established Student and Trainee Mental Health program was able to expand and adapt its role to serve trainee needs more effectively. Results: We expanded resources to target trainee well-being across a broad array of domains within a short time frame. With investment in access to the Student and Trainee Mental Health program, utilization increased by 25.7%, with 1,231 more visits in 2020 compared to the number of visits in 2019, prior to the COVID-19 pandemic. The creation of Recharge Rooms had a positive impact on the well-being of health care workers. After a single fifteen-minute experience in the Recharge Room, an average 59.6% reduction in self-reported stress levels was noted by users. Other interventions were noted to be helpful in regular town hall meetings with trainees. Conclusion: Addressing trainee well-being is an essential aspect of a crisis response. The Mount Sinai Health System was able to care for the physical, mental, psychosocial, and safety needs of our trainees thanks to the collaborative effort of a pre-existing institutional well-being program and the GME Office. The ability to implement such a response was enabled by our well-being foundation, which allowed leadership at the highest institutional level and the Office of GME to provide support in response to this unprecedented crisis.


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