Primary care physicians : financing their graduate medical education in ambulatory settings : a report of a study

Primary care physicians financing their graduate medical education in ambulatory settings : a report of a study

Detalles Bibliográficos
Autor principal: Institute of Medicine (U.S.).
Autor Corporativo: Institute of Medicine (U.S.). Committee to Study Strategies for Supporting Graduate Medical Education for Primary Care Physicians in Ambulatory Settings (-)
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press 1989.
Edición:1st ed
Materias:
Medicine > Study and teaching (Graduate) > United States > Finance.
Ambulatory medical care > Study and teaching > United States > Finance.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820308706719
Tabla de Contenidos:
  • Primary Care Physicians: Financing Their Graduate Medical Education In Ambulatory Settings
  • Copyright
  • Contents
  • Summary
  • PROBLEMS IN FINANCING GME FOR PRIMARY CARE PHYSICIANS IN AMBULATORY SETTINGS
  • ADDITIONAL BENEFITS FROM IMPROVING SUPPORT FOR PRIMARY CARE GME
  • COMMITTEE CONCLUSIONS AND RECOMMENDATIONS
  • Physician Payment Reform
  • Medicare Direct Graduate Medical Education Payment
  • Medicare Indirect Graduate Medical Education Adjustment
  • State and Local Roles
  • Grants
  • Academic Leadership
  • Efficient Use of Training Resources
  • Introduction
  • SCOPE OF THE STUDY
  • CONDUCT OF THE STUDY
  • REFERENCES
  • Chapter 1 Concerns about Primary Care Residency Training
  • NEW DIRECTIONS FOR PRIMARY CARE RESIDENCIES
  • Why is There a Need to Increase Ambulatory GME?
  • The Match Between Training and Practice Sites
  • Primary Care Physicians and Cost Containment
  • OTHER POLICY ISSUES RELATING TO FINANCING PRIMARY CARE GME
  • REFERENCES
  • Chapter 2 Costs and Revenues for Primary Care Residencies in Ambulatory Settings
  • INTRODUCTION
  • COSTS
  • REVENUES
  • Federal Manpower Policy and GME for Primary Care
  • State Support for GME
  • The Veterans Administration
  • Patient Care Support
  • REFERENCES
  • Chapter 3 Options and Recommendations for Financing Graduate Medical Education for Primary Care Physicians in Ambulatory…
  • BARRIERS
  • Costs of Training
  • The Reimbursement Playing Field is Not Level
  • Academic Barriers
  • CRITERIA FOR EVALUATING POLICY OPTIONS
  • Budget Constraints
  • Matching the Needs of Primary Care Residency Programs
  • Do No Harm to Valued Institutions and Activities
  • Administration
  • CONCLUSIONS AND RECOMMENDATIONS
  • Academic Leadership
  • Efficient Use of Training Resources
  • Physician Payment Reform
  • Medicare Direct Graduate Medical Education Payment.
  • Medicare Indirect Graduate Medical Education Adjustment
  • State and Local Roles
  • Grants
  • REFERENCES
  • Appendix A Program and Proceedings of a Workshop
  • PROGRAM
  • APRIL 18, 1989
  • INTRODUCTION
  • CHARACTERISTICS OF PRIMARY CARE GRADUATE MEDICAL EDUCATION IN THE AMBULATORY CARE SETTING
  • Demographics of Pediatric Training and Practice
  • The Setting of Residency Training
  • Medical Education as an Apprenticeship Model
  • The Residency Review Committee
  • Challenges of Primary Care Education
  • Funding Constraints
  • Bibliography
  • GRADUATE EDUCATION IN FAMILY MEDICINE - ITS AMBULATORY EMPHASIS
  • Bibliography
  • THE CASE FOR INCREASING THE EDUCATION OF GENERAL INTERNISTS IN AMBULATORY SETTINGS
  • CHARACTERISTICS OF PRIMARY CARE OSTEOPATHIC GRADUATE MEDICAL EDUCATION IN THE AMBULATORY SETTING
  • Overview
  • The Michigan State University College of Osteopathic Medicine
  • Model4
  • The Kirksville College of Osteopathic Medicine Model
  • Summary
  • References
  • Discussion
  • COST AND REVENUES FOR GRADUATE MEDICAL EDUCATION
  • Introduction
  • History of Support
  • Patient Care Support
  • Role of the States
  • Primary Care Residencies and Ambulatory Care Training
  • Who Should Support GME?
  • THE COST OF GRADUATE MEDICAL EDUCATION IN OUTPATIENT SETTINGS
  • Discussion
  • LESSONS FROM THE EXPERIENCES OF PROGRAM DIRECTORS
  • Introduction
  • Lesson One
  • Lesson Two
  • Lesson Three
  • Lesson Four
  • Data Management is Essential in Primary Care Training, not a Luxury
  • Conclusion
  • References
  • LESSONS FROM A PEDIATRIC PROGRAM DIRECTOR
  • PRIMARY CARE PROGRAMS: THEN (1980) AND NOW (1990)
  • 1980
  • 1990
  • Discussion
  • The Allocation Of Resources At The Institutional Level
  • The Problem
  • POLICY OPTIONS
  • Discussion
  • Appendix B
  • THE COST OF GRADUATE MEDICAL EDUCATION IN OUTPATIENT SETTINGS
  • Introduction.
  • The Cost of Medical Training in Hospitals
  • Cost of Training in The Outpatient Sector: An Analytical Approach
  • Empirical Studies of The "Net Cost" of Training In The Outpatient Setting
  • Time and Motion Studies
  • Replacement Cost Studies
  • Before and After Studies
  • Comparative Cost Studies
  • Differences in the Use of Ancillary Services
  • Summary
  • What Is The Financial Impact Of Training Programs In Primary Care?
  • Net Revenues from a Program in Primary Practice
  • Programs in Family Practice
  • General Internal Medicine Ambulatory Practices in Teaching Hospitals
  • Summary
  • Discussion: Other Issues
  • The Efficiency of the Training Process
  • The Patient's Role
  • The Efficiency with Which the Practice is Operated
  • Training in the Health Maintenance Organization
  • Conclusions
  • Bibliograpy
  • FINANCING OF MEDICAL AND GRADUATE MEDICAL EDUCATION EDUCATION: ISSUES IN PRIMARY CARE EDUCATION SUPPORT
  • Introduction
  • History of Support
  • Federal Support
  • Biomedical Research
  • Education Support
  • Patient Care Support
  • Role of the States
  • Primary Care Residencies and Ambulatory Care Training
  • The Importance of Patient Payor Mix As A Source of Financing of Primary Care Education
  • Who Should Support GME
  • References
  • FINANCING GRADUATE MEDICAL EDUCATION IN PRIMARY CARE: OPTIONS FOR CHANGE
  • Abstract
  • Current GME Financing
  • Payment for Patient Care
  • Direct Federal Support
  • Direct State Support
  • Issues For Primary Care GME Raised By Current Funding Scheme
  • Resident Compensation
  • Faculty compensation
  • General Concerns
  • Criteria For Evaluating Alternative Proposals
  • Financial Criteria
  • Administrative Criteria
  • Educational Criteria
  • Stakeholders' Criteria
  • Source of Funds
  • Change in Existing Medicare GME Payments
  • Increase in Categorical GME Funding
  • Increase in Ambulatory Payment.
  • Grant Support
  • Commitment from Future Employer
  • Redistribution of Funds
  • Expenditure Alternatives
  • Analysis of Funding Options
  • Analysis of Spending Alternatives
  • Summary
  • RECOMMENDATIONS FOR FURTHER ANALYSIS
  • Acknowledgments
  • References
  • FINANCING PRIMARY CARE RESIDENCY TRAINING EXAMPLES AND LESSONS FROM SUCCESSFUL PROGRAMS
  • Introduction
  • Problems With Current Financing of Ambulatory Primary Care Education
  • Published Examples of Successful Financing of Ambulatory Based GME
  • Other Examples of Successful Financing
  • Summary
  • References
  • Exhibit 1.

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