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The Struggle To Retain Physicians

Some states are finding it tough to retain physicians. Take Virginia for instance:

A recent study found Virginia retains only 35 percent of its medical school graduates and ranks 31st among other states in retaining doctors.

In 2008, Virginia spent more than $50 million from the general fund to support medical education and had nearly 600 new physicians graduate from Virginia’s four medical schools.

Despite this, Virginia still struggles to retain medical graduates, with less than 25 percent of Virginia’s physicians graduating from medical schools in the Commonwealth.

Some feel incentives might work:

Dr. Greenawald says other states including North Carolina have incentives to keep medical students in state. He hopes Virginia considers following suit. Dr. Greenawald also said the over burden of paperwork and insurance company oversight have taken doctors away from what they love doing which is providing care to patients. He said that’s prompted many doctors to retire early.

I’m not so sure. Until more medical students feel primary care is worth the effort, the mass exodus to specialties (and the out-of-state training that is often required) will continue.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Dating An American Medical Student? Some Financial Advice

The average medical school debt today, according to the Association of American Medical Colleges, is $156,456.

The United States is the only country in the world were future doctors have to bear such a financial burden of their education. That places significant strain on any relationship involving an American medical student.

Recently, there was an interesting piece in the New York Times discussing this very issue. The article profiled a female medical student who had amassed $250,000 of school debt:

Still, if she and [her boyfriend] Mr. Kogler are going to move in together and get engaged, she wants their financial arrangements to be clear and fair. But how do you define fair when you’re bringing a quarter of a million dollars in debt to a relationship?

Indeed. It’s an issue that’s rarely discussed, yet frequently encountered by medical students. With that degree of debt, there is little room for flexibility should one’s future plans change. You have to continue working to pay off the loan. Read more »

*This blog post was originally published at*

3 Things That Make A Better Doctor

On Monday, NPR’s Scott Hensley posted:

“Between the Internet and all the data insurance companies and the government collect on doctors, you’d think it would be a lot easier than it used to be to find a good one. But it’s not.”

Sound familiar around here? See his thoughts: “3 Tips For Picking A Slightly Better Doctor.”

(Thanks to friend Cindy Johnson for the tip.)

*This blog post was originally published at*

Do Foreign Medical Graduates “Doctor” Better?

Yes, according to a study in today’s Health Affairs. (The full text of the study is available only to subscribers, but Kaiser Health News Daily has a good summary of its findings and links to other news reports.)

The study compares inpatient death rates and lengths of stay for patients with congestive heart failure or acute myocardial infarction when provided by U.S. citizens trained abroad, citizens trained in the United States, and non-citizens trained abroad. Treatment was provided by internists, family physicians, or cardiologists. The differences were striking, according to the authors:

“Our analysis of 244,153 hospitalizations in Pennsylvania found that patients of doctors who graduated from international medical schools and were not U.S. citizens at the time they entered medical school had significantly lower mortality rates than patients cared for by doctors who graduated from U.S. medical schools or who were U.S. citizens and received their degrees abroad.”

Read more »

*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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