SEATTLE — This summer, medical students from the University of Washington took a long look under the hood of the health care system they are about to inherit, and many returned to campus last week with their eyes wide open and their idealism tempered.
Jacob R. Opfer shadowed a pediatrician in Gillette, Wyo., who sometimes saw 45 patients a day, allowing little more than five minutes a visit. Amanda I. Messinger worked with a family practitioner in Kodiak, Alaska, who eschewed electronic medical records, leaving staff members to decipher histories from illegible script. Jens N. Olsgaard manned a community health center in Butte, Mont., where four of five patients had no insurance, and treatment was often structured around ability to pay.
The students learned not only to deliver babies and suture wounds, but also to order unnecessary tests as protection against lawsuits, to hector specialists into seeing Medicaid patients, to match patients with prescriptions on Wal-Mart’s $4 list. And they saw firsthand what Mr. Olsgaard called “a tidal wave of chronic disease” — diabetes, hypertension, obesity, depression — that left many questioning how much any one physician could really accomplish.
“I often wondered what we were actually doing to help people,” Mr. Olsgaard said.
Not surprisingly, many concluded that it was critical to reorient a reimbursement system that had profoundly devalued primary care and prevention. Click this link to read the original posting
http://www.nytimes.com/2009/09/09/health/policy/09medschool.html?_r=1&pagewanted=print
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