Thanks, Paul.
Having identified (or at least highlighted) the need (which a previous study several years also "identified"), what is the evidence-based approach to meeting it?
My guess is that we don't begin to have the evidence we would need to construct a feasible and effective approach, which would need to factor in the differential effects of fatigue with aging (combined with the effects of fatigue on learning); the cognitive effects of current practice styles; the effects of mandatory re-certification in some younger cohorts (for example, those in practice less than about 20 years in the United States); the effects of well-designed EHRs and networked PHRs; the effects of team-based care (in which the physician may not be expected to be the sole repository of knowledge); any role of increased satisficing with time in practice; etc.
A grand challenge, unlikely to solved with more and even better courses or more and better tests.
Best regards.
Jim
James M. Walker, MD, FACP
Chief Medical Information Officer
Geisinger Health System
The best way to predict the future is to invent it.
- Alan Kay
>>> Paul Elias 07/28/11 4:14 PM >>>
http://www.reuters.com/article/2011/07/15/us-patients-worse-off-idUSTRE76E62T20110715
According to findings in the American Journal of Medicine, patients whose
doctors had practiced for at least 20 years stayed longer in the hospital and
were more likely to die compared to those whose doctors got their medical
license in the past five years.
no doubt this raises serious questions and supports the evidence based approach
and the need for doctors to remain seasoned and in touch with not just the needs
of the patient but the updated science.
Best,
Paul E. Alexander
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