The Flexner Report was a study on the state of the medical education in Canada and the United States that was released in 1910. Some of the key recommendations in the report included the enactment of higher education standards and adherence to the mainstream science protocols in research and teaching. These recommendations came because of a study done in 155 medical schools in North America that exposed the dismal state of the medical schools. However, particular institutions such as Harvard, John Hopkins and Western Reserve received praise for having excellent performance and high medical education standards. The recommendations proposed in the Flexner Report have had a great impact on the medical profession
The Flexner report identified some of the problems in medical school such as subjecting students to unending regular lectures followed by irrelevant quizzes. The medical schools also focused on theoretical lectures at the expense of practical courses. Schools that went an extra mile to consider real life medical experiences in hospitals for their students limited this exposure to observation.
Some of the recommendations suggested in the Flexner Report included raising the minimum qualifications for admission to medical schools to higher diplomas or its equivalent. He also recommended the lengthening of the medical education to four years and to integrate the Council on Medical Education (CME) contents as was agreed in 1905. Flexner also recommended that proprietary medical schools should be upgrade to universities or be shut down as they had insufficient facilities and charged too much fees. The report also proposed that medical schools include clinical professors in their staff.
Exposing of physician comparative performance to medical consumers means that patients will be quite selective over whom they trust with their health. Patients will always want to seek the best medical attention from the best performing physicians. Therefore, exposing their performance gives consumers a chance to know whom to trust with their health as well as the best physicians. This would encourage the physicians to work hard to rank high in the comparative performance. This would result in increased performance of all the physicians, raising the standards medical service provision by the physicians. Therefore, I believe this would be fair as it exposes unethical physicians who might put lives of patients at a risk.
The primary physicians and nurses are under pressure to perform and appeal to the patients. Somehow, it will appear as though they were answerable to the patients the serve. This is because patients will be reviewing their comparative performance to make decisions, while hospital nurses work will depend on the performance of the hospital physicians.
Chapter 5 Discussion
Medicine does differ within different countries as well as specialization and learning methods. Thus, bringing in foreigners could create a chance of interacting between the different skills. America could learn some skills from foreign resident physicians. Having foreigners fill the resident position is not a problem considering it does not hinder any of the American graduates from accessing such a position. In fact, the demand for physician in the United States is higher than the number of them it can produce. Thus, hiring of foreign residence physicians is okay.
Above all, the main reason is the decreasing number of physicians in the United States. Many hospitals are finding a shortage of residents to fill up the positions. Thus, foreign residents come in as a supplement for the shortage. Additionally, many foreigners want to work in the United States after graduating in medicine form their country. Through residence, it can be ensures that the students meet the requirements of becoming good physicians in the future. Thus, this provides a chance of training future physicians to fill up the deficiency of physicians in the United States.
Chapter 5 Reply
I think that if we have qualified medical graduates who can fill the residency positions in the hospitals, there would be no need of hiring foreigners. While they are not enough, opting for nurse practitioners and physician assistances could be a good option to give them a chance to become better physicians. However, there is program already in place giving nurse practitioners a chance to practice medicine as well as the assistant physicians. Therefore, without enough graduates to fill the residency positions, hiring foreigners to fill them would be in order.
Cross training requires that an employee receive training needed to operate in different roles within the hospital other than specializing to one. Cross training has its implications in the health care provision, in terms of cost effectiveness, quality of care as well as efficiency. When employees are cross-trained, they are able to handle different roles in the hospital. Therefore, cost effectiveness can be achieved when fewer physicians are serving the whole organization. In terms of efficiency, cross training ensures that work runs efficiently even when some key employee in the hospital may not be there.
The biggest disadvantage of cross training employees is that particular employees know a lot of sensitive in the facility. When one employee can work in the finance, procurement and outpatient departments, they are privy to crucial information that can be detrimental if used for illegal purposes. Employees who have undergone cross training also tend to resign and start their own companies. These because employees accrue necessary skills that assist them in running their own businesses and may have no need to maintain their current jobs. Cross training employees may also be disadvantageous as it may lower morale levels when employees discover that they have little room for promotion or job flexibility. The government has however recognized area with fewer physicians as health professional shortage areas and qualified them for state assistance.
Despite many students graduating in medical studies, there has been a shortage of physicians in the rural areas with many physicians opting for urban and more affluent areas. Many physicians opt for the urban areas where there are higher populations and people that are more affluent as well as well-insured people. Thus, physicians are attracted to urban areas because there is a higher opportunity of making more money. This is caused by two reasons, one being lack of enough demand for the physicians in the rural areas due to lower population. The other cause is their isolation causing lower amenities, quality of services as geographically unattractive.
Nursing has always has always been dominated by female workers. Despite being a good paying job, women continue to dominate. Although men continue to increase in the profession in a time when its demand is high, it may not attract many males. One of the reasons is the belief that a woman is better at providing care, which the whole world has always had. Even with advocacy on gender equality in the work force, many still think that nursing is a feministic cause.
Chapter 6 Discussion
Being a doctor is a profession like any other. Those who choose the line of medicine do not do it just for the community. They do it from their own will and as a profession to earn them a living. Thus, the society should not feel owed by medical practitioners upon completion of their causes. Doctors also happen to be part of the society that pays taxes like anybody else. Therefore, the subsidies they got as students were deserved since they are also part of the taxpayers. This would amount to saying that children owe their profession to their guardians, and should follow their will. This is not the case. Thus, I feel that they owe no body anything since through their hard work in studying that makes them what they are.
Chapter 6 Reply
I do feel that students in the medical field do not have any obligation to the taxpayers for receiving subsidies from the government during their training. In fact, many people in other profession as well as other areas receive subsidies but continue to pursue their dreams. The reason for these subsidies is providing the students with support to finish their course so they can serve the society. However, this does not tie them to the society. Becoming a doctor was not the efforts of the society. Rather, it is individual effort. There are high requirements for entering medical teaching institutions. Additionally, once there, the students have to work tirelessly hard to accomplish their goal. Thus, I feel that the society plays a small part in helping them become doctors.