General Internal Medicine as an Engine of Innovation
- PDF / 86,039 Bytes
- 2 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 224 Views
General Internal Medicine as an Engine of Innovation Richard L. Kravitz, MD, MSPH1,3 and Mitchell D. Feldman, MD, MPhil2 1
Division of General Medicine, University of California Davis, Sacramento, CA, USA; 2Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA; 3, UC Davis Division of General Medicine, Sacramento, CA, USA.
J Gen Intern Med 28(6):749–50 DOI: 10.1007/s11606-013-2450-0 © Society of General Internal Medicine 2013
“More than any time in history mankind faces a crossroads. One path leads to despair and utter hopelessness, the other to total extinction.”—Woody Allen Almost 10 years ago, JGIM published a seminal report from the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine.1 Boldly titled “The Future of General Internal Medicine”, the report challenged the field of general internal medicine to take responsibility for addressing the “chaos and dysfunction” the Task Force believed characterized medical care at that time. Many of the innovations they proposed, including team based care, enhanced information systems, and the abandonment of the fee-for-service financing model, seemed pie-in-the-sky at the time, but are now accepted by most as essential for improving health care delivery and curbing costs. While much has changed in the past decade, in many ways, general internal medicine still stands at the crossroads. While the options may not be quite so bleak as Woody Allen suggests, general internal medicine continues to face some critical challenges in research, education and clinical practice. In this issue of JGIM, Armstrong et al. (on behalf of the 2012–2013 SGIM Council) articulate these challenges and present a vision for the future of general internal medicine.2 They point out that the pressure to reduce health care costs and increase value along with the historic passage of the Patient Protection and Affordable Care Act (ACA) will lead to new initiatives in primary care and GIM, featuring population management, team-based care and innovative use of electronic health records. Changes in medical education spurred by duty hours reform and enhanced workforce diversity have resulted in a shift to more training in the ambulatory setting and a shift in focus to measuring competencies rather then medical knowledge. For researchers in academic GIM, they argue that these changes bring both challenges and opportunities. GIM researchers are ideally situated to study the impact of practice transformation and payment reform that will be Published online April 12, 2013
brought by the Affordable Care Act (ACA), but despite optimism fueled by the Patient Centered Outcomes Research Institute (PCORI), funding challenges will persist. The United States spends almost $3 trillion on health care. According to some analysts, up to 1/3 of these expenditures are wasted on inappropriate, equivocal, misapplied, or inefficient care. If just 1 % of health care payments were applied to scientific evaluation of what works and wh
Data Loading...
