"Medical Education System today is being pushed,
primed, brainwashed, and prepared to take
action to permit our government to not
only control healthcare, but also the
medical profession itself."
The future of medical school education today must require seriously planning by every graduating physician for what is being required of medical doctors in the very near future.
I'm referring here to the rapidly increasing percentages of graduating medical students who because of their overwhelming educational debt or because of the new generation of medical students who don't want or need to work hard for much of anything, are choosing to become employed physicians. The AMA Survey recently reported that at least 50% of students are choosing that route to practice medicine.
If private practice, as predicted, disappears in the next few years, then all medical students will of necessity have to be taught and trained how to survive as an employed physician.
Should that be the case, it's logical that medical schools will become easier and less stressful for students since all medical students will be doing the same thing in practice--having limited practice and independence as an employee. Because they will be told where and how to practice medicine.
Probably, medical education will follow the highly promoted concept today of "Team Health Care" in the future. That's where patient treatment becomes a matter of committee decisions exactly as
corrupt as we see daily in our government committee decisions. It reminds me of the description of a "committee." ... where a committee project is to create a horse, and in the end results in creating a camel. Committees have a hard time agreeing on anything.
Up to now, private physicians have had the advantage of using every element of medical education,
medical training, experience and expertise to give their own patients the best form of treatment they know to give to a patient.
When that means of treating medical patients converts to a "team/committee" decision process (where each member always seems to have a better idea or different way to treat the medical problem), the medical treatment options widen, but are not any more reliable than the patient's own medical doctor would have done anyway.
My definition of "team medical care" is where several physicians and nurses discuss a medical treatment of a single patient, present their ideas of the best medical treatments for the medical patient, quiet down the one or two that have a different idea about treatment, and take a vote from the members of the team to see what treatment is recommended by the most individuals.
All done to spread out the liability of care over several medical personnel, to ensure that fewer medical treatment mistakes will be made in treatments in the long run, and to demonstrate that more medical minds are far superior to any single medical doctor's treatment and knowledge."
My follow-up thought is that such a team decision for treatment is very much like a medical patient's medical treatment when they go to a clinic and see a different physician every time, which results in some modification of treatment and advice given by the previous physician that saw the patient earlier.
What is not being considered is the fact that any physician educated in any medical school has their own beliefs about what they were taught for treatments and the options for treatments, which are all different opinions to a great degree sometimes. To my knowledge no proof exists that team treatment decisions are no more error-free than that of a single physician.
The supposition that team efforts are better for a patient than what the patient's own doctor would have done, has not been proven to be better by double blind or other studies.
Supposedly, that "instant education" by the committee process fills in all the essential gaps in the medical knowledge that's necessary to provide the patient with even better healthcare or treatment, may be a myth. To reduce medical treatment errors, it might be far more legitimate
and accurate to have a hundred members on the team voting.
Of course, in healthcare you can't possibly know everything so there is a concept that using a
committee to decide the best care incorporates the knowledge of many members in order to
reach a better treatment than you can do yourself. And, if that's true and reliable, then why not
put every patient treatment decision in front of all the medical staff members which would statistically be even more legitimate medical process with far less clinical treatment errors.
Then there's the fact that many members of that committee won't even be medical doctors, but
yet can influence the decision making without having all that medical experience and knowledge.
The most efficient and reliable form of control is a dictatorship. So, who is the head of the committee and does that person make the final decision?
How does a medical school curriculum teach a student to handle the peer pressure, intimidation and coercion present during any committee decision making process. As an employee, a physician must be adaptable to what the decision makers want them to do.
That factor means that the student or young doctor doesn't have to be medically smart, just learn the easy and common medical stuff and the rest will be decided by the "team". I call that "welfare practice"... treatment is derived from the entitlements of the team, not the extra
knowledge added in.
A good example of that point happened during my employment as a Clinic physician for five years when I was the back-up for nine certified nurse midwives. Two cases come to mind.
- A nurse midwife requested my opinion on a patient ready for delivery. She insisted that the fetal monitor was so abnormal that a C-section was needed, I checked out the monitor tape and evaluated the labor progress.
The monitoring strip in my opinion was normal and left the room. About 15 minutes later, the neonatal perinatologist phoned me and gently indicated that he was evaluating the fetal situation and taking over. I asked him to call me about
his results.
An hour and a half later he called me and he had done a C-section and the baby was perfect. He later brought the monitor strip to show me. On the monitor strip he could see a half millimeter nudge along the strip that he judged to be almost invisible and a questionable indication for fetal distress. He decided to do the C-section anyway to please the nurse midwife and protect his risk of possibly there might be fetal distress that wasn't diagnosable. - An obese lady requested a post delivery tubal ligation. I took her to the OR, did the procedure through a one inch umbilical incision, without any difficulty or problems. She went to recovery. An hour later the patient's blood pressure was lower than expected but not unusual. She was given fluids IV and the nurse called me that she was concerned.
I again examined the patient and found no post surgical problems and left the recovery room. The nurse called the Chief of Service who called me stating, he was going to open her up himself unless I preferred to do it for what he diagnosed as internal bleeding. I took her to the OR, opened up the abdomen, no blood, no bleeding, and closed the larger incision.
After which the patient recovered normally. And I took on the dissatisfaction of the patient as an incompetent surgeon, operating twice, and was the cause of her blood pressure problem in some way. I had been ordered to do the second surgery by the Chief and the patient never knew that. And it was an unnecessary surgery, incited by a recovery nurse's judgement, and was done to save a potential complication that never happened.
Our society and culture has been educating all of us to get a job. Whether it was in high school, or college, or medical school. Meaning that we are all being educated to become employees, not independent thinkers or entrepreneurs.
Medical education will have to add to their curriculums to teach physicians how to handle medical
employment situations and how to handle being restricted from using all of their medical knowledge they were taught and able to use. So, they would not need to be taught a lot of extra medical stuff they will never use during their employment. Maybe that would reduce medical school to less than 4 years as well.
Somehow all this seems to be pointed towards college educational systems that have succeeded over the years in convincing premed students that the "getting a job" goal is of primary importance to them. It follows that these students enter medical school already mentally predetermined to seek employment as a physician rather than private practice.
It drives the herd to follow the leader until all medical doctors seek the same employment attraction. Couple that with the new generation of medical doctors who also prefer an easier way to practice medicine, to practice part time, or to consider medical practice a hobby to do
now and then. Well, that's what medical technology is enabling them to do.
Add to those factors the fact that 50% of female doctors that occupy 50% of each med school classes and 25% that practice medicine only part time. Part time practice usually requires being employed in one fashion or another.
Do you think that medical education must conform to whatever kind of medical practice is available to graduating medical students, such as being employees only?
Or, do you believe that medical education will not change, regardless of who controls the practice
of medicine and methods of healthcare in the future?
These are thoughts that run through my mind often. It bothers me because I will soon be the recipient of future healthcare and I dread the thought that my care or my family's care will be
managed by part time doctors, lazy 9 to 5 foreign physicians, or by team decisions that I consider
unreliable and infected with mixed biases and opinions.
----Professional Probe----
