Health Affairs, 27, no. 5 (2008): 1357-1361 doi: 10.1377/hlthaff.27.5.1357 © 2008 by Project HOPE	New Online   Obama's Success & Next Steps   3 Health Policy Options for President Obama   A Hybrid Proposal   Bipartisan Compromise

This Article Full Text (HTML) Reprint (PDF) Submit a response to this article Comments: View responses Alert me when this article is cited Alert me when Comments are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Archive Download to Citation Manager Reprints & Permissions Google Scholar Articles by Baron, R. J. PubMed PubMed Citation Articles by Baron, R. J. Related Collections Ethical Issues Health Professions Education Physicians Quality Of Care Workforce Issues

Commentary

Medicine Cut Off From Its Roots: Context Matters In Medical Education

The values and rewards that animate community practice are not clearly visible to those in traditional medical training programs. Flexnerian education explicitly chose to exclude practitioners in favor of full-time faculties. Academic health centers today are organized to take maximum advantage of a reimbursement system that has been described as perverse; perhaps one of the perversities is that the values embedded in the reimbursement system (reimbursement driven by discrete services rather than overall health or function) have been internalized by trainees and their institutions, and other things valuable to patients and communities (longitudinal care, coordinated care, and appropriateness of care) have become invisible.

                      What's this?

Comments: