Monday, 10 November 2014

Resident’s values and the hidden training program

Dr. Rafael Manzanera, the author of this week’s selected tweet, is a doctor with a career related to the planning and management of public health. Now he is responsible for quality and "knowledge management" at MC Mutual.

Dr. Manzanera’s tweet refers us to a report signed by the three most prominent managers of Dartmouth Institute, with John Wennberg leading the team. It’s a document aimed at last year medical students to warn that when they choose their residency program, they mustn’t get duped by the hospitals reputation, but they ought to be aware of a phenomenon the authors call the "hidden training program" that will definitely mark their values ​​and therefore the way they’ll treat their patients throughout their careers.

If you can take a look, you will see how the report reveals, through the "Hospital Care Intensity Index", the degree of (inappropriate) aggressiveness in the treatment of chronic disease by the leading American university hospitals (note the poor performance of Mass General and the excellent results from Mayo Clinic) or the rates of population’s surgical overtreatment observed in the areas served by the aforementioned hospitals.

The authors believe, and I concur, that the values ​​of appropriate use of health resources and respect for patient preferences are as important for doctors in training as well as in the clinical learning itself.

Jordi Varela

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