Monthly Archives: May 2013

The Two Faces of Physician Shortage

A medical residency is not easy.  Part of the coping mechanism involves complaining among your fellow residents about everything from the work hours to the deteriorating quality of vanilla pudding parfait in the cafeteria.  Generally the discussion goes something like this:

Resident A: “The vanilla pudding parfait has too much whip cream and not enough pudding.”
Resident B: “We get paid fifty-thousand dollars a year for working eighty hours a week, and they can’t even have a respectable dessert in the cafeteria.”
Residenc A: “I am going to go have a chocolate parfait.  That one comes with an Oreo.”

While Resident A is probably just partial to chocolate, Resident B’s observation begs for an obvious non-dessert-related question.  If medical residents create such immense value at a low cost to hospitals, then increasing the size of the residency program must also be highly desirable.  But the truth is even in the face of increasing demand for physicians, America is not making many more doctors to match the demand. Continue reading

Great Storytellers of Our Moral Decisions

Not long ago, I had the opportunity to participate in a medical research project.  In broad terms, the researchers developed a virtual tool to evaluate the skills of doctors on a particular procedure without performing on a real patient, and they needed people at various stages of proficiency to test the training program.  Since I was a total novice, it made me an ideal subject – I was expected to stumble and burn.  In fact, I was so clueless that I had to ask the experimenter to repeat the instructions for the simulation.  Then, through either sheer luck or innate talent (ha), I scored near the top of the chart.

Shortly after the study concluded, I was notified that after discussing with the co-researchers, the research team has decided to discard my data-point because “the instructions were given twice, which gave an unfair advantage over the other participants.”  I wanted to reply, “But if a complete novice can score like this without knowing how to do the actual procedure, doesn’t that say something about the quality of the virtual evaluation?”

More interestingly, if I had scored much lower than the average novice – making the results look even better – would the research team have thrown out my data-point all the same? Continue reading