Attendees at Tufts Health
Care Institute's third annual conference left energized with valuable
teaching tools and a healthy perspective on an environment undergoing constant
change. The centerpiece of the May 1999 conference was THCI's
exportable curriculum, Preparing Residents to Succeed in Managed Care (PRS).
"Program directors have told us about the enormous pressures
on them to prepare residents for practicing medicine in the
21st century," says Philip Boulter, MD, medical director of THCI and
senior vice president and chief medical officer at Tufts Health Plan.
"This year, our conference focused on training the
trainer—providing knowledge and tools that faculty
can take back and adapt to their own environment. We had to close
off enrollment early, which attests to the curriculum's practicality."
The curriculum is comprehensive, with lesson plans and
bibliography, notes Mary Lee, MD, THCI director of faculty development and dean
for educational affairs at Tufts University School of Medicine. "Its content
and structure are guided by leading thinkers and educators in the field.
Program directors also like the curriculum's flexibility. The pieces
can be mixed and matched to suit their institutions' needs," says Lee.
The nationally prominent plenary speakers described what they see
on the horizon, combining a measure of grim reality with optimism.
Thomas Mayer, MD, MBA, executive director of managed care education at
the Institute for Health Care Advancement
in Whittier, California, acknowledged that many physicians feel betrayed
by the system that trained them.
"Physicians find themselves woefully ill-prepared for what they are
facing now," said Mayer.
| Medical educators at THCI's annual
conference learn how to implement
a comprehensive managed care curriculum for
residents and medical students.
|
However, academic medical centers continue to teach topics that only
partially address the challenges facing a new generation of caregivers. "The
curriculum ignores things like who is going to pay your bills, and what it
means to be in a group practice, a staff model, a solo practice or an IPA,"
noted Mayer.
David Blumenthal, MD, MPP, director of The Institute for Health Policy at
Massachusetts General Hospital/
Partners Health Care System, another plenary speaker, stated the
challenge: "We are preparing residents for a dimly-perceived reality that
pertains to their prime years of practice _ 2010 to 2030. We know that
their patient panels, on average, will be older and more ethnically
and economically diverse. They will also be more knowledgeable and
more demanding."
Blumenthal added that for physicians to practice effectively in the
future, "the system will become increasingly organized and highly managed by
providers of service who are knitted together more completely." The
implications for training point to skills and models that
prepare students and trainees for constant change.
Preparing Residents
to Succeed in Managed Care
C u r r i c u l u m U n i t s
Understanding Managed
Care: Learning the Essentials
through Case Presentations
(an introductory CD-ROM with leader's guide)
Practicing Patient-Centered Care in the Managed Care Environment
Evaluating, Adapting and Using Clinical Practice Guidelines
Model Curriculum for a Managed Care Rotation in a
Community Practice and Managed Care
Organization
