This process of developing EBM-based guidelines and applying them to clinical care highlights the tension between generating unbiased knowledge based on statistical aggregation and the application of this information to individual patients.
Although measures of patient satisfaction are being used to improve patients’ hospital experience, implementing incentives based on these measures may be premature and have unintended consequences for care delivery.
AMA J Ethics. 2015;17(7):616-621. doi:
10.1001/journalofethics.2015.17.7.ecas3-1507.
The Sustainable Growth Rate was replaced in 2015 by the Medicare Access and CHIP Reauthorization Act, which introduced fixed annual physician fee updates and a merit-based incentive payment system.
AMA J Ethics. 2015;17(11):1053-1058. doi:
10.1001/journalofethics.2015.17.11.pfor1-1511.
It is the clerkship director's role to advise students labeled gunners when their behavior becomes a problem, but changes in the larger system might help to prevent this behavior from occurring in the first place.
Role-playing exercises, which help participants understand the experience of being harassed, can be helpful in addressing mistreatment in medical education.
The David Geffen School of Medicine at UCLA formed the Gender and Power Abuse Committee in 1995 to address mistreatment of medical students, residents, and junior faculty.
The Association of American Medical Colleges has added and refined questions about mistreatment in medical education to its Graduation Questionnaire, increasing the amount and specificity of information about what kinds of incidents occur and how students feel about them.
Any use of nonanonymous student surveys will compromise the ability of schools to obtain valid data on mistreatment of students and attendant efforts to reduce the problem.