Physicians working in close-knit communities, whether small towns or urban neighborhoods, have to manage relationships with people who may be simultaneously patients and neighbors, friends, and business associates.
Many patients in settings where residents operate can only afford to seek care in a public hospital. The hospital, faculty, and resident surgeon must find ways to minimize the risk to those patients.
The physician must consider the potential benefits of the new procedure and then determine, through discussion with the patient, what value the patient places on those specific benefits.
The Moseley study found no significant difference between those in the arthroscopic lavage and debridement arm of the study and those in the sham surgery arm.
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.
The NRMP’s new “all-in” policy requires every residency program to fill every first-year position either exclusively through the match or outside of it. Programs that continue to offer prematches will operate outside the match.