Open AccessThe AMA in Health Care Reform: A “Flexner Report” to Improve Pain Medicine Training and Practice
Author(s) -
Gallagher Rollin M.
Publication year - 2010
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/j.1526-4637.2010.00965.x
Subject(s) - medicine , alternative medicine , pain medicine , pain management , training (meteorology) , medline , family medicine , nursing , physical therapy , anesthesia , anesthesiology , pathology , political science , law , physics , meteorology
In 1910, Abraham Flexner published his famous “Flexner Report” which in painstaking detail highlighted the deficiencies and variability in medical student education in the United States [1]. The Report began the revolution in medical education mandating standardized, science-based medical student education across the United States. Marking the 100 Anniversary of Flexner, Whitcomb and others call for similar reform in graduate medical education [2]. Consistent with this theme and health care reform, in this issue of Pain Medicine , the Report on the AMA Pain Medicine Summit held in May 2010, virtually 100 years after Flexner, specifically outlines the problems in pain medicine education and training and the negative effects of this on pain care and the public health. Similar to Flexner, the Report advocates sweeping changes in undergraduate and graduate medical education [3].This call for reform is sorely needed. It is trite to say that medical practice is changing rapidly. Doctors no longer stand far above their patients, superheroes separated in their powers of decision-making and skill by a vast differential in education, training and medical experience. “Doctor knows best” no longer seems true. Today the web and media provide patients and families with immediate access to literature, blogs, illness information, marketing of treatments and physicians, advocacy groups for illnesses, and doctor ratings. However, the medical marketplace is also changing rapidly. The smorgasbord menu of treatments based on consumers' preferences and doctors' decisions is no longer fully available to those who depend on insurance to pay for treatment, moving us towards a two-tiered system of care. The decisions of patients without an inexhaustible health care budget, and their providers, will be increasingly shaped by a menu-driven, tiered approach to treatment based on costs analysis and evidence of effectiveness as well as patients' willingness …