Training in subspecialty internal medicine. On the chessboard of health care reform

N. Franklin Adkinson, Joseph S. Alpert, D. Lynn Loriaux, Paul W. Ladenson, Lawrence S. Friedman, Peter A. Cassileth, Rüssel E. Kaufman, John G. Bartlett, Mark S. Klempner, Eric G. Neilson*, John H. Glick, Robert J. Mayer, Spencer K. Koerner, Edward D. Crandall, William P. Arend

*Corresponding author for this work

Research output: Contribution to journalShort survey

8 Citations (Scopus)

Abstract

Many reform-minded observers of the U.S. health care system have asked recently whether we are training too many subspecialists in internal medicine. Of course' the answer to this question may not be the same for all subspecialties or all manners of professional career, but any proposed answer has extended consequences for the entire health care system and the patients it serves. Some have even begun to advocate a firm ceiling on the numbers of subspecialty training positions in the future. Who, in fact, should be deciding such matters? These decisions are complex and not easily made by government, consumers, or insurance companies on their own, nor should they. These decisions are best made by a profession willing to examine and regulate itself where necessary. Recent legislative initiatives have made it abundantly clear that others are more than willing to act on our behalf, if we cannot. Whatever process is adopted for making such decisions, it needs to be fair, efficient, flexible, and responsive to unexpected demands in the future, including new practice economics, the availability of research funds, and medical innovation.

Original languageEnglish (US)
Pages (from-to)810-813
Number of pages4
JournalAnnals of internal medicine
Volume121
Issue number10
StatePublished - Dec 1 1994

Fingerprint

Health Care Reform
Internal Medicine
Delivery of Health Care
Financial Management
Insurance
Biomedical Research
Decision Making
Economics

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Adkinson, N. F., Alpert, J. S., Loriaux, D. L., Ladenson, P. W., Friedman, L. S., Cassileth, P. A., ... Arend, W. P. (1994). Training in subspecialty internal medicine. On the chessboard of health care reform. Annals of internal medicine, 121(10), 810-813.
Adkinson, N. Franklin ; Alpert, Joseph S. ; Loriaux, D. Lynn ; Ladenson, Paul W. ; Friedman, Lawrence S. ; Cassileth, Peter A. ; Kaufman, Rüssel E. ; Bartlett, John G. ; Klempner, Mark S. ; Neilson, Eric G. ; Glick, John H. ; Mayer, Robert J. ; Koerner, Spencer K. ; Crandall, Edward D. ; Arend, William P. / Training in subspecialty internal medicine. On the chessboard of health care reform. In: Annals of internal medicine. 1994 ; Vol. 121, No. 10. pp. 810-813.
@article{c5488993d01241bea2fb12866b138e8d,
title = "Training in subspecialty internal medicine. On the chessboard of health care reform",
abstract = "Many reform-minded observers of the U.S. health care system have asked recently whether we are training too many subspecialists in internal medicine. Of course' the answer to this question may not be the same for all subspecialties or all manners of professional career, but any proposed answer has extended consequences for the entire health care system and the patients it serves. Some have even begun to advocate a firm ceiling on the numbers of subspecialty training positions in the future. Who, in fact, should be deciding such matters? These decisions are complex and not easily made by government, consumers, or insurance companies on their own, nor should they. These decisions are best made by a profession willing to examine and regulate itself where necessary. Recent legislative initiatives have made it abundantly clear that others are more than willing to act on our behalf, if we cannot. Whatever process is adopted for making such decisions, it needs to be fair, efficient, flexible, and responsive to unexpected demands in the future, including new practice economics, the availability of research funds, and medical innovation.",
author = "Adkinson, {N. Franklin} and Alpert, {Joseph S.} and Loriaux, {D. Lynn} and Ladenson, {Paul W.} and Friedman, {Lawrence S.} and Cassileth, {Peter A.} and Kaufman, {R{\"u}ssel E.} and Bartlett, {John G.} and Klempner, {Mark S.} and Neilson, {Eric G.} and Glick, {John H.} and Mayer, {Robert J.} and Koerner, {Spencer K.} and Crandall, {Edward D.} and Arend, {William P.}",
year = "1994",
month = "12",
day = "1",
language = "English (US)",
volume = "121",
pages = "810--813",
journal = "Annals of Internal Medicine",
issn = "0003-4819",
publisher = "American College of Physicians",
number = "10",

}

Adkinson, NF, Alpert, JS, Loriaux, DL, Ladenson, PW, Friedman, LS, Cassileth, PA, Kaufman, RE, Bartlett, JG, Klempner, MS, Neilson, EG, Glick, JH, Mayer, RJ, Koerner, SK, Crandall, ED & Arend, WP 1994, 'Training in subspecialty internal medicine. On the chessboard of health care reform', Annals of internal medicine, vol. 121, no. 10, pp. 810-813.

Training in subspecialty internal medicine. On the chessboard of health care reform. / Adkinson, N. Franklin; Alpert, Joseph S.; Loriaux, D. Lynn; Ladenson, Paul W.; Friedman, Lawrence S.; Cassileth, Peter A.; Kaufman, Rüssel E.; Bartlett, John G.; Klempner, Mark S.; Neilson, Eric G.; Glick, John H.; Mayer, Robert J.; Koerner, Spencer K.; Crandall, Edward D.; Arend, William P.

In: Annals of internal medicine, Vol. 121, No. 10, 01.12.1994, p. 810-813.

Research output: Contribution to journalShort survey

TY - JOUR

T1 - Training in subspecialty internal medicine. On the chessboard of health care reform

AU - Adkinson, N. Franklin

AU - Alpert, Joseph S.

AU - Loriaux, D. Lynn

AU - Ladenson, Paul W.

AU - Friedman, Lawrence S.

AU - Cassileth, Peter A.

AU - Kaufman, Rüssel E.

AU - Bartlett, John G.

AU - Klempner, Mark S.

AU - Neilson, Eric G.

AU - Glick, John H.

AU - Mayer, Robert J.

AU - Koerner, Spencer K.

AU - Crandall, Edward D.

AU - Arend, William P.

PY - 1994/12/1

Y1 - 1994/12/1

N2 - Many reform-minded observers of the U.S. health care system have asked recently whether we are training too many subspecialists in internal medicine. Of course' the answer to this question may not be the same for all subspecialties or all manners of professional career, but any proposed answer has extended consequences for the entire health care system and the patients it serves. Some have even begun to advocate a firm ceiling on the numbers of subspecialty training positions in the future. Who, in fact, should be deciding such matters? These decisions are complex and not easily made by government, consumers, or insurance companies on their own, nor should they. These decisions are best made by a profession willing to examine and regulate itself where necessary. Recent legislative initiatives have made it abundantly clear that others are more than willing to act on our behalf, if we cannot. Whatever process is adopted for making such decisions, it needs to be fair, efficient, flexible, and responsive to unexpected demands in the future, including new practice economics, the availability of research funds, and medical innovation.

AB - Many reform-minded observers of the U.S. health care system have asked recently whether we are training too many subspecialists in internal medicine. Of course' the answer to this question may not be the same for all subspecialties or all manners of professional career, but any proposed answer has extended consequences for the entire health care system and the patients it serves. Some have even begun to advocate a firm ceiling on the numbers of subspecialty training positions in the future. Who, in fact, should be deciding such matters? These decisions are complex and not easily made by government, consumers, or insurance companies on their own, nor should they. These decisions are best made by a profession willing to examine and regulate itself where necessary. Recent legislative initiatives have made it abundantly clear that others are more than willing to act on our behalf, if we cannot. Whatever process is adopted for making such decisions, it needs to be fair, efficient, flexible, and responsive to unexpected demands in the future, including new practice economics, the availability of research funds, and medical innovation.

UR - http://www.scopus.com/inward/record.url?scp=0028596375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028596375&partnerID=8YFLogxK

M3 - Short survey

C2 - 7944061

AN - SCOPUS:0028596375

VL - 121

SP - 810

EP - 813

JO - Annals of Internal Medicine

JF - Annals of Internal Medicine

SN - 0003-4819

IS - 10

ER -

Adkinson NF, Alpert JS, Loriaux DL, Ladenson PW, Friedman LS, Cassileth PA et al. Training in subspecialty internal medicine. On the chessboard of health care reform. Annals of internal medicine. 1994 Dec 1;121(10):810-813.