3. Funding for graduate medical education should be increased and wrestled away from hospitals (where the education takes place) and channeled toward the residency programs themselves.
While the point about graduate medical education is a good start, the DMCB thinks the American Association of Medical Colleges (AAMC) has been remarkably unhelpful in matching their members' undergraduate medical student recruitment, selection and financial support process to the nation's manpower needs. Given how much public money these institutions receive, the DMCB asks if it's time to ask them to stop being so self-serving and step up to the plate when it comes to doing their part on behalf of health reform.
We also still don't know how many primary care physicians in doctor-owned businesses/practices will a) embrace the kind of profound practice transformation that will lead to the creation of a medical home and/or b) readily cooperate with being pushed into relationships with local hospitals to form accountable health organizations. The authors are fancifully assuming that a model of care that has been the topic of research in physician-salaried settings, in Medicaid programs and a pending Demo will work today everywhere in every town in every State - if only Congress would throw money at it. The DMCB doubts that and so does, by the way, the Congressional Budget Office.
Last but not least, the population-based care/disease management community has an emerging track record of working in and with in wide variety of practice settings to promote better coordination of care. Funny how that evidence was skipped over in the Journal's published narrow-minded holodeck construct.
The DMCB thinks there are many primary care physician practices nationwide that already provide excellent care. They need more than money and Boston-style central planning built on wishful thinking about half-proven concepts. The Journal's readers deserve better and so do whoever is getting copies of this opinion piece.
The DMCB's advice is to step toward the holodeck door and press the reality button.