Inconvenient truths about effective clinical teaching

摘要

I've been teaching clinical medicine for more than 30 years but it seems to be getting harder, not easier:. Conventional wisdom in the USA holds that the problem is time and money (or, more precisely: time is money). Hospitalised patients, discharged before doctors can get to know them, are sicker and quicker today. Outpatient teaching is no less awkward, 10-minute office visits and outdated Medicare reimbursement rules gumming up the works. Long overdue restrictions on resident work hours won't solve these problems.