Virtual Mentor

Virtual Mentor. May 2009, Volume 11, Number 5: 349-422.

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May 2009 Contents

Specialty Choice and Business Decisions in Medicine

Ethics Poll

Would you be more likely to get a massage, manicure, facial, or other nonmedical body treatment at a “medical spa” that advertised physician ownership than you would to get one at a nonmedically affiliated spa, if the price were the same at both?
Yes.
No.

There is great disparity between the average pay earned by subspecialty surgeons (e.g., cardiac surgeons, neurosurgeons, orthopaedic surgeons) per hour of surgery and that earned by primary care physicians per hour of patient care that includes taking histories, making diagnoses, suggesting treatment plans, and educating and counseling patients. Which of the following best describes why you think this disparity exists?
The difference in the expertise needed for the task.
The difference in the length of training.
Greater appreciation of society for specialists.
The difference the service makes in the life of the patient being cared for.
All of the above.
None of the above.

The fact that many rural and inner city regions are medically underserved has been described as a “market failure,” implying that some outside help for pure market forces is needed. Which of the following interventions do you think would improve the distribution of needed primary care medical services? Check all that you think apply.
Restructure the National Health Service Corps so that loan repayment terms are fairer and service terms, more flexible.
Establish a national Heal America program based on the Teach America model that would pay physicians to practice in underserved areas for 2 years after they complete their training.
Increase Medicare payment for many primary care services, offset by reduction in Medicare payments for some specialist services.
Increase federal funding for medical schools that consistently produce a greater-than-average percentage of graduates who enter primary care residencies and work in underserved areas.
Increase salaries of all resident physicians so that overwhelming debt is not the driving factor in their choice of practice location.
Provide federal or state government subsidies for physicians who locate their practices in underserved regions.
Use more nonphysician health care professionals such as physician assistants and practitioners.
None of the above.

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From the Editor

The Growing Importance of Business to Medical Students
Nathaniel J. Brown and Jeffrey M. Dueker
Full Text | PDF
Virtual Mentor. 2009; 11:351-354.

Educating for Professionalism

Clinical Cases

Decision Making at the Crossroads of Practice Choice
Commentary by John G. Halvorsen
Full Text | PDF
Virtual Mentor. 2009; 11:355-360.

Mainstream Medicine Meets the Medi-Spa
Commentary by Lionel Bercovitch
Full Text | PDF
Virtual Mentor. 2009; 11:361-367.

Competitiveness Can Undermine Team Goals
Commentary by Jeffrey Reagan and Laurel C. Blakemore
Full Text | PDF
Virtual Mentor. 2009; 11:368-372.

Medical Education

Medical Business Ethics Education: Guarding the Patient-Centered Focus of Medicine
James M. DuBois
Full Text | PDF
Virtual Mentor. 2009; 11:373-377.

The Character of the Physician
Edmund D. Pellegrino
Video
Virtual Mentor. 2009; 11.

Journal Discussion

O Doctor, Where Art Thou? Why Fewer Students Pursue Internal Medicine
David Y. Chen
Full Text | PDF
Virtual Mentor. 2009; 11:378-382.

Clinical Pearl

What Is the Consensus about Managing Health Risks Associated with Type-A Personality?
Sundeep Jayaprabhu
Full Text | PDF
Virtual Mentor. 2009; 11:383-386.

Law, Policy, and Society

Health Law

Splitting Fees or Splitting Hairs?
Cheryl Miller
Full Text | PDF
Virtual Mentor. 2009; 11:387-389.

Policy Forum

Closing the Gap: Finding and Encouraging Physicians Who Will Care for the Underserved
Keisa Bennett, Julie Phillips, and Bridget Teevan
Full Text | PDF
Virtual Mentor. 2009; 11:390-398.

Medicine and Society

The Business of Healing, Then and Now
Daniel N. Robinson
Full Text | PDF
Virtual Mentor. 2009; 11:399-401.

History, Art, and Narrative

Medical Narrative

On Money in Medicine and the Angst It Creates for Medical Students
Allison Carmichael
Full Text | PDF
Virtual Mentor. 2009; 11:402-405.

Op-Ed and Correspondence

Op-Ed

Higher Pay
E. Ray Dorsey, John A. Dorsey, and E. Richard Dorsey
Full Text | PDF
Virtual Mentor. 2009; 11:406-409.

Resources

Suggested Readings and Resources
PDF
Virtual Mentor. 2009; 11:410-419.

About the Contributors
Full Text | PDF
Virtual Mentor. 2009; 11:420-422.