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1.
Acad Med ; 97(4): 484-486, 2022 04 01.
Article in English | MEDLINE | ID: mdl-35020613

ABSTRACT

The great health paradox is that the least expensive and most effective public health measures available for addressing the COVID-19 pandemic-and other society-wide health challenges-have long been ignored and rejected in the United States in favor of more expensive and personalized care. The U.S. medical system is being overwhelmed in part because of this paradox. The authors argue that the country has invested excessively in acute care medical technology while investing insufficiently in its public health infrastructure. In this Invited Commentary, the authors recommend 5 steps that academic medicine should take to increase emphasis on and understanding of public health interventions to address society's health problems: (1) incorporate problem-based learning experiences in the medical school curriculum and community-based clinical rotations in public health departments, (2) better integrate schools of public health and schools of medicine, (3) encourage physicians to pursue public health careers, (4) educate the public about strategies for decreasing chronic illnesses, and (5) increase collaboration with colleagues around the world to identify and track outbreaks.


Subject(s)
COVID-19 , Public Health , COVID-19/epidemiology , COVID-19/prevention & control , Curriculum , Humans , Pandemics/prevention & control , Schools, Medical , United States
3.
Acad Med ; 95(8): 1143-1145, 2020 08.
Article in English | MEDLINE | ID: mdl-32287082

ABSTRACT

The coronavirus (COVID-19) pandemic is having profound effects on the lives and well-being of the world's population. All levels of the nation's public health and health care delivery systems are rapidly adjusting to secure the health infrastructure to manage the pandemic in the United States. As the nation's safety net health care systems, academic medical centers (AMCs) are vital clinical and academic resources in managing the pandemic. COVID-19 may also risk the financial underpinnings of AMCs because their cost structures are high, and they may have incurred large amounts of debt over the last decade as they expanded their clinical operations and facilities. This Invited Commentary reviews existing data on AMC debt levels; summarizes relief provided in the Coronavirus Aid, Relief, and Economic Security Act; and suggests policy options to help mitigate risk.


Subject(s)
Academic Medical Centers/economics , Betacoronavirus , Coronavirus Infections/economics , Pandemics/economics , Pneumonia, Viral/economics , Public Health/economics , COVID-19 , Delivery of Health Care/economics , Humans , SARS-CoV-2 , United States/epidemiology
6.
Am J Geriatr Psychiatry ; 22(3): 241-7, 2014 Mar.
Article in English | MEDLINE | ID: mdl-23567412

ABSTRACT

OBJECTIVE: The objective is to provide information on successful programs providing home-based services to mentally ill elderly in order to assist other communities wishing to establish such programs. PARTICIPANTS: The ten programs described in this article were selected by peer review from applications for an award given by the American Association for Geriatric Psychiatry and were participants in an invitational conference. RESULTS: Eight of the programs were components of a community agency and two were components of a medical school department of psychiatry. Six of the programs focused primarily on individuals with anxiety and depression and utilized a range of individual psychotherapies. The other four accepted patients with any psychiatric diagnosis including dementia and included medication management as part of their services. The numbers served by the ten programs ranged from about 50 to 300 new cases per year, and the staffing ranged from 2 to 13 often with a combination of full and part time. The annual budget for the ten programs ranged from $30,000 to $1,250,000. Budget sources usually included some combination of public funds, philanthropy, and fee-for-service income. CONCLUSIONS: Despite the logistic and fiscal challenges of providing home-based services to mentally ill older adults there are many long-standing successful programs that can serve as models for communities wishing to establish similar programs. A great opportunity exists for a unified outcome research endeavor as well as expansion into many more communities.


Subject(s)
Community Mental Health Services/organization & administration , Home Care Services/organization & administration , Home Care Services/standards , Program Development , Psychiatric Department, Hospital/organization & administration , Aged , Community Mental Health Services/economics , Community Mental Health Services/standards , Home Care Services/economics , Humans , Psychiatric Department, Hospital/economics , Psychiatric Department, Hospital/standards
7.
Acad Psychiatry ; 32(3): 241-8, 2008.
Article in English | MEDLINE | ID: mdl-18467483

ABSTRACT

OBJECTIVE: To describe the American Board of Psychiatry and Neurology (ABPN) Maintenance of Certification Program, its underlying rationale, how it will be implemented now, and what it might look like in the future. METHODS: The authors describe the philosophical foundation, specific components, and the implementation timeline of the ABPN Maintenance of Certification Program; the development of specific products that might be used by ABPN diplomates to meet its requirements; and several unanswered questions about its current status and future development. RESULTS: The ABPN Maintenance of Certification Program consists of specific requirements pertaining to professional standing, self-assessment and lifelong learning, performance in practice, and cognitive expertise that will be implemented incrementally over the next decade. CONCLUSION: The ABPN Maintenance of Certification Program has been implemented in a manner that is as consistent as possible with its underlying philosophical beliefs as well as the current and expected public and political concerns, diplomate needs, and the requirements of organizations responsible for licensure, credentialing, privileging, accreditation, professional development, and physician reimbursement.


Subject(s)
Certification/standards , Clinical Competence/standards , Education, Medical, Continuing/standards , Educational Measurement/methods , Neurology/standards , Psychiatry/standards , Specialty Boards/standards , Certification/methods , Certification/trends , Education, Medical, Continuing/methods , Forecasting , Humans , Licensure, Medical/standards , Models, Educational , Neurology/education , Organizational Objectives , Professional Practice/standards , Program Development/methods , Psychiatry/education , Specialty Boards/trends
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