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The Invisible Hand of the Government in Medical Education

Paul T. Kefalides, MD
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Copyright ©2004 by the American College of Physicians

Ann Intern Med. 2000;132(8):686. doi:10.7326/0003-4819-132-8-200004180-00102
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Leaders in medical education have long questioned the government's proper role in directing the teaching of young doctors. But there are many examples in which special interests and local political agendas motivate state legislators to pass new laws affecting medical training. And state governments have for a long time influenced undergraduate, graduate, and continuing medical education (CME) through a system of laws, financial incentives, and sometimes content mandates. Popular notions are frequently the driving force behind specific initiatives that emerge from state houses, encouraging medical schools to redirect resources. The impact of these anecdotal initiatives pales, however, in comparison with the ways in which the federal government's balanced budget amendment and its widely touted campaign against Medicare fraud affect teaching institutions. The reduction in Medicare funds and the enforcement of documentation requirements have changed the way students and physicians work and learn on hospital wards.





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