Mu gawo ili la mndandanda wa Prioritizing Equity, phunzirani za kusiyana kwa mbiri yakale komanso kwamakono mu maphunziro azachipatala, ntchito, ndi mwayi wa utsogoleri.
Makanema a Prioritizing Equity akufotokoza momwe chilungamo mu chisamaliro chaumoyo chikusinthira chisamaliro panthawi ya mliri wa COVID-19.
Muyezo wa chisamaliro sumadalira momwe chimaperekedwera, kotero ntchito zothandizira zaumoyo ziyenera kutsatiridwa ndi miyezo yofanana ndi chisamaliro cha maso ndi maso.
Pa Msonkhano wa ChangeMed®️ wa 2023, Brian George, MD, MS, adalandira Mphotho ya 2023 Accelerating Change in Medical Education. Kuti mudziwe zambiri.
Kuyambitsa sayansi ya machitidwe azaumoyo m'masukulu azachipatala kumatanthauza kupeza kaye malo ochitira izi. Dziwani zambiri kuchokera kwa aphunzitsi azachipatala omwe adachitapo izi.
Zosintha za AMA zikufotokoza mitu yosiyanasiyana yazaumoyo yomwe imakhudza miyoyo ya madokotala ndi odwala. Dziwani momwe mungapezere chinsinsi cha pulogalamu yopambana yopezera anthu okhala m'nyumba.
Zosintha za AMA zikufotokoza mitu yosiyanasiyana yazaumoyo yomwe imakhudza miyoyo ya madokotala ndi odwala. Dziwani momwe mungapezere chinsinsi cha pulogalamu yopambana yopezera anthu okhala m'nyumba.
Kuyimitsa kulipira ngongole za ophunzira kwatha. Dziwani tanthauzo la izi kwa madokotala ndi njira zomwe ali nazo.
Kodi wophunzira zachipatala kapena wokhala m'dziko lino angapange bwanji ulaliki wabwino kwambiri? Malangizo anayi awa ndi chiyambi chabwino.
AMA ku CMS: Chitanipo kanthu mwachangu kuti madokotala asalandire kusintha kwa malipiro a MIPS mu 2024 kutengera momwe MIPS imagwirira ntchito mu 2022 ndi deta ina yomwe yapezeka mu zosintha zaposachedwa zomwe zikulimbikitsa kusintha kwa malipiro a Medicare.
Dziwani momwe CCB imalimbikitsira kusintha kwa malamulo ndi malamulo a AMA komanso momwe imathandizira kusintha malamulo, malangizo ndi njira zoyendetsera magawo osiyanasiyana a AMA.
Pezani tsatanetsatane ndi chidziwitso cholembetsa misonkhano ndi zochitika za Young Doctors Section (YPS).
Pezani ndondomeko ya msonkhano, zikalata ndi zina zowonjezera za Msonkhano wa Pakati pa Nthawi wa 2023 YPS pa Novembala 10 ku Gaylord National Resort and Convention Center ku National Harbor, Maryland.
Msonkhano Wolimbikitsa Ophunzira Azachipatala wa American Medical Association (MAC) wa 2024 udzachitika kuyambira pa 7 mpaka 8 Marichi, 2024.
Zinthu Zofunika Kwambiri pa Sepsis: Webinar yomaliza mu mndandanda wa webinar wa Centers for Disease Control and Prevention (CDC) ikukambirana za momwe maphunziro a sepsis amakhudzira kulemba ntchito ogwira ntchito zachipatala. Lembetsani.
Zosintha za AMA zikufotokoza mitu yosiyanasiyana yazaumoyo yomwe imakhudza miyoyo ya madokotala, okhalamo, ophunzira zachipatala ndi odwala. Mverani kuchokera kwa akatswiri azachipatala, kuchokera kwa atsogoleri a mabungwe azaumoyo ndi azaumoyo mpaka asayansi ndi akuluakulu azaumoyo, za COVID-19, maphunziro azachipatala, upangiri, kutopa, katemera ndi zina zambiri.
Mu AMA News ya lero, Purezidenti wakale wa AMA Gerald Harmon, MD, akugwirizana ndi kukambirana za kusowa kwa ogwira ntchito zachipatala komanso kufunika kwa madokotala okalamba. Dr. Harmon akugawana malingaliro ake pa udindo wake watsopano monga dean wanthawi yochepa wa University of South Carolina School of Medicine ku Columbia, ntchito yake monga wachiwiri kwa purezidenti wa nkhani zachipatala ku Tidelands Health ku Pawleys Island, South Carolina, ndi zomwe zimafunika kuti munthu azitha kuyenda bwino m'munda wa zamankhwala. Malangizo a momwe angakhalire otanganidwa. Madokotala azaka zopitilira 65. Woyang'anira: Mkulu wa AMA Experience Officer Todd Unger.
Pambuyo pomenyera madokotala panthawi ya mliriwu, bungwe la American Medical Association likuchitapo kanthu pa vuto lake lotsatira lachilendo: kutsimikiziranso kudzipereka kwa dzikolo kwa madokotala.
Unger: Moni ndipo takulandirani ku kanema ndi podcast ya AMA yomwe yasinthidwa. Lero tikulankhula za kusowa kwa antchito komanso kufunika kwa madokotala okalamba pothetsa vutoli. Nkhaniyi ikukambidwa pano ndi Dr. Gerald Harmon, woyang'anira wanthawi yochepa wa University of South Carolina School of Medicine ku Columbia, South Carolina, komanso purezidenti wakale wa AMA, kapena m'mawu akeake, "purezidenti wobwezeretsedwa wa AMA." Ine ndine Todd Unger, Chief Experience Officer wa AMA Chicago. Dr. Harmon, ndikusangalala kukudziwani. Muli bwanji?
Dr. Harmon: Todd, funso limenelo ndi losangalatsa. Kuwonjezera pa udindo wanga monga Mpando wa AMA Recovery, ndapeza udindo watsopano. Mwezi uno wokha, ndayamba udindo watsopano pantchito yanga monga Chief Health System Scientist komanso Woyang'anira Wanthawi Yochepa wa Sukulu ya Zamankhwala ku University of South Carolina ku Columbia, South Carolina.
Dr. Harmon: Nkhani yaikulu imeneyo. Zinali kusintha kosayembekezereka pantchito kwa ine. Winawake anandilankhula za ziyeneretso zawo ndi zomwe amayembekezera. Ndikuganiza kuti kwa ine izi ndi zofanana ndi zomwe zapangidwa kumwamba, ngati si zofanana ndi zomwe zapangidwa kumwamba ndiye kuti pakati pa nyenyezi.
Unger: Ndikukhulupirira kuti atayang'ana CV yanu, adakondwera ndi zina mwa zomwe mwachita. Mwakhala dokotala wa mabanja kwa zaka 35, Wachiwiri kwa Dokotala Wamkulu wa United States Air Force, Dokotala Wamkulu wa National Guard, ndipo, ndithudi, posachedwapa, Purezidenti wa AMA. Sizinali ngakhale theka la nkhondo. Mwapeza ufulu wopuma pantchito, koma mukuyamba mutu watsopano. N’chiyani chimayambitsa izi?
Dr. Harmon: Ndikuganiza kuti ndinali kuzindikira kuti ndili ndi mwayi wogawana zomwe ndakumana nazo pa moyo wanga ndi ena. Mawu oti "dokotala" amachokera ku Chilatini ndipo amatanthauza "kunyamula kapena kuphunzitsa." Ndikuganiza kuti nditha kuphunzitsa, kugawana zomwe ndakumana nazo pa moyo wanga, komanso kupereka maphunziro ndi chitsogozo (ngati si chitsogozo) kwa mbadwo wa madokotala omwe akuphunzitsidwa komanso omwe akuchita ntchito zachipatala. Chifukwa chake zinali zabwino kwambiri kuti ndikhale woona mtima kutenga udindo wothandizira kafukufuku pamene ndikupitirizabe luso langa lophunzitsa zachipatala. Chifukwa chake sindingathe kukana mwayiwu.
Dr. Harmon: Udindo wa provost ndi chinthu chomwe sindinachionepo kale. Ndinali pulofesa wa ku koleji ndipo ndinkaphunzitsa makalasi (ndinkaphunzitsa) pamasom'pamaso m'malo mopereka magiredi ndi mayeso olembedwa kwa ophunzira, okhala m'deralo, ndi akatswiri ena azaumoyo (anamwino, akatswiri a radiology, akatswiri a sonographer, othandizira madokotala). Kwa zaka zambiri zanga 35-40 zomwe ndinkachita, ndinali mphunzitsi, mphunzitsi wothandiza. Choncho udindo umenewu si wachilendo.
Kukopa kwa maphunziro sikunganyalanyazidwe. Ndikuphunzira - ndikugwiritsa ntchito fanizoli osati ndi payipi yozimitsira moto, koma ndi magulu a zidebe. Ndikupempha anthu kuti andiphunzitse chidziwitso chimodzi ndi chimodzi. Choncho dipatimenti ina imabweretsa chidebe chawo, dipatimenti ina imabweretsa chidebe chawo, manejala amabweretsa chidebe chawo. Kenako ndinatenga chidebe m'malo modzazidwa ndi payipi yozimitsira moto ndikumira. Kuti ndizitha kuwongolera mfundo za deta pang'ono. Tidzayesa chidebe china sabata yamawa.
Unger: Dr. Harmon, mfundo zomwe mukutsegula mutu watsopano pano ndi zosangalatsa. Nthawi yomweyo, tikudziwa kuti madokotala ambiri akusankha kupuma pantchito msanga kapena kufulumira chifukwa cha mliriwu. Kodi mwawona kapena kumva izi zikuchitika pakati pa anzanu ogwira nawo ntchito?
Dr. Harmon: Ndinaziwona sabata yatha, Todd, inde. Tili ndi deta yapakati pa mliri, mwina kafukufuku wa data wa AMA wa 2021-2022, womwe ukuwonetsa kuti 20%, kapena dokotala m'modzi mwa asanu, adati adzapuma pantchito. Adzapuma pantchito mkati mwa miyezi 24 ikubwerayi. Tikuwona izi pakati pa akatswiri ena azaumoyo, makamaka anamwino. 40% ya anamwino (awiri mwa asanu) adati ndidzasiya ntchito yanga ya unamwino wazachipatala mkati mwa zaka ziwiri zikubwerazi.
Inde, monga ndidanenera, ndidawona izi sabata yatha. Ndinali ndi dokotala wapakati yemwe adalengeza kuti wapuma pantchito. Ndi dokotala wa opaleshoni, ali ndi zaka 60. Anati: Ndikusiya ntchito yogwira ntchito. Mliriwu wandiphunzitsa kutenga zinthu mozama kuposa ntchito yanga. Ndili ndi ndalama zambiri. Pankhani ya kwawo, ayenera kukhala ndi nthawi yochulukirapo ndi banja lake. Chifukwa chake adaganiza zopuma pantchito kwathunthu.
Ndili ndi mnzanga wina wabwino pa nkhani ya zachipatala za mabanja. Ndipotu, mkazi wake anabwera kwa ine miyezi ingapo yapitayo nati, “Mukudziwa, mliriwu wabweretsa mavuto ambiri m'banja mwathu.” Ndinapempha Dr. X, mwamuna wake, ndi mnzanga m'chipatala kuti achepetse mlingo. Chifukwa amakhala nthawi yambiri mu ofesi. Atabwerera kunyumba, anakhala pa kompyuta ndikuchita ntchito zonse za pakompyuta zomwe analibe nthawi yochitira. Anali wotanganidwa kuona odwala ambiri. Choncho anasiya. Anali pansi pa kukakamizidwa ndi banja lake. Ali ndi ana asanu.
Zonsezi zimayambitsa nkhawa zambiri kwa madokotala ambiri okalamba, koma omwe ali pakati pa ntchito, azaka 50 kapena kuposerapo, ali pachiwopsezo chachikulu cha nkhawa, monga momwe zilili ndi mibadwo yathu yachinyamata.
Unger: Zimapangitsa kuti vuto la kusowa kwa madokotala likhale lovuta kwambiri monga momwe tikuonera kale. Ndipotu, kafukufuku wopangidwa ndi Association of American Medical Colleges akuwonetsa kuti kusowa kwa madokotala kudzafika pa 124,000 pofika chaka cha 2034, zomwe zikuphatikizapo zinthu zomwe takambirana kumene, chiwerengero cha okalamba ndi ogwira ntchito zachipatala okalamba.
Monga dokotala wakale wa zamankhwala a mabanja amene amatumikira anthu ambiri akumidzi, kodi maganizo anu ndi otani pa nkhaniyi?
Dr. Harmon: Todd, wanena zoona. Kusowa kwa madokotala kukukulirakulira kwambiri, kapena osachepera logarithmically, osati kungowonjezera ndi kuchotsa. Madokotala akukalamba. Tikulankhula za mfundo yakuti m'zaka khumi zikubwerazi, odwala ku US adzakhala ndi zaka 65 kapena kuposerapo, ndipo 34% ya iwo tsopano adzafunika chithandizo chamankhwala. M'zaka khumi zikubwerazi, 42% mpaka 45% ya anthu adzafunika chithandizo chamankhwala. Akufunika chisamaliro chowonjezereka. Mwatchula kusowa kwa madokotala. Odwala okalamba awa amafunika chisamaliro chapamwamba, ndipo ambiri amakhala m'madera akumidzi omwe ali ndi anthu ochepa.
Choncho pamene madokotala akukalamba, kupuma pantchito sikusiya madokotala ambiri ndi ogwira ntchito zachipatala omwe akufuna kupita kumadera akumidzi, omwe akufuna kupita kumadera omwe alibe chithandizo chokwanira. Chifukwa chake, mkhalidwe m'madera akumidzi udzaipiraipira kwambiri. Zili ngati odwala m'derali akukalamba ndipo chiwerengero cha anthu m'madera akumidzi sichikukula. Sitikuwonanso kuchuluka kwa ogwira ntchito zachipatala omwe akusamukira kumadera akumidzi awa.
Choncho tiyenera kupanga ukadaulo watsopano, malingaliro atsopano, telemedicine, chisamaliro chochokera kwa gulu kuti tithandize kukwaniritsa zosowa za anthu akumidzi aku America omwe alibe chithandizo chokwanira.
Unger: Chiwerengero cha anthu chikukulirakulira kapena kukalamba, ndipo madokotala nawonso akukalamba. Izi zimapangitsa kusiyana kwakukulu. Kodi mungangoyang'ana deta yosafunikira momwe kusiyana kumeneko kumaonekera?
Dr. Harmon: Tiyerekeze kuti madokotala omwe alipo pano akutumikira odwala 280,000. Pamene chiwerengero cha anthu aku US chikukwera, ndi 34% tsopano ndipo 42% mpaka 45% m'zaka khumi, kotero monga mwanenera, ndikuganiza kuti ziwerengerozo ndi za anthu pafupifupi 400,000. Chifukwa chake ichi ndi kusiyana kwakukulu. Kuwonjezera pa kufunikira kwa madokotala ambiri, mudzafunikanso madokotala ambiri kuti athandize okalamba.
ndikuuzeni. Osati madokotala okha. Uyu ndi katswiri wa radiology, uyu ndi namwino, osatchulanso momwe anamwino amapuma pantchito. Machitidwe athu azipatala kumidzi ku America atopa kwambiri: palibe akatswiri okwanira a sonographer, akatswiri a radiology, ndi akatswiri a labotale. Dongosolo lililonse lazaumoyo ku United States layamba kale kuchepa chifukwa cha kusowa kwa ogwira ntchito zachipatala amitundu yonse.
Unger: Kukonza kapena kuthetsa vuto la kusowa kwa madokotala tsopano kukufunika njira yothetsera mavuto osiyanasiyana. Koma tiyeni tikambirane momveka bwino. Mukuganiza kuti madokotala okalamba akugwirizana bwanji ndi njira imeneyi? N’chifukwa chiyani ndi oyenera kwambiri kusamalira okalamba?
Dr. Harmon: Ndizosangalatsa. Ndikuganiza kuti palibe kukayika kuti adzamvera chisoni, ngati sadzamvera chisoni, odwala omwe akubwera. Monga momwe timalankhulira za aku America azaka 65 kapena kuposerapo omwe amapanga 42% ya anthu, chiwerengerochi chikuwonekeranso m'magulu a madokotala: 42-45% ya madokotala nawonso ali ndi zaka 65. Chifukwa chake adzakhala ndi zomwezo pamoyo wawo. Adzatha kumvetsetsa ngati ndi kulephera kwa mafupa ndi mafupa, kuchepa kwa chidziwitso kapena kulephera kuzindikira, kapena kulephera kumva ndi kuwona, kapena mwina matenda ena omwe timakumana nawo tikamakalamba, matenda a mtima.
Tinakambirana za momwe podcast yomwe ndidachita idawonetsera kuti anthu pafupifupi 90 miliyoni aku America ali ndi matenda a shuga, ndipo 85 mpaka 90 peresenti ya iwo sadziwa ngakhale kuti ali ndi matenda a shuga. Zotsatira zake, okalamba aku America nawonso ali ndi vuto la matenda osatha. Tikalowa m'gulu la madokotala, mupeza kuti ndi achifundo, komanso ali ndi zokumana nazo pamoyo wawo. Ali ndi luso. Amadziwa momwe angadziwire matenda.
Nthawi zina ndimakonda kuganiza kuti madokotala a msinkhu wanga ndi ine tingathe kuganiza komanso kupeza matenda popanda ukadaulo winawake. Sitiyenera kuganiza kuti ngati munthuyu ali ndi vuto pang'ono ndi ziwalo izi kapena zija, sindidzachita MRI kapena PET scan kapena mayeso aliwonse a labotale. Ndikudziwa kuti ziphuphuzi ndi shingles. Izi si contact dermatitis. Koma chifukwa chakuti ndakhala ndikuwona odwala kwa zaka 35 kapena 40 ndi chomwe chimandithandiza kugwiritsa ntchito zomwe ndimatcha nzeru zenizeni za anthu, osati nzeru zongopeka, pozindikira matenda.
Kotero sindiyenera kuchita mayeso onsewa. Nditha kuzindikira bwino matendawa pasadakhale, kuchiza komanso kutonthoza okalamba.
Unger: Iyi ndi nkhani yabwino kwambiri yotsatira. Ndikufuna kukambirana nanu zambiri za nkhaniyi yokhudza ukadaulo. Ndinu membala wokangalika wa Senior Doctor Division, mukupereka malingaliro ndikupereka malingaliro pa nkhani zomwe zimakhudza madokotala akuluakulu. Chimodzi mwa zinthu zomwe zimabwera kwambiri posachedwapa (kwenikweni, ndakhala ndikulankhula kwambiri za luntha lochita kupanga m'masabata angapo apitawa) ndi funso la momwe madokotala achikulire adzasinthira ku ukadaulo watsopano. Kodi muli ndi malingaliro otani pankhaniyi? Kodi AMA ingathandize bwanji?
Dr. Harmon: Chabwino, mwandionapo kale - ndalankhulapo pagulu pamisonkhano ndi ma panelo - tifunika kuvomereza ukadaulo watsopanowu. Sizidzatha. Zimene timaona mu luntha lochita kupanga (AMA imagwiritsa ntchito mawu awa ndipo ndikugwirizana nawo kwambiri) ndi luntha lowonjezera. Chifukwa silidzalowa m'malo mwa kompyuta iyi kwathunthu pano. Tili ndi luso linalake loweruza komanso lopanga zisankho lomwe ngakhale makina abwino kwambiri sangaphunzire.
Koma tifunika kudziwa bwino ukadaulo uwu. Sitiyenera kuchedwetsa kupita patsogolo kwake. Sitiyenera kuchedwetsa kuugwiritsa ntchito. Sitiyenera kuchedwetsa kujambula zinthu zina zamagetsi zomwe timalankhula monyoza. Uwu ndi ukadaulo watsopano. Sudzatha. Izi zithandiza kupereka chithandizo chamankhwala. Izi zithandiza chitetezo, kuchepetsa zolakwika, komanso, ndikuganiza, kupititsa patsogolo kulondola kwa matenda.
Choncho madokotala ayenera kuvomereza izi ndi kuziyang'anira. Ndi chida, monga china chilichonse. Zili ngati kugwiritsa ntchito stethoscope, kugwiritsa ntchito maso anu, kukhudza ndi kuyang'ana anthu. Ndi kukulitsa luso lanu, osati cholepheretsa.
Unger: Dr. Harmon, funso lomaliza. Ndi njira zina ziti zomwe madokotala omwe asankha kuti sangathenso kusamalira odwala angapitirire kukhala otanganidwa pantchito zawo? Nchifukwa chiyani kuli kopindulitsa kwa madokotala ndi akatswiri kusunga ubale wolimba chonchi?
Dr. Harmon: Todd, aliyense amasankha yekha zochita zake pogwiritsa ntchito deta yake. Chifukwa chake, ngakhale dokotala angakhale ndi mafunso okhudza luso lake, chitetezo chake, kaya ndi m'chipinda chochitira opaleshoni kapena kuchipatala komwe mukungoyang'anira matenda, sikuti mukuchita opaleshoni kapena zida zoimbira. Pali kusintha kwabwinobwino. Tonsefe tiyenera kuda nkhawa ndi izi.
Choyamba, ngati muli ndi nkhawa yeniyeni, ngati mukukayikira luso lanu, la maganizo kapena la thupi, lankhulani ndi mnzanu wa kuntchito. Musachite manyazi. Tili ndi vuto lomweli ndi thanzi labwino. Ndikamalankhula ndi magulu a madokotala, ndimadziwa kuti timalankhula za kutopa ndi madokotala. Timalankhula za mavuto a ntchito komanso momwe timakhumudwitsidwa. Deta yathu ikuwonetsa kuti madokotala opitilira 40% anali kuganizira za ntchito zawo—ndikutanthauza, chiwerengerocho ndi choopsa.
Nthawi yotumizira: Okutobala-13-2023