Competencias transversales en la formación de los profesionales médicos. Una revisión / Cross-cutting Competencies in Medical Professional Training. A Review / Competências transversais na formação de profissionais médicos. Uma revisão

El presente artículo discute el proceso de formación del profesional médico en Colombia y sus posibles estrategias de enseñanza y tiene como fin problematizar el documento de política pública Perfiles y competencias profesionales de la salud, elaborado por el Ministerio de Salud y Protección Social y la Academia Nacional de Medicina a través de la selección de las competencias que correspondían con la relación social y la comunicación, propias de la atención médica: reconocimiento del contexto y relaciones interpersonales. Para esto se hizo una revisión documental a través de la búsqueda, selección y análisis de artículos académicos que trabajaran las posibles estrategias de enseñanza de las competencias mencionadas. Como conclusiones destacan la reflexión permanente que se ha hecho sobre el tema, así como la urgencia de trascender de la formación biológica hacia una formación más integral; no obstante, son pocas las reflexiones que concretan propuestas específicas de cómo lograrlo. De igual manera, existe un vacío sobre la definición y los alcances del concepto de integralidad y una falta de consenso en la forma de llamar aquellas competencias que le apuntan a esta.

This article discusses the process of training medical professionals in Colombia and their possible teaching strategies. Besides, it sought to problematize the public policy document "Profiles and Professional Competencies of Health" (Prepared by the Ministry of Health and Social Protection and the National Academy of Medicine) through the selection of competencies that corresponded to the social relationship and communication that constitute medical care: Recognition of Context and Interpersonal Relationships. For this purpose, a documentary review was done through the search, selection, and analysis of academic articles that worked on the possible teaching strategies for the mentioned competences. Among the conclusions, it stands out the permanent reflection that has been done on the subject, as well as the urgency of transcending biological formation towards a more integral formation. However, a few reflections define specific proposals on how to achieve it. Likewise, there is a gap in the definition and scope of the integrality concept or even a consensus about de definitions and concepts that those competences reach out.

Este artigo discute o processo de formação profissional médico na Colômbia e suas possíveis estratégias de ensino e tem como objetivo problematizar o documento de política pública Perfis e competências profissionais em saúde, elaborado pelo Ministério da Saúde e Proteção Social e pela Academia Nacional da Medicina através da seleção das competências que correspondem à relação social e à comunicação, próprias da assistência médica: reconhecimento do contexto e relações interpessoais. Para tanto, foi realizada uma revisão documental por meio da busca, seleção e análise de artigos acadêmicos que trabalharam as possíveis estratégias de ensino das referidas competências. Como conclusões destacam-se a reflexão permanente que se tem feito sobre o assunto, bem como a urgência de transcender a formação biológica para uma formação mais integral; no entanto, poucas reflexões fazem propostas específicas sobre como alcançá-lo. Da mesma forma, há um vazio na definição e abrangência do conceito de integralidade e uma falta de consenso na forma de denominar as competências que apontam para ele

Physician Practice Consolidation Driven By Small Acquisitions, So Antitrust Agencies Have Few Tools To Intervene.

The growing concentration of physician markets throughout the United States has been raising antitrust concerns, yet the Department of Justice and the Federal Trade Commission have challenged only a small number of mergers and acquisitions in this field. Using proprietary claims data from states collectively containing more than 12 percent of the US population, we found that 22 percent of physician markets were highly concentrated in 2013, according to federal merger guidelines. Most of the increases in physician practice size and market concentration resulted from numerous small transactions, rather than a few large transactions. Among highly concentrated markets that had increases large enough to raise antitrust concerns, only 28 percent experienced any individual acquisition that would have been presumed to be anticompetitive under federal merger guidelines. Furthermore, most acquisitions were below the dollar thresholds that would have required the parties to report the transaction to antitrust authorities. Under present mechanisms, federal authorities have only limited ability to counteract consolidation in most US physician markets.

Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea.

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.

[Current SHI physician legislation: succession rules for surgical seats : Surgical vacancies can be filled with orthopedic/trauma surgery specialists only within narrow limits]. / Aktuelles Vertragsarztrecht: Nachfolge bei Chirurgensitzen : Nachbesetzung einer chirurgischen Zulassung durch Fachärzte für Orthopädie/Unfallchirurgie nur in engen Grenzen.

It is a physician's certified continuing medical education category-rather than their actual medical activity, in this case in the field of trauma surgery-that is decisive in filling statutory health insurance (SHI) practice vacancies. This evaluation arising from §16 of the requirement planning guideline applies accordingly when filling physician vacancies. Thus physician vacancies or statutory health insurance (SHI) practice places can only be filled by a physician in the same physician group in line with requirement planning. Scope for argumentation initially remains in the context of filling surgical SHI physician vacancies where the ceding physician is certified as an accident insurance consultant.

Associate Buy-Ins: What You Need to Know. Part II.

In part two of this article, which began last month, Ted Schumann discusses contract issues to consider, including associate employment agreements, buy-in agreements, operating agreements, and buy-sell agreements. Plus - 10 things to avoid after the buy-in is concluded.

Strategies for Appropriate Patient-centered Care to Decrease the Nationwide Cost of Cancers in Korea / 예방의학회지

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.