This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (63)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Howard L. Kirz, MD, MBA

JAMA. 1986;256(6):734-739.

Abstract
As health maintenance organizations (HMOs) and managed health care systems expand, they represent an increasing potential as sites for medical student teaching. Considerable difference of opinion exists about the impact of medical training on these prepaid delivery systems. This study presents a methodology for estimating the subjective and objective costs and benefits of medical student training to an independent staff model HMO with a long-standing training program. Data are derived from a provider survey, a consumer survey, and patient visit logs. Principal subjective benefits include increased perceived quality of care, improved patient satisfaction, and enhanced provider education and joy of practice. Objective impacts include a decrease in productivity of 1.1 patient visits per half day and direct physician teaching labor of 46.8 minutes per half day. Applying this methodology to the specific program of ten courses gives rise to a figure of $180 000 ($16 900 per full-time equivalent student per year) for the "opportunity cost" of medical student training to the HMO. Rules of thumb are developed for application of this method prospectively to new programs in similar relationships between staff model HMOs and academic medical centers.

(JAMA 1986;256:734-739)

Author Affiliations
Cheryl Larsen

From the Departments of Medical Staff Management (Dr Kirz) and Medical Education (Ms Larsen), Group Health Cooperative of Puget Sound, Seattle.

Footnotes
Reprint requests to Medical Staff Management, Group Health Cooperative of Puget Sound, 300 Elliott Ave W, Seattle, WA 98119 (Dr Kirz).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Ambulatory Care Teaching and the Psychiatric Clerkship
Pessar
Acad. Psychiatry 2000;24:61-67.
ABSTRACT | FULL TEXT  

Direct Observation of Community-Based Ambulatory Encounters Involving Medical Students
Frank et al.
JAMA 1997;278:712-716.
ABSTRACT  

Medical Student Education in Managed Care Settings: Beyond HMOs
Veloski et al.
JAMA 1996;276:667-671.
ABSTRACT  

Cost-Effectiveness and Cost-Benefit Analyses in the Medical Literature: Are the Methods Being Used Correctly?
Udvarhelyi et al.
ANN INTERN MED 1992;116:238-244.
ABSTRACT