While biomedical research continues to advance medical knowledge, improvements in the delivery of health care in the United States have been quite slow. Gallup polls show that the level of confidence, as assessed by the question, “Please tell me how much confidence you, yourself, have in medicine—a great deal, quite a lot, some or very little” has declined from 80% in 1975 to 36% in 2019.1 Despite time and attention to quality improvement and patient safety efforts, much of the US health care system still contains troubling inequities and ranks poorly among high-income nations for a number of health outcomes.2-4 This is not surprising; there has not been sufficient progress in improving patient care experiences or improving the health of populations or reducing the per capita cost of care5 because so little has been done to change the models of delivery or address increasing labor costs or the rising extent of poverty.6 Improving health care in the United States will require careful consideration of future needs of the population as reflected in the physician workforce and the skills and competencies students and trainees will need to modernize clinical practice.
Green M, Wayne DB, Neilson EG. Medical Education 2020—Charting a Path Forward. JAMA. 2019;322(10):934–935. doi:10.1001/jama.2019.12661
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