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July 2014

Bringing High-Value Care to the Inpatient Teaching Service

Author Affiliations
  • 1Department of Medicine, University of California, San Francisco
  • 2Medical Service, San Francisco Veterans Affairs Medical Center, San Francisco, California
JAMA Intern Med. 2014;174(7):1021-1022. doi:10.1001/jamainternmed.2014.2012

High-value care is a strategic priority of major academic and medical organizations.1 One of the greatest challenges training programs face is fostering practice patterns in young physicians that avoid tests and treatments of dubious value.

We now have high-quality curricula and elegant campaigns to help residents grapple with a previously neglected notion: that much of what we do in medicine is wasteful and sometimes harmful. This formal curriculum is essential to signal new values, start conversations, and redefine what a great physician does. But it is not enough. Medical students and residents are in a formative stage of their professional development where their attitudes and behaviors are shaped less by PowerPoint or posters and more by the actions of their supervisors and peers (the informal curriculum).2