To the Editor Faucett et al,1 in their review of Accreditation Council for Graduate Medical Education (ACGME) core competencies, concluded that there should be an increased emphasis on nonclinical core competencies, such as professionalism and systems-based practice.
Noticeably absent are demonstrating competencies in the business of medical practice, medical practice entrepreneurship, and the process of medical innovation and quality improvement. As a former program director, my observation was that these learning gaps contribute to poor patient outcomes, persistent systemic dysfunction, and patient experience problems because of ignorance about best practices, many of which derive from nonsick care industries.