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Editor's Correspondence |

Entrenched Medical Academia as a Culprit

Herman Steinberg, MD
Arch Intern Med. 1998;158(16):1827-1829. doi:.
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The recent article by Alpert1 asks the proper question, but is somewhat off the mark in placing all the blame on managed care when he says,

All of us, particularly those who are entrenched in medical academia, contributed to the excesses of private medical care that ultimately paved the way for managed care. The academics failed to teach students and house staff to practice cognitive minimalist medicine, which is not only economically appropriate but also medically sound. They were too busy being academic, and furthermore, it was to their economic advantage to pile up the hospital bills and fill the beds so that their reimbursements were maximized. Even in a managed care environment, corporate executives of academic institutions, departmental chairmen, and division chiefs are making outrageous salaries. These individuals are not in the least interested in reducing the cost of medical care by limiting the number of unnecessary procedures, for example. As role models, they condition both students and house staff to an undisciplined style of medical practice.

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