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  • What Kind of Physician Will You Be? How Variation in Health Care Impacts Your Training

    By Anita Arora, MD Geisel School of Medicine at Dartmouth’s Class of 2012, and Alicia True, Geisel School of Medicine at Dartmouth’s Class of 2015

    When fourth-year medical students choose which residency programs to rank highly in the Residency Match, various factors play an important role: a hospital’s reputation, the training curriculum, and the student’s own geographical and lifestyle preferences. But there’s something else America’s next wave of doctors should consider: the differences in care provided by even the most elite teaching hospitals, and how these differences affect the way we will practice medicine.

    During residency training, we learn by observing faculty who make decisions regarding how to treat chronically ill patients or whether to recommend elective surgeries. A new report from the Dartmouth Atlas Project, which examined the care provided by 23 top academic medical centers, found considerable variation in both the intensity of care provided to chronically ill patients at the end of life as well as the frequency with which patients undergo surgery when other treatment options are available. It also showed that quality, safety, and patient experience ratings did not increase with increased intensity of care. These variations in the way care is delivered are not ...

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