He is taking a staff position in an osteopathic emergency medicine residency program in the Frankford Hospital System. Switch to Non-Clinical Career G. Caleb Alexander, M.D. , went into medical school viewing issues of health care cost and quality as somehow distinct from the practice of caring for patients. Now in his final year of residency in internal medicine at the University of Pennsylvania Health System, Alexander says he has become aware of the tension between the best interests of patients and of health care institutions. He notes, for example, how a patient with a rare disease may not receive an expensive screening exam because of cost-reduction efforts to reduce overutilization of services. He anticipates a career in academic medicine focusing on health services research and medical administration, but says he may pursue a career within managed care or as a consultant outside the clinical setting.
Physicians are part of the problem.
Alexander is a member of the AMA and the Society for General Internal Medicine. He says he supports the efforts of organized medicine to defend physician autonomy, but says that those efforts should also focus on improving physician behavior to control health care cost and increase quality. After teaching high school for seven years, Michael Devon, M.D. , says he wanted to serve young people in a more enduring way. Now Chief Resident of pediatrics at Children's Hospital of Philadelphia, he has spent ten years retraining for his new career. At the start of that training, he had only a cursory knowledge of the increasing pressures on physicians in clinical practice.