But however appreciated they may be, budding physicians usually do not foresee attractive reimbursement, high professional status, and gratifying social recognition in nursing-home practice. Funds allocated for nursing-home medical teaching are pitiful compared with the jealously guarded funds for acute care facilities. Fourth-year clerkship time on acute and specialty care services is also jealously guarded. But cheer up, nursing home residents. Things will change.
Medical necessity is the mother of public policy.
Many medical schools are striving to meet the growing demand for physicians trained and willing to devote themselves to primary care practice. In providing such education, a crucial issue is how the presence of medical students during the ambulatory medical encounter affects patient satisfaction and the use of clinical time. Opinions vary widely, but reliable data are hard to obtain. Investigators at Case Western Reserve University in Cleveland, Ohio have now utilized an elaborate protocol involving direct observation and review of medical records by research-trained nurses. An exit questionnaire was also administered to the patients.