Tinkering or Real Reform? The Choice Is Ours
Authors: James P. Nolan, Thomas S. Inui
Journal: Annals of Internal Medicine (1992)

Article15 June 1992Tinkering or Real Reform? The Choice Is OursJames P. Nolan, MD, Thomas S. Inui, MDJames P. Nolan, MDSearch for more papers by this author, Thomas S. Inui, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-12-1042 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptInternal medicine has been in a dynamic process of change throughout this century (1). Much of the ferment has resulted from new knowledge about disease causes and treatments, development of new technologies, shifts in the settings of care (for example, from office and home to hospital early in this century), and the leadership of notable individuals in internal medicine who established new norms for the discipline and its institutions. A present-day observer could contend that all of these preconditions for change are present again. Additional forces driving the process are the oversupply of specialists and the spiraling costs of health...References1. Beeson P and Maulitz R. The inner history of internal medicine. In: Maulitz RC, Long DE, Wood FC; eds. Grand Rounds: One Hundred Years of Internal Medicine. Philadelphia: University of Pennsylvania Press; 1988:15-54. CrossrefGoogle Scholar2. Schroeder S, Showstack B, and Gerbert B. Residency training in internal medicine: time for a change? Ann Intern Med. 1986;104:554-61. LinkGoogle Scholar3. Halperin A and Kaufman A. Ambulatory medical education: a reconsideration of sites and teachers. J Gen Intern Med. 1990;5(Suppl 1):S35-44. CrossrefMedlineGoogle Scholar4. Noble J. General internal medicine in internal medicine: at the core or on the periphery? Ann Intern Med. 1992;116(12 pt 2):1058-60. LinkGoogle Scholar5. Ende J and Davidoff F. What is a curriculum? Ann Intern Med. 1992;116(12 pt 2):1055-7. LinkGoogle Scholar6. Burke W and Inui T. 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Ann Intern Med. 1992;116(12 pt 2):1106-10. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: James P. Nolan, MD; Thomas S. Inui, MDAffiliations: University of Washington Seattle, WA 98195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAssociations between subspecialty fellowship interest and knowledge of internal medicine: A hypothesis-generating study of internal medicine residentsInadequate training in the biological sciences and medicine for dental studentsRedesigning Residency Education in Internal Medicine: A Position Paper from the Association of Program Directors in Internal MedicineJohn P. Fitzgibbons, MD, Donald R. Bordley, MD, Lee R. Berkowitz, MD, Beth W. Miller, MD, and Mark C. 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