Change is inevitable

Residency Program Insider, June 21, 2005

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 Dear residency program colleague:

Around this time of year, many of you are busy welcoming your incoming class of residents. This is an exciting time, for them and for us, but it is also an opportune time to share with them the changes they can expect to see in the medical profession.

The greatest certainty you can offer residents is that healthcare will change dramatically in this decade. One only has to look around to see change everywhere, including

The healthcare industry is also experiencing explosive technological advances. Within a few years, genetics will be even more clinically pertinent and there will be more individualization in treatment based on patient profiles and responses to pharmacotherapuetics. However, much of the country's morbidity is still due to chronic disease and these conditions are marked by tremendous opportunities to prevent or at least delay their manifestation.

What we "know" continuously changes as new information becomes available. Not only do we need to know this information, we need to have it at the point of care-literally at our fingertips-as we experience new ways of communicating with the patient, his or her family, and other members of the healthcare team.

The physician-patient relationship will also be greatly affected, as consumerism becomes a stronger driving force in medicine. Patients can already easily check clinician profiles and find out what percentage of their patients have had pap smears, mammograms, etc. They can also choose hospitals based on published quality markers such as antibiotics administered within 4 hours of pneumonia. Some popular sites for these purposes include:


In the future, residents won't just be board certified once, but throughout their professional lives. Certification will not only involve testing and keeping a valid medical license, but an assessment of practice outcomes and in some cases, patient satisfaction.

If residents seem hesitant to embrace the changing climate in our profession, encourage them to view change as an inevitable and even welcome opportunity. Change is a good thing.

That's all for this week!

All the best,

Kathryn M. Andolsek, MD, MPH
Clinical Professor, Department of Community and Family Medicine
Duke University School of Medicine
Associate Director, Duke Office of Graduate Medical Education
Duke Hospital

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