NIH Public Access Author Manuscript Fam Med. Author manuscript; available in PMC 2014 September 09.
NIH-PA Author Manuscript
Published in final edited form as: Fam Med. 2014 May ; 46(5): 340–347.
Student specialty plans, clinical decision-making, and health care reform Robert L. Williams, MD, MPH1, Crystal Romney1, Miria Kano, MA1, Randy Wright2, Betty Skipper, PhD1, Christina Getrich, PhD1, Andrew L. Sussman, PhD, MRCP1, and Stephen J. Zyzanski, PhD3 1Department 2Health
of Family and Community Medicine, University of New Mexico
Sciences Library and Informatics Center, University of New Mexico
3Department
of Family Medicine and Community Health, Case Western Reserve University
NIH-PA Author Manuscript
Abstract Background and objectives—Health care reform aims to increase evidence based, costconscious, and patient-centered care. Family medicine is seen as central to these aims in part due to evidence of lower cost, comparable quality care compared with other specialties. We sought evidence that senior medical students planning family medicine residency differ from peers entering other fields in decision-making patterns relevant to these health care reform aims. Methods—We conducted a national, anonymous, internet-based survey of senior medical students. Students chose one of two equivalent management options for a set of patient vignettes based on preventive care, medication selection or initial chronic disease management scenarios, representing in turn, evidence-based care, cost-conscious care, and patient-centered care. We examined differences in student recommendations, comparing those planning to enter family medicine with all others using bivariate and weighted, multilevel, multivariable analyses.
NIH-PA Author Manuscript
Results—Among 4,656 surveys received from seniors at 84 participating medical schools, students entering family medicine were significantly more likely to recommend patient management options that were more cost-conscious (p=.01) and more patient-centered (p
NIH-PA Author Manuscript
Published in final edited form as: Fam Med. 2014 May ; 46(5): 340–347.
Student specialty plans, clinical decision-making, and health care reform Robert L. Williams, MD, MPH1, Crystal Romney1, Miria Kano, MA1, Randy Wright2, Betty Skipper, PhD1, Christina Getrich, PhD1, Andrew L. Sussman, PhD, MRCP1, and Stephen J. Zyzanski, PhD3 1Department 2Health
of Family and Community Medicine, University of New Mexico
Sciences Library and Informatics Center, University of New Mexico
3Department
of Family Medicine and Community Health, Case Western Reserve University
NIH-PA Author Manuscript
Abstract Background and objectives—Health care reform aims to increase evidence based, costconscious, and patient-centered care. Family medicine is seen as central to these aims in part due to evidence of lower cost, comparable quality care compared with other specialties. We sought evidence that senior medical students planning family medicine residency differ from peers entering other fields in decision-making patterns relevant to these health care reform aims. Methods—We conducted a national, anonymous, internet-based survey of senior medical students. Students chose one of two equivalent management options for a set of patient vignettes based on preventive care, medication selection or initial chronic disease management scenarios, representing in turn, evidence-based care, cost-conscious care, and patient-centered care. We examined differences in student recommendations, comparing those planning to enter family medicine with all others using bivariate and weighted, multilevel, multivariable analyses.
NIH-PA Author Manuscript
Results—Among 4,656 surveys received from seniors at 84 participating medical schools, students entering family medicine were significantly more likely to recommend patient management options that were more cost-conscious (p=.01) and more patient-centered (p
