Facilitating the transition to practice: a weekend retreat curriculum for business-of-medicine education of United States anesthesiology residents

Abstract

Anesthesiology residents in the United States (US) not only must develop the clinical skills needed to provide independent patient care, but also are required to become familiar with the business aspects of the modern health care system. Unfortunately, practice management education may be inadequate during anesthesiology residency training. The authors describe the design and implementation of a weekend retreat curriculum in business-of-medicine education for anesthesiology residents. Experts were recruited to discuss interviewing skills, contract law and negotiation, billing and reimbursement, insurance, malpractice, and financial planning. A strict lecture didactic format was avoided, and presentations were designed to encourage speaker-audience interaction. The program was relatively simple to design and implement, satisfied several Accreditation Council of Graduate Medical Education core competencies for US anesthesiology education, may be altered as practice management evolves, and may be adapted to accommodate the needs of programs in other countries.

How accurate are we? A comparison of resident and staff physician billing knowledge and exposure to billing education during residency training

“…11,13,14 A variety of teaching methods for practice management have been studied, ranging from lecture series to educational weekend retreats, with varying degrees of success. 8,[14][15][16][17][18][19][20][21] The purpose of this study was (a) to determine the current level of knowledge of surgical resident physicians on topics relating to billing and physician remuneration, (b) to compare the accuracy of residents' billing with the accuracy of the billing of staff physicians already in independent practice and (c) to explore resident and staff physician experiences and opinions regarding practice management education during residency training.…”

Review article: Closing the research gap at the interface of learning and clinical practice

“…With further analysis, articles were selected wherein interventions relevant to one or more of the three themes were studied, resulting in a final selection of 56 citations Twenty-one studies analyzed transitions in, during, and after residency education; 19 studies addressed the educational effects of duty hour limits, [33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51] and 16 articles presented research on use of the competencies in teaching and assessing anesthesiology residents. [19][20][21][22][23][24][25][26][27][52][53][54][55][56][57][58] For the theme ''duty hours and the acquisition of competence'', the only articles included were those that assessed the effect of duty hour limits on measures of physician competence and those that studied changes in patient care experience in anesthesiology that could be attributed to the reduction in resident hours.…”

“…In anesthesiology, much of the research has focused on technical skills, such as airway management and dealing with anesthesia crisis management, with frequent use of simulation for teaching and assessment. [19][20][21][22][23][24][25] The focus of other recent work that explicitly or implicitly mentioned educational transition has been on education in the ''business'' aspects of medicine 26 and leadership training for fellows. 27 Promising areas to prepare physicians for the transition into practice include enhanced preparation for providing culturally competent care; 28 end-of-life care, particularly for individuals in subspecialty training in pain medicine and critical care; 29 and the cost-effective use of medical resources.…”

Good-Bye and Good Luck: Teaching Residents the Business of Medicine After Residency

“…The program satisfies several Accreditation Council for Graduate Medical Education competencies. 6 Other than this small number of focused interventions, very few programs specifically address employment contracts and negotiation tactics. As a result, the majority of newly graduated physicians are unlikely to have prior exposure to contract terms and negotiation.…”

“…It is imperative that such programs include an introduction to the basics of physician employment contracts, to ensure residents are exposed to these concepts prior to entering the real world of practice, so they are not left to learn some of these lessons ''the hard way.'' Residency programs may need to tailor the educational material and the format to the most efficient and effective method of delivering this curriculum, whether it be in the form of a retreat led by experts in the field 6 ; the development of a comprehensive nonclinical curriculum 8 ; a collaboration with local business educators, attorneys, or financial counselors 9 ; or another creative and innovative format. The most valuable lesson we learned is that regardless of how, when, or by whom this information is taught, some introduction to the basic concepts of the business of medicine is better than none at all, and is imperative for starting life after residency on the right track.…”