The decline of clinical contact in medicine

Abstract

Patient contact with medical students and clinicians may be on the decline. Increasing medical graduate numbers, workforce and training demands, and the institution of safe working hours are putting pressure on opportunities for direct clinical interaction. Medical education curricula and clinical postgraduate education supervisors must ensure that students and junior doctors recognise the importance of hands‐on clinical contact with patients. Although many new developments aid health care efficiencies and can assist with the complexities of care required in a modern hospital, clinicians need to maintain their focus on the patient.

Nephrology training in Australia and New Zealand: A survey of outcomes and adequacy

“…2 Despite a lack of current evidence for diminished adequacy of training, future concerns regarding quality of training remain, particularly regarding reduced work hours for junior doctors, increasing numbers of medical graduates, reduced doctor-patient contact time, and increased flexible training such as part-time appointments and job sharing. 5,[10][11][12][13] Although there have been valid concerns raised, our data is consistent with other published reports of inadequate evidence that these issues (particularly reduced junior doctor working hours) have led to less adequate training. 14,15 Nephrology trainees have expressed concerns that increasing trainee numbers will impact employment opportunities; however, most respondents in our survey reported being able to secure their desired positions.…”

“…This is despite increased numbers of nephrology advanced trainees in ANZ over that time while clinical exposure and procedures performed by trainees has decreased . Despite a lack of current evidence for diminished adequacy of training, future concerns regarding quality of training remain, particularly regarding reduced work hours for junior doctors, increasing numbers of medical graduates, reduced doctor–patient contact time, and increased flexible training such as part‐time appointments and job sharing . Although there have been valid concerns raised, our data is consistent with other published reports of inadequate evidence that these issues (particularly reduced junior doctor working hours) have led to less adequate training …”

Increase in nephrology advanced trainee numbers in Australia and associated reduction in clinical exposure over the past decade

“…With increasing complexity of medical care, as well as increasing numbers of medical undergraduates and junior doctors being trained in Australia, the time that individual clinicians spend seeing patients may be declining . One recent Australian study reported that doctors spend only 15% of their working day in direct clinical contact with patients .…”

Simplifying the upper limb peripheral motor screen

“…[ 1 ] The pressures on junior clinicians to learn, retain, and apply a growing body of knowledge and understanding have never been greater. With recognized graduate deficiencies in core anatomical knowledge,[ 2 3 ] the expectation of a clear extrapolation of pathologic findings by junior doctors to anatomic bases is becoming less accepted. Screening assessment approaches to aid rapid patient evaluation have merit whereby such approaches minimize the risk of gross oversight while providing a platform for “abnormality” identification, prompting deeper and targeted inquisition.…”