The Medical School: How to Navigate the Post–Health Care Reform World

By Charlotte Bruce Harvey ’78 / July/August 2010
June 4th, 2010

What does the future look like for new doctors? Given the sweeping changes that the recent health-care bill and other reforms have brought to medicine, what’s the outlook for the ninety-five members of the Warren Alpert Medical School’s class of 2010?

Frank Mullin
Medical School graduates process down College Street during Commencement. 
On May 30, as the graduates sat in Providence’s First Unitarian Church waiting to recite the Physician’s Oath and receive their diplomas, Dean Edward J. Wing rattled off some of ways he believed their future as changed.

Because tomorrow’s doctors will be employed by larger health-care systems, he said, they won’t have to spend so much of their time on the business of medicine. This should free them to focus more on doctoring. They’ll work in teams, and their decision-making will be informed by access to electronic medical records as well as from advances in genetics, pharmacology, and other research fields.

On the other hand, Wing said, “You’ll make less money.” The graduates also will have less autonomy. “Electronic records will keep track of your patients,” he observed, holding doctors more accountable for their mistakes.

If, he said, “you and your patients will have more time together,” everybody gains. To have more and closer contact with patients is a privilege: “You will be the recipients of all your patients’ emotions.

Graduation speaker T.R. Reid, best known for his lighthearted reports on National Public Radio, struck a less sentimental note when he stepped up the pulpit. “You’re about to face a tremendous drop in stature,” he said, warning students that the moment they walk into the hospital as residents, “You will be the newest, greenest, lowliest, most poorly paid, and frankly the most ignorant doctor in the place.”

“You’ll be freshmen again,” Reid said. But that’s okay. “The fact is, this is not a demotion.” To be a freshman, he said, is to be fresh. “Freshmen ask the impertinent questions; they don’t know we’ve always done it that way,” he said. “And that is the most important source of change.”

Paraphrasing Confucius, he advised the new MDs, “When in doubt ask a lot of questions. When not in doubt, ask more.”

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July/August 2010