Turmoil in Orlando.

[EctopicFetus]

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Florida medical school loses 40% of student training sites after partnering with HCA - Becker's Hospital Review | Healthcare News & Analysis

Third-year medical students at Orlando-based University of Central Florida can no longer complete clerkships at the region's two largest health systems, according to the Orlando Sentinel.

www.beckershospitalreview.com

 

[gamerEMdoc]

Florida medical school loses 40% of student training sites after partnering with HCA - Becker's Hospital Review | Healthcare News & Analysis

Third-year medical students at Orlando-based University of Central Florida can no longer complete clerkships at the region's two largest health systems, according to the Orlando Sentinel.

www.beckershospitalreview.com

“The split is a major loss for UCF — the two health systems hosted 40 percent of its clerkships, and student feedback on HCA sites has not been overwhelmingly positive, according to the report. For example, one student's end-of-year evaluation said, "HCA facilities are not good places to train. We are treated very poorly at HCA sites and there is very little going on," according to the report.”

Wow!

 

[littlejuan]

Orlando Health and AdventHealth are continuing to partner with UCF in other ways, including offering training for nursing students.

.

UCF had a really nice set up yet they go and **** it up with a for profit system.

 

[miacomet]

We need a new Flexner report

 

[Zebra Hunter]

We need a new Flexner report

An EM residency version, as well.

 

[EctopicFetus]

More proof why HCA sucks

 

[The Knife & Gun Club]

Serves them right. Make a deal with a devil, you suffer the repercussions.

I hope this shows everyone HCA site are not worth training at.

 

[deuist]

I hope this shows everyone HCA site are not worth training at.

It really doesn't. One vague negative review isn't terribly useful. How about hard numbers comparing number of scrubbed in procedures, number of patient-days, and shelf scores? For as much as everyone complains about Press-Gainey, you would think that we would look with a critical eye toward these type of articles.

 

[gro2001]

It really doesn't. One vague negative review isn't terribly useful. How about hard numbers comparing number of scrubbed in procedures, number of patient-days, and shelf scores? For as much as everyone complains about Press-Gainey, you would think that we would look with a critical eye toward these type of articles.

Yes, but in the undergraduate medical education world, consistent negative evaluations from students should be enough to shut down a site. It would be very hard to explain not doing so during the next accreditation cycle otherwise. Additional methods of course/program/site evaluation like the ones you mentioned are also necessary, but they would not rescue a primary rotation site from the axe if student feedback was consistently negative.

 

[EctopicFetus]

Yes, but in the undergraduate medical education world, consistent negative evaluations from students should be enough to shut down a site. It would be very hard to explain not doing so during the next accreditation cycle otherwise. Additional methods of course/program/site evaluation like the ones you mentioned are also necessary, but they would not rescue a primary rotation site from the axe if student feedback was consistently negative.

I think people on here graduated from mlk/drew em residency and that place had a fairly bad reputation back in the day for quite a long time before it was shut down. I think the problem wasn’t EM but it kept chugging along. The issue is people are rightfully afraid that if they complain they will be harmed. It’s what you see with attendings and cmgs.
I know it’s not why Hannehman closed but let’s say it was. That’s a total mess and with the match you are stuck so you only make it worse on yourself as each successive class is crappier and crappier or perhaps doesn’t fill. Food for thought in this broken world.

 

[AdmiralChz]

It really doesn't. One vague negative review isn't terribly useful. How about hard numbers comparing number of scrubbed in procedures, number of patient-days, and shelf scores? For as much as everyone complains about Press-Gainey, you would think that we would look with a critical eye toward these type of articles.

Do yourself a favor and read the much longer linked article here: AdventHealth, Orlando Health bar UCF med students after medical school picks HCA as partner

This is much worse than one Negative review it looks like a systemic problem and these students no longer have access to the major referral centers in the city! This was a really, really bad decision by UCF. I have no doubt HCA came in cheaper and (maybe) offered more of a split with the school, but hoping and praying that you’d remain partners with Advent and ORMC is foolish.

 

[TheSingularity]

To the high school and college students that may be lurking:

Let's have a BIG IQ moment here.

If you insist on pursuing a career in medicine, which I still insist is non-viable option for a HS or College student in 2019, then listen up: You MUST choose a large, stable, "real" academic university type place for your undergraduate med ed and GME. There is other safe option. Read about what happened at Summa, Hahanemann, and now UCF. If your don't have the grades/scores for them then just forget it and pick a different career. Medicine can be cool but it's not the end all be all. Your are not a failure if you don't go into medicine/law! Shareholder held corporations and private equity are assimilating the system. These med schools cropping up will just suck your loan money in and spit you out. They're basically domestic Caribbean schools.

 

[miacomet]

Y

To the high school and college students that may be lurking:

Let's have a BIG IQ moment here.

If you insist on pursuing a career in medicine, which I still insist is non-viable option for a HS or College student in 2019, then listen up: You MUST choose a large, stable, "real" academic university type place for your undergraduate med ed and GME. There is other safe option. Read about what happened at Summa, Hahanemann, and now UCF. If your don't have the grades/scores for them then just forget it and pick a different career. Medicine can be cool but it's not the end all be all. Your are not a failure if you don't go into medicine/law! Shareholder held corporations and private equity are assimilating the system. These med schools cropping up will just suck your loan money in and spit you out. They're basically domestic Caribbean schools.

Yup, medical education is going the way of PA and NP school with for-profit schools lacking any educational standards are opening left and right. I did NOT see this coming, and it's bad. If we graduate low IQ people with poor training, we have nothing to offer over midlevels.

 

[Listen2Savage]

To the high school and college students that may be lurking:

Let's have a BIG IQ moment here.

If you insist on pursuing a career in medicine, which I still insist is non-viable option for a HS or College student in 2019, then listen up: You MUST choose a large, stable, "real" academic university type place for your undergraduate med ed and GME. There is other safe option. Read about what happened at Summa, Hahanemann, and now UCF. If your don't have the grades/scores for them then just forget it and pick a different career. Medicine can be cool but it's not the end all be all. Your are not a failure if you don't go into medicine/law! Shareholder held corporations and private equity are assimilating the system. These med schools cropping up will just suck your loan money in and spit you out. They're basically domestic Caribbean schools.

My Caribbean school has better 3rd and 4th-year clerkships than DOs Ive been rotating with.

At Larkin hospital in south florida looking around like Jesus I would *** if I had to do another rotation here and the DO students are like we do all of our cores here.

Blank stare

***crickets***

not saying my school doesnt suck, just how surprised I am how equally shytty DO schools are.

 

[gamerEMdoc]

You MUST choose a large, stable, "real" academic university type place for your undergraduate med ed and GME. There is other safe option. Read about what happened at Summa, Hahanemann, and now UCF.

So all non-university residencies arent “real”? Hahnemann was Drexel Universities program. It was one of the oldest GME centers in the country. The “U” In UCF stands for University. There are many stable community training programs out there. To suggest that community programs are all unstable is an unfair characterization when 2/3 examples given were in fact “University” programs.

 

[AdmiralChz]

The trumpeting of a “physician shortage” has led to the creation of very marginal MD and especially DO schools in the last decade or so.

UCF looked to be on an amazing trajectory since they didn’t have a medical school in such a large city and the nearest was 2 hours away in USF and UF but now see what has happened... woof.

 

[TheSingularity]

So all non-university residencies arent “real”? Hahnemann was Drexel Universities program. It was one of the oldest GME centers in the country. The “U” In UCF stands for University. There are many stable community training programs out there. To suggest that community programs are all unstable is an unfair characterization when 2/3 examples given were in fact “University” programs.

Hahnemann/Drexel have been sketchy for some time. Hahnemann lost credibility as a "real" place when they sold out.

UCF just launched it's school 10 yrs ago, thus unstable and untested.

Little community places are targets for acquisition. The suits don't care about you as learners. But people need to decide what their risk tolerance is.

Sent from my Pixel 3 using SDN mobile

 

[gamerEMdoc]

Hahnemann/Drexel have been sketchy for some time. Hahnemann lost credibility as a "real" place when they sold out.

UCF just launched it's school 10 yrs ago, thus unstable and untested.

Little community places are targets for acquisition. The suits don't care about you as learners. But people need to decide what their risk tolerance is.

Sent from my Pixel 3 using SDN mobile

Right. Thats my point. Its not a community vs University issue. There are places that are well run financially. Places that are stable. And there are those that are perhaps not. And there are places that are financially stable but have cmg faculty, which could change contracts anytime. I think its oversimplified and unfair to say this is a community hospital problem when 2/3 of the examples given were Universities.

 

[Rekt]

It doesn't even matter if it's a "big university school". There's been several instances and articles from even the UC schools where students have to stand in line behind mid-levels to get procedures/training and have lost clerkship sites so they can train their cheaper replacements instead.

 

[RustedFox]

Oh, I can't wait for MLP Judgement Day; where they will be forced to sink or swim on their own.
Once the hospitals realize that they're awful, they will shut up and get in line.

 

[emletters]

Oh, I can't wait for MLP Judgement Day; where they will be forced to sink or swim on their own.
Once the hospitals realize that they're awful, they will shut up and get in line.

What if they’re “good enough” by corporate and public standards?

 

[RustedFox]

What if they’re “good enough” by corporate and public standards?

Good question.
I just don't see that happening. At all.
I've worked with enough of them to know that they're not even close to "good enough".

 

[emletters]

Good question.
I just don't see that happening. At all.
I've worked with enough of them to know that they're not even close to "good enough".

As an intern, I hope that’s true. But I just can’t underestimate both c suite and the general public’s laser focus on saving a dollar, as well as midlevels’ agenda of being noninferior with less training (whether it’s secondary to arrogance or naivety).

 

[deleted109597]

M4A might do this. If CMS says we are equals, but we all go private and they have to use midlevels for that plan to keep costs down, we will learn really fast what people want. Someone to do what they ask, or someone who knows what they're doing.

 

[deleted547339]

First Summa, now UCF. The plague of these monstrosities continue. Glad for UCF, they got what they deserve.

 

[DrGasPasser]

Part of the problem is that it is increasingly difficult to distinguishing academic from community programs as healthcare systems consolidate and academic institutions partner with private entities to insure their survival.

 

[pkwraith]

I'm not sure it will make much difference as I doubt it will even dent the applicants who are still lining up by the droves. I took a look at their Application thread expecting a tiny amount of discussion on this, but it's just filled with people desperate to get off the waitlist and other people saying how much better it is going to be with the HCA hospitals.

 

[deleted547339]

I'm not sure it will make much difference as I doubt it will even dent the applicants who are still lining up by the droves. I took a look at their Application thread expecting a tiny amount of discussion on this, but it's just filled with people desperate to get off the waitlist and other people saying how much better it is going to be with the HCA hospitals.

Lolz

 

[jw3600]

Good question.
I just don't see that happening. At all.
I've worked with enough of them to know that they're not even close to "good enough".

Dude many attending consultants don’t give a F about patients if it’s not convenient for them. You think execs on the board of a hospital actually give a **** about patients or outcomes. They spend the smallest amount possible to provide care that’s deemed medically legal. It has nothing to do with what’s right.

 

[EctopicFetus]

If you have spent any time dealing with admin at your hospital you will know they care about money and money only. They dont care about quality, service or anything else. It is money. This is true at the non profits. I trained at an academic center.. money was front and center. I worked in 2 "non profit" systems and money was front and center. To be fair no money no mission in the non profit game but they are the worst as they pretend they care about people and not money but thats far from true.

 

[MedicineZ0Z]

My Caribbean school has better 3rd and 4th-year clerkships than DOs Ive been rotating with.

At Larkin hospital in south florida looking around like Jesus I would *** if I had to do another rotation here and the DO students are like we do all of our cores here.

Blank stare

***crickets***

not saying my school doesnt suck, just how surprised I am how equally shytty DO schools are.

Some DO schools have decent sites and are flexible. The latter is the most important thing. MD sites may be good in theory but day to day tasks of students is identical to a very good portion of what DO students also do. Med students as a whole are very limited nowadays.

It doesn't even matter if it's a "big university school". There's been several instances and articles from even the UC schools where students have to stand in line behind mid-levels to get procedures/training and have lost clerkship sites so they can train their cheaper replacements instead.

I'm not sure how someone can stand by and watch that. It should make heads spin. I've seen attendings try to (without making it obvious) exclude midlevels from learning so they can only teach med students and residents. THAT is how we should all be to save our own butts.

The trumpeting of a “physician shortage” has led to the creation of very marginal MD and especially DO schools in the last decade or so.

UCF looked to be on an amazing trajectory since they didn’t have a medical school in such a large city and the nearest was 2 hours away in USF and UF but now see what has happened... woof.

The only physician shortage is in rural montana among other isolated areas. lol. There is NO physician shortage in any remotely desirable area of USA. Key word: remotely. Literally semi-crappy towns in random states have people lined up for their jobs. Let alone decent cities.

 

[AdmiralChz]

The only physician shortage is in rural montana among other isolated areas. lol. There is NO physician shortage in any remotely desirable area of USA. Key word: remotely. Literally semi-crappy towns in random states have people lined up for their jobs. Let alone decent cities.

Wow, this is a pretty nasty post but anyways...

AAMC and others will disagree with you.

New Findings Confirm Predictions on Physician Shortage

The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply.

www.aamc.org

America's aging population is leading to a doctor shortage crisis

As America's population ages and demand outpaces supply, a physician shortage will intensify.

www.cnbc.com

The US is on the verge of a devastating, but avoidable doctor shortage

There is a way to prevent nightmare scenarios from becoming new norms.

qz.com

 

[deuist]

I think some of us are confusing the proliferation of EM residencies with the false notion that there is no doctor shortage. If you ask your patients how long they have to wait to see any outpatient physician (no matter the specialty), you'll quickly realize that we need more physicians.

 

[Dr.Bruh]

My DO school is affiliated and rotates at this site (send about 10-12 kids each year). I know their EM program is mostly DO.

My Caribbean school has better 3rd and 4th-year clerkships than DOs Ive been rotating with.

At Larkin hospital in south florida looking around like Jesus I would *** if I had to do another rotation here and the DO students are like we do all of our cores here.

Blank stare

***crickets***

not saying my school doesnt suck, just how surprised I am how equally shytty DO schools are.

My DO school is affiliated and send 10-12 kids a year to Adventhealth Orlando for 3rd/4th year. I know their EM program is mostly DOs.

 

[TooMuchResearch]

AAMC's job is to create more medical school spots. They don't give a **** if we need more doctors.

Wow, this is a pretty nasty post but anyways...

AAMC and others will disagree with you.

New Findings Confirm Predictions on Physician Shortage

The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply.

www.aamc.org

America's aging population is leading to a doctor shortage crisis

As America's population ages and demand outpaces supply, a physician shortage will intensify.

www.cnbc.com

The US is on the verge of a devastating, but avoidable doctor shortage

There is a way to prevent nightmare scenarios from becoming new norms.

qz.com

 

[TooMuchResearch]

Really? In my area there is generally quick turnaround to see primary care and most specialties.

I think some of us are confusing the proliferation of EM residencies with the false notion that there is no doctor shortage. If you ask your patients how long they have to wait to see any outpatient physician (no matter the specialty), you'll quickly realize that we need more physicians.

 

[EctopicFetus]

I think some of us are confusing the proliferation of EM residencies with the false notion that there is no doctor shortage. If you ask your patients how long they have to wait to see any outpatient physician (no matter the specialty), you'll quickly realize that we need more physicians.

The proliferation of residencies will lead to that changing. The real restriction was with medical schools. The number of schools and students is growing. There have always been open resdiency spots (mostly in primary care). Primary care still sucks as a specialty. The proliferation of hospitalists has made this worse as their pay is much better and no stress about running an office nor dealing with the nonsense that has become primary care. To fill that vacuum PCPs have 2-4+ MLPs working under them and they are working like anesthesiologists supervising a handful of CRNAs.

 

[RustedFox]

Dude many attending consultants don’t give a F about patients if it’s not convenient for them. You think execs on the board of a hospital actually give a **** about patients or outcomes. They spend the smallest amount possible to provide care that’s deemed medically legal. It has nothing to do with what’s right.

Once the lawsuits stack up and the general public complains about "not seeing a doctor" (which is already at or near the top of the list of patient complaints every time we get the list to review), the C-Fux will figure out that they're losing business by being penny wise and pound foolish.

 

[EctopicFetus]

Once the lawsuits stack up and the general public complains about "not seeing a doctor" (which is already at or near the top of the list of patient complaints every time we get the list to review), the C-Fux will figure out that they're losing business by being penny wise and pound foolish.

Your c suite must be way smarter than mine.

 

[RustedFox]

Your c suite must be way smarter than mine.

Probably.

We remodeled our coverage map from 1 doc:2 MLPs and 3 doc shifts/day to four doc shifts a day and just one MLP just recently.

Life is so much better when you're not the lone physician ape on top of the skyscraper swatting at the two MLP biplanes circling you.

 

[EctopicFetus]

We already staff 8ocs to 1 mlp.
Site 2 is 5:1. Site 3 5:1

volume wise it’s probably 12:1 and 8:1 docs to mlps. Our c suite doesn’t believe an ed needs nurses or techs.

 

[RustedFox]

We already staff 8ocs to 1 mlp.
Site 2 is 5:1. Site 3 5:1

volume wise it’s probably 12:1 and 8:1 docs to mlps. Our c suite doesn’t believe an ed needs nurses or techs.

???

 

[GeneralVeers]

We basically have 1:1 physician to PA coverage. It seems to work well as we work as a team. I assign them the procedures and low acuity stuff while I pick up the higher acuity things. If I'm busy they can jump in and help on a higher acuity one, and I'll pick up some Level 4 BS if they are busy. It's great to have them see dental pains and abscesses. Those things absolutely do not need a trained ED physician to see.

 

[RustedFox]

We basically have 1:1 physician to PA coverage. It seems to work well as we work as a team. I assign them the procedures and low acuity stuff while I pick up the higher acuity things. If I'm busy they can jump in and help on a higher acuity one, and I'll pick up some Level 4 BS if they are busy. It's great to have them see dental pains and abscesses. Those things absolutely do not need a trained ED physician to see.

This.

The MLP directive is going to be: see the low acuity things only, and quickly.

The old MLPs would let the 4's pile up in fast track and pick up 2's and 3's because they wanted to try to 'medicine'. Once the physicians had to empty the fast track with predictable regularity with certain MLPs, we knew that they had to go.

 

[Mr. D.O.five]

My DO school is affiliated and rotates at this site (send about 10-12 kids each year). I know their EM program is mostly DO.

My DO school is affiliated and send 10-12 kids a year to Adventhealth Orlando for 3rd/4th year. I know their EM program is mostly DOs.

There's 6 of us here right now. I believe KCU is expanding to add a total of 10-12 spots when our group talked to the clinical coordinators last Monday. Also there are only 4/18 residents that are DOs in the EM program. Other than that, EM here is a great program and I talked to the director and he doesn't mind 3rd years coming in on the weekends to the ED to get more experience in EM since we don't have a EM as a core rotation.

 

[jw3600]

This.

The MLP directive is going to be: see the low acuity things only, and quickly.

The old MLPs would let the 4's pile up in fast track and pick up 2's and 3's because they wanted to try to 'medicine'. Once the physicians had to empty the fast track with predictable regularity with certain MLPs, we knew that they had to go.

If they wanna try medicine, they can go to medical school!

 

[DocEspana]

Somehow this accidentally became a threat about DO education.

I apologize on behalf of the other osteopathic magicians.

 

[deleted941485]

Y


Yup, medical education is going the way of PA and NP school with for-profit schools lacking any educational standards are opening left and right. I did NOT see this coming, and it's bad. If we graduate low IQ people with poor training, we have nothing to offer over midlevels.

No point to pumping out ****ty MDs from a student perspective. Rampant standard free proliferation of medical schools is a detriment to the field.

 

[deleted941485]

Wow, this is a pretty nasty post but anyways...

AAMC and others will disagree with you.

New Findings Confirm Predictions on Physician Shortage

The United States will see a shortage of up to nearly 122,000 physicians by 2032 as demand for physicians continues to grow faster than supply.

www.aamc.org

America's aging population is leading to a doctor shortage crisis

As America's population ages and demand outpaces supply, a physician shortage will intensify.

www.cnbc.com

The US is on the verge of a devastating, but avoidable doctor shortage

There is a way to prevent nightmare scenarios from becoming new norms.

qz.com

They have been saying this crap for years. There could be a doctor living in every barnhouse in Idaho and they’d still be screaming shortage. Organizations like that have no incentive to ever take the opposing view.

 

[deleted941485]

I think some of us are confusing the proliferation of EM residencies with the false notion that there is no doctor shortage. If you ask your patients how long they have to wait to see any outpatient physician (no matter the specialty), you'll quickly realize that we need more physicians.

Probably not the best way to measure that. I honestly don’t care about a person who comes to the ER for their allergies and doesn’t get seen for 7 hours.