Â鶹ŮÓÅ

U.S. health care is in a revolution that is starting to shake up one of the most conservative parts of medicine: its antiquated model for training doctors. Once paid a la carte for the procedures and services they perform, physicians are beginning to be reimbursed for keeping their patients healthy. ... The AMA is worried enough about the problem that it has been giving out millions of dollars to prod new kinds of teaching, in the hope that doctors’ training can adapt as quickly as the system they will soon join. (Johnson, 10/8)

The well-being of some 700 patients in state psychiatric hospitals is in the hands of nurses who say they're overworked, overtired and overstressed because of excessively mandated double shifts. Sometimes several days a week, nurses in Michigan's five state-run hospitals end their regular eight-hour shifts only to be ordered to cover staffing shortages by working another eight hours. Against the recommendations of nursing groups and one of the state's own task forces, several current and former nurses at the Michigan Department of Health & Human Services told the State Journal they're worked to the point of exhaustion and ragged nerves, more prone to errors or poor judgment as they deal with unpredictable, sometimes violent patients. (Hinkley, 10/8)

In a small study of hospitilized patients, those who felt ready to go home when they were discharged were more satisfied with the hospital and their caregivers than those who didn’t feel ready to go. It may be useful to use patient readiness for discharge as one measure of quality of care, the authors write in the Journal of the American College of Surgeons. (Doyle, 10/8)