History has shaped academic medical centers (AMCs) to perform 3

Question

History has shaped academic medical centers (AMCs) to perform 3 functions: patient care, research, and teaching. These 3 missions are now fraught with problems because the attempt to combine them has led to such inefficiencies as duplication of activities and personnel, inpatient procedures that could and should have been outpatient procedures, and unwieldy administrative bureaucracies.

One source of inefficiency derives from mixed lines of authority. Clinical chiefs and practitioners in AMCs are typically responsible to the hospital for practice issues but to the medical school for promotion, marketing, membership in a faculty practice plan, and educational accreditation. Community physicians with privileges at a university hospital add more complications. They have no official affiliation with the AMC’s medical school connected, but their cooperation with faculty members is essential for proper patient treatment. The fragmented accountability is heightened by the fact that 3 different groups often vie for the loyalty of physicians who receive research. The medical school may wish to capitalize on the research for its educational value to students; the hospital may desire the state-of-the-art treatment methods resulting from the research; and the grant administrators may focus on the researchers’ humanitarian motives. Communication among these groups is rarely coordinated, and the physicians may serve whichever group promises the best perks and ignore the rest—which inevitably strains relationships.

Another source of inefficiency is the fact that physicians have obligations to many different groups: patients, students, faculty members, referring physicians, third-party payers, and staff members, all of whom have varied expectations. Satisfying the interests of one group may alienate others. Patient care provides a common example. For the benefit of medical students, physicians may order too many tests, prolong patient visits, or encourage experimental studies of a patient. If AMC faculty physicians were more aware of how much treatments of specific illnesses cost, and of how other institutions treat patient conditions, they would be better practitioners, and the educational and clinical care missions of AMCs would both be better served.

A bias toward specialization adds yet more inefficiency. AMCs are viewed as institutions serving the gravest cases in need of the most advanced treatments. The high number of specialty residents and the presence of burn units, blood banks, and transplant centers validate this belief. Also present at AMCs, though less conspicuous, are facilities for ordinary primary care patients. In fact, many patients choose to visit an AMC for primary care because they realize that any necessary follow—up can occur almost instantaneously. While AMCs have emphasized cutting-edge specialty medicine, their more routine medical services need development and enhancement.

A final contribution to inefficiency is organizational complacency. Until recently, most academic medical centers drew the public merely by existing. The rising presence, however, of tertiary hospitals with patient care as their only goal has immersed AMCs in a very competitive market. It is only in the past several years that AMCs have started to recognize and develop strategies to address competition.    1 
 1. The author's attitude toward the inefficiencies at academic medical centers is one of

A. reluctant acquiescence
B. strident opposition
C. agonized indecision
D. reasoned criticism
E. enthusiastic support

2 
 2. The author of the passage would most likely agree with which of the following statements about primary care at AMCs?

A. AMCs would make more money if they focused mainly on primary care.
B. Burn and transplant patients need specialty care more than primary care.
C. AMCs offer the best primary care for most patients.
D. AMCs have not tried hard enough to publicize their primary care services.
E. lnefficiencies at AMCs would be reduced if better primary care were offered.

3 
 3. The author’s primary purpose in this passage is to

A. discuss the rise and fall of academic medical centers
B. explain that multiple lines of authority in a medical center create inefficiencies
C. delineate conflicts occurring in academic medical facilities
D. examine the differences between academic and other health care entities
E. warn that mixed accountabilities result in treatment errors

4 
 4. The author implies which of the following about faculty physicians at AMCS?

A. Most of them lack goodlbusiness sense.
B. They put patients’ physical health above their hospitals’ monetary concerns.
C. They sometimes focus on education at the expense of patient care.
D. They lack official affiliation with the medical schools connected to AMCS.
E. They choose AMCS because follow—up care can be given very quickly.

5 
 5. Which of the following would the author probably consider a good strategy for academic medical centers dealing with competition from tertiary hospitals?

A. recruiting physicians away from tertiary centers
B. increasing the focus on patient care
C. sending patients to tertiary facilities
D. eliminating specialty care
E. reducing dependence on grant money

SSandy066 · Answer

1. The author's attitude toward the inefficiencies at academic medical centers is one of

A. reluctant acquiescence
B. strident opposition
C. agonized indecision
D. reasoned criticism  -> Correct  
  Explanation: 
Par1 author describe the 3 motives of AMC and problem associated to aligned 3 motives.
Para-2: reason 1 for inefficiency “Practicing medical profession along with promoting , marketing etc for medical school. Also maintain relationship Community of physicians. The fragmented Accountability for 3 different groups often vie for the loyalty of physicians who receive research. The medical school: capitalize on the research for its educational value to students;
The hospital: desire the state-of-the-art treatment methods resulting from the research
 The grant administrators: focus on the researchers’ humanitarian motives.
Para3: Reason 2 for inefficiency “ Physician responsible for various group, and satisfying all group at a time is difficult. And solution about how Physician can be better served.
Para 4: reason 4 for inefficiency “ Biased toward specialized in treatment”
Para 5: reason 5 for inefficiency “recognize and develop strategies to address competition”
  
E. enthusiastic support

2. The author of the passage would most likely agree with which of the following statements about primary care at AMCs?

A. AMCs would make more money if they focused mainly on primary care.
B. Burn and transplant patients need specialty care more than primary care.
C. AMCs offer the best primary care for most patients.
D. AMCs have not tried hard enough to publicize their primary care services.
E. lnefficiencies at AMCs would be reduced if better primary care were offered.  ->Correct  
  Explanation:
Para 4: reason 4 for inefficiency “ Biased toward specialized in treatment….. many patients choose to visit an AMC for primary care because they realize that any necessary follow—up can occur almost instantaneously. While AMCs have emphasized cutting-edge specialty medicine, their more routine medical services need development and enhancement.”

3. The author’s primary purpose in this passage is to

A. discuss the rise and fall of academic medical centers  -> out of scope  
B. explain that multiple lines of authority in a medical center create inefficiencies -> only para2. Wrong answer. 
C. delineate conflicts occurring in academic medical facilities.  -> only para3. Wrong answer. 
D. examine the differences between academic and other health care entities. -> out of scope 
E. warn that mixed accountabilities result in treatment errors  -> correct

4. The author implies which of the following about faculty physicians at AMCS?

A. Most of them lack goodbusiness sense.
B. They put patients’ physical health above their hospitals’ monetary concerns:
C. They sometimes focus on education at the expense of patient care  .-> Correct  
  Explanation
Para 3: “… Satisfying the interests of one group may alienate others. Patient care provides a common example. For the benefit of medical students, physicians may order too many tests, prolong patient visits, or encourage experimental studies of a patient….”  
D. They lack official affiliation with the medical schools connected to AMCS.
E. They choose AMCS because follow—up care can be given very quickly.

5. Which of the following would the author probably consider a good strategy for academic medical centers dealing with competition from tertiary hospitals?
A. recruiting physicians away from tertiary centers
B. increasing the focus on patient care.  -> Correct  
  Explanation
Para 5: “…The rising presence, however, of tertiary hospitals with patient care as their only goal…”  
C. sending patients to tertiary facilities
D. eliminating specialty care
E. reducing dependence on grant money

SiffyB · Answer

1. The author's attitude toward the inefficiencies at academic medical centers is one of

A. reluctant acquiescence
B. strident opposition
C. agonized indecision
D. reasoned criticism
E. enthusiastic support

2. The author of the passage would most likely agree with which of the following statements about primary care at AMCs?

A. AMCs would make more money if they focused mainly on primary care.
B. Burn and transplant patients need specialty care more than primary care.
C. AMCs offer the best primary care for most patients.
D. AMCs have not tried hard enough to publicize their primary care services.
E. lnefficiencies at AMCs would be reduced if better primary care were offered.

3. The author’s primary purpose in this passage is to

A. discuss the rise and fall of academic medical centers
B. explain that multiple lines of authority in a medical center create inefficiencies
C. delineate conflicts occurring in academic medical facilities
D. examine the differences between academic and other health care entities
E. warn that mixed accountabilities result in treatment errors

4. The author implies which of the following about faculty physicians at AMCS?

A. Most of them lack goodlbusiness sense.
B. They put patients’ physical health above their hospitals’ monetary concerns.
C. They sometimes focus on education at the expense of patient care.
D. They lack official affiliation with the medical schools connected to AMCS.
E. They choose AMCS because follow—up care can be given very quickly.

5. Which of the following would the author probably consider a good strategy for academic medical centers dealing with competition from tertiary hospitals?

A. recruiting physicians away from tertiary centers
B. increasing the focus on patient care
C. sending patients to tertiary facilities
D. eliminating specialty care
E. reducing dependence on grant money

3. The author’s primary purpose in this passage is to A. discuss the rise and fall of academic medical centers - passage does not discuss the "rise" or the "fall" of AMcs. B. explain that multiple lines of authority in a medical center create inefficiencies - Scope limited to paragraph 2. C. delineate conflicts occurring i.n academic medical facilities D. examine the differences between academic and other health care entities - While such a comparison has been made, it is not prevalant throughout the passage. Thus, the purpose of the passage wasn't to examine differences between the two entities. E. warn that mixed accountabilities result in treatment errors - Very limited scope. 4. The author implies which of the following about faculty physicians at AMCS? A. Most of them lack goodlbusiness sense. - Not having correct information about cost of treatment does not amount to lacking good business sense. B. They put patients’ physical health above their hospitals’ monetary concerns: - Not stated in the passage. C. They sometimes focus on education at the expense of patient care. - "For the benefit of medical students, physicians may order too many tests, prolong patient visits, or encourage experimental studies of a patient". This sentence strengthens out belief that they sometimes give more weightage to education than patient care. D. They lack official affiliation with the medical schools connected to AMCS. - Not stated in the passage. E. They choose AMCS because follow—up care can be given very quickly. - Patients tend to choose AMCs because of this reason, not the faculty physicians. 5. Which of the following would the author probably consider a good strategy for academic medical centers dealing with competition from tertiary hospitals? A. recruiting physicians away from tertiary centers B. increasing the focus on patient care C. sending patients to tertiary facilities D. eliminating specialty care E. reducing dependence on grant money The last few sentences of the final paragraph states that tertiary hospitals are a big competition to the AMCs because their sole goal is patient care. Thus, if the AMCs were to deal with this competition, they must also increase their focus on patient care. Option (B) is most approporiate here.

AnirudhaS · Answer

Answers are in  bold .

1. The author's attitude toward the inefficiencies at academic medical centers is one of
A. reluctant acquiescence
B. strident opposition
C. agonized indecision
 D. reasoned criticism 
E. enthusiastic support

Explanation of question 1: 
The author criticizes the AMCs, and states four inefficiencies - 1. mixed lines of authority, 2. too many obligations, 3. bias towards specialisation, 4. organisational complacency. Each inefficiency is described in a separate paragraph. Hence the answer is reasoned criticism.
A - The question has tough vocabulary usage for example, acquiescence. Now I am not sure what this means, but I am pretty sure that my answer is D. Anyways I will try to use the preceding word reluctant to understand the tone of the question setter. Is the author reluctant? No. Surely not the answer then. See what I did there? I have no clue what that word means but I have successfully determined this is NOT my answer.
B - strident. I dont know what this means, but the author is definitely not opposing. Out.
C - indecision? No author is pretty sure what he is talking about.
E - support? Nope.
_______________________________________________________________________________________________________________________

2. The author of the passage would most likely agree with which of the following statements about primary care at AMCs?
A. AMCs would make more money if they focused mainly on primary care.
B. Burn and transplant patients need specialty care more than primary care.
C. AMCs offer the best primary care for most patients.
D. AMCs have not tried hard enough to publicize their primary care services.
 E. lnefficiencies at AMCs would be reduced if better primary care were offered.

Explanation of question 2: 
Has to be POE, lets go then.
A - No mention of making more money. The author just says that primary care needs DEVELOPMENT & ENHANCEMENT.
B - Yes this might be true, it is not a statement about primary care. Clever idea gmat test maker, but Out Out.
C - Nope. Also best is a strong word. How can it be best when the author is suggesting it needs improvenement?
D - Marketting has not been talked about at all.
E - Of course, even the author specifies this as one of the inefficiency. This is our answer.
_______________________________________________________________________________________________________________________

3. The author’s primary purpose in this passage is to
A. discuss the rise and fall of academic medical centers
B. explain that multiple lines of authority in a medical center create inefficiencies
C. delineate conflicts occurring i.n academic medical facilities
 D. examine the differences between academic and other health care entities 
E. warn that mixed accountabilities result in treatment errors

Explanation of question 3: 
A - rise and fall? You are joking. Rise and fall. haha I cannot believe this is an option.
B - Too specific.
C - this is a tempting choice, however I do not think the word - conflicts is correct. That is the only reason why I am not going to choose this one.
D - Yes much better. here the author, by talking about the inefficiencies of AMCs also compares it with other health care entities. Our answer!
E - Again too narrow.
_______________________________________________________________________________________________________________________

4. The author implies which of the following about faculty physicians at AMCS?
A. Most of them lack goodlbusiness sense.
B. They put patients’ physical health above their hospitals’ monetary concerns:
 C. They sometimes focus on education at the expense of patient care. 
D. They lack official affiliation with the medical schools connected to AMCS.
E. They choose AMCS because follow—up care can be given very quickly.

Explanation of question 4: 
A - Not implied.
B - Although this might be true, there is actually no MONETARY concern specified in the passage. Trust me I read it again!
C - In fact this is also stated in the passage. the author therefore MUST agree!
D - Nope.
E - Faculty physicians do not choose AMC because care can ne given quickly. It is the patients who choose.
_______________________________________________________________________________________________________________________

5. Which of the following would the author probably consider a good strategy for academic medical centers dealing with competition from tertiary hospitals?
A. recruiting physicians away from tertiary centers
 B. increasing the focus on patient care 
C. sending patients to tertiary facilities
D. eliminating specialty care
E. reducing dependence on grant money

Explanation of question 5: 
Here there is only one strong answer choice - increasing the focus on primary care. The author does point out that this is out - recall in the first question we listed all the inefficiencies. This is the 3rd inefficiency "Bias towards specialisation". Therefore to increase the focus on primary care would be what the author would consider as a good strategy in dealing with competition.

BlueBook · Answer

1)   The author's attitude toward the inefficiencies at academic medical centers is one of 
The author has clearly laid out all the inefficiencies at AMCs in a clear and reasonable without showing any bias or strong emotion towards one side or the other throughout the passage. Therefore, D) is the answer.

2)  The author of the passage would most likely agree with which of the following statements about primary care at AMCs? 
The answer of this question stems from the 4th paragraph.
A.  AMCs would make more money if they focused mainly on primary care.  The amount of money that could be made is not the focus of the discussion around primary care.
B.  Burn and transplant patients need specialty care more than primary care.  This answer can seem attractive but it’s simply a restatement of what’s in the paragraph. It’s a general fact that burn and transplant patients do need special attention.
C.  AMCs offer the best primary care for most patients.  This is not something that the author believes but the general public does believe this hence their bias towards AMCs for primary care.
D.  AMCs have not tried hard enough to publicize their primary care service.  Advertising of primary care is not up for discussion in the passage.
E.  lnefficiencies at AMCs would be reduced if better primary care were offered.  This is supported through the last line of the 4th paragraph in the passage:  ‘While AMCs have emphasized cutting-edge specialty medicine, their more routine medical services need development and enhancement.’  In addition, the first line of the 4th paragraph states:  ‘A bias toward specialization adds yet more inefficiency.’  This bias has been created by the perception of the general public that AMCs can offer instant follow up if needed. Therefore, if better primary care were offered, it would reduce the inefficiencies that arise from specialization due to general public perception.

3)  The author’s primary purpose in this passage is to 
A.  discuss the rise and fall of academic medical centers.  The ‘rise’ of AMCs has not been discussed in this passage.
B.  explain that multiple lines of authority in a medical center create inefficiencies.  Partial scope. This has only been discussed in the 2nd paragraph.
C.  delineate conflicts occurring in academic medical facilities.  The passage is about AMCs and the conflicts they face.  The first conflict is from mixed lines of authority.  (2nd paragraph).
The second conflict is the fact that  physicians have obligations to many different groups.  (3rd paragraph). The 3rd conflict arises from the bias toward specialization due to general perception which adds more inefficiencies. The last conflict according to the passage is due to  organizational complacency  and the increased competition AMCs from tertiary hospitals face due to this. 
D.  examine the differences between academic and other health care entities.  This has only been discussed in the last paragraph.
E.  warn that mixed accountabilities result in treatment errors.  Partial scope. This has only been covered in the 2nd paragraph.

4)  The author implies which of the following about faculty physicians at AMCS? 
The answer comes from the 3rd paragraph. This paragraph is mainly about how inefficiencies are caused at AMCs due to the obligations that physicians have to different groups. The author then goes on to give an example of the obligation that physicians have to students and how this causes ill care of patients. ‘ For the benefit of medical students, physicians may order too many tests, prolong patient visits, or encourage experimental studies of a patient.’  Therefore, faculty physicians place education ahead of patient care. C) is the answer.

5.  Which of the following would the author probably consider a good strategy for academic medical centers dealing with competition from tertiary hospitals?

From the last paragraph, the passage mentions that:  ‘The rising presence, however, of tertiary hospitals with patient care as their only goal has immersed AMCs in a very competitive market.’  Thus increasing the focus on patient care, especially primary care would be a good strategy. B) is the answer.

Sajjad1994 · Answer

Official Explanation

3. The author’s primary purpose in this passage is to

Explanation

Paragraph 1  tells us that the text will discuss the inefficiencies that have resulted from the combined presence of 3 missions in academic medical centers. This is supported by the remaining paragraphs, where 4 sources of inefficiency are explored.

(A)  is way too broad.  (B)  focuses on one source of inefficiency, discussed in  Paragraph 2 , but doesn't encompass the larger scope of the passage.

And while  (D)  is mentioned briefly in the passage, it is not the main point  (E)  is out of scope.

(C)  correctly captures the author's intention of explaining challenges faced by AMCs tasked with multiple missions.

Answer: C

Sajjad1994 · Answer

Official Explanation

4. The author implies which of the following about faculty physicians at AMCS?

Explanation

The answer here must be clearly supported by evidence from the text.  (A) and (B)  are extreme and go beyond anything in the passage.  (D)  is a distortion of a detail in  Paragraph 2 , which describes only community physicians with privileges at an academic hospital, not faculty physicians at AMCs.

(E)  is another distortion, this time of a point in  Paragraph 4 , which discusses why some patients choose AMCs for primary care.  (C) , on the other hand., is supported in  Paragraph 3 ; we're told that physicians may  "order too many tests, prolong a visit, or encourage experimental studies of a patient"  for educational purposes.

Answer: C

History has shaped academic medical centers (AMCs) to perform 3

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History has shaped academic medical centers (AMCs) to perform 3

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