HARRISBURG, Pa. — The doctors-in-training removed their shoes and padded into Glorian Watson's tidy first-floor apartment in socks and bare feet. They pulled up chairs at her dining room table, plopped down on her love seat and caught up with the cheerful 52-year-old whose body often rebels against her, with digestive issues so severe that she can find herself hospitalized for days or weeks.
These doctors-to-be don't know much about her illness, Crohn's disease. They can't prescribe her medications, order lab tests or admit her to a hospital. Instead, they're here to learn something that most medical schools never teach but that matters as much: What's in her fridge? Does she have a ride to an upcoming appointment? Can she afford her drugs and gluten-free diet?
"We learn a lot about barriers to health care that physicians don't normally think about," said Christopher Davis, a second-year medical student at Penn State College of Medicine.
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. Doctors trained in the science of medicine, the diagnosis and treatment of the sick person in front of them, are increasingly responsible for helping to keep their patients out of the hospital.