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Commentary |

Millennial Health CareMillennial Health Care: Change You Can Believe in

Susan K. Pingleton, MD, FCCP
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From the Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS.

Correspondence to: Susan K. Pingleton, MD, FCCP, Department of Internal Medicine, University of Kansas School of Medicine, 2016 Student Center, MS 4001, 3901 Rainbow Blvd, Kansas City, KS 66160; e-mail: spinglet@kumc.edu

Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.


This article is excerpted from the 2011 American College of Chest Physicians Presidential Address presented by Susan K. Pingleton, MD, at CHEST 2011 in Honolulu, Hawaii, on October 29, 2011.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(1):22-29. doi:10.1378/chest.11-3034
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A millennium is 1,000 years. In little over a decade after the beginning of the new millennium in 2000, remarkable changes have occurred in health-care education and health-care delivery. A new millennial generation of students, trainees, junior faculty, and young practicing physicians has come of age. The numbers of women in medicine have vastly increased. Technology has impacted education with an array of educational content-delivery techniques vastly different from the usual broadcast method of teaching. New curricula have expanded to encompass teamwork with interprofessional education of the entire team. Outcomes of educational efforts now include not only knowledge transfer but also performance improvement. Delivery of health care is also dramatically different. The sentinel driver of the quality and patient safety moment, To Err Is Human, was published only 12 years ago, yet fundamental changes in expectations and measurement for health-care quality and safety have occurred to alter the health-care landscape. Financing health care has become a prime issue in the current state of the US economy. New themes in health-care delivery include teamwork and highly functioning teams to improve patient safety, the dramatic increase in palliative care and end-of-life care, and the expanded role of nursing in health-care delivery. Each issue emanating since the beginning of the millennium does not have a right vs wrong implication. This discussion is an apolitical “environmental scan” with the purpose of illuminating these dramatic changes and then outlining the implications for health-care education and health-care delivery in the coming years.

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