title: Why is academic medicine run by former C-students?
abstract: The present paper hypothesizes that the top positions in academic medicine are generally occupied by less talented and skilled physicians who find more time to spare for administrative activities as compared to physicians who are successful in their research projects or enjoy their skills as practicing clinicians. A physician's utility in advancing a medical career can be modeled as the product of two preferences, administration and biomedical work, weighted by time and talent, respectively. It corresponds with a characteristic Cobb-Douglass utility function of economics, which physicians will try to maximize in pursuing their preferences. The utility function becomes maximized if the split between administration and research mirrors the split between free time and talent, respectively. Physicians with few talents and lots of time to spare will accumulate in administration and politics, whereas those with talents and little time will remain committed to biomedical research or clinical practice.
authors.affiliation: Portland VA Medical Center P3-GI, Oregon Health and Science University, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239, USA. sonnenbe@ohsu.edu
authors.forename: Amnon
authors.initials: A
authors.lastname: Sonnenberg
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D002321:Career Choice; D006739:Hospital Administration / Q000706:statistics & numerical data; D010820:Physicians / Q000706:statistics & numerical data*; D011361:Professional Competence; D013337:Students, Medical / Q000706:statistics & numerical data*; D014481:United States; D000078329:Workforce