Medical Student "Education"
No question that our students are well trained in the science of medicine. Unfortunately, very few students prove to be well trained in the business of medicine. Many students are even embarrassed to ask questions pertaining to the business of medicine because they are afraid they will betray their idealistic or altruistic beliefs that made them commit to a career in medicine in the first place. What do I mean? A student who recently rotated with me felt she could not discuss the business aspects of a career in medicine with her professors or colleagues in fear that she will appear to be cold or unfeeling. I had a student rotating on my service recently who wanted to go into Cardiothoracic surgery because it was "really cool." He had no idea how much their reimbursement has been cut. He had no idea that their case load has diminished dramatically over the years and he had no idea that true cardiac centers were performing some "pretty cool" new cardiac procedures. Some women are afraid of a career in ortho because they are petite. Some think that a pediatrician makes 300-400k per year.
I must say that I feel we owe the students much more than a book based education about the science of medicine. They need to know about what a career in medicine entails. They need to know about some of the hardships we are experiencing now and some that we are afraid may materialize. They need to know about EMRs, P4P, reimbursement changes, and the people/organizations behind the push to change the way that medicine will be practiced in the near future. LEAPFROG, PROMETHEUS, CMS, Payors, PBMs, EMRs, PHRs etc should be terms the students should be comfortable with. Otherwise they will plod through their residency, learn little more about the biz of medicine than they already do and then they will be thrust into a practice environment they have no idea how to navigate through.
What are your thoughts?
Howard J Luks, MD
6 Comments
5 References
References (5)
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Response: The business of medicineLongtime readers of this blog know that business and medicine go hand in hand. Howard Luks agrees, and says that medical schools do a disservice when business isn't emphasized: -
Response: The MD & MoneyAn AMA-affilated staffer (former WWII combat medic) described MDs and money to me once: 1/3 of MDs go into medicine to do good, 1/3 for the science, and 1/3 for the money and security.
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If I did one thing -- it would be to make sure there is a good, well-funded working capital (WC) account. That is: there is such a time-lag in treatment to billing to payment, WC is very important.
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Response: medicinemedicine
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Response: googlegoogle
Reader Comments (6)
You raise an important issue. (One might wonder that the earlier in the process they learn all that, the more likelier they'd bail out and find a better job!) Lately I've been thinking that as residency training is impacted by shorter hours, leading to people coming out with less experience, there will be a need for -- and the ACS ought to be addressing it now -- a formal mentoring program, for as long as a year or two after training. Such a thing would necessarily include the issues you raise as well. Given the time constraints now, it's hard to see where the time will be found within a residency to spend on such learning, even though it ought to be.
Sid... you are absolutely correct. I spend a lot of time with our residents to teach them the basics of utilziing evidence based medical guidlines, risk sharing, coding, etc. I do not have control over the education the students receive. Usually after they spend a day with me in the office they either think I'm off the wall or they run home and check out some of the blogs I have mentioned. I have never had a student run to the dean's office to drop out. They want to be docs and are proud of their choice. They simply want to be...and need to be informed.
Help share the word.
thanks
Howard
I am definitely puzzled by most of the terms in your second paragraph. I'm not sure about how much interest there would be among 4th years for structured sessions on the business of medicine - I think most of us are still in some level of denial about our debt burden. But would you consider putting together an online informational series for students?
As a senior in college applying to medical school, I feel this is very important information for students to know. I don't know what students in my age group could do from our end, however. The Bureau of Labor Statistics can provide some insight, but we're otherwise very uninformed (I know pediatricians don't make that much, but you're correct in that many of peers think they make bank).
Rabia... I am already working on it :-) Send me your email and I'll keep you informed.
http://www.howardluksmd.com/