U-M physicians call for national curriculum in health policy at medical schools in New England Journal of Medicine article
Ann Arbor, Mich. – Changing medical student and resident education to include instruction in how health care systems function is critical, especially with the implementation of national health care reforms, University of Michigan physicians say. In an article published Feb. 24 by the New England Journal of Medicine, two U-M physicians and a U-M Medical School graduate argue for a national curriculum in health policy for medical students and residents. “Without education in health policy and the health care system, physicians are missing critical tools in their professional toolbox,” says Matthew M. Davis, M.D., M.A.P.P., associate professor at U-M in Pediatrics and Communicable Diseases, Internal Medicine and Public Policy and a co-author of the NEJM article. In previous research, Davis found that less than half of graduating medical students in the U.S. say they received adequate training in understanding health care systems and the economics of practicing medicine. “As a resident, I routinely care for patients who cannot afford their medications or don’t have access to regular medical care,” says Mitesh S. Patel, M.D., M.B.A., a 2009 U-M Medical School graduate and lead author of the article. “These issues have a major impact on the delivery and cost of health care. However, they are rarely discussed in educational lectures or during teaching rounds,” says Patel, who is currently a second year internal medicine resident at the University of Pennsylvania School of Medicine. Physicians who don’t understand the health care system or health insurance policies do a real disservice to their patients, says Monica Lypson, M.D., M.H.P.E., assistant dean of Graduate Medical Education at U-M and a co-author on the article. “The health care system is complicated, but it’s no more complicated than the other things we expect medical students and residents to learn,” Lypson says. “Regardless of partisan persuasion or political beliefs, physician trainees and medical doctors in general should have the knowledge needed to engage in meaningful discussions regarding health policy,” she adds. At U-M, the Medical School has added an elective course in health care policy, which Davis teaches. “It is enrolled to the maximum,” Davis says. “The students were hungry to learn more. We have to find the best ways to teach medical students to be the best navigators of the health care system for their patients.” In the article, authors call for a common national curriculum -- with content tailored to regional and local needs. The authors recommend early pilot projects as a precursor to a standardized national curriculum and propose a focus on four concentrations: health care systems, health care quality, value and equity, and health politics and law. The authors call for implementing the new curriculum without jeopardizing other topics. Davis says policy discussions can and should be integrated with clinical instruction and permeate the educational training. They advocate for a multidisciplinary faculty to conduct the health policy training, including experts in health economics, sociology, business, and psychology. Lypson adds that patients are demanding this kind of knowledge from their physicians. “We don’t expect them to learn to practice medicine simply by saying, ‘Go take care of patients now’,” Lypson says. “That doesn’t work for clinical knowledge, and it doesn’t work for policy knowledge, either.” About the University of Michigan Medical School: The School, which opened its doors in 1850, is consistently ranked among the top Medical Schools in the nation. Our 19 clinical and six basic science departments are committed to a single mission: To educate students, physicians and biomedical scholars and to provide a spectrum of comprehensive knowledge, research, patient care and service of the highest quality to the people of the state of Michigan and beyond.