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Medical Students Should Learn Business of Health Care

November 14, 2013

Teaching medical students the business of health care

Medical students do not understand the business of health care, but changing that may be as easy as attending an eight-hour lecture. That's according to a study from Drexel University College of Medicine that was recently published in the Journal of the International Association of Medical Science Educators.

"The implementation of recent health care reforms and the national debate associated with them have made it clear to medical school educators that students need to have a basic understanding of the business of health care," said Michael S. Weingarten, MD, MBA, professor in the Department of Surgery, chief of the Division of Vascular Surgery, and a co-investigator of the study.

The researchers gave tests to four consecutive classes of second year medical students to assess their knowledge of health care economics. Simply put, these students did not understand the United States health care system.

"Although the students came from diverse educational backgrounds and had many different life experiences before entering medical school, few students in any of the consecutive classes could pass a basic examination of health care business principles," said Barbara Schindler, MD, professor in the Departments of Psychiatry and Pediatrics, vice dean for educational and academic affairs, the William Maul Measey Chair in Medical Education, and a study co-investigator.

These medical students were then required to participate in a module that consisted of a series of two hour lectures that were spread out over a two week period. At the completion of the two-week module, another test was given to assess the students' understanding of the basic principles of health care economics. This time nearly all of the students passed this test, suggesting that the concentrated lecture format can be effective in teaching the basics of health care business to medical students.

The data for this study was collected from 2008 to 2011 and the size of each of the classes taking the course varied from 193 to 207 students. Grades on the pre-assessment exam ranged from an average of 47 to 54 out of a possible 100. The post-course assessment was given one week after the completion of the lecture series and consisted of 50 multiple choice questions. Grades on the post-test increased dramatically with the average scores ranging from 84 to 90 out of a possible 100.

While only Drexel University College of Medicine students participated in this study, the fundamental lack of health care business knowledge is a national concern. Although the Liaison Committee on Medical Education guidelines mandate that medical schools teach aspects of health care financing, health care systems and the socioeconomic impact that medicine has on a society, less than 70 percent of all allopathic schools do so, based on a national survey. Only 40 percent of schools surveyed offered courses in subjects such as health care systems, health services financing, health care work force and the health policy process. Please note that Dr. Weingarten has integrated the teaching of a course on the Business of Health Care into the curriculum for third- and fourth-year medical students at Drexel, which is unique among medical schools in the United States.

In addition to Drs. Weingarten and Schindler, co-investigators of this study included Burton J. Landau, PhD, emeritus professor in the Department of Microbiology and Immunology and former associate dean for medical education (retired) and Edward Siegel, MD, a former medical student at Drexel who is now a resident in emergency medicine.

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