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Posted on Wed, Sep 30, 2009 : 11:07 a.m.

University of Michigan survey finds majority of U.S. medical school graduates think they lack understanding of health care system

By Tina Reed

A University of Michigan survey found fewer than half of graduating medical students believe they have an adequate understanding of health care systems. 

The future doctors overwhelmingly reported feeling clinically prepared as they left medical school. But they said they lacked confidence in understanding the economics of the health care system, managing a medical practice or even medical record-keeping, the study found.

Students in programs with a higher intensity curriculum were three times more likely to feel they’d received appropriate training in health care systems, the survey of more than 58,000 medical students across the country between 2003 and 2007 found. 

The findings could have broader implications for the national health care reform debate and the role medical schools have in educating their students, researchers say. 

"If we don't expect doctors to understand the health care system, 
who is going to?" Matthew Davis, an associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research unit at U-M’s medical school, said in a release. 

Davis is a co-author of the report, which was was published this month in the journal of Academic Medicine. 

Tina Reed covers health and the environment for She can be reached at, at 734-623-2535 or find her on Twitter @TreedinAA.



Wed, Sep 30, 2009 : 9:44 p.m.

aareader: I would not put my faith in a single-payor system run by the government. Medicare already undervalues physician services. Medicaid is a worse joke - it already pays next to nothing and just today the Michigan State Legislature voted to cut it by up to 8%. Oh but don't worry, the Legislature says it will fix the cut. How? Well, they are voting on a special "fee" (yes, a tax) on physicians only (up to 4% on gross receipts). Doesn't sound fair, right? Must be the evil Republicans, right? Well, A2's own Liz Brater thinks that taxing doctors is a great idea to plug the state's budget shortfalls. So, back to the article above. Why should medical students be expected to understand this stuff? They are going there to learn to be doctors not politicians. And if you told them that they are going through all this education, sleepless nights, to end up a couple hundred thousand dollars in debt, so that some know-nothing politician can determine how they should practice medicine and how much they "deserve" to be reimbursed - how many do you think would actually bother to finish med school?

Matt Van Auker

Wed, Sep 30, 2009 : 3:51 p.m.

AWESOME. Yeah, Tina, I've also often felt so myself. It simply amazes me, people don't care either about their education, or their health. Wow.


Wed, Sep 30, 2009 : 1:06 p.m.

This is a good example of why we need a simple single payer system that covers everyone. Costs could be managed on a non-profit basis like medicare where the overhead is around 3% not 30+% for profit based systems. Doctors could deliver great care without being lobbied by groups to provide extras etc. Doctors could prescribe based on diagnosis and they would be in charge of what a patient needs... not a for profit insurance company. And if for some reason there is a dispute in what might be covered I would rather have a government system where there is a real appeal process. Not an appeal process based in an insurance companies profit motive. Doctors under this system would be paid well for their expert services and they would not need to keep track of a maze of individual insurance services. They could concentrate on what hey do best. Providing great service.

David Bardallis

Wed, Sep 30, 2009 : 12:31 p.m.

Yeah, hey, here's a great idea: Let's add even more bureaucratic red tape and byzantine controls for nobody to be able to understand, further mucking up the doctor-patient relationship and severing the economic consumer-provider links that ensure supply meets demand at a reasonable cost. We will call this brilliance "public option" and use "the uninsured" as our boogeyman/mascot to prove how compassionate we are. Then, if anyone objects, use a strawman about how they are defending the awful results of the existing bureaucratic red tape and byzantine controls, only call it "the free market." Have I got it about right?


Wed, Sep 30, 2009 : 11:42 a.m.

Too bad they did not ask them if they knew how many people are uninsured and what role doctors have in caring for uninsured people.