As a fourth year University of Michigan medical student, Milad Sharifpour said he felt comfortable when it came to knowing how to properly treat a patient.

But when it comes to the business of health care … well, he’s not quite so confident.

“I'm not sure I could give a five minute lecture on how the health care system works,” Sharifpour said. 

As a medical student who’s taken a year off to get his master’s degree, he said, the business side of things just doesn’t take precedence. 

“In medical school, so much of the emphasis is on directly caring for the patient," he said. "The financial aspect of health care is kind of on the backburner.”

A recent U-M study found at least half of medical school students didn’t feel confident in their understanding of the U.S. health care system by the time they graduated.

That’s a problem because the future doctors are the ones who will have some control over future medical spending and will play a vital role in the ongoing health care reform debate, said Matthew Davis, an associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research unit at U-M’s medical school.

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

“As a primary care doctor myself, patients routinely ask me why the health care system works in one way or the other because they’ve had a confusing experience themselves,” Davis said.

For instance, when a patient who’s been taking a blood pressure medication that costs $10 a month for years suddenly sees that prescription cost jump to $25 a month, they look to their doctor to explain why and help find a cheaper alternative.

It’s upon individual physicians to know what the latest costs and alternatives are.

“As an educator at the medical school, I think medical schools should be graduating students with a great confidence in the health care system and not a great deal of confusion about why the health care system works the way it does,” Davis said. “Beyond 2009, the country is going to continue to evaluate whether it needs health care reform; the public is looking to physicians to inform that debate and lead that dialogue.”

In the survey of more than 58,000 medical students between 2003 and 2007, graduates 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.

In a separate look at individual medical school programs, the study found students enrolled in a program that put special emphasis on studying health care economics were three times more likely to feel they had a better understanding of the health care system, while still reporting confidence in their clinical skills.

That shows that a shift in priorities at medical schools likely wouldn’t harm clinical training, but would enhance future physicians ability to help their patients navigate health care, Davis said.

Tina Reed covers health and the environment for AnnArbor.com. Reach her at tinareed@annarbor.com, call her at 734-623-2535 or find her on Twitter @TreedinAA.