Mayo Proposal: Make Med Students Understand Costs?

Corrected 6:50 pm – the Medical Professionalism Blog belongs to the ABIM Foundation, not to the Board.

ABIM is the American Board of Internal Medicine, one of the two U.S. organizations that certifies internal medicine physicians. Their The ABIM Foundation’s Medical Professionalism blog just posted a new item, ‘Extremist Proposal Shocks the Medical Establishment. Here’s the lead: (caps & !! added)

I suspect many were shocked, even disturbed, upon reading the article, “Professionalism, the Invisible Hand, and a Necessary Reconfiguration of Medical Education” by distinguished professor of medical education at Mayo Clinic, Fred Hafferty, and his two colleagues, Drs. Brennan and Pawlina. .. the authors call for all medical students to achieve competency in THE ECONOMICS OF CARE(!!) prior to seeing their first patients.(!!)

“There will be no traditional ‘patient care’ contact until students are fully able to decode and explain the highly cryptic billing statements that encumber patients. As students enter the bio-medical side of their training, patient meetings will begin to add explanations of diagnosis and treatment options to those of cost.”…

Bonus: the article they’re talking about is open access – free to all. Makes sense, eh? If we want patients / consumers to be engaged in healing healthcare, we/they need to be involved in the discussion, no?

Another takeaway: don’t fault clinicians for being uninformed about something, if nobody ever trained them to think that way. (Do you like it if somebody criticizes you for something you were never taught?)


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6 Responses to “Mayo Proposal: Make Med Students Understand Costs?”

  1. In medical school, there is minimal training in cost-effective clinical care. Making medical economics a core module in the transition to clinical medicine is progressive and essential to change the structural issues in our health care system. If all parties (patients, providers, insurers, employers, governments, universities, etc.)have a common understanding of price, we will be able to better solve the problems of access to care, cost escalation, and rational guidelines. It starts with good education.

    Thanks for the post!

    • David graciously didn’t spotlight his enterprise, HealthScepter, which is about understanding costs, particulary having a shared view of what the costs are.

      I personally don’t know much about all the ins and outs of healthcare finance, but the more I try to find out (now that I’m mostly self-pay), the more it smells like a stinking shell game, where NOBODY can tell where the money’s going.

      I have no reason to think that’s corruption, but I have no reason to think it’s not, either. :-)

  2. Ileana Balcu says:

    I think the article is great, and the link is great, but the titles of both this and the ABIm posts should be revised. They aren’t supported by the content. No one was shocked or considered the proposal extremist as far as the article mentions.

    We will be better listened if we act in a rational way and support our claims than if we use cheap media tricks.

  3. Will says:

    I like the sentiment, but why make this a requirement BEFORE seeing patients. You can do both at the same time. Plus, no one will ever be 100% knowledgeable about anything, so it will be really hard to say when med students have “achieved” this competency.

    Is it when they can explain what a deductible is? When they can talk about Long Term Care payment from medicaid? When they understand what the “doc-fix” is and the new provisions of the ACA? When they understand the main BC-BS insurance plans? When they understand all insurance plans?

    Frankly medical students should have exposure to this, but crippling their learning because the finances of medicine are confusing in 2012 is counter productive.

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