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Study: Young Docs Stumped By Health Care System, Too

Oct 01, 2009

This story comes from our partner NPR

So you think you're having a hard time understanding how the American health care system work? Well, so does your doctor.

A study of graduating medical students finds that less than half say they have a good sense of how to navigate health care systems or the economics of practicing medicine.

The new doctors say they feel their medical schools did not prepare them to understand the mind-numbing mess of American health care. Only 40 to 50 percent of medical students, polled between 2003 and 2007, said they felt confident they were leaving medical school with appropriate training in the practice of medicine.

The problem with this, of course, is that patients expect their doctors to guide them through the health care system.

"Patients look to their doctors for this kind of guidance," says study co-author Dr. Matthew Davis, an associate professor at the University of Michigan Medical School. "If we're graduating students from our medical schools in the U.S. who have coin-flip odds of being confident of knowing the U.S. health care system, then are we really preparing them to be the best source of information for their patients?"

The study was the idea of one of Davis' students: Mitesh Patel (now Dr. Patel, working at the University of Pennsylvania). Davis says Patel knew from his own experience, and from talking to other friends in med school, that medical students often felt they weren't getting adequate instruction in how health care systems work.

So Patel and Davis looked at data from an annual survey of U.S. medical graduates conducted by the Association of American Medical Colleges. More than 58,000 young doctors were surveyed between 2003 and 2007. And it was those doctors -- more than half of them -- who reported the low confidence in their training to understand the complicated health care system.

The study authors then identified a top medical school that had a lot of classes in health systems and then found another highly regarded school with little training. Not surprisingly, students from schools with more training felt more confident that they could negotiate patients though the health care system. But even in that group, just over 60 percent said they had received adequate training in the practice of medicine.

There's some good news from the study: 80 to 90 percent of young doctors feel they've been adequately trained to diagnose your illness and make clinical decisions.

The study appears in the journal Academic Medicine.


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