med students lack health care system knowledge, calmer days, unearned wealth

Less than half of medical students understand health care system

Less than half of graduating medical students in the U.S. say they received adequate training in understanding health care systems and the economics of practicing medicine, according to a study conducted by the University of Michigan Medical School.
The national survey of more than 58,000 medical students from 2003-2007 showed an overwhelming majority were confident about their clinical training. But when it came to understanding health economics, the health care system, managed care, managing a practice or medical record-keeping, 40 percent to 50 percent of students reported feeling inadequately prepared.

The findings were published this month in Academic Medicine.

“Our patients expect us to understand the system,” says Matthew M. Davis, M.D., associate professor of pediatrics and internal medicine in the Child Health Evaluation and Research (CHEAR) Unit at the University of Michigan Medical School. “If we don’t, that can result in poor patient care.

“And if we don’t expect doctors to understand the health care system, who is going to?” asks Davis, who co-authored the research with Monica L. Lypson, M.D., assistant dean of graduate medical education at the U-M Medical School and Mitesh S. Patel, M.D., M.B.A., a U-M medical school graduate now at the University of Pennsylvania

We do have some of the world’s best trained doctors. That clinical training has a publicly subsidized element to it in the form of guaranteed loans and grants to the students. In addition to those direct subsidies – there are multiple layers of subsidies in the form of grants to the medical schools and grants for basic research incorporated into the training of new doctors. Davis says that a course in medical economics seems to help doctors guide their patients. How about a course for the sign waving hot heads that do not seem to have a clue how our health system works. One can be a patriot without understanding every Supreme Court Decision or every arcane aspect of our economy, but that ignorance should warrant a little humility rather then self righteous bleeping and accusations about health care reform being the same as the rise of Stalinism.

calmer days

The Forbes 400 Shows Why Our Nation Is Falling Apart

It’s great to know that during the worst economic crisis since the Great Depression, the wealth of the 400 richest Americans, according to Forbes, actually increased by $30 billion. Well golly, that’s only a 2 percent increase, much less than the double digit returns the wealthy had grown accustomed to. But a 2 percent increase is a whole lot more than losing 40 percent of your 401k. And $30 billion is enough to provide 500,000 school teacher jobs at $60k per year.

Collectively, those 400 have $1.57 trillion in wealth. It’s hard to get your mind around a number like that.

It defies logic to think those 400 have done $1.57 trillion worth of labor. Some financial experts – and I use that term with a lot of irony – I’ve seen multiple times on various Sunday morning news show provide that yea OK they do not do actual work, they’re providing either ideas or unique leadership worth trillions. There is not one person on the list that can honestly make the claim that they have contributed some ground breaking, utterly new ideas or has irreplaceable leadership skills. Everyone one of them has and still does enjoy a ride on the shoulders of people that are smarter and have worked harder. The late and brilliant paleontologist Stephen Jay Gould acknowledged that like generations of scientists, his work rested on the shoulders of giants. Maybe at the root of our economic problems is the lack of Gould’s humility.

seeing double