According to a study conducted by the University of Michigan Medical School, fewer than half of graduating medical students in the U.S. say they have received adequate training in the economics of how to practice medicine.¹ Of course, the good news is that over 90 percent of graduating students say they are confident with their training in clinical decision making, which is certainly the foremost concern for any new physician. But only about 40 to 50 percent of students feel prepared to guide their patients through the increasingly complex healthcare system.

Should that be higher? Perhaps.

Historically, the teaching of business and economics has not been a particularly high priority for medical schools. Often they have been strewn together with other topics such as the social and historical backgrounds of medicine, or relegated to informal workshops offered outside of class. One study from over 70 years ago showed that at the time, less than 20 percent of medical schools offered systematic courses on the subject.² Things have improved little over the years.

In fact, in terms of the sheer views and opinions that abound on campuses, medical students are probably worse off now than they were in 1938. Back then, economics was simply neglected. Today, the subject is not just neglected, but actively undermined by the left-leaning social commentary that is injected into courses on public health, medical ethics, and new concentrations like "health disparities" and "urban medicine."³

Many educators today view economics not as a subject that could potentially help prepare young doctors to set up successful practices, but rather as a matter of "maximizing the benefit society as a whole receives from the limited productive capability at hand." ⁴ If you wonder whether the propaganda is taking hold, just search for public policy pieces written by med students, or read just about anything published by the American Medical Student Association (AMSA). Self-sacrificial service for the greater good is the dominant ethical message of the day.

Economics is the study of the production of goods and services under a market-based, division-of-labor system. There is no economics under single payer—there is only central planning, global budgets, and empty promises. Perhaps this is why educators see little need to teach the subject. In any case, while greater attention to medical economics in the medical curriculum would be welcomed, it will not accomplish much good unless accompanied or preceded by a shift towards a more rational view of ethics.

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¹ Patel, et al. "Medical Student Perceptions of Education in Health Care Systems" Academic Medicine September 2009, 84:9, pp 1301-1306

² Roberts and Davis. "Teaching of Medical Economics to Undergraduate Medical Students" Academic Medicine November 1938, 13:6, pp 359-362

³ Yes, medical schools really do offer courses and entire programs under this name. For instance, see the University of Wisconsin School of Public Health, or the University of Illinois College of Medicine at Chicago.

⁴ Schifrin, L. "Teaching Health Economics in Medical School: Experiences and Observations from the US" Journal of Management in Medicine November 1989, 4:3, pp 184-188

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