NEJM: Are We in a Medical Education Bubble Market?

<p>Free online version available here:</p>

<p>Are</a> We in a Medical Education Bubble Market -- NEJM</p>

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The problem is this: if we aim to reduce the costs of health care, we need to reduce the costs of medical education. We don't have to believe that the high cost of medical education is what causes increases in health care costs in order to develop this sense of urgency. We just have to recognize that the high costs of medical education are sustainable only if we keep paying doctors a lot of money, and there are strong signs that we can't or won't.

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<p>There is a very instructive chart of debt to income ratio (by specialty) as part of the article.</p>

<p>And another of debt to income by profession. (Doctors are still better off than veterinarians, optometrists, lawyers, dentists and pharmacists.)</p>

<p>it seems a little weird to compare medical specialties to the entire field of “law” or “business” when one could easily make the case that just as medical specialty can drastically impact that ratio, so can choice of law practice (e.g. public defendant vs. mergers & acquisitions).</p>

<p>I’m also not sure how comparable the status of a medical school graduate is to a law school graduate or business school graduate in the sense that a law school graduate going into a high paying field becomes an associate at a firm with a nice salary while a medical school graduate still has years ahead of them even for high paying specialties.</p>

<p>That being said, I know people who have had the stance for many years now that med school tuition should be free for all matriculants - and it certainly is an interesting idea.</p>

<p>IIRC, physician pay is a pretty small part of healthcare costs. I’d have to go look for it again, but I think it was 10% or less. So if the point of the article is that we can reduce healthcare expenses by reducing physician pay, I think that’s not backed up by the facts.</p>

<p>^the point of the article was that if we are going to cut physician pay then we have to cut medical education costs. This is regardless of the proportion of the problem that is attributable to physician salary.</p>

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<p>How would free medical education work, per se?</p>

<p>I remember reading in T.R. Reid’s book that the cost of medical education in Japan amounted to the equivalent of only a few thousand dollars per year, but I have no idea how they make that work. Do the Japanese have a similar structure as Germany with respect to higher education?</p>

<p>No surprise that there is a shortage of primary care physicians when family medicine specialists have high debt/income ratios compared to other specialists.</p>

<p>Can a medical student at a high cost medical school afford to choose a lower paying specialty like family medicine or other primary care ones?</p>

<p>How many pre-meds get into more than one medical school so that they can actually choose to attend the less expensive one if they are considering a lower paying specialty?</p>

<p>Cleveland Clinic Lerner College of Medicine is free. No tuition. The institution just decided that was what they wanted to do. Students also get paid for doing research. </p>

<p>Applications certainly went up.</p>

<p>From wikipedia:

So it sounds like it is the same as europe.</p>

<p>How would it work? I mean I haven’t thought the whole idea all the way through so in no way am I implying it’s definitely the answer or something we should definitely do but my first thought it just like medicare pays for residency training or the NIH pays for MSTP, HHS should pay the tuition for med school matriculants. Things like housing, textbooks, and other COA things would still fall on the students.</p>

<p>A legal education bubble will burst before a medical education one will…</p>