An opinion piece published in February's edition of the New England Journal of Medicine calls for the creation of a national health policy curriculum for medical schools.
The idea was launched more than 15 years ago, during conversations around health reform proposed by then-President William Clinton's administration. At the time, medical students made an argument for healthcare policy education in their schools, but nothing was decided.
“What we’re saying is we can’t just talk about (creating a national curriculum). We have to get trainees now,” said Monica Lypson, MD, MHPE, one of the authors of "Advancing Medical Education by Teaching Health Policy" and an assistant dean of graduate medical education at the University of Michigan.
“Medical education has long struggled with the questions of how and when to educate physicians about subjects such as healthcare systems, quality improvement and medical economics – matters that are affected by health policy and that, in turn, ultimately affect patient care,” said the authors in their opinion paper.
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“The students are asking about (healthcare policy) and at the same time, our patients are asking, ‘Doc, what’s your opinion about … ?’ I don’t think doctors can answer those questions to the full breath they can answer questions about pneumonia. It’s an awkward silence when you say ‘I don’t understand the system I work in,'” Lypson said.
The opinion piece proposes that a national curriculum be split into four modules: Healthcare systems and principles, value and equity, healthcare quality and safety and health politics and law. Schools would select which modules on which to focus on and would use the national curriculum as a guideline for their programs, rather than creating programs on their own.
Healthcare policy education could be folded into existing coursework, Lypson suggested. For example, studies on pharmacology,could include which drugs require out-of-pocket payments.
“However it’s approached, (the creation of a national healthcare policy curriculum) should be approached in a multi- or interdisciplinary way,” Lypson said.
Patients have to deal with primary care physicians, nurses, billing office administrators and insurers, she pointed out. “We need all those people or their representatives to sit down at the table” to develop an educational program that addresses all the angles experienced in the modern healthcare system.
“What we’re saying makes total sense. You’d want your doctor to know about the system,” she said.