Medical students lack knowledge of healthcare overhaul

New York Tue Sep 25, 2012 4:33pm EDT

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New York (Reuters Health) - The 2010 Affordable Care Act affects almost every aspect of the U.S. healthcare system, but many future doctors who will be operating under its policies admit they don't know that much about the law.

In a survey of about 850 medical students in Minnesota, less than half said they understood the healthcare law's basic components, and more than 40 percent said they had no opinion on the law.

"We think a lot of that has to do with a lack of understanding with the bill itself and the lack of education in medical schools of healthcare systems and the bigger picture of healthcare," said lead author Dr. Tyler Winkelman, an internal medicine and pediatrics resident at the University of Minnesota in Minneapolis.

Winkelman said he got the idea for the survey while still in medical school. His fellow students, he said, didn't seem to have a firm grasp on the changes taking place under the new law.

"It was our thought that if students are not informed about healthcare policy then the implementation may not be as successful as it could be," he added.

To see what medical students knew or thought about the law, Winkelman and his colleagues worked with the Mayo Clinic to email an online survey to all 1,235 medical students in Minnesota in January 2011.

The researchers, who published their results in the Archives of Internal Medicine, received surveys back from 843 students, representing about 68 percent of the invitations.

Of those who participated, a little over 48 percent said they understood the basic components of the law while 40 percent said they did not. The rest said they had no opinion on the question.

About the same proportion who said they understood the law also said they supported it - about 47 percent. Only 13 percent said they did not support it, while 41 percent didn't have an opinion either way.

Despite the number of students who disagreed with or didn't have strong feelings about the law, the majority - about 69 percent - agreed that doctors were professionally obligated to play a role in its implementation.

As for who supported the law, students who identified themselves as politically liberal were more likely to support, understand and feel a duty to implement the law when compared to conservatives.

Also, the researchers found that the students who understood the law were more likely to support it compared to those with little understanding.

POLICY IN MEDICAL EDUCATION

Overall, Winkelman said the results agree with past research and hopefully medical schools will start to expand their curriculum beyond the traditional basic science education to include policy.

"Medical students don't understand healthcare reform any more than they understand the rest of healthcare policy," said Nathan Moore, who was not involved with the new research but co-authored The Health Care Handbook, a guide to the U.S. healthcare system.

"It's not explicitly stated in here, but from personal experience, medical students aren't taught about health policy or healthcare reform, but they want to be," said Moore, who is also a fourth year medical student at Washington University in St. Louis, Missouri.

There has been some movement on the national level to educate students about policy, according to Moore, but those efforts have been restrained by the individual schools.

He told Reuters Health there are several ways schools can incorporate policy education into their curricula, including offering courses during students' preclinical years, workshops, online education or independent reading.

Winkelman said, "Physicians are uniquely situated to affect healthcare beyond just the clinical visit. I hope that our findings open a discussion in the medical education community about the role of medical education in regards to creating socially conscious physicians."

SOURCE: bit.ly/Rf6ruV Archives of Internal Medicine, online September 24, 2012.

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