Dear Medical Schools, Educate Students on the Business of Medicine

Graduation day. A moment of shear elation. I’ve been there.

Years of medical school. Scut work. Rotations. Cadaver labs. Foreign smells. Short white coats. Board exams. And now, the students are done (with the med school part, anyway). But then they must face: The loans. God, the loans. They have just invested in a business that forces the average medical student to take out a $200-250K (!) business loan.

Yes, it’s called a “student loan,” but let’s be honest: they just invested a quarter of a million dollars in a business (their medical career) in a healthcare sector they know very little about. Sure, they understand the practice of medicine (and will understand more after residency) and will likely land a job that pays a great salary; but do they understand who controls the business and finances in the industry? The dollar flows and financial incentives?

Some who teach in medical school, and even attendings in residency, will perhaps say their mission is, “to improve the health and well-being…by achieving excellence and providing leadership in the interrelated areas of patient care, education, and research.”

OK, sure. Medical schools do a great job with this; but as every attending knows, the practice of medicine and the healthcare ecosystem are very different than what they originally learned about. Some attendings even say they wouldn’t “go back into medicine” or “encourage their children to go into medicine” — perhaps they’d even discourage it.

I teach a “Challenges of Healthcare” survey course at Kenan-Flagler at the University of North Carolina Chapel Hill to MBA students, and I typically have a few students in my class who are doctors, nurses, or advanced practice providers. Without fail, every single one tells me: “I wish I had learned more about the business of medicine

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