While medical students are required to know the names of every body part and disease, most graduate with only a cursory understanding of how the health care system actually works, and some of the ways it doesn't.
Helping to redress this deficiency, Weill Cornell Medical College offers an innovative program to teach medical students and residents about the variety of ways that patient care is managed and paid for, both in this country and abroad.
"With the current debate among policymakers and others about how our health care system should be reformed, it is ever more important to give our students the skills necessary to navigate our increasingly complex health care system," says Dr. Madelon Finkel, professor of clinical public health and director of the Office of Global Health Education at Weill Cornell Medical College, and author of an article on the topic in the current issue of the journal Clinical Teacher. "As the public face of health care delivery, it is incumbent on doctors to be fully conversant with the workings of the health care system. In fact, this knowledge is a prerequisite for quality patient care."
Fourth-year students at Weill Cornell Medical College are required to take a two-week health policy clerkship -- taught by Dr. Finkel for more than 10 years -- that offers an overview of the non-clinical side of practicing medicine and aims to open their eyes to some of the issues that may confront them as they treat patients. This includes what she calls the confusing, and at times conflicting, restrictions placed on physicians and patients alike.
Students are introduced to the complexities of the U.S. health care system, including the organization, financing, administration, and delivery of care, as well as health insurance options. According to Dr. Finkel, physicians and medical students need to understand the constraints and restrictions of different insurance plans, especially prescription drug coverage. To this point, she emphasizes the importance of communicating with patients about their insurance coverage, so as to make sure they won't be exposed to unexpected charges.
The courses also take a comparative look at health care systems around the world. "The U.S. health care system is a costly hodgepodge of public and private insurance entities, and is by far the most expensive in the world," Dr. Finkel says. "Yet, when compared with other health care systems, the U.S. does not rank highest on important outcomes like infant mortality and life expectancy."
"But while there is lively debate about how the health care systems should be restructured, the issue does not receive much attention in a typical U.S.United States and abroad." medical school curriculum," she continues. "Unfortunately, health policy has been practically ignored by most medical schools and residency programs. It's our hope that the courses at Weill Cornell will serve as a model for other curricula, both in the