During the long debate over health-care reform, many of us became students of health-care financing and policy.

Now a young area doctor says medical students also need better instruction on how the health system works.

Dr. Mitesh Patel said he graduated from medical school ready to diagnose and care for patients.

At the bedside of his first patient with heart trouble, Patel knew exactly what tests to order.

"I explained what my plan was to the patient, and the patient said to me 'That's great, but how am I going to pay for this? I don't have insurance.' I didn't know what to tell him. I had no idea how the insurance system worked, how Medicare or Medicaid works, so I was really lost," Patel said.

With a better understanding of the health system, Patel said he could have directed his patient to the right resources.

Patel, now a resident at the Hospital of the University of Pennsylvania, has written a column calling for more health policy training that appears in the current issue of the New England Journal of Medicine.

Patel said a recent survey found that medical students who got intensive health-policy training were no less satisfied with their instruction in basic science and clinical care.

David Nash, dean of the Jefferson School of Population Health, has been advocating for more health-policy training since 1990. He said he doesn't buy the argument that medical school education is already too overloaded.

"We don't need 15 lectures to learn every muscle in the foot, there's lots of way-more important stuff and health policy is way at the top of the list, most especially given what the nation is facing," Nash said.

Patel and Nash said young doctors also need better information on the effectiveness of comparable treatments.


Health and Science reporter