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Training the Modern Physician: A Call to Incorporate Finance and Law into Medical Education

By SAI BALA, JD

The United States medical education system is heralded as one among the top in the world for medical training. Given the strict standards of education, multiple licensing boards, and continuous oversight by governing bodies, getting a placement to train in the US is extremely competitive.  In 2017 alone, nearly 7000+ non-US citizens (commonly referred to as “foreign medical graduates”) applied to compete with 24,000+ US citizens for American residency spots to pursue specialty training. The reasons for this competitiveness are simple. The vast majority of medical institutions in the US boast a comprehensive curriculum that entails basic sciences, clinical principles, practical and hands-on didactics, and enriched exposure to the clinical aspects of patient care. This training produces astute clinicians that are capable of resolving the most complex diagnoses while providing comprehensive patient care.

However, it is high time to recognize that being a shrewd clinician is no longer a sufficient product for the demands of the healthcare market today. That is to say, the scope of medicine today for a physician has gone far beyond resolving complex medical problems, but demands a higher understanding of multidisciplinary skillsets, most important of which are finance and legal theory. In these aspects, the US medical education system direly underprepares physicians, and thus, requires a thorough reevaluation.

The art of medicine, as much as it was originally developed to be purely about the betterment of patient health, has become yet another siloed service industry. Simply put, patients are customers, and physicians are increasingly held accountable for the financial metrics and revenue their work produces. Compensation models are increasingly favoring productivity based payment methods, such as the relative value unit (RVU) system, and are moving away from the traditional, salaried physician. This has resulted in increased pressure on physicians to become more efficient with their workload and patient docket, while managing the often turbulent and contradictory interests of insurance, patients, and hospital administration.

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