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Letters to the Editor  |   November 2010
Medical Business Education in Colleges of Osteopathic Medicine
Author Affiliations
  • Todd R. Fredricks, DO
    Amesville, Ohio
Article Information
Medical Education
Letters to the Editor   |   November 2010
Medical Business Education in Colleges of Osteopathic Medicine
The Journal of the American Osteopathic Association, November 2010, Vol. 110, 679. doi:10.7556/jaoa.2010.110.11.679
The Journal of the American Osteopathic Association, November 2010, Vol. 110, 679. doi:10.7556/jaoa.2010.110.11.679
To the Editor:  
Regarding the disagreement that Debra A. Smith, DO,1 expresses with my suggestion2 that osteopathic medical students could receive adequate instruction in medical business topics in 5 to 10 hours, I wish to point out that the premise of such instruction should not be to create more “administrative suits” out of physicians by running them through MBA-level programs in medical economics and healthcare modeling paradigms. Given that osteopathic medical students today receive no formal education in medical business and that individuals in charge of curriculum development at colleges of osteopathic medicine seem to struggle intensely with medical education planning based on limited hours, 5 to 10 hours of business-focused education would be an enormous amount of time for the average student to learn many essential aspects of medical business that they currently must acquire ad hoc. 
Dr Smith1 would also likely disagree with my perspective that we do not need more complexity added to medicine. Medical economics become absurdly simple when actual market models are applied to the system. This nation successfully used fee-for-service in primary care for almost all of its history until comprehensive medical insurance became a widespread product. The last things we need are more layers of bureaucracy and cost added to the system by expecting that the only people qualified to comment intelligently on the economics of medicine must be graduates of the osteopathic equivalent of the Wharton School of business. Of the five self-made millionaires who are close friends of mine, only one graduated from college. Yet, all of them currently run very successful businesses that employ hundreds of people. The concepts of business are quite simple if one understands the basics and has the requisite discipline to apply them. 
The predominant problem that we confront today is that these “comprehensive” insurance products have created a false and unnecessarily complex system that cannot accurately predict the needs of patients as consumers or the number of physicians that are required in the US market. By contrast, if people paid the full cost of primary care, I suspect that we would see far fewer individuals showing up in the office “just to get checked out.” As a result, demand for services would necessarily drop, and the need for physicians would shrink. 
The bottom line is that right now—lacking any sort of basic understanding of medical business—osteopathic medical students would derive tremendous benefit from 1 hour per week of business education in a quarter of their sophomore year. At the very least, such education would illustrate the utter disconnect between the producers and consumers of the medical economy. I would hope that it would also spur our emerging young osteopathic physicians into action to demand, both professionally and politically, that their profession and means of reimbursement be placed back in their hands, rather than the hands of business school graduates. 
Smith DA. Response [letter]. J Am Osteopath Assn. 2010;110(8):485-487. http://www.jaoa.org/cgi/reprint/110/8/485. Accessed October 12, 2010.
Fredricks TR. Understanding insurance: will a public option or co-op get us where we want [letter]? J Am Osteopath Assn. 2010;110(8):423,485. http://www.jaoa.org/cgi/reprint/110/8/423. Accessed October 12, 2010.