PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

Is medical education in a bubble market?

Lowering the cost of health care requires lowering the cost of medical education

2013-10-31
(Press-News.org) Contact information: Katie Delach
katharine.delach@uphs.upenn.edu
215-776-6063
University of Pennsylvania School of Medicine
Is medical education in a bubble market? Lowering the cost of health care requires lowering the cost of medical education PHILADELPHIA – The costs of medical education must be reduced as part of efforts to reign in health care costs more generally, according to a Perspective published online this week in the New England Journal of Medicine. The currently high costs of medical education – which at some schools rise above $60,000 per year – are sustainable only if physician salaries remain high, which the authors, led by a physician from the Perelman School of Medicine at the University of Pennsylvania, say is less likely because of efforts to reduce health care costs.

Noting that students leave medical school with debt that often exceeds $150,000, the authors argue: "If we want to keep health care costs down and still have access to well-qualified physicians, we need to keep the cost of creating those physicians down by changing the way that physicians are trained. From college through licensure and credentialing, our annual physician-production costs are high, and they are made higher by the long time we devote to training."

"People wonder whether we are in a bubble market in medical education," says lead author David A. Asch, MD, MBA, Professor of Medicine and Director of the Center for Health Care Innovation at Penn Medicine. In bubble markets, such as the recent US housing market and the dotcom bubble of 2000, prices rise based on speculation rather than intrinsic value, as people buy houses or stocks with the hope of reselling them to those with even more optimistic views of their valuation. When clearer thinking returns, those who haven't sold are left having overpaid, holding an asset they cannot unload. "In the case of medical education, students buy their education from medical schools and resell that education in the form of services to patients. Medical education can remain expensive only so long as there are patients, insurers, and employers who are willing to pay high prices for health care. But if prices for physician services decline, then the cost of medical education will have to decline too, or people won't be willing to pay for medical school in the first place," Asch says.

The authors warn that high debt-to-income ratios drive students away from less financially rewarding fields. "Debt-to-income ratios reveal how much a student has to go into the hole financially for education compared to what a graduating student might earn," says Asch. "For example, it costs approximately the same to become an orthopedist, psychiatrist, or primary care physician, but orthopedists earn much more."

That might suggest that there is already a medical education bubble for psychiatry and primary care, but as bad as the debt-to-income ratios might be for those fields, they are even worse for some other fields outside of medicine. The authors note that veterinary medicine is closer to a bubble market situation, which could burst when potential students recognize that the high costs of becoming a veterinarian aren't matched by high income later.

As the cost of education in general rises, students might naturally be expected to focus more on those fields that provide a better balance between cost and return. "Veterinary education is vulnerable, medicine less so. Business education still seems to be a good buy." But, Asch asks, "Do we really want a world populated only by MBAs?"

"Doctors do well financially," says Asch, "but the cost of becoming a doctor is rising faster than the benefits of being a doctor, and that is catching up to primary care more quickly than orthopedics, and that ratio is close to overtaking the veterinarians." While only about 20 percent of health care costs are attributable to physician payments, physicians' earnings have been sluggish since the early 2000s. The authors note that a burst bubble can be averted if schools see these changes coming before their students do and lower their prices.

### Co-authors on the perspective are Sean Nicholson, PhD, Cornell University and the National Bureau of Economic Research; and Marko Vujicic, PhD of the American Dental Association.

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $4.3 billion enterprise.

The Perelman School of Medicine has been ranked among the top five medical schools in the United States for the past 16 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $398 million awarded in the 2012 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania -- recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report; Penn Presbyterian Medical Center; Chester County Hospital; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Chestnut Hill Hospital and Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2012, Penn Medicine provided $827 million to benefit our community.


ELSE PRESS RELEASES FROM THIS DATE:

New experiments reveal the types of bacteria involved in human decomposition

2013-10-31
New experiments reveal the types of bacteria involved in human decomposition A new field of forensic science turns its attention to bacteria The type of bacteria involved in human decomposition can change over time, according to new research published October 30th ...

Listening to music before you're even born may boost your auditory system

2013-10-31
Listening to music before you're even born may boost your auditory system Prenatal music exposure leads to long-lasting changes in the brain after birth Playing music while you're pregnant may influence your child's auditory system, according to new research published ...

One of the oldest cases of tuberculosis is discovered

2013-10-31
One of the oldest cases of tuberculosis is discovered Scientists verify the presence of tuberculosis from 7,000 years ago Tuberculosis was present in Europe as early as 7000 years ago, according to new research published October 30th in the open-access journal PLOS ...

Baby brains are tuned to the specific actions of others

2013-10-31
Baby brains are tuned to the specific actions of others Observing body movements activates related brain regions in infants Infant brains are surprisingly sensitive to other people's movements, according to new research published October 30th in the open-access journal ...

First results from LUX dark matter detector rule out some candidates

2013-10-31
First results from LUX dark matter detector rule out some candidates Results from the first run of the Large Underground Xenon (LUX) experiment operating a mile underground in the Black Hills of South Dakota, have proven the detector's sensitivity and ruled ...

Babies can learn their first lullabies in the womb

2013-10-31
Babies can learn their first lullabies in the womb The study focused on 24 women during the final trimester of their pregnancies. Half of the women played the melody of Twinkle Twinkle Little Star to their fetuses five days a week for the final stages ...

New SARS-like coronavirus discovered in Chinese horseshoe bats

2013-10-31
New SARS-like coronavirus discovered in Chinese horseshoe bats 10 years after SARS outbreak -- Ecohealth Alliance finds plausible evidence for direct bat to human transmission NEW YORK – October 30, 2013 – EcoHealth Alliance, a nonprofit organization that ...

Mystery planet baffles astronomers

2013-10-31
Mystery planet baffles astronomers Kepler-78b is a planet that shouldn't exist. This scorching lava world circles its star every eight and a half hours at a distance of less than one million miles - one of the tightest known orbits. ...

New multiple action intestinal hormone corrects diabetes

2013-10-31
New multiple action intestinal hormone corrects diabetes Scientists from the Helmholtz Zentrum Muenchen and the Technische Universitaet Muenchen, together with scientists in the USA, have ...

Public insurance fills the health coverage gap, new UCLA analysis shows

2013-10-31
Public insurance fills the health coverage gap, new UCLA analysis shows In the years leading up to implementation of the Affordable Care Act, the percentage of Californians who received their health insurance through public programs continued to rise, ...

LAST 30 PRESS RELEASES:

CMD-OPT model enables the discovery of a potent and selective RIPK2 inhibitor as preclinical candidate for the treatment of acute liver injury

Melatonin receptor 1a alleviates sleep fragmentation-aggravated testicular injury in T2DM by suppression of TAB1/TAK1 complex through FGFR1

Single-cell RNA sequencing reveals Shen-Bai-Jie-Du decoction retards colorectal tumorigenesis by regulating the TMEM131–TNF signaling pathway-mediated differentiation of immunosuppressive dendritic ce

Acta Pharmaceutica Sinica B Volume 15, Issue 7 Publishes

New research expands laser technology

Targeted radiation offers promise in patients with metastasized small cell lung cancer to the brain

A high clinically translatable strategy to anti-aging using hyaluronic acid and silk fibroin co-crosslinked hydrogels as dermal regenerative fillers

Mount Sinai researchers uncover differences in how males and females change their mind when reflecting on past mistakes

CTE and normal aging are difficult to distinguish, new study finds

Molecular arms race: How the genome defends itself against internal enemies

Tiny chip speeds up antibody mapping for faster vaccine design

KTU experts reveal why cultural heritage is important for community unity

More misfolded proteins than previously known may contribute to Alzheimer’s and dementia

“Too much going on”: Autistic adults overwhelmed by non-verbal social cues

What’s driving America’s deep freezes in a warming world?

A key role of brain protein in learning and memory is deciphered by scientists

Heart attacks don’t follow a Hollywood script

Erin M. Schuman wins 2026 Nakasone Award for discovery on neural synapse function and change during formation of memories

Global ocean analysis could replace costly in-situ sound speed profiles in seafloor positioning, study finds

Power in numbers: Small group professional coaching reduces rates of physician burnout by nearly 30%

Carbon capture, utilization, and storage: A comprehensive review of CCUS-EOR

New high-temperature stable dispersed particle gel for enhanced profile control in CCUS applications

State gun laws and firearm-related homicides and suicides

Use of tobacco and cannabis following state-level cannabis legalization

Long-term obesity and biological aging in young adults

Eindhoven University of Technology and JMIR Publications announce unlimited open access publishing agreement

Orphan nuclear receptors in metabolic dysfunction-associated steatotic liver disease development

A technological breakthrough for ultra-fast and greener AI

Pusan National University researchers identify key barriers hindering data-driven smart manufacturing adoption

Inking heterometallic nanosheets: A scalable breakthrough for coating, electronics, and electrocatalyst applications

[Press-News.org] Is medical education in a bubble market?
Lowering the cost of health care requires lowering the cost of medical education