Tuesday, March 17, 2015

Medical Students' Views and Knowledge of the Affordable Care Act: A Survey of Eight U.S. Medical Schools.

The future for the Affordable Care Act may well live in the minds of the current generation of medical students and trainees and not the electorate or political party.  In reality the future of medicine is in their destiny.  

Journal of General Internal Medicine:   March 10, 2015

BACKGROUND
It is not known whether medical students support the Affordable Care Act (ACA) or possess the knowledge or will to engage in its implementation as part of their professional obligations.

PARTICIPANTS
All 5,340 medical students enrolled at eight geographically diverse U.S. medical schools (overall response rate 52 % [2,761/5,340]).

CONCLUSIONS
The majority of students in our sample support the ACA. Support was highest among students who anticipate a medical specialty, self-identify as political moderates or liberals, and have an above-average knowledge score. Support of the ACA by future physicians suggests that they are willing to engage with health care reform measures that increase access to care.

KEY RESULTS
The majority of respondents indicated an understanding of (75.3 %) and support for (62.8 %) the ACA and a professional obligation to assist with its implementation (56.1 %). The mean knowledge score from nine knowledge-based questions was 6.9?±?1.3. Students anticipating a surgical specialty or procedural specialty compared to those anticipating a medical specialty were less likely to support the legislation (OR?=?0.6 [0.4-0.7], OR?=?0.4 [0.3-0.6], respectively), less likely to indicate a professional obligation to implement the ACA (OR?=?0.7 [0.6-0.9], OR?=?0.7 [0.5-0.96], respectively), and more likely to have negative expectations (OR?=?1.9 [1.5-2.6], OR?=?2.3 [1.6-3.5], respectively). Moderates, liberals, and those with an above-average knowledge score were more likely to indicate support for the ACA (OR?=?5.7 [4.1-7.9], OR?=?35.1 [25.4-48.5], OR?=?1.7 [1.4-2.1], respectively) and a professional obligation toward its implementation (OR?=?1.9 [1.4-2.5], OR?=?4.7 [3.6-6.0], OR?=?1.2 [1.02-1.5], respectively).

Author's Opinion

Judging from the survey result the majority of trainees support the ACA and will work with the new system.  This is not surprising. Young physicians are altruistic and by and large are not driven by monetary aspects.  of health care. Few are knowledgable about the inner workings of the payment system until they enter practice. It would be interesting to survery physicians in age groups centering around their length in practice. Perhaps the quote, "Old dogs do not learn new tricks"  would be appropriate.






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