Teaching Health Economics in Medical School: Experiences and Observations from the US Available to Purchase

Michael F. Drummond, in a recent paper in this Journal, has pointed out the usefulness and even necessity of physicians in clinical practice understanding certain key concepts of economics that apply to the provision of medical care. While the clinical practice of medicine and economic theory may appear to be quite unrelated, in fact they share a basic purpose: that of maximising the benefit society as a whole receives from the limited productive capability at hand. Viewed in this way, choices in the provision of medical care are but a subset of all choices that society must make in allocating this limited capability among many competing uses. ‘Economising’ thus is applicable to each component of economic activity, including the provision of medical care. ‘Scarcity’ and ‘opportunity cost’, as defined by Drummond, are the anchors of the bridge joining medical care and economics, and represent the fundamental concepts in the teaching of economic ways of thinking to those who determine the allocation of resources between medical care and other sectors of production, and within medical care. This paper builds on Drummond's ‘teaching approaches’ — his suggestions about where, when, what, and how to proceed until the infusion of this sort of economics education into the medical curriculum — with observations derived from 16 years' experience in teaching health care economics, in many settings, in the United States. It offers them, with due qualification for the differences between the US and UK medical care delivery and financing systems, in the hope that they may prove useful in expanding the teaching of economic concepts to future clinical practitioners and managers in both countries.