November 06, 2003

Medical schools need a civil procedure course

Yesterday's discussion in my civil procedure course was focused on the the consequences and rationales for who should make what decisions in civil litigation, the judge or the jury. It was fascinating. So many substantive consequences flow from the structure of our justice system, as the judge vs. jury discussion reveals.

It's very similar, I think, to our health care system. The results are in part determined by the structure and by the procedures.

Believe it or not, though, many medical students aren't taught anything about the health-care system in this country. There is no commonly available analog to a civil procedure course in the medical curriculum. A medical student can graduate without any knowledge of how patients end up seeing this doctor over that one; who pays the bills for the treatment the doctor renders, and who the major decision-makers are. It would be analogous to a legal education that completely ignored the court system and the rules of procedure, focusing almost entirely on the questions of whether this particular client was tortiously injured or deprived of a legal right. The stuff that's taught would be valuable, but it would leave out too much of the big picture

Medical schools need to have a "civil procedure" course. I remember once suggesting such a thing to my medical school dean; his response was that this would be useless because the structures are changing so rapidly that any instruction would be outdated too quickly.

By that logic, genetics should not be taught in medical schools. Indeed, this answer is inconsistent with the medical profession's recognition that physicians need to be "lifetime learners," and that one of their professional responsibilities is to stay current.

Nonetheless, some medical schools do not recognize the need to teach student doctors about their profession in general terms, and how it relates to health care delivery generally. No wonder many physicians are heard to whine about "the system" and yet feel inadequately equipped to engage in the debate beyond merely asserting that "I need more time to see patients; my reimbursement isn't high enough; etc."

A medical school "civil procedure" course would help.

Posted by Carey at November 6, 2003 09:41 AM