Medical, Law, and Business Students' Perceptions of the Changing Health Care System

Published in: Social Science and Medicine, v. 47, no. 8, 1998, p. 1043-1049

Posted on RAND.org on December 31, 1997

by Michael Wilkes, Ian D. Coulter, Eric Hurwitz

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An unanswered question in previous research on attitudes to health care systems is whether the values held by medical students are unique to them or simply a cohort phenomenon. This study addresses this by measuring values and attitudes on entry to medical school, and comparing them with two other groups whose academic standing at entry and social status are likely to be comparable--business and law students. In this paper four substantive areas are dealt with: managed care, cost controls such as rationing, access to care, and the role of the federal government in regulating health care. There was a high level of agreement between the three groups that society should provide health care to all citizens, and that individuals should have appropriate access. There was also a general preference for being treated in a fee-for-service setting. Some differences were that medical students held more negative views about managed care than some of the others. The students tended to disagree on cost controls, particularly on issues that might impact on their own professions. Medical students were more restrictive than others on concepts of rationing health care and with regard to high tech procedures. Thus the results reflect areas of extensive agreement, but also the fact that even at entry students may differ on issues that are likely to have an economic impact on their careers. The relationship of these attitudes to the changing health care system and to theories about professionalism and the state is discussed.

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