Why Education Is Important

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U.S. health care costs are the highest in the world.

One basic cause of health care costs is medical education.

Medical education has not been considered in controlling costs.

In debates about the soaring costs of American health care, attention typically turns to insurance reform, pharmaceutical pricing, hospital consolidation, or corporate profiteering. These are important concerns. But they all address the visible structures of the system—the branches, not the roots.

I propose a long-range strategy that begins upstream. If we are serious about controlling both the clinical and financial excesses of what is often called the medical industrial complex (MIC), we must examine the institution that shapes the entire enterprise from the outset: medical education.

Medical schools chart the course of medicine. They determine how physicians are trained to think, what they are taught to value, and what they consider to be their responsibility. That intellectual framework does not stay confined to the classroom. It ripples outward into hospitals, insurance companies, pharmaceutical manufacturers, and device makers—the MIC. In short, it helps define the culture within which the MIC operates.

The proposal is straightforward: an independent federal investigation into medical education and its long-term impact on health care delivery and costs. This would not be a punitive exercise, nor an attack on biomedical science. Rather, it would be a comprehensive review—akin to a modern “Flexner Report”—designed to assess whether current training priorities serve the public’s needs in the 21st century.

One central concern is medical education’s persistent and overwhelmingly narrow focus on physical disorders. The biomedical model has produced extraordinary achievements,........

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