Will Free Medical School Make a Difference?

Will Free Medical School Make a Difference?

Ever since The New York University School of Medicine announced that it would waive the tuition of all its students, regardless of merit or need, citing concerns about the “overwhelming financial debt” facing graduates, opinions have been across the board about the wisdom of the decision.

One side applauded the move as a way to reduce (not eliminate) the crushing student debt of medical students, now about $200, 000 on average. The other side questions the wisdom of giving those who can pay a free pass.

Will tuition free medical school make a difference in producing more doctors, produce a more diverse talent pipeline, and, eventually, do a better job of reducing the quality, cost, access, experience and equity gaps that plague the system? I'm skeptical for the following reasons:

  1. The demand for medical education, based on recent applications, does not seem to be price elastic.
  2. The graduate medical education (residency) still represents a significant bottle neck and the mechanisms to fund it is likely to remain stuck in the maw of partisan politics in Washington.
  3. Making a dysfunctional and out of date educational system tuition free will only encourage more people to be dysfunctional and out of date graduates.
  4. The evidence that levels of medical student debt drives specialty choice is inconclusive and reducing the debt burden is unlikely to alter not just general-specialty choice, but the existing geographic maldistribution as well.
  5. The clinical half life of newly minted doctors might shrink given generational attitudes about work-life balance and the increasing attractiveness of alternative non-clinical career paths, such as side gigs, and entrepreneurship. Some, those on FIRE, will just wait until they can pay off their loans and rewire to do something else.
  6. More women in medicine, based on patterns of productivity, family care demands and the white ceiling, will not significantly satisfy the demand for services.
  7. The fundamental restructuring of the economy and the future of sick care work demands that we stop fighting the last war to meet the almost infinite global demand for sick care services, regardless of how much less it costs.
  8. The medical school business model is unsustainable and giving money to subsidize it has a limited life span. Pretty soon you run out of other people's money.
  9. Premeds have little or no understanding of what a sick care job means. Putting more doctors on the grill to get burned out won't help.
  10. We might be looking at a medical school bubble.
  11. As long as the US higher educational system stays rigged in favor of the lucky haves who won the ovary lottery, the have-nots, like low income first generation students, will struggle.
  12. The medical manpower supply chain is extremely long and is regulated and impacted by multiple entities from high school to graduate medical education and state boards of medical examiners.

The sick US medical education system has a long problem list. Treating it with just another pill is unlikely to make a significant difference in reducing long term morbidity or mortality.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs.

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  • Daniel Beaumont

    I applaud NYU’s step. I hope others will follow.

  • George MacDonald

    Good article !!!

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Arlen Meyers, MD, MBA

Former Contributor

Arlen Meyers, MD, MBA is a professor emeritus of otolaryngology, dentistry, and engineering at the University of Colorado School of Medicine and the Colorado School of Public Health and President and CEO of the Society of Physician Entrepreneurs at www.sopenet.org. He has created several medical device and digital health companies. His primary research centers around biomedical and health innovation and entrepreneurship and life science technology commercialization. He consults for and speaks to companies, governments, colleges and universities around the world who need his expertise and contacts in the areas of bio entrepreneurship, bioscience, healthcare, healthcare IT, medical tourism -- nationally and internationally, new product development, product design, and financing new ventures. He is a former Harvard-Macy fellow and In 2010, he completed a Fulbright at Kings Business, the commercialization office of technology transfer at Kings College in London. He recently published "Building the Case for Biotechnology." "Optical Detection of Cancer", and " The Life Science Innovation Roadmap". He is also an associate editor of the Journal of Commercial Biotechnology and Technology Transfer and Entrepreneurship and Editor-in-Chief of Medscape. In addition, He is a faculty member at the University of Colorado Denver Graduate School where he teaches Biomedical Entrepreneurship and is an iCorps participant, trainer and industry mentor. He is the Chief Medical Officer at www.bridgehealth.com and www.cliexa.com and Chairman of the Board at GlobalMindED at www.globalminded.org, a non-profit at risk student success network. He is honored to be named by Modern Healthcare as one of the 50 Most Influential Physician Executives of 2011 and nominated in 2012 and Best Doctors 2013.

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