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A study among medical students at Ben-Gurion University of the Negev revealed that most of them believe that their future decisions on the type of treatment to give patients will be based on issues of cost.

Most of the students would also like the material they are studying to include information about the price of medicines and medical treatments, something the current curriculum does not cover, the study found.

The study was carried out two years ago by a team headed by Dr. Assaf Tucker of the Soroka Medical Center, and the findings were published in a recent edition of Harefu'ah, the journal of the Israel Medical Association.

The study examined the responses of the doctors of the future to two questions: Should their studies include material about economic matters; and to what extent will their decisions in the future about treatments be influenced by the cost. The results were clear-cut. Some 70 percent of the 270 students who participated in the study said that they would decide on the method of treatment on the basis of its cost.

Two-thirds of all the students in the six-year course replied that they would like the curriculum to include information about prices of medical treatments and medicines.

The students were also asked whether at any time during their studies they had received formal information about the cost of medical treatments. A majority (70 percent) answered in the negative, even though 84 percent felt that economic information was essential in "the decision-making process of a modern health economy," as it was phrased in the study.

Tucker writes in the study that the national expenditure on health is growing in Israel, and that physicians are responsible for 50-80 percent of the general expenses of the health system. For that reason, he says, those making overall health policy are directing "a significant part of their efforts at giving quality health services while deliberately cutting down on expenses."

Nevertheless, at the same time the Health Ministry and the health maintenance organizations are dictating a policy of efficiency and saving, the study found, "the medical schools ignore these changes." According to the study, the fact that the medical study programs ignore the influence of the health economy on the work of the doctor in modern times is "close to educational negligence," and the medical faculties must respond more swiftly to the economic changes that are occurring in the world of medicine.

Tucker proposes that curricula be developed that will teach the medical student not only how to make diagnoses, but also how to determine the economic justification for certain medical procedures, how to calculate the expected cost of a treatment until a patient's recovery, and how to check on whether cheaper alternatives exist.