FODEMAN: Time to loosen left’s grip on medical schools

Regulations on trainee access to drug information can hurt quality of care

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From Iranian President Mahmoud Ahmadinejad’s remarks at Columbia University to Harvard’s lengthy cold shoulder to the ROTC program, the issue of bias at our nation’s academic institutions is by no means a new one.

Research from George Mason University has better quantified this problem, concluding that the ratio of tenure-track faculty registered as Democrats to those registered as Republicans across all departments at 11 California universities was an astonishing 5-1. This same bias dominates our nation’s medical schools and academic medical centers as well.

Some might find the immersion of an agenda into medical schools quite surprising. After all, while the average English 101 class can easily reflect the personal opinions of the professor and his respective institution, material as seemingly objective as biochemistry or endocrinology would appear to be above politics as usual.

Yet even in a web of pathophysiology, human anatomy and countless disease syndromes, at many medical schools, one does not need a microscope to notice an anti-industry and pro-preventive-medicine bias peeking through the curriculum.

Certainly, health care policy and the structure of the nation’s health care system are fair game for debate in medical school. The problem, in my experience, is there never was any debate.

The curriculum routinely presented one view of the problems and solutions related to health care. Professors would offer their personal views as fact and would fail to acknowledge the existence of alternate perspectives. At times, one would wonder if those putative teachings were actually designed to educate young, malleable minds or mold them like putty. In medical schools, this one-sided view also limits opportunities to engage in debate outside of the classroom.

The course material is by no means unbiased, as the professors often portray it. Yes, the relationship between doctors and drug companies needs to be researched, but which regulations are appropriate is an important issue.

The question is, with whom should pharmaceutical researchers consult when conducting research on innovative new drugs that may prolong and improve the lives of thousands suffering from debilitating illnesses if they make it through the long and complicated Food and Drug Administration approval process? Clearly, researchers need to work with experts in the field - others who do research in that area and people who prescribe those drugs.

It’s also important that pharmaceutical representatives be able to meet with doctors to explain the benefits of new drugs. In many cases, doctors do not have the time to learn about the advantages of a new drug versus an older drug in the same class. Drug representatives give doctors a chance to learn about new treatments without the doctors having to take time away from seeing their patients.

Perhaps if only one company engaged in such a practice, there could be a potential conflict-of-interest issue. But most drug companies in the states or localities where such activity is permitted do this. Ultimately, it is up to doctors to decide whether a drug is right for their patients. These industry interactions help keep physicians practicing effective, up-to-date medicine.

It’s safe to say that at too many medical schools, arguments like these do not find their way into the curriculum and discussion.

With that said, medical students who do not believe that affordable, accessible, quality care can be achieved by greater involvement of the federal government in the health care system have a place to meet and debate at our nation’s academic medical centers. The Benjamin Rush Society (BRS) was founded on the successful model of the Federalist Society to unite medical students, residents, fellows and physicians who believe that practitioners should serve their patients - not the federal government.

In essence, BRS is the antidote to the bad medicine ingrained in medical schools across this country. Rather than trying to indoctrinate, the organization strives to educate.

After the passage of the Patient Protection and Affordable Care Act, BRS is needed more than ever. Health care in the near future will only become more political, and as it does, it is likely that more of these issues will be included in the medical school curriculum. A recent New EnglandJournalofMedicine article calls for exactly that.

With the fate of the world’s premier health care system at stake, it is of the utmost importance that medical students be presented these topics in an objective, nonpolitical way.

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