Medical students' opinions concerning the health care system

The opinions of freshman and senior medical students on major health system problems and policies were investigated in 1980-81. Responses of 214 freshmen and 203 seniors are reported in four major areas: (1) physician dominance of the health care system, (2) autonomy in patient care, (3) availability of services, and (4) preventive and social aspects of care. With respect to physician dominance, more seniors (63%) than freshman (44%) agree that physicians should determine health policy and that dominance of other health personnel is necessary (75%) and (61%). Professional review of patient care is generally acceptable to both classes, but more freshmen than seniors agree that evaluation should be a condition for relicensure. Less than a fifth of the students in either class believe that patients should be told as little as possible or that they should accept the authority of doctors without question. More freshmen than seniors consider the availability of medical care a major problem (76%) and (58%), and similar proportions believe it is the responsibility of government to assure access to all. Freshmen and seniors generally agree on the need for greater emphasis on prevention and social aspects of illness. Because of the important role played by physicians in the health care system, it is recommended that serious attention be devoted to education in this area, even though it may have a limited impact on professional attitudes.