[Clinical ecomomics: a pleading for complementing the medical curriculum and specialty training].
Clinical economics requires an understanding of clinical relationships just like health economy requires an understanding of economic relationships. Hitherto we have ensured that economists can differentiate symptoms from diagnoses and diagnostics from screening at the interface between medicine and economy. However, we overlooked the fact that physicians should be able to understand the principles of marginal benefit and medical ethics, as well as the differences among efficacy, effectiveness, and benefit, to be able to make sound decisions. To make up for this neglected demand, we present our definition of clinical economics, identify the potential conflicts between medical professionalism and commercialized medicine, describe the importance - but also the limits - of scientific evidence, explain the difference between 'prioritization' and strict rationing, and attempt to justify the fact that the necessary changes in the provision of healthcare will probably only be achieved if we instill this new way of thinking in medical students during their medical education. Complementing the medical curriculum with clinical economics would achieve this goal.
Klinische Ökonomik, Universität Ulm, Ulm, Germany. franz.porzsolt@uniklinik-ulm.de
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Porzsolt
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Weiss
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Hege-Scheuing
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Fangerau
D003132:Commerce / Q000191:economics / Q000941:ethics; D003362:Cost-Benefit Analysis; D003479:Curriculum; D003695:Delivery of Health Care / Q000191:economics* / Q000941:ethics; D004501:Education, Medical; D004992:Ethics, Medical; D019317:Evidence-Based Medicine / Q000191:economics / Q000941:ethics; D005858:Germany; D015276:Health Care Rationing / Q000191:economics* / Q000941:ethics; D018166:Health Care Reform / Q000191:economics / Q000941:ethics; D006292:Health Priorities / Q000191:economics / Q000941:ethics; D006801:Humans; D009313:National Health Programs / Q000191:economics* / Q000941:ethics; D013038:Specialization / Q000191:economics*; D019564:Unnecessary Procedures / Q000191:economics* / Q000941:ethics