title: Medical Students' Opinions About the Commercialization of Healthcare: A Cross-Sectional Survey.
abstract: There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients' best interests in the face of market demands.
authors.affiliation: Department of Medical Ethics, Uludag University School of Medicine, Bursa, Turkey. mcivaner@gmail.com.
authors.forename: M Murat
authors.identifier: http://orcid.org/0000-0001-5376-3499
authors.initials: MM
authors.lastname: Civaner
authors.affiliation: Department of Medical Education, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Harun
authors.initials: H
authors.lastname: Balcioglu
authors.affiliation: Department of Medical Education, Ege University School of Medicine, Izmir, Turkey.
authors.forename: Kevser
authors.initials: K
authors.lastname: Vatansever
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000941:ethics / Q000592:standards; D004992:Ethics, Medical; D004995:Ethics, Professional; D005260:Female; D006801:Humans; D008297:Male; D008389:Marketing of Health Services / Q000941:ethics; D012577:Schools, Medical; D013337:Students, Medical / Q000523:psychology*
keywords: Commercialization; Medical education; Medicine; Privatization; Professional ethics; Professionalism