June 24, 2016

For-profit med schools are on the rise—but not everyone is on board

Daily Briefing

More for-profit medical schools are opening up their doors, offering the potential to address physician shortages in underserved areas—but not everyone is sold on the new ventures, Rebecca Boone reports for the Associated Press.

For-profit medical schools are a recent phenomenon in the United States: The first, Rocky Vista University College of Osteopathic Medicine, opened in Parker, Colorado, in 2007. Several others have opened since, including California Northstate University School of Medicine and the Burrell College of Osteopathic Medicine in New Mexico. Rocky Vista recently has also expanded into Utah.

Debate over for-profits

Robert Hasty, dean of the new for-profit medical school Idaho College of Osteopathic Medicine, says for-profits can help address physician shortages, particularly in rural areas. Idaho and other rural states need more general practitioners to treat patients amid the aging baby-boom generation and the Affordable Care Act's insurance expansions, the Associated Press reports.

Hasty notes that for-profit hospitals used to be stigmatized but now make up about 25 percent of U.S. hospitals.

"We have such a need for doctors, and if we have to make this investment, it's worthwhile," Hasty says.

Is the physician shortage a real concern? Depends where you live.

Justin Rose, who was among the first group of students to graduate from Rocky Vista, supports for-profit medical schools even though he has incurred about $350,000 in student loan debt, nearly twice the average debt carried by a typical medical school graduate. Rose doesn't qualify for many federal loan forgiveness programs because he attended a for-profit program.

However, Rose notes that it can be costly for states to open new medical school programs, and he says the for-profit option was best for him after he was rejected from several state-run schools.

Yet not everyone is convinced that for-profit medical schools are worthwhile.

Ted Epperly, who runs a family practice residency program in Boise, says that "on face value," having for-profit medical schools "looks like a pretty good deal," since the schools don't require public funding. "But it's a little bit like Wal-Mart moving into a small community with mom-and-pop shops—it damages the existing workforce producers," he adds.

Evaluating for-profits

Claudia Goldin, a professor of economics at Harvard University who has studied for-profit education models, says that the differences between for-profit and schools are not always as clear as one might think.

How to right-size residency programs

"I've always tried to think about for-profits without the jaundiced view of them that we all now seem to have," she says. "I always try to enter this with the notion that there are good training programs all over the place, and the [not-for-profits] have some pretty lousy places."

Goldin notes that prospective students can evaluate for-profit medical schools by looking at residency placement numbers—which all medical schools have to share publicly—as well as data on whether students pass medical board examinations and meet state requirements for practicing.

"If they're not providing the requisite training and hands-on work, then it's going to be public information that these students didn't pass those" Goldin says (Boone, AP/Sacramento Bee, 6/21).

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