ENTERING FIRST-YEAR MEDICAL-STUDENTS ATTITUDES TOWARD MANAGED CARE

Purpose. To study the attitudes of entering first-year medical student s toward reform of the U.S. health care system. Method. All 631 first- year medical students at the five medical schools in the University of California System were asked during orientation (late summer of 1992) to complete a self-administered questionnaire regarding their attitud es toward and knowledge about health care reform. Statistical methods used were chi-square tests and factor analyses. Results. Of the 631 st udents, 594 (94%) responded. Of the respondents, 392 (66%) felt that t here should be a national health insurance plan, and 428 (72%) felt th at practicing physicians had a major responsibility to help reduce hea lth care costs. When asked about specific changes intended to control health care costs, the students identifiedreform of the medical malpra ctice system (374, 63%) and increased spending on preventive health (3 56, 60%) as the most likely to be effective. The students generally he ld negative attitudes toward managed care organizations; only 59 (10%) indicated they would choose to receive care in health maintenance org anizations. Conclusion. The students held strong opinions about access to care, managed care organizations, and strategies intended to reduc e health care spending. Medical educators not only need to find creati ve methods of introducing these content areas into medical school curr icula but should also anticipate the need for strategies to deal with negative attitudes held by students.