How Different Medical Schools Impact Prescribing

Physicians with a degree from what institute of higher learning are most likely to prescribe fewer opioids in practice?

a. Harvard Medical School

b. Baylor College of Medicine

c. Johns Hopkins University School of Medicine

d. Penn State College of Medicine

Answer: a

Physicians trained at the lowest ranked U.S. medical schools prescribe nearly 3 times as many opioids per year as physicians who trained at Harvard, which sits in the No. 1 spot on the US News and World Report's “Best Medical Schools: Research Rankings.” Johns Hopkins (#3) and Baylor (#21) also cracked the list, while the unranked Penn State remains on the outside looking in.

According to the findings, 65% of physicians who trained at Harvard Medical School wrote at least one opioid prescription in a given year between 2006 and 2014, compared with nearly 80% of physicians who trained at the lowest ranked medical schools. General practitioners (GPs) prescribed over half of all opioids, according to the findings, which said if all GPs prescribed opioids like physicians from Harvard did, there would have been 56.5% fewer opioid prescriptions and 8.5% fewer deaths over the study period. Notably, differences in prescribing practices were much smaller among physicians who received specialized training in pain management after graduating from medical school.

Most people who become addicted to opioids start by abusing prescription drugs and, because the drugs are legally prescribed by physicians, it makes sense to know what characteristics of physicians are associated with high rates of prescribing opioids, said study co-author Dr. Janet Currie of the Center for Health Wellbeing at Princeton University. She added that current efforts to solve the opioid epidemic have focused on the behaviors of addicted patients, but not on the role physicians play in indirectly allowing patients to become addicted in the first place. Her research showed that doctors vary greatly in their prescribing patterns, even within specialties and practice locations, meaning that the same patient is more likely to receive opioids if they go to a high-prescribing doctor than if they go to another doctor.

Many physicians receive no specialized training in how to prescribe opioids, even though the opioid epidemic is a public health emergency that is driving up death rates, pointed out Dr. Currie. She recommended that all new medical school graduates receive basic training about the dangers of opioids, best practices for prescribing the pills, and alternatives to opioid medications for treating chronic conditions. Dr. Currie also suggested that changing the habits of liberal prescribers, who most often come from lowest-ranked medical schools, could have significant public health benefits.

—Dan Cook

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