For the ninth year, the Epocrates unit of athenahealth Inc. has published survey results on the opinions and expectations of medical students soon to enter the profession. The vendor surveyed 1,462 students in late August and early September 2014.

In an era when physicians in small practices increasingly are transitioning to larger organizations, the students appear ready to follow suit. Seventy-three percent of respondents hope to join a hospital or large group practice; only 10 percent are aiming toward a solo or partnership practice. That’s up slightly from 2013, when 70 percent wanted to join a large organization and 17 percent wanted to stay relatively small.

“One factor may be the lack of preparedness,” according to Epocrates. “Medical schools put little to no emphasis on building business skills to run a practice. Fifty-seven percent of medical students are dissatisfied with training they received in practice management and ownership, while 65 percent indicated they feel unprepared in billing & coding.”

Medical students also worry about the obstacles to improved care coordination. Fifty-seven percent of those surveyed cite lack of communication between care teams, 42 percent also are concerned with the capability of electronic health records to talk to each other and 34 percent further target lack of accessible patient records.

Medical schools aren’t teaching students what they need to know about fundamental changes in the industry in very recent years. Nearly 70 percent of students believe they are uninformed about EHR meaningful use and two-thirds don’t know enough about accountable care organizations. To a small degree, however, the teaching has improved in the past year; 72 percent didn’t know much about meaningful use or ACOs in 2013.

Despite misgivings of the current state of interoperability, three-quarters of the students believe advancements in data sharing will be the biggest health information technology achievement in the next decade. Nearly 40 percent also see big advancements in genetic profiling and digital personal health records.

Other top concerns include a work-life balance (60 percent now and 51 percent last year), being a good physician (50 percent now and 55 percent last year) and paying off student debt (27 percent).

Surveyed students in large part are comfortable with several other aspects of becoming prepared to be physicians. They include being prepared in bedside manner, patient-centered care, using mobile reference tools, patient safety, EHR exposure and utilization, and infection prevention and control.

In general, almost all surveyed medical students would encourage patients to use remote monitoring devices to track weight, blood sugar and vital signs. Most, however, prefer office visits over virtual visits for initial and most follow-up visits, yet for other purposes half of them would encourage video conferencing.

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