To assess the influence of medical education on opioid prescribing practices, economics professors at Princeton (N.J.) University examined data on all opioid prescriptions written between 2006 and 2014. The researchers also used a composite ranking of medical schools based on several years of U.S. News and World Report rankings. A comprehensive assessment of both datasets indicated the propensity to prescribe opioids was higher among physicians educated at lower-tier medical schools when compared to physicians educated at top medical schools. This association persisted across regions and medical specialties.
Among physicians across specialties who attended Boston-based Harvard Medical School, on average, wrote fewer than 100 opioid prescriptions per year. Physicians across all specialties educated at the lowest-ranked schools averaged about 300 opioid prescriptions annually. Among general practitioners, the average Harvard-grad wrote 180.2 opioid prescriptions each year, while graduates from lower-ranked schools wrote an average of 550.
“Taken together, our findings suggest that a doctor’s initial training has a large impact on their attitudes towards opioid prescribing, especially for [general practitioners],” concluded the study’s authors. “Since variations in opioid prescribing have contributed to deaths due to the current opioid epidemic, training aimed at reducing prescribing rates among the most liberal prescribers — who disproportionately come from the lowest ranked medical schools — could possibly have large public health benefits. Physician education therefore likely has a role to play in addressing the opioid epidemic.”
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