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Report: Physician opioid prescriptions are higher with lower medical school rank

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at August 28, 2017

Physicians prescribing the most opioids tend to have attended lower-ranked medical schools, according to a recent report by the National Bureau of Economic Research.

In fact, many graduates of highly ranked schools did not write any opioid prescriptions. Researchers also noted that doctors of osteopathy (DOs) wrote a higher number of opioid prescriptions on average than medical doctors (MDs). They found that this prescribing behavior was consistent across various physician specialties, locations, and patient types.

Training was likely the most important factor for differences in prescribing behavior, according to the report. They found that differences in opioid prescribing patterns between graduates of higher- and lower-ranked medical schools were smaller when physicians received training on pain management. The rank of a physician’s medical school mattered less than the type of training he or she received.

Policymakers and physician educators could offer pain management training to help combat opioid addiction. For example, at the urging of the White House, in March of 2016, more than 60 medical schools agreed to incorporate the Centers for Disease Control’s pain management guidelines in their curriculum.

Background: Researchers used prescriber data from QuintilesIMS, which included background information from the American Medical Association and medical school rankings from US News and World Report’s, “Best Medical Schools: Research Rankings.”

Related: One in 12 US physicians received opioid-related payments – largely honoraria or speaking fees – from manufacturers of opioid drugs between 2013 and 2015, according to new research published in the American Journal of Public Health. In total, drug makers paid over $46 million to 68,177 physicians. Researchers compared this with payments for non-steroidal anti-inflammatory drugs, also used to treat pain, and found that total payments for NSAIDs were much less, around $13 million.

The majority of payments to physicians were for honoraria or speaking fees. Researchers excluded payments tied to research. They studied data from the Open Payments database. CMS requires pharmaceutical companies disclose payments to physicians and posts the data publically.

(Sources: Molly Schnell and Janet Currie, “Addressing the opioid epidemic: Is there a role for physician education?” National Bureau of Economic Research, August 2017; Scott Hadland, Maxwell Krieger, et al., “Industry payments to physicians for opioid products,” American Journal of Public Health, September 2017)

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