Sign up for our daily briefing

Make your busy days simpler with Axios AM/PM. Catch up on what's new and why it matters in just 5 minutes.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on the day's biggest business stories

Subscribe to Axios Closer for insights into the day’s business news and trends and why they matter

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios Pro Rata

Dive into the world of dealmakers across VC, PE and M&A with Axios Pro Rata. Delivered daily to your inbox by Dan Primack and Kia Kokalitcheva.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sports news worthy of your time

Binge on the stats and stories that drive the sports world with Axios Sports. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Tech news worthy of your time

Get our smart take on technology from the Valley and D.C. with Axios Login. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Get the inside stories

Get an insider's guide to the new White House with Axios Sneak Peek. Sign up for free.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Catch up on coronavirus stories and special reports, curated by Mike Allen everyday

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Denver news?

Get a daily digest of the most important stories affecting your hometown with Axios Denver

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Des Moines news?

Get a daily digest of the most important stories affecting your hometown with Axios Des Moines

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Twin Cities news?

Get a daily digest of the most important stories affecting your hometown with Axios Twin Cities

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Tampa Bay news?

Get a daily digest of the most important stories affecting your hometown with Axios Tampa Bay

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Charlotte news?

Get a daily digest of the most important stories affecting your hometown with Axios Charlotte

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Nashville news?

Get a daily digest of the most important stories affecting your hometown with the Axios Nashville newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Columbus news?

Get a daily digest of the most important stories affecting your hometown with the Axios Columbus newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Dallas news?

Get a daily digest of the most important stories affecting your hometown with the Axios Dallas newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Austin news?

Get a daily digest of the most important stories affecting your hometown with the Axios Austin newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Atlanta news?

Get a daily digest of the most important stories affecting your hometown with the Axios Atlanta newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Philadelphia news?

Get a daily digest of the most important stories affecting your hometown with the Axios Philadelphia newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top Chicago news?

Get a daily digest of the most important stories affecting your hometown with the Axios Chicago newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Sign up for Axios NW Arkansas

Stay up-to-date on the most important and interesting stories affecting NW Arkansas, authored by local reporters

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Want a daily digest of the top DC news?

Get a daily digest of the most important stories affecting your hometown with the Axios DC newsletter.

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Please enter a valid email.

Please enter a valid email.

Subscription failed
Thank you for subscribing!

Doctors from the lowest-ranked U.S. medical schools are three times as likely to prescribe opioids as those trained at Harvard, the top-ranked U.S. school, according to a new research paper.

Why it matters: The authors argue that doctor training is an overlooked driver of the American opiate epidemic.

Expand chart
Data: National Bureau of Economic Research; Chart: Andrew Witherspoon / Axios

In a paper published Monday with the National Bureau of Economic Research, Princeton economists Molly Schnell and Janet Currie find a "striking relationship" between the frequency of prescriptions and medical school attended: doctors trained at top-ranked medical schools like Harvard, Johns Hopkins, Penn, Stanford and Washington University in St. Louis "are less likely to write any opioid prescriptions," they write. And such doctors who do prescribe opiates do so at a lower rate than the typical MD.

How the study was done: The paper is based on a cross-referencing of prescription data from 2006 to 2014 and medical school rankings by U.S. News and World Report.

The authors considered the possibility that their study reflected a propensity of elite medical students to develop a conservative approach to prescribing opiates, rather than their education at these institutions. They also considered the possibility that doctors from less elite schools are systematically more likely to see more patients in need of opiates.

  • But the authors batted away the first point by showing that the difference in prescription rates between elite and lower-ranked schools has shrunk over time, even as the top schools have become more selective. They argue this shows a diffusion of good educational methods from top institutions to the rest.
  • If the difference in prescription rates were about the type of students at elite institutions, they said, the difference would have grown over time.
  • The study also finds the difference in prescription rates is maintained when you control for the doctor's speciality and place of practice.

The GP Problem: Another important finding was general practitioners accounted for 48% of opioid prescriptions, even though they were just 27% of the doctors studied.

  • General practitioners were less likely to be from elite schools, but when they were trained at Harvard, they averaged 180 opioid prescriptions a year; when they were from the lowest-ranked schools, they handed out an average of 550 opioid prescriptions a year.
  • "If all GPs prescribed like those from [Harvard], we would have had 56.5% fewer opioid prescriptions and 8.5% fewer deaths over the period 2006 to 2014," they wrote, making outreach to this type of doctor critical.

What should policymakers do: This paper argues that training matters, but it doesn't investigate what elite institutions are specifically doing to produce more restrained prescribers. That said, the authors point to data showing that the effect of a pedigree is lessened when the doctor — regardless of medical school — is in a practice requiring specialized pain management training. They argue this could be reason to require all MDs to take classes as well, and the Trump Administration's Chris Christie- led opiate commission recommended that such training be mandated.

Go deeper

Shooting at Michigan high school leaves 3 dead, 6 wounded

Screengrab: CBSN

Three people dead and six others are wounded after a shooting at a high school in Michigan according to the Oakland County Sheriff's Office.

Driving the news: The alleged shooter was a 15-year-old sophomore at Oxford High School and has been arrested, per police.

Fed signals it could yank economic support quicker as inflation sticks around

Federal Reserve chairman Jerome Powell testifies during a hearing before Senate Banking, Housing and Urban Affairs Committee today. Photo: Alex Wong/Getty Images

The Federal Reserve will consider pulling back economic support sooner "as the threat of persistently high inflation has grown," chair Jerome Powell said during a congressional hearing on Tuesday.

Why it matters: This is the biggest signal yet the Fed is backing away from its stance that soaring prices would be fleeting — a change that could shift its policies that underpin the economy.

Felix Salmon, author of Capital
Updated 4 hours ago - Economy & Business

Crypto meets the real world

Illustration: Megan Robinson/Axios

The two largest countries in the world seem intent on effectively banning their citizens from participating in crypto, which poses a serious threat to the crypto agenda.

Why it matters: The crypto world is global — but the real world is fragmented into nation-states, each of which claims control of what happens within its borders.