As health care reform gets underway, health policy is finding its way into the curricula of more U.S. medical schools. Along with anatomy and biochemistry, future physicians need to have a good understanding of the health care system.
Dr. Sachin H. Jain
In recent years, elective courses in health policy have enjoyed swelling enrollments as students have come to appreciate the clinical relevance of knowledge of the health care system – including costs, quality, and disparities in care. This new generation of physicians may emerge with both a heightened awareness of the challenges associated with care delivery and a sense of responsibility to address these challenges.?
Medical schools are meeting this growing demand through a diverse array of curricular offerings. Students at Harvard Medical School, for example, now study health policy in their first year, while Dartmouth Medical School requires fourth-year students to enroll in a course covering key issues such as the causes of poor-quality care, inadequate access, and rising costs.?At Jefferson Medical College, each third-year student participates in a day-long conference on health care quality and has the option to enroll in semester-long health policy electives. According to Dr. David Nash, professor and chair of Jefferson’s Department of Health Policy, “every physician has a civic responsibility to be a steward of health care resources, to participate in public debate on health care reform, and to advocate for the poor and disenfranchised.”?
For students attending schools that have yet to develop effective curricula in health systems and health care policy, the American Medical Student Association and the student section of the American Medical Association have become two popular venues for discussion. Through these organizations, thousands of students each year learn to appreciate the intersection between health policy and medical practice, meeting annually at national conferences to debate and pass resolutions on issues ranging from cost containment to influenza A(H1N1) preparedness. The resolutions are then passed on to state and federal legislative bodies for their consideration.?
Jordan Bohnen
Advances in technology have also facilitated new forms of collaboration among students with limited access to health policy education. In 2003, Harvard Medical School’s ImproveHealthCare Web site began offering a series of interactive health policy cases to introduce medical students to issues of quality, access, and disparities in U.S. health care. Three years later, the site launched a collaborative project with students from 17 medical schools to lead health policy discussions across the country. These students now meet annually for a national conference to discuss how to spur further adoption of health policy into medical school curricula.?
Some colleges have even introduced health policy issues into premedical curricula. Since 1999, for instance, Harvard has offered an undergraduate course called “The Quality of Healthcare in America” that is largely populated by premedical students. Dr. Donald Berwick, one of the course’s creators and administrator of the Centers for Medicare and Medicaid Services, has pointed out that many of the students who have taken the course have gone on to pursue training in policy to complement their careers in medicine, and some have gone on to work for state and federal agencies. According to Dr. Berwick, “Physicians with an early appreciation for policy and systems science can become pivotal agents for the improvement of patient safety, outcomes, costs, and the overall experience of care.”
Students who learn how health policy influences patient care will be more likely to serve as proponents of change.?As physicians with a deep understanding of the structure and workings of America’s complex and troubled health care system, they will become advocates and leaders of effective health care reform.
Dr. Jain is Special Assistant to the National Coordinator for Health Information Technology at the Department of Health and Human Services. He is also the cofounder of ImproveHealthCare. Mr. Bohnen is a student at Harvard Medical School and Harvard Business School, Boston. This commentary solely reflects the perspective of the authors and does not represent the views of the Department of Health and Human Services or Harvard University.