March 26, 2007
Spotlight
Health Care Policy: The Context for Practice
Photo by Graham Ramsay
In the new curriculum, the study of health care policy is now required, which greatly expands enrollment and has necessitated reorganizing the class formats, according to course directors Haiden Huskamp (left) and Barbara McNeil. |
HMO. PPO. Utilization review. Ask any doctor who has had an insurance company breathe down her neck and she’ll tell you that being a skilled physician now takes more than correctly diagnosing the patient. The alphabet soup and work-talk of health care financing and policy permeate the examination room as do symptoms and disease.
Beginning this September, the formerly elective Introduction to Health Care Policy will be a required course for all medical students in the new integrated curriculum (with exceptions such as dental students) in their fall semester.
“Health policy directly affects how our students will be practicing medicine when they’re out in the real world,” said Haiden Huskamp, HMS associate professor of health economics. “Understanding how the policies will affect their clinical decision-making and their patients is important. Knowing how these policies get made, and how they may be able to help influence future policy, is also important. Some students in the past said that their first interaction with these issues—for example, what’s their patient’s insurance and how does that affect the services they can provide?—doesn’t come up until they’re dealing with patients directly. They’re learning after the fact. We want to give them more information up front.”
Being deemed educationally essential posed an instant challenge to course directors Huskamp and Barbara McNeil, chair of the Health Care Policy Department: the intimacy of a course that once had only 30 students had to make way for new teaching approaches when upwards of 150 will now pack the lecture hall.
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“Health policy directly affects how our students will be practicing medicine when they’re out in the real world. Understanding how the policies will affect their clinical decision-making and their patients is important.” |
“Whereas in the past, every session was taught with the full group of students,
now we’ll have more of a lecture format, with case discussions, and then
we’ll break up into small groups where students can dig into some of the
issues with one or two faculty from around the Medical School,” said Huskamp.
Nine discussion groups, each with 15 or so students and led by faculty from throughout
the Medical School and its affiliated hospitals, will enable these in-depth explorations.
Most of the topics covered by the course are similar to those in the prior
course, from how the U.S. health care system is structured and financed to
how doctors are paid to what defines quality care and the politics of reforming
health care.
ut with developments in health policy coming as fast as the expansion of medical knowledge, important, topical new material will be added. Three topics the discussion groups will chew on—whether the United States overspends on health care, new ways of preventing medical errors, and the commonwealth’s landmark health reform law—are newcomers to the syllabus.
In another project, small teams of three or four will be assigned to write policy “memos,” as if they were advising lawmakers on a pressing topic. Whether Medicare should negotiate lower drug prices, for example, is one topic likely to be used in the course. The memos will be presented in the discussion sections, and students will debate the memos’ conclusions.
With many policy issues controversial, professors will take care not to evangelize, said Huskamp. When the School of Public Health’s Katherine Swartz lectures on alternatives to U.S. health care financing, for instance, she will not endorse a particular approach. “She’ll say, ‘Here’s what we know about how different systems are likely to work.’” With this information, students will be able to participate in an intelligent debate and discussion with those who propose one view or another.
On Match Day, Internal Medicine Leads List of Popular Residencies
Photo by Liza Green, HMS Media Services
Ruma Rajbhandari and her husband Parag Pahak are all smiles after Ruma learned she matched to Brigham and Women's.
On the 55th annual Match Day, 180 HMS students, and more than 15,000 across the country, tore open their envelopes and learned where they will do their residencies. More than half of the HMS grads will remain in Massachusetts, with 7 percent going to New York City and 18 percent heading to California. The most popular specialty is internal medicine, with pediatrics and emergency medicine tying for second. Specialties that saw an increase in the percentage of HMS students matched compared to last year include anesthesia, radiology, and neurology, while pediatrics, emergency medicine, and family practice saw a decrease. According to the National Resident Matching Program, a record number of fourth-years applied for residencies this year.
Photo by Liza Green, HMS Media Services
Patricia Garcia, Raul Calderon, and Edgar Sinai Macias celebrate matching to BWH, the University of California, Los Angeles, and the University of California, San Francisco, repectively.
| Jenny Siegel and Chris Russell won't have to say goodbye after graduation, because they are both headed to the University of California, San Francisco. |  Photo by Liza Green, HMS Media Services |
Photo by Liza Green, HMS Media Services
Clockwise from front, Matthew Lewis, Haley Naik, Connor Klewno, Payman Zamani, Ryan Gerry, and Ji Yeon Kim were among the 180 HMS students to learn where they will do their residencies on Match Day 2007.
Copyright 2007 by the President and Fellows of Harvard College