Why We’re Here

nejmp1009202_t1The rigors of basic science prerequisites, medical school itself, and medical training make it a serious challenge to give students and trainees appropriate and comprehensive knowledge of the larger health care system outside of their own experiences. As two medical students with graduate degrees in public health and personal interests in varied health policy topics, we see the impact of limited health policy instruction in medical school curriculum. We hope Health Policy Ddx can help to fill this void and encourage broader interest in health policy among medical students.

The ever-evolving landscape of health care delivery has emphasized the need for health policy literate physicians. However, a small body of research has indicated that nearly half of graduating medical students feel they receive inadequate instruction in health policy. Another survey of medical students indicated that 58% of respondents felt they received “too little” health policy education. This is an educational failure for future health care practitioners–one that is also reflected in anecdotal evidence of our peers. For example, rather than harboring frustration when a patient does not take their prescribed medication, it is imperative that providers probe for intentional (and unintentional) reasons for medication nonadherence. This is just one situation where knowledge of the U.S. health care system and the barriers faced by vulnerable populations is particularly crucial. Perhaps transportation to the pharmacy is an issue, or the patient does not have consistent access to food and the medication requires it be taken with food. Understanding the system that impacts your patients’ access to care allows you to better provide more appropriate and individualized medical treatment.

Just as medical schools revamp their curricula to reflect advances in clinical and biomedical sciences, so too should they update their academic offerings to provide students with instruction in health policy and public health. Medical schools offer instruction on the biological mechanisms of vaccination and the schedule by which it should be provided, but often lack even a brief contextual discussion of the legal basis for compulsory vaccination. Students will memorize hundreds of medications, including those for conditions that inhibit concentration in school-aged children however, they will spend minimal time discussing that lack of access to food and physical activity (both under the purview of federal and/or state policymakers) can significantly impact focus in school. Medication might still be a necessity for some children, but looking beyond the immediate medical complaint to the child’s environment could impact how and what care is provided.

Medication noncompliance and understanding children with concentration issues are just two situations in which a greater understanding of health policy and public health would be useful. Providers will encounter situations like this every day, with nearly every patient, because each patient is a unique human being with unique experiences and environments. Patients do not live in a vacuum and we must understand the greater policy forces at work that impact how they lives their lives.

Health Policy Ddx will provide updates on pending legislation, brief overviews of important laws and regulations, roundups of ongoing and interesting policy research that impacts clinical practice, and everything in-between that might be of interest for health policy nerd wanna-be’s. Until all medical schools provide adequate, comparable instruction in health policy, Health Policy Ddx will try to level the playing field and infuse health policy into the everyday clinical education of medical students.

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