How much does your doctor know about health policy and how it impacts you as a patient?
Unfortunately, not enough. Medical students are given little to no knowledge on how policy and politics influence the system we will train and ultimately practice in.
I’ve already written about this a few times, so check out this post on engaging in advocacy as a medical student, this one about integrating health policy in medical school, and this post on how medical schools are failing students on health policy.
I wanted to write this post last week, but I had to play some serious catch-up with school work instead. I shared a little bit about the conference I attended in D.C. and the amazing celebs I met (!!) but I wanted to let you in about why I attended in the first place and why I think more medical students should be engaged in advocacy.
Prior to medical school, I worked at a policy non-profit in D.C. for three years. Part of my job included meeting with Congressional staff and legislators and running workshops to give high schoolers and adults the skills to be an advocate at the local, state, and federal level. I loved teaching about the basics of government, a little bit about a policy issue, and giving some tips for effective advocacy. [I’ll be back soon with my tips for effective advocacy!]
The “pre-clinical” years of medical school are pretty similar at most medical schools — anatomy, basic science courses, and organ modules. No matter how the curriculum works, you spend a lot of time watching lectures and studying in the library. I only have two weeks left of our cardiovascular system module and then it’s Spring Break and our last module of MS1, Neuroscience and Behavioral Science! I had a busier than usual day earlier this week and thought I’d take you through it!
I need to thank the Clare at Fitting It All In for blogging about her experiences in a post bacc premed program. When I learned that this type of program existed for people like me — career-changers who wanted to go to medical school (or other biomedical or health sciences careers) with no science background — I got onto Google and typed in “post bacc premed blog.” Her site was one of the first to come up! Now I’m in medical school after five years in the professional and graduate school worlds, a year in a post bacc, and a glorious year spent as a nanny for the cutest two year old. So, I think it’s time to pay it forward.
Nutrition education is lacking in most health professions education — either isn’t incorporated, exists in the context of specific disease-related diets, or glosses over the concept of nutrition and diet. Honestly, it’s understandable considering how much knowledge needs to be conveyed and learned — especially in medical school, the only health profession I can speak to personally. But, just as I’ve written before about the need to incorporate more health policy education, it’s time to also offer more discussions about nutrition and the vast impact of society and policy on the “what” and “where” people eat. [Also just as important is proper education on eating disorders. This post from my friend Clare of Fitting it All In is a great overview about caring for individuals with eating disorders.]
Obesity is common, costly, and poses serious health risks. So let’s start with some numbers to get our bearings about why this topic warrants our attention:
We are in a time when physicians are increasingly speaking the language of health policy and public health — “value-based care,” “co-payment,” “social determinants of health,” “accountable care organization” — and are increasingly asked by patients to ensure that a particular treatment or procedure is covered by their insurance before moving forward. This dizzying list of health policy terms (and the responsibility of a physician to understand the lingo) just keeps growing. And there is no better time to introduce students to this world than in medical school, when they are primed for learning and not yet overwhelmed with patient care.
On a short study break, a classmate and I were discussing how the public health and health policy courses we took in graduate school influence our view of the healthcare system as medical students. It was the most productive form of procrastination (nerding out about public health and health policy) but it was also supremely frustrating to talk about all the problems in the healthcare system. The ACA was such a monumental step forward and now it seems like we’ve taken many steps back–only 34 states have expanded Medicaid, states are implementing work requirements for Medicaid, and Congressional Republicans have tried to repeal the ACA dozens of times with no real replacement or effort to fix the provisions that aren’t working well.