Leadership

Medical Schools and Health Policy: Adapting to the Changing Health Care System

Article · February 1, 2017

With the rapid pace of health care delivery reform, there have been calls for medical schools to increase their focus on health policy research and education. These calls are grounded in the beliefs that a clinical perspective will enrich health policy research and that future physicians should play a role in improving the quality, cost, and experience of care.

A major obstacle to integrating health policy into the fabric of medical school research and education is the availability of institutional faculty, departments, and centers of focus. To better understand the current state of institutional support for health policy, we performed a review of academic entities affiliated with U.S. medical schools that focus on health policy.

The location of health policy education and research within a university varies nationwide; some universities have formalized departments of health policy, while others have developed centers for health policy research and education. More than half (75 of 147 = 51%) of all LCME-accredited schools of medicine are within institutions that include a health policy entity. However, only 10 (7%) schools of medicine have a health policy department. Of the remaining 65 schools with another type of formalized health policy entity, 32 are have a department of health policy in the institution’s affiliated school of public health, and 49 have a health policy center.

Prevalence and location of health policy research entities in schools of medicine

Figure includes all schools of medicine who are part of the LCME process, including preliminary and provisional accreditation. Percentages in the right three columns add to more than 100% because some schools of medicine have more than one health policy entity. Click To Enlarge.

Interestingly, all of the 2016 top 20 schools of medicine have at least one affiliated health policy entity. The majority (14) of top 20 schools had health policy centers: 7 had a health policy department in an affiliated school of public health. Five (25%) of the top 20 schools have a department of health policy within the school of medicine. Additionally, we found that the number of schools of medicine with a health policy department has risen by 66% since 2009, which may indicate an increased focus on health policy in medical school curricula. Despite the critiques of the departmental system in medical schools (and universities more generally), a formalized departmental structure in both schools of medicine and public health may convey prominence of health policy within the school.

Over the past several years, more than 10 new medical schools have been announced or gained preliminary accreditation. The mission and focus of many of these new schools is to train physicians in population health improvement. Whether these new schools of medicine will be able to fulfill this mission and provide the rigorous medical and clinical training necessary for accreditation is yet to be seen. However, the inclusion of a health policy entity, which typically comprises an interdisciplinary faculty with diverse research interests, could help these new medical schools incorporate population health, public health, and health policy into their mission and curricula. Moreover, formally including health policy in all schools of medicine may facilitate the training of physicians able to adapt to the changing health care landscape.

New Call for Submissions ­to NEJM Catalyst

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

More From Leadership
Framework for Comprehensive Community Wellness

A Vision for Upending the Siloed Status Quo

A five-point plan unveils ways that leaders of health care and public health organizations can take action to enhance community wellness.

Mangi01_pullquote - patient flow dynamic work design

Improving Patient Flow with Dynamic Work Design

Staff make big improvements in post-operative care by changing small details.

Lerman01_pullquote leadership development

Leadership Development in Medicine

It is time for a critical assessment of the ways in which health systems develop, select, and support emerging physician leaders.

Perlo01_pullquote community organizing principles for restoring joy in work in health care

Applying Community Organizing Principles to Restore Joy in Work

IHI offers four lessons on how to nurture joy in the health care workforce.

MHCM Physician Leaders Career Paths Post-Graduation

Physician Leader Training: The Value, Impact, and Challenges

Alumni of Harvard’s postgraduate Master in Health Care Management degree program reveal the benefits of academic training, and the real-world challenges for new clinical leaders that can lead to success as well as frustration.

Nurok02_pullquote - physician-hero - team-based care

The Adverse Impact of the Physician-Hero

In a value-based world, the sickest patients need the benefit of a comprehensive team to provide evidence-based treatment that will deliver desirable clinical outcomes while optimizing the cost of care.

Patel01_pullquote - interprofessional education and collaboration

Interprofessional Collaboration for a Health System in Crisis

To overcome current failures within our health systems, we need to improve interprofessional education and collaboration.

Tina Freese Decker

Cultivating “Systemness” to Create Personalized, High-Reliability Health Care

Becoming a high-reliability health system that is personalized, efficient, and effective means making some tough choices.

Shapiro01_pullquote - Using Simulations to Improve Physician Leadership Hiring

Using Simulations to Improve Physician Leadership Hiring

Department chairs are expected to motivate and inspire a diverse group of smart, ambitious, overworked physicians. But for most, it’s a challenge.

Standard Daily Management Visual Board at Baptist Health

Using Daily Management and Visual Boards to Improve Key Indicators and Staff Engagement

Baptist Health leverages Daily Management as a way to engage frontline staff and create a data-driven problem-solving culture to help the health system achieve its goals.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Leading Teams

141 Articles

Leadership Development in Medicine

It is time for a critical assessment of the ways in which health systems develop,…

Physician Burnout

37 Articles

Applying Community Organizing Principles to Restore…

IHI offers four lessons on how to nurture joy in the health care workforce.

Leading Transformation

206 Articles

Survey Snapshot: Design Thinking Is Useful,…

NEJM Catalyst Insights Council members agree that design thinking useful, but leadership buy-in and understanding…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now