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.

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