The term “medical doctor” often conjures the image of a white coat and a stethoscope. But not all MDs are full-time clinicians; many combine clinical work with teaching or research.
While research often involves lab work and clinical trials, there’s another side to it: health services, which includes health care policy. That career path has led several MDs to the Department of Health Care Policy. HCP Head Barbara J. McNeil, MD, PhD, and faculty members John Z. Ayanian, MD, MPP; Alisa B. Busch, MD, MS; Nicholas A. Christakis, MD, PhD, MPH; Nancy L. Keating, MD, MPH; Elizabeth B. Lamont, MD, MS; Bruce E. Landon, MD, MBA, MSc; and J. Michael McWilliams MD, PhD, are practicing clinicians who bring medical expertise to their research at HCP.
What draws a medical student to health care policy? Every story is different. Keating connected with HCP during her residency at Brigham and Women’s Hospital. Already interested in research, she had the opportunity to work with Ayanian and Harvard professor Arnold M. Epstein, MD, MA, and found that the type of research performed at HCP was a match for her interests and disposition.
“It’s a nice mix, to do primary care and research,” she says.
Keating spends a half day each week seeing patients in her clinic and half a day supervising residents, enabling her to see more patients without adding to her caseload. Her area of research is quality of care for cancer patients, with the goal of understanding the care that leads to better outcomes.
She sees her clinical and research work as complementary. Witnessing the problems in receiving and delivering care informs her research. The research makes her a better clinician, too. For example, a study she worked on about doctor/patient communication influenced how she communicates with patients. The symbiotic relationship resonates with her. “It’s the best of both worlds,” she says.
McWilliams came to HCP with a similar mix of interests. He had a knack for math and science, but was also interested in the humanities. In medical school, he preferred health policy research over lab work because he was more interested in people than cells. HCP was a natural fit.
McWilliams provides primary care to many patients with chronic illnesses and socioeconomic challenges. Like Keating, his clinical work motivates his research, which focuses on quality, access, and costs of care for aging adults with chronic conditions. He’s currently studying the effect of near-universal Medicare coverage after age 65 on disparities in health outcomes.
For McWilliams, research is a creative and challenging process. Unlike other scientists, health services researchers usually can’t run experiments to answer their questions. Drawing from his doctoral training in research methods, McWilliams enjoys trying to “recover the truth” from existing datasets.
Also satisfying is when study findings prompt responses from policymakers or even individuals for whom the research was conducted. McWilliams’ research mentor, Ayanian, once played a voicemail for the rest of the team from an older underinsured woman thanking them for their research.
A dual interest in medicine and business led Landon to HCP. He came to economics in college, where he took business courses to widen his worldview. The business of medicine appealed him, so he concurrently obtained MBA and MD degrees.
Landon was exposed to HCP during a fellowship. He found HCP was “an ideal environment because of the top-notch people and multidisciplinary faculty,” which includes statisticians, economists, and scientists.
Landon’s main research focus is the impact of aspects of physician and health care organizations on the provision of health care. One study he’s working on, with Christakis, looks at physicians, social networking, and how information sharing might influence care. His other areas of research include studying the impact of physician financial incentives and quality of care.
The 20 percent of his week he spends working as a clinician strongly influences his research. Seeing firsthand that people can’t afford their medications or a visit to their doctor reveals important questions for health policy and inspires his research.
What is most satisfying about his work at HCP? He likes the intellectual challenge and working with high-caliber people. But, like McWilliams, Keating, and the rest of the faculty, he sees the potential to influence policy; having that happen would be the most satisfying reward of all.
