With so much critical work happening at the Department of Health Care Policy, it’s hard to imagine spending time away from it. But gaining some perspective on the ongoing work and learning something new is also critical to the life of the department. HCP faculty member Richard G. Frank, PhD, found this to be true during his recent sabbatical that spanned the globe.
Frank is the Margaret T. Morris Professor of Health Economics at HCP, engaged in research here in the economics of mental health care, the economics of the pharmaceutical industry, and the organization and financing of physician group practices. His recent travels brought insight into his work and stimulated a variety of new activities.
Frank spent the first month of his sabbatical in Taos, New Mexico, a location that was both inspiring for his own projects and convenient for ongoing work that he is doing for the state of New Mexico in Santa Fe. Frank is involved in helping the state understand the results of a recent restructuring of its mental health system by developing a specialized spreadsheet to analyze their data. He is also providing guidance to help the state to understand better the direction of its mental health care system since the restructuring. He also has introduced methodologies to help the state find the answers in their data.
“Being an hour away from Santa Fe for a month helped me make terrific progress on this project,” he says.
The time spent in New Mexico was also productive for his own projects, including a paper on how diffusion works in a medical community with regard to psychotropic medications. He is working on this paper with former student Marisa Domino, PhD, of UNC-Chapel Hill and with Ernst R. Berndt of MIT. They ask: “Do physicians within the same community influence the prescribing habits of others?” He is also looking at practices in different parts of Florida to show to what degree a peer effect influences physicians’ use of new drugs.
Surrounded by mountains and enjoying the benefits of nature, Frank found Taos to be conducive to the type of thinking that is necessary to stay on the vanguard of thought and hard to find time for in his busy days at Harvard. He was able, for example, to work on reanalyzing a large trial of antipsychotic drugs and on rethinking the basic premise of the economic evaluation of that experiment.
Rather than spending his sabbatical at one location, Frank spent some time back at HCP to oversee his grant work before heading off to London for the rest of his hiatus. Using this approach, he says, provided the perfect balance because he could be exposed to new things and new experiences while staying on top of his ongoing research at Harvard.
In London, Frank sat at the Sainsbury Centre for Mental Health, a research and policy center. There he learned about mental health policy in England and had access to a large birth cohort study on the relationships between childhood mental health and adult outcomes. The study enables researchers to see how those who experienced behavior problems as a child, for example, turned out as adults. This study relates to work he has done here and provides a valuable basis for comparison.
He is also working on a paper with a British health economist at the Sainsbury Centre about a policy debate in England concerning individual budgets for those with chronic illness, such as the mentally ill. This policy would give recipients and their case managers control over their health care budget instead of having a government agency allocate a certain amount of money to each patient’s health care and a certain amount to living expenses. He is looking at the pros and cons of the proposal, offering the perspective of the U.S. experiences with the use of market mechanisms for allocating mental health care.
After such a productive and creative semester, Frank is enthusiastic about his sabbatical, which is wrapping up now. “It’s amazing how much one can accomplish without the distractions of the complicated activities at Harvard,” he says. “It’s been a phenomenal experience.”
