Like most pre-meds, I decided to go to medical school because of a desire to take care of patients. That desire remains alive and well – few experiences compare to meeting someone who has a problem and being able to fix it. The privilege of patient care is the foundation of a career in medicine.
At the same time, my experience in business school has shown me that doctors can have an important role outside of clinical practice. American health care is riddled with problems, and it will be impossible to solve them without physician involvement.
As such, I have spent the past few months exploring ways in which doctors help patients outside of the exam or operating room. Based on my reading and discussions with practitioners, there are three broad areas where physicians can and should take leadership roles.
1. Academic medicine – research and teaching
Research is the traditional way that physicians transform health care. Physician-scientists make breakthrough discoveries about how the body works, develop innovative therapies, and validate new drugs and devices that can be used in practice. Scientific inquiry advances our understanding of human health and disease. Physicians have long been the drivers of this inquiry and must continue to push the frontiers of what is medically possible.
Teaching is another core tenet of academic medicine. The impact of an individual physician is reflected not only in the patients that they see, but also in the students that they train. New discoveries and clinical methods are only useful if they can be communicated to the next generation of providers. Academic physicians take on that responsibility.
2. Health system leadership – management and policy
There is a well-characterized path for doctors who plan to pursue a career in academics. There are far fewer physicians involved in health-care management and policy. Fortunately, that is changing.
Health system leadership can take several different forms. Perhaps the best known is hospital administration. Physicians make up just 4-5 percent of hospital CEOs in the United States, but a 2011 study found that quality scores were higher at physician led hospitals. It intuitively makes sense that a physician CEO would better understand the needs of his or her employees (doctors, nurses, etc.) and patients.
Health policy is another domain where physicians should get involved. This includes policy positions at the federal, state, and local levels, along with advocacy through professional organizations. Health care often becomes a battleground more oriented towards the needs of politicians than patients. Physicians active in health policy can help redirect that conversation.
Policy involvement can also take the form of elected positions, many physicians have run for office, and the current U.S. Congress includes three Senators and 15 representatives.
There are countless other ways in which physicians can help shape the health-care system as well, including roles in public health, insurance, pharmaceuticals, and more.
Finally, doctors are well-suited to entrepreneurship. Physicians observe patient needs on a daily basis and must often address them in creative ways. Doctors can also create tools tailored to the end-users of health care products: other providers and patients.
It is unsurprising, then, that many of the most useful innovations in medicine come from physicians. For instance, Paul Yock, MD, (a Stanford cardiologist and founder of its Biodesign program) created the balloon angioplasty and stent system that is the primary technique used worldwide.
In addition to implementing their own ideas, physicians can support biomedical entrepreneurship as venture capitalists. An increasing number of doctors are becoming investors to help bring new products and services to market.
Clinical practice is the core function of a doctor. It is what inspires people to go into medicine and what we train to do in medical school. Yet the role of physicians is evolving. With a changing health -care system and a population that has ever more complex medical needs, there are new ways for doctors to help their patients.
Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the Stanford Medicine Unplugged category.
Akhilesh Pathipati is a fourth-year MD/MBA student at Stanford. He is interested in issues in health care delivery.
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