When I’m not wondering how I could possibly wrap my mind around every regulatory step in metabolism, I am geeking out about health policy. Why? Well, after spending my premedical career at Johns Hopkins, a place that prides itself on “saving lives millions at a time,” I, too, wanted the skill set to help the masses.
What I have learned along the way is that many people find policy boring. Maybe they associate it with clips of C-SPAN they watched in middle school civics class, or perhaps it evokes the frustration felt when yet another health policy dies a silent death on a Congressional floor, but whatever the reason, policy is ascribed as a responsibility solely for politicians.
This presents a massive conundrum because our interests as future clinicians cannot be represented if we are not the ones speaking to policymakers. I think of it akin to asking me to provide an educated opinion on the structural integrity of a bridge. Unless it’s actively cracking, I won’t know if it was built according to code, or if the best principles of engineering were employed. Similarly, much of Congress has little to no experience with providing health care, and therefore, cannot be expected to make informed decisions on those topics. So, for issue after issue, Congress solicits experts to provide their testimony, but if we as future clinicians are not abreast of policy trends, how can we advocate for ourselves? And yes, I do understand that the average person has little to no free time to be reading policy after policy in its pure, legal jargon-laced state, but I do feel strongly that we can all make ten minutes a week to figure out what is happening in the world.
So if you’re up to learning about policy trends but you don’t have an abundance of time, fear not! This column will distill for you some of the most pressing issues in health policy for your consumption in ten minutes or less. I have a lot of topics I want to cover, ranging from prescription drug abuse to LGBT health care under the Affordable Care Act, but I’m also open to your suggestions. Please use this column as a place to engage in healthy debate about the issues that matter to you!
I wanted to kick off the New Year with ten issues I think will have significant implications for policy conversations this year. This list comes inspired by one from the National Council for Behavioral Health. Admittedly, many of my suggestions have a behavioral health tinge to them because I am a big advocate for integrating physical and behavioral health services, and I think that our policy culture is moving in that direction. After you check out my list, I’d love to see yours. What do you think we’ll be hearing a lot about in 2015?
1. Prescription Drug Abuse: In 2014, many communities were ravaged by accidental deaths related to prescription drug abuse. Congress has had several briefings on the topic, and in 2015, will likely continue to seek measures to address this crisis. In fact, the National Institute on Drug Abuse has put out a call for your insights and ideas in terms of how to address prescription drug abuse.
2. Marijuana: As more states debate “legalization” and “decriminalization” of marijuana, clinicians must decide how to address marijuana in the office. How can we provide unbiased, accurate information for our patients about the potential benefits and risks of marijuana?
3. Affordable Care Act Challenges: With the Supreme Court slated to rule on the federal subsidies viewed as central to the law, a strike-down could make insurance unaffordable for many newly enrolled individuals and families. Aside from this case, there are several smaller cases in the pipeline addressing varying aspects of the ACA.
4. The Physician Shortage: With each passing year, we grow closer to the precipice of a massive physician shortage, especially in light of more Americans finding coverage under the ACA. I am hopeful that in 2015 we’ll hear more from Congress about plans to address the physician shortage, but this is an area where activism will particularly be important.
5. Physician Burnout: Year after year, we hear about how physician burnout is a major issue, contributing to preventable medical errors, to career dissatisfaction and to mental health concerns. It is my hope that this year we will talk not only about the causes of physician burnout, but also some of the solutions.
6. “The Merger”: 2015 is a big year for residency training programs. The unification of osteopathic and allopathic graduate medical training program begins this summer and is expected to continue until 2020. Expect conversations about what it means to “merge” and what allopaths and osteopaths can expect in the coming years.
7. Vaccines: This past year, many celebrities publicly criticized vaccines, suggesting that they may not be safe for a variety of reasons. Yet, California currently battles a measles outbreak. This year, policymakers should consider what we can do to educate the masses about the importance of getting their children vaccinated, not only for themselves, but for those who are too immunocompromised or otherwise unable to receive vaccinations.
8. Mental Health Stigma: In 2014, people worldwide suffered great tragedies as loved ones died by suicide. On a global scale, we saw the impact of the loss of Robin Williams. Now is the time to spark a conversation about stigma and barriers to recognizing distress in those around us. Programs such as Mental Health First Aid aim to do just this, addressing symptoms and signs of common psychiatric conditions in a non judgmental setting. Funding for these programs, as well as national and local initiatives to promote mental well being are critical.
9. Tobacco Free Policies: Last September, CVS went tobacco free. Will 2015 be the year where other large pharmacies follow suit? What about including or excluding e-cigarettes from these policies? Expect many companies to weigh their options. If you’re passionate about smoke-free policies, get involved!
10. E-cigarettes: Currently unregulated by the FDA, e-cigarettes are a new frontier for clinicians. Evidence is mixed about their utility as cessation devices, but the CDC reports increased calls related to nicotine poisoning as their use increases. It’s time we have a conversation about how to talk about e-cigarettes.
I hope to delve a little deeper into each of these topics over the course of the year, so I welcome your questions, comments and feedback on any and all.
Doctor of Policy is a column dedicated to exploring and challenging contemporary health policy issues, especially in the fields of behavioral health, health care access, and inclusion, all from the eyes of a public health girl in a basic sciences world.
Writer-in-Training, Columnist and in-Training Staff Member
Philadelphia College of Osteopathic Medicine
Aishwarya is a second year medical student at the Philadelphia College of Osteopathic Medicine. She relishes any opportunity to talk policy, social determinants of health, mental health parity and inclusion topics. Outside of school, Aishwarya enjoys yoga, green tea with lemon and copious amounts of dark chocolate.
Doctor of Policy
Doctor of Policy is a column dedicated to exploring and challenging contemporary health policy issues, especially in the fields of behavioral health, health care access, and inclusion, all from the eyes of a public health girl in a basic sciences world