Duke University | Center For Health Policy | Translating Research Into Policy

Without exaggeration, the U.S. health care system is undergoing its most rapid transformation in history. This is a combination of the turbulence caused by a variety of factors:

the continued shift towards managed care and the fact that managed care itself is undergoing an evolution in terms of how to control costs without sacrificing quality;
the growing importance of government payers (e.g., Medicare and Medicaid) and the attendant response of politicians struggling to contain health spending (which typically are the fastest-growing components of federal, state and local budgets); and
the rapid growth of new technology which escalate the cost pressures felt by business, government and consumers and in some cases, such as the Human Genome project, raise powerful ethical questions about how far science can and should go in the pursuit of better health.

All of the above trends inevitably raise complex policy questions that someone has to decide: for example, what should we do about the 44 million uninsured whose numbers rise every year due to ever-increasing health costs? Do we need special protections in managed care plans for vulnerable populations, including the poor, the elderly and the disabled? Should Medicare be expanded to include prescription drugs and if so, what is the most sensible way to do this? Because of the rapid pace of change in medicine and health policy, physicians now have to negotiate a career that is far more complicated and fraught with uncertainty than those in past generations. Their lives and practices increasingly are influenced by decisions often made by public and private policymakers with no training in medicine.

The Certificate program offers a number of courses that presumably might be of interest to an aspiring physician in their own right; these include, as examples, Managed Care, Ethical Issues in Health Care, Health and Illness in Society, and Social Aspects of Mental Illness. Moreover, the very turbulence that creates uncertainty for freshly minted physicians also offers exciting new opportunities for those who might want to combine their clinical knowledge with skills that would help them influence the direction of decisions made by public policymakers or private industry.

These skills would be useful for those eventually wanting to take leadership positions in their local medical society, serve on various hospital committees that may have to wrestle with policy questions, or get involved in the multiplicity of citizen advisory groups that help guide policy at all levels of government. And even if none of these are of current interest to you, keep in mind that just a basic understanding of the alphabet soup of managed care (e.g., IPAs, HMOs, PPOs) or major government programs (e.g., Medicaid compared to Medicare) may help you gain some wisdom that could be of great value as you later make decisions about what kind of practice you want to enter or what kinds of business relationships you want to consider within your practice. Consider the following observation of a recent Duke pre-med:

"I really enjoyed the Health Policy Certificate Program and I feel as though it has allowed me to enter medical school with my eyes open to the realities about healthcare in our society."

"...especially for someone going to medical school, studying health policy in depth is helpful-- it gives important insight into a facet of medicine that is notoriously missing from the typical premed, science intensive curriculum."

In short, a Health Policy Certificate can be of benefit to you even if you never have any intention of becoming a policymaker or engaging directly in the formulation of public policy.

Finally--and this is the least important reason to consider a Certificate--in the very competitive medical school admissions, a Health Policy Certificate can help you stand out from the crowd of many other equally qualified candidates. It will mark you as an individual with a broader view of the world who has made the effort to understand the larger role that medicine plays in society and the many other social factors besides medicine that affect human health, including poverty, lack of education, and risk-taking behavior.

Regardless of whether you ultimately want to pursue a Certificate, please at least scan the diverse array of more than 40 different health policy related courses at Duke. We think you will find at least a handful or more that will better prepare you for a career in medicine.

Should pre-med students pursue a health policy certificate?