The Lessons and The Legacy of the Pew Health Policy Program (1997) / Chapter Skim
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Part 1: Introduction
Part 1: Introduction
Pages 1-34
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Ultimately, these many and varied sources of information came together to tell a most provoking and stimulating story. The Program Office, in consultation with the program directors, envisioned and ultimately produced a report that would capture some of the history of the Pew Health Policy Fellowship Programs, include the curriculum from each of the program sites, and report on interviews with program directors regarding specific issues.
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By 1994, the Pew Charitable Trusts had eight signature scholarship programs. The Pew Health Policy Program (PHPP)
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The Pew Charitable Trusts invited a Health Advisory Group of nine experts in health care to assist them in developing their programmatic initiatives. Eight members of this advisory group were academicians, and the ninth person was a physician representing the foundation community (see Table 1~.
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The proposal containe(1 three specific elements: the Pew Scholars Program, an intensive 2-year, post-master's, multi(lisciplinary program lea(ling to a PhD in health policy, offere(1 at both universities; the Pew Fellows Program, which inclu(le(1 a 2-year seminar program to raise the level of health resource management skills of upper-level corporate and government managers (calle(1 senior fellows) , and a 2- to 3year commitment of selected midcareer-level corporate staff to focus on improving access to health care services through .
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The second component was the Pew Health Policy Management Program, offering a 2-year term of diverse management experiences in hospitals, the School of Medicine, and other UCSF professional schools and participation in the Health Policy Research Seminar. The University of Michigan proposed a 2- to 3-year, nonresidential on-job/on-campus doctoral program providing 20 4-day sessions and two 4-week sessions for health services policy makers and administrators and offering doctoral-level training without requiring fellows to leave their current employment for extended periods of time.
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Eight performance indicators used in those evaluations greatly influenced the progress and development of the individual programs: The interdisciplinary strength of the curricula ~ The richness of the health policy-related research and policy analysis environments accessible to fellows ~ The existence of a nurturing orientation and structured mentoring function and the quality of the fellows ~ The impact of the program on local, state, and national scenes The degree to which Pew funding has had a capac ity-building influence within the universities housing the programs The ability of the fellows to routinely secure appointment to appropriate health professional positions having a significant health policy content . ~ The impact of the fellowship experience on the The evolution of the , fellow s career paths prods Will loe descriloed in further ~ The degree to which grantees' programs comple detail in Part 1:1:.
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The objective of the program was to develop and support a unique program of advanced training and education in health policy that would attract talented young and midcareer professionals interested in preparing for leadership roles in policy development at the highest levels of government and industry. The program envisioned that these future health policy leaders would come from a variety of disciplines including medicine, public health, other health professions, law, management, social sciences, economics, and political science but that all would benefit from multidisciplinary training in policy research and analysis, handson-experience, and management.
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Following the resulted in several very first 5-year funding cycle, however, pre(loctoral and man different kinds of agement fellowships were discontinued in favor of strength training centers and a ening the postdoctoral program. At the same time, the post rich diversity of.health doctoral program was expanded to include some midcareer policy professionals.
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The role of key people in the development and evolution of the UCSF postdoctoral program cannot be overstated. In particular, the role of its founder' Phil Lee, as program champion is widely acknowledged' as cited by Hal Lutt: Phil Lee's commitment to training, to doing health policy and health policy research, and incorporating ~ wide range of people with different loackgrounds and expertise was crucial To the development of the UCSF program7....
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The course work and hands-on research experi ence resulted in the development of an effective network for fellows that included academicians, health professionals, and policy makers (UCSF Report, 1994~. At UCSF, there was no In an effort to make the Pew Health Policy Program at preexisting set of UCSF self-sufficient, its faculty implemente(1 major steps courses to serve as a towards.
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This contrasts with the traditional PhD programs, whose principal aim is to prepare future teachers and researchers and whose students therefore benefit from being immersed full time in the academic and research environment for which they are being prepared (Michigan Report, 1994~. The RAND/UCLA program evolved out of a Tong-term relationship between the University of California at Los Angeles and the RAND Graduate School of Policy Studies.
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At RAND/UCLA, fellows The RAND/UCLA doctoral program prescribed a 3 worked approximately year enrollment perio(1 of stu(ly (luring which time students half time as staff on completed the requirements of either the RAND Graduate health policy research .
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This resulted in the discontinuance of Pew funding for the RAND/UCLA doctoral and midcareer programs. Nonetheless, the residential doctoral program continued after the Pew funds were discontinued, and it remains a vibrant program today, with the courses created for the Pew program fully institutionalized at both universities.
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Steve Crane discussed how the merging of the two institutions and their philosophies created programs that aimed at involving the business community in the health policy world: The particular center at BU that was involved was the Center for Industry and Health Care.... [T7he Pew Corporate Fellows Prod at BU brought together major industry leaders who were involved in health care issues, brought them to Boston twice year, and created ~ network in the business community, the results of which are still being seen today in terms of the corporate coalitions that have been created and the analyses that continne to be done on health outcomes.
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It provides an excellent working laboratory for Pew fellows interested in conducting and pursuing careers in health policy research. Boston University's Health Policy Institute and the Institute for Health Policy at Brandeis University's Heller School initially offered three distinct programs: The Pew Corporate Fellows Program, the Pew Associates Program and the Pew Doctoral Program.
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It was envisioned that these health policy leaders might work in either the public or the private sector or might assume academic or nonacademic roles in policy formulation, research, and education. With the withdrawal of Boston University as a joint sponsor of the training program, the Heller School's complement of fellows increased from 6 to 12, and an effort was made to better integrate the Pew program into the Heller School's existing (loctoral program in social policy.
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In an article written for the commemoration of IOM's 25th anniversary, Marion Ein Lenin, Director of the Office of Health Policy Programs and Fellowships, discussed the relationship between IOM and its fellowship programs. Lenin states that over the years, the Pew Health Policy fellows have developed a close relationship with IOM, even though most fellows only formally interact with IOM twice during their Pew program training.
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Marion Ein Lenin indicated that in preparation for her report, the Office of Health Policy Programs an(1 Fellowships conducted an informal mad! survey "to get a better sense of the degree to which Pew alumni have been involved in IOM activ ities." Forty percent of Pew alumni respon(le(1 to the survey, and of that group approximately 20 percent reported partici pation in an IOM activity.
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This awareness leads Schroeder to commend the Pew Charitable Trusts and the Robert Wood Johnson Foundation for continuing their felTowships in light of these impediments. He praises the Pew Charitable Trusts and the Robert Wood Johnson Foundation for their commitment to investing in the future through longrange projects.
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The structure of the Leon Wyszewianski remarked that the University of Michi Michigan program gan continues to corner the market for this type of (loctoral enabled many.highl- training and that it still has no competition. However, many P P believe that Michigan's success with the Pew health policy to go back and get the additional training nonresi(lential (loctoral program in health policy will inspire needed to more other institutions to follow suit.
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Traditional doctoral programs allow for that peer group processing, an activity that Patricia Butler and others believe is very important to any program at this level. Bill Weissert discussed another concern related to nonresi(lential (loctoral programs.
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We somehow forgot that at the beginning of the Pew program, but we soon remembered and then set up the program much as we had done for our master's-level program. This worked much bet ter.
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and the intense commitment of the faculty to the fellows. All four Michigan fellows interviewed mentioned the benefits of having in the classroom students with a rich diversity of backgrounds.
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Student integration at RAND was strong, and Al Williams attributed this in part to the fact that the workshops were open to people outside the Pew program. Integrating Pew and non-Pew fellows in the workshops led to a more diverse student body that enriched class discussions.
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This concept comes up again and again with the Pew fellows, whether they are doctoral, postdoctoral or midcareer fellows. To most, PHPP was Filly representative of the health policy world, with health policy leaders teaching in a relevant, timely, and applicable manner.
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She also considered the work projects to be a great strength of the RAND midcareer program. However, she would have liked to have seen more general discussions of the big-picture health policy issues.
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Fellows were pleased that the faculty had top-level policy influence and real-world perspectives, were committed to teaching and being supportive, an(1 treate(1 the fellows as peers (Richar(l Cross-fertilization of individuals who had worked in the policy arena and other health care professionals is what the Pew Charitable Trusts hoped to accomplish with PHPP. The aspect of mixing physicians with social scientists was one of the greatest challenges and one of the greatest rewards of the UCSF program.
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researchers pants in the health policy process, an(1 so it consi(lere(1 super and prachhoners but to vise field placements In public- and pr~vate-sector organ~za ensure that graduates be effective and lions a valuable "learning-by-(loing" part of the fellowship relevant participantsin program, especially for midcareer fellows (UCSF Annual the health policy Report, 1992~. Mark Legnini, a post(loctoral alumnus, process.
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. UCSF program directors concluded that the optimal amount of structure depends on the needs of individual fellows.
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Steve Crane explained how determining program structure was a learning experience for the program directors as well as the fellows:
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Boston University faculty and fellows alike cited the involvement and dedication of several faculty and program (Erectors as a major strength of the program. Steve Crane described how several key people, Diana Chapman Walsh, So!
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According to Steve Crane, "UPP was the educational home for the BU Pew Doctoral Program, and Diana was the intellectual inspiration." Sol Levine was the academic director at BU and a leading national expert on medical sociology. He was the faculty member who bridged the gap between students, UPP, and BU.
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A second common theme that emerged from the interviews is the "reality focus" of the Pew programs. Almost all of the fellows commented on how the programs were applicable to the real world and how the research and work projects were focused on current health care issues and problems.
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a given issue. The Pew Health Policy Program trained fel most effective way to train health policy saws to view health care problems through many different professionals.
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