The Lessons and The Legacy of the Pew Health Policy Program (1997) / Chapter Skim
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Appendix A: Telephone Interviews
Appendix A: Telephone Interviews
Pages 137-300
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From page 137... ...
APPENDIX A Ctelephone ewe Telephone Anteto~ewe Bill Weissert Carroll Estes Dennis Beatrice Hal Lutt John McDonough Lisa Bero Leon Wyszewianski Mark Legnini Patricia Butler Pamela Paul-Shaheen Stuart Altman Sarita Bhalotra Stan Wallack Marion Ein Lewin John Griffith Dan Rubin Joan DaVanzo Terry Hammons Jonathan Howlan Kate Korman Steve Crane Al Williams Kathleen Eyre Leighton Ku Lin(la Simoni-Wastila
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From page 138... ...
We helpe with the (Effusion of the health services research findings. I am always struck when I go to meetings and talk to folks who are making major policy (recisions or influencing policy (recisions without reacting the literature.
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From page 139... ...
It broadened our presence in training health services researchers at the doctoral level. We had been primarily a master's program with a very small (loctoral program; this gave us a whole new program, more bellies, and a slightly different cut of people.
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From page 140... ...
The cohort effect locking people into being part of a group for 2 years of intensive course work. I think that has a terrifically positive effect, is very successful, and socializes a Tot of people.
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Answered previously. Based on your experience, what lessons were learned aloout the educational process in terms of: recruitment?
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Our penultimate cohort is up to 66 percent with a couple more likely to come through. I don't think doctoral programs ever want to be 100 percent.
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From page 143... ...
How does the Pew fellowship approach differ from ~ traditional fellowship approach? How have the major outcomes differed ?
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From page 144... ...
There certainly are seminars and courses that exist on our campus that would not have existed on this campus without support from Pew. There are other postdoctoral programs that are multiplier effects from the Agency for Health Care Policy and Research (AHCPR)
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From page 145... ...
I think we found that the midcareer program was a very good route for certain people who were quite accomplished and had a lot to bring to the classroom, but who needed to acquire the health policy and interdisciplinary skills. These people already had positions of influence into which they could carry this.
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From page 146... ...
What was the need in the health policy community when your program started, and how have those needs changed today? Is the jolt done?
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From page 147... ...
educational process? The Pew conferences every year have been important.
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From page 148... ...
We only had a predoctoral program for a couple of years. We missed the predoctoral part and were sad that it was cut out.
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From page 149... ...
How does the Pew fellowship approach differ from ~ traditional fellowship approach? How have the major outcomes differed ?
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From page 150... ...
The outcomes have (liffere(1 (dramatically from those trom the traditional fellowship approach, for example, the productivity of our fellows in terms of research and publications. We would stand them up against any fe(leral post(loc program, and I think they would be probably have twice the rate in terms of explicit measures of productivity.
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From page 151... ...
We trained our fellows in analysis and policy. This approach is more important now than ever because the fine lines between health policy analysts and health policy makers are becoming blurred.
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From page 152... ...
How can we measure successfor those pro,grams where completion rates do not apply ((i.e., postdoctoral pro,gramsJ ? What happened to the fellows?
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From page 153... ...
that we would have not had a postdoctoral program had there not been the Pew funds to get it started. We would not have had the AHCPR (Agency for Health Care Policy and Research)
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From page 154... ...
We now have quite a few faculty at UCSF who were trained in the Pew program who would not be (1oing what they are (1oing at UCSF had they not been Pew fellows. So, in a sense it is being institutionalized through the faculty.
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From page 155... ...
(2) I think over time, admittedly with some prodding from the Pew Charitable Trusts, we developed a more structured set of seminars and courses.
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From page 156... ...
methods of implementation? } educational process?
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From page 157... ...
They sort of freeze. We are now restructuring that a little bit.
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From page 158... ...
We have some people who are on trajectories toward faculty positions, so they really need to be publishing and we are encouraging them to do that. There are others who are much more policy oriented, and for these fellows publication is secondary.
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From page 159... ...
They are now doing work on risk adjustment models and health care costs of AIDS, etc., exactly the kinds of things the Pew fellows do. In this way we are integrating our fellows with other people in the classic fellowship programs on this campus.
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From page 160... ...
I can tell you that I went through a postdoc training program, and had I not done that, I would have had a very different career trajectory. How does the Pew fellowship approach differ from ~ traditional fel lowship approach?
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From page 161... ...
It's not like we are a PhD program where faculty are going to get teaching credits for doing the teaching as a fairly structured kind of thing where you can say here is the syllabus, go do it. Our program is a little bit like an individually designed house that you need to build onto the wall of a mountain.
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From page 162... ...
Not really knowing a large number of other Pew fellows, I think it would be the combined legacy of what people have been able to do with their degrees, and I assume that it's substantial, but I don't know that for sure. What was the most innovative or unique aspect of your pro,gram design and implementation?
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From page 163... ...
I got a Health Care Financing Administration dissertation grant to help me finish.
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From page 164... ...
The program positioned me for doing a Tot of international work. I had my first contact with the World Health Organization while I was a Pew fellow.
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What was it aloout the curriculum that contrilouted or did not contribute to the pro,gram's success? The writing seminar.
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From page 166... ...
I'll never forget when I started the Pew fellowship, the person in charge of the admissions at that time called me up and told me I got the fellowship, and I was working in this lab and I was just so happy. For over a year I had been pondering how I was going to get where I wanted to go.
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From page 167... ...
For example, when I do a sabbatical I'll almost definitely do it in a nonacademic setting. Also, I do a lot of technical assistance and policy work that is kind of off the traditional academic track, which hurts me a little because you don't get a lot of brownie points as an academic for doing that.
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From page 168... ...
There definitely was a contribution to the health policy field, and those fellows who wanted to go into health policy were able to go into health policy. Training and/or a decree from Michi ~ ~r '' .
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From page 169... ...
There was this very large group of people out in the health policy field alrea(ly, in responsible positions, who felt inadequately prepared to deal with a Tot of their tasks. They wanted to do a better job at what they were already doing and were looking toward our PhD program as a place to learn that.
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From page 170... ...
In the beginning there was a very lenient attitude toward the students and their course work, so we foun many students hobble(1 (town with huge numbers of incompletes. This hampered the students' ability to get (lone because not only were they writing a (lissertation but they had state papers to get (lone from courses Tong gone.
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From page 171... ...
What was the most innovative or unique aspect of: your prod design? We offered a doctoral program on a nonresidential basis, where students come here once a month for 4 days, 12 times a year.
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We learned to pay a lot more attention to grades, past academic accomplishment, as well as Graduate Record Examinations (GREs)
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From page 173... ...
We would like to think that everything we teach is useful, but the students on their own account have confirmed the usefulness of the course work. Ilow can we measure successfor those pro,grams where completion rates do not apply ((i.e., postdoctoral pro,gramsJ ?
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Those are basically the two reasons why someone would come here. How does the Pew fellowship approach differ from ~ traditional fel lowship approach?
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What are the most important contriloutions? It seems to me important to distinguish between the two kinds of Pew programs (postdoc versus predoc)
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From page 176... ...
What value has Pew training added to your life? It's nice to be employed.
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From page 177... ...
The courses that I particularly wanted to have training in were epidemiology, research methods, biostatistics, health economics, and, to my surprise, health behavior, which turned out to be one of the most useful and interesting subjects that we studie(l. I really got my money's worth there.
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From page 178... ...
On the other hand, for most of us who were midcareer and for many of us who live in places where there isn't even a graduate-level health policy program offered, this was the only way we could do this. That's why I am so grateful to the Pew Charitable Trusts for supporting this kind of program.
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From page 179... ...
What was the most innovative or unique aspect of your program design and implementation? It was the nonresidential aspect.
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From page 180... ...
Some people who are more interested in health services research or health systems management may not care as much about that. To me, public health is a fundamental set of disciplines whose influ ence is often lacking in our current national debate.
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From page 181... ...
I guess any midcareer program would attract (liverse groups of people, .
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From page 182... ...
There are opportunities for me to integrate what I've learned into my work. Hasyon~ career trajectory changed as ~ result of your time spent in the Pew program ?
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From page 183... ...
Clearly, for the individuals involved, Pew has created both learning opportunities and incre(lible networking opportunities. I use many of the people in the Pew network continually, an(1 I'm always amaze(1 as I go through my professional life the people I run into and find out we share the common framework of having gone through the Pew program.
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From page 184... ...
Secondly, when you combine that, as the Michigan program dill, with people who are actively en~a~e(1 in nolicv activities in their work, a symbiotic rela tionships occurs between problems from work and techniques learne(1 from class, a(l(ling an interesting (1ynamic into the program. The program empowered these individuals in their own workplaces.
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From page 185... ...
Since we were the first "guinea pigs" there were more barriers in terms of people not knowing how things were going to operate. There were still faculty discussions of what was going to be demanded of students and were these really doctoral students, etc.
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From page 186... ...
That has not changed one iota. What the program has (lone for me is that it has given me additional credibility, some additional options for choices of work than I would have had without it, but it has not made a major change in my professional life at all.
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From page 187... ...
How did the Pew Health Policy Program start? Who are the key people involved ?
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From page 188... ...
But there are always, on the margin, individual students who don't get a Pew fellowship. I pretty much left the running of the program to Stan Wallack.
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From page 189... ...
Clearly, the Pew program (li(1 (1emonstrate the importance of inter(lisciplinary research. It was also terribly valuable to the Heller School tat Brandeis]
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From page 190... ...
What are the most important contriloutions? The most important thing that the Pew program accomplished for me was the opportunity to network with a Tot of important players in the health policy field, including the other Pew fellows, as well as the people that they worked with.
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From page 191... ...
I have gotten more interested in health policy and health services research than I was before. What value has Pew trainin,g added to your life?
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From page 192... ...
I am not ruling that out in the future, but at this point it seems like I'll pretty much stay in health services research for the foreseeable future. l:fyon did not complete the program, do you plan to?
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From page 193... ...
Most traditional PhD programs are teaching methods and theory. Schools of public health teach a Tot of statistics, etc.
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From page 194... ...
To what extent will your prod continue now that Pew funding has ceased ? We slid not have a training program.
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From page 195... ...
When the program switched from BU and Brandeis to Brandeis alone, we became more concentrated on the vulnerable populations that we are most concerned with at Brandeis. We integrated more with the Heller School.
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From page 196... ...
Both the weakness and the strength was being in the Heller School. The health policy curriculum is multidimensional in terms of political science, economics, and sociology.
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From page 197... ...
So, placing the Pew program within the Heller School's curriculum was a very big challenge. Based on your experience, what lessons were learned aloout the educational process in terms of: recruitment?
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From page 198... ...
That would be something that I think is very important in a PhD program. I think the people at San Francisco brought in people who already had PhDs in disciplines, and I think that is important for the kinds of research and publications we need to do.
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From page 199... ...
We started off with just having Pew fellows in the courses, but we realized that while the Pew students were very good, there were some other students who were very good who didn't get a Pew stipend. So we broadened these classes, and I think that by changing the educational process we helped to break down those barriers that we had in effect created by saying it was such a special program.
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From page 200... ...
The institute has some excellent economists, political scientists, and po~icy analysts, but outside the institute there are other interesting faculty with whom the students may choose to work. completion rates (where applicaloleJ ?
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From page 201... ...
How does the Pew fellowship approach differ from ~ traditional fellowship approach? How have the major outcomes differed ?
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From page 202... ...
Another thing is that if you are training people to (lo policy in the real world, you must be flexible.
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From page 203... ...
(1987~. The interesting footnote about that move is that when the Pew Health Policy Program was first thought about at the Pew Charitable Trusts and they were looking for an organization to direct it, IOM had respon(le(1 to the proposal.
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From page 204... ...
This program came along at a time when health policy research was becoming increasingly recognize as an important (discipline, and health care programs and bu(lgets were becoming such a significant aspect of public, fe(leral, state, community, and private-sector bu(lgets. Until the Pew Health Policy Program came along there were not many people who were goo(1 at policy but who also had the analytic skills to really un(lerstan(1 what these (1ynamics were all about, how to develop a changed agenda.
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From page 205... ...
The feeling is that the Pew Health Policy Program really enriched the field of health policy research and informed the debate. When you Took through the literature at how the Pew fellows are represented, in what areas, and with what activities they've been active, it reflects the world of health policy and health care reform in the last dozen years.
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From page 206... ...
Based on your experience, what lessons were learned aloout the educational process in terms of: ~} recruitment? There has been tremendous improvements in terms of thinking about the kinds of people you want to recruit to these programs, the kind of people who could succeed in these kin(ls of programs.
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From page 207... ...
How do you marry the worlds of health policy and health services research with decision makers who have very different requirements and timeliness So it was not only being very aware of the quality content of the curriculum but also being very much aware of how this content nee(le(1 to be applicable to people who were not going to wind up in an ivory tower but who were going to be on the front lines of change. inte,gration offellows with other students, the rest of the university and the pro,gram in,general?
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From page 208... ...
Another interesting issue for me was, in the beginning, when we used to have these annual meetings, that no one ever thought of themselves as Pew fellows. People thought, "I am getting a (legree at the University of Michigan or at Brandeis or UCSF or at UCLA." Everyone at these different programs was so intense and wrapped up at (1eveloping and establishing the individual programs at the individual universities that they looked at the Pew Charitable Trusts as only a financier and that's all we have to do with them.
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From page 209... ...
Some of the fellows didn't like some of the panelists because they didn't share their views, and I remember that some of the program directors felt that it was really time to call the fellows together to talk about this hostility that was being expresse(1 either explicitly or implicitly through sign language, etc. Leon Wyszewianski from the Michigan program got up and said that the purpose of being a Pew fellow is that you gain an understanding about how to be an effective change agent in the world of health policy and that the purpose of the Pew Health Policy Fellowship Program is for people to become good communicators and to work in the real world, not in some ideological world.
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From page 210... ...
Very few people were completing the program. The programs were just getting started, so that people (li(ln't think of themselves as a "family" of Pew fellows.
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From page 211... ...
I thought about whether we would have had more "value added" if we started this program at schools that were still a little bit behind but with some resources that could get them into the first rank. I think it is a shame that we were never able to get some funding to expand these programs to schools (e.g., the LBT School)
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From page 212... ...
I think, not blowing the horn of the national program office, that the network has contributed very much to the identity of the Pew Health Policy Program fellows as a group, and the vanguard of change certainly enhance(1 the visibility of the program in the larger world of health policy and in Washington. It always amazes me when I go on the Hill and I say that I run the Robert Woo(1 Johnson Health Policy Fellowships Program and also the Pew program that
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From page 213... ...
We accept them in the "family." How does the Pew fellowship approach differ from ~ traditional fellowship approach? How have the major outcomes differed ?
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From page 214... ...
Major outcomes were clearly that these people were trained to be effective change agents in the real world, and to that (legree I think that this fellowship was so much ahead of its time. I don't think that when the Pew Charitable Trusts thought about this program many years ago that they even realize(1 how on target this program would be for the wori to(lay.
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From page 215... ...
Everyone who entered and completed the course work (not just those Who completed the degree) were trained to handle policy issues.
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From page 216... ...
At the Pew program breakfast during the Association for Health Services Research Conference, I thought about the Pew program as a whole. I hadn't thought about that for awhile; it was sort of fun.
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From page 217... ...
So, the average doctoral graduates in health services research may not have been as inter(lisciplinary before the Pew programs. That (li(ln't mean, however, that there were no practitioners who combined fields, whether at the individual level or by being active participants in study centers or on interdisciplinary project teams where there was a good intellectual process.
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From page 218... ...
The Michigan program tended to have a higher percentage of real midcareer, senior-level professionals with considerable responsibilities as opposed to my perception that the Brandeis program tended to have a higher mix of earlier career people who were several years out of a master's program and on a track of considerable responsibility but not yet in senior positions. At Michigan, not everybody was in a truly senior position, but every cohort that I was aware of was peppered with people who had large impacts or major management responsibilities within organizations or major political roles.
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From page 219... ...
Past cohorts had probably found that a typical introductory technical course was very unsatisfactory. With the audience of the Pew fellows, the faculty were challenged to deal with relevance to policy issues.
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From page 220... ...
Having senior faculty teaching the courses certainly helped strengthen the curriculum. One of the things that attracted me to the Michigan program was that it was housed in the School of Public Health.
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From page 221... ...
I thought that the program could have done alot better working across disciplinary lines or across interests with people who were involved in public health policy. To my mind the lack of rigor in public health policy is something that needs to be addressed, rather than a reason to continue separating public health from health services research along traditional lines.
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From page 222... ...
Whether my career speeds up or changes, I think that I can talk the language of health services research better. I know the technical, methodological issues a Tot better.
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From page 223... ...
i] "Impact on health policy" is the impact of what evolves n the health policies of the Unite(1 States.
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From page 224... ...
So, in the health services research or health policy research side of things, the question is, "Is an interdisciplinary dissertation real, or is interdisciplinarity something that happens in groups of people and a dissertation would become too big if you tried to do it with multiple disciplines to a standard of excellence? " I personally think it is possible to do a multidisciplinary dissertation.
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From page 225... ...
For me, the structure of the Michigan program and being in the School of Public Health were very attractive. The Heller School had other aspects that were attractive.
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From page 226... ...
I don't know how much is the selection of people or what you did along the way or being associated with RAND/UCLA, etc. But it seemed to be that the support of the Pew programs distinguished them from other doctoral programs in university settings.
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From page 227... ...
What was the most innovative or unique aspect of your particular prom design and implementation? I would say the flexibility among the programs.
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From page 228... ...
What aloout the interaction between non-Pew fellows and Pew fellows? Perhaps there was a tension here as in all other programs, but I think less so at RAND because if you were accepted to RAND, whether or not you were on a Pew felTowship, you had the same project opportunities.
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From page 229... ...
If yes, how ? My professional life has totally changed.
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From page 230... ...
Between the network of alumni and the network of the other Pew fellows, it's the people and the stuff together that made the educational experience what it was. The combination of topics from economics, statistics, behavioral, public health, etc., to produce this gestalt is just revolutionary.
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From page 231... ...
Not only people that you know but even people from the Pew Directory, you could just ring them up. Marion Ein Lewin and the Institute of Medicine do a really good job of keeping the network alive with the newsletter and having the functions and the updating of the Pew directory.
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From page 232... ...
Congress and also private or quasipublic things like the Kaiser Family Foundation, the University of Virginia, and the Radiological Society of America. A secondary contribution was that it enabled many of us to learn the basics, and in my case more than that because I already had a strong background in health services research, and to do that research in a policy-relevant manner.
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From page 233... ...
Department of Health and Human Services (DHHS) understand what academic medical centers were going through and how to make policy that relate(1 to gra(luate medical education, research and training, and so forth that was appropriate for the nation's goals but that also took into account what academic medical centers could do and were doing.
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From page 234... ...
that were more like the people in the other Pew programs (less experienced and so forth)
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From page 235... ...
But I know there have been others from my program and the other Pew programs that have made huge contributions to education. What aloout how the Pew training has changed, if at all, the method for training health policy makers?
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From page 236... ...
If so, please feelfree to add comments and/or concerns. I was angry and (lisappointe(1 and thought it was a huge mistake for the Pew program to quit funding my particular version of the Pew Health Policy Program in midstream.
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From page 237... ...
What was the most innovative or unique aspect of your particular pro m design and implementation? I was at Boston University (BU)
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From page 238... ...
We felt like Pew fellows, and that had a higher profile than what school we were at. People like Steve Crane were incre(libly helpful across the board for all fellows as an advocate, counselor, a mentor.
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From page 239... ...
sort of mechanism in place that would ensure that people got the necessary skills, yet still be left alone to do it. Other~vise, I would say that it is too risky and that there should be a curriculum that has a minimum skill set requirement that everyone must take.
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From page 240... ...
It's hard for me to say, not having done other doctoral programs. In other (loctoral programs there is more of an adversarial relationship between the doctoral candidate and the faculty.
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From page 241... ...
Conversely, in a traditional PhD program, the whole process is set up for people to fail. The fact that the students had that sort of unspoken edge over the program, the fact that once they were in it was not in the program's best interest for them to leave, gave a kind of tolerance that I think bred an attitude that was not great.
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From page 242... ...
I run a fellowship program now, and it's really hard to pick who is going to make it and who is not. But, I (lon't think anyone ever spelle(1 it out for the Pew students.
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From page 243... ...
I graduated with city planning as my undergraduate at a time when Lyndon Johnson was President and there was the great society, so the marketplace was creating these people. Whether or not the Robert Wood Johnson felTows or the Pew fellows will be seen as seeding the field and changing the spin of health policy, I just don't know.
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From page 244... ...
Of course, things (lo happen. A lot of people (lon't finish doctoral programs.
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From page 245... ...
It was my understanding from people like Steve Crane (Boston University tBU]
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From page 246... ...
a residential midcareer program for scholars to steep themselves in health policy for 9 months to a year. The residential doctoral program continues both at UCLA and at the RAND Graduate School since the courses created for the Pew program are fully vetted at both institutions.
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From page 247... ...
Clinical Scholars, nonPew doctoral students at UCLA, and postdoctoral fellows from other departments also contributed to the success and necessity for continuation of the course work even after Pew funding dried up. I don't think there was anything about the curriculum that didn't contribute or was a problem.
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From page 248... ...
Doctoral and midcareer fellows were required to align themselves with a research project or projects immediately upon entering He program. We (lesignate(1 this on-the-job Gaining, and a requirement for doctoral students was 16 to 20 hours a week.
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From page 249... ...
Getting the bureaucracies at RAND and UCLA to accept cross-registration of course work was challenging. It seems simple-minded, but it was actually quite challenging.
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From page 250... ...
For example, Steve Crane, Ted Benjamin, and I had a booth at the American Public Health Association annual meetings for several years, and we always placed it right next to the Michigan booth because that is where David Periman was and we had this national program with all these offerings. It was wonderfi~.
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From page 251... ...
I no longer have access to this information. My sense is that the doctoral program has a nearly 90 percent completion rate and the mi(lcareer program had no (lropouts, which is essentially a 100 percent completion rate.
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From page 252... ...
I think that speaks well. One person actually applied for the midcareer program and the PhD program and then chose the PhD program.
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From page 253... ...
One way may be that people in He clinical scholars program become clinical faculty; people who are Kellogg fellows sort of stay where Hey are but Men go off to Turkey and China and different places, but as I see it Kehogg fellows sort of stay in He career Hey were in, and I think He Heath Policy Fellowship Program offered more opportunities for people to either change career or ready advance in Heir career more quickly. If you were,goin,g tontine advice to another university attemptin,g to initiate ~ similar pro,gram, what would you say?
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From page 254... ...
It's grand. Former fellows are very proud to say that they were Pew fellows.
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From page 255... ...
, we had to get policy issues out of the public sector and involve the private sector. So, the whole focus, at least of the Boston University side of the BU/Brandeis program, was to try to create links with the business community where attempts were alrea(ly being ma(le to control costs, improve quality, and gain a handle on what was going on in the health care system.
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From page 256... ...
A very important part of the history of our program and I think the history of the Pew program is the fact that there were really three programs at BU/Brandeis: the doctoral program, which we always talk about; and the Pew Corporate Fellows program at BU that brought together major industry leaders involved in health care issues to Boston twice a year and created a 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 continue to be done on health outcomes. I think these things are attributable to the types of (liscussions that took place not just at BU.
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From page 257... ...
I certainly subscribed to that in my own doctoral program, but that is not what this program was about. That is not what these students were about.
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From page 258... ...
I think the BU students really appreciate(1 the flexibility that we gave them. It was little bit difficult because they would come into the program and sort of have to find their own way, but once they (li they appreciate(1 the chance to (lo what they wanted to (lo.
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From page 259... ...
Faculty often want to create students in their own image. Yes, there are tensions, but what we broke out of were the traditional doctoral program of 5 years of suffering and 4 years of .
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From page 260... ...
When the program started there was ~ real emphasis on training health policy researchers and health policy makers, and it seems that today the programs that are getting funding have changed that emphasis, at least in name, to health services researchers. Why is that?
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From page 261... ...
Furthermore, there is a tremendous community of support in health services research, and you tend to go where your friends are. Most of the policy-type programs tend not to be oriented toward health care but rather public administration, public policy, and political science, all a different set of institutions than we chose to involve in this program.
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From page 262... ...
Why the programs were cut off is another study in and of itself. The Michigan program structurally shoul(1 have been as practically oriented as the BU program, and certainly the students who were at Michigan were closest to the types at BU/Brandeis.
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From page 263... ...
That is an interesting question. The kinds of people that the Pew programs were graduating are rare.
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From page 264... ...
methods of implementation? ~} educational process?
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From page 265... ...
That was the toughest thing: how you formulate a question. One of the other big intellectual challenges that I found myself addressing all the time was teaching the students that they came to a doctoral program not to learn what they were to know but to learn what they did not know.
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From page 266... ...
I think overall we did OK there. There are two or three things that you get out of a doctoral program.
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From page 267... ...
If you want to learn how to collect data, then I think you ought to go to a traditional doctoral program and take longer to do because it takes longer to collect data. I think a lesson was learned there.
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From page 268... ...
And that is very unique because most doctoral programs don't do that. Do you want to say anything else about the "set" of programs, how they complemented each other yet were very different?
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From page 269... ...
That phrase "inter" is really so important, not "intra" as doctoral programs traditionally are. They only Took within themselves.
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From page 270... ...
thing unique about me, but it (loos very much help to have someone who has the vision and, number tam, has the time to spend on this. There are a Tot of people like that, I found them all over the place.
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From page 271... ...
Whether you absolutely needed a PhD to be successful I would say it should be more competency based than (1egree base(l. Ilow can we measure successfor those pro,grams where completion rates do not apply ((e.,g., postdoctoral pro,gramsJ ?
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From page 272... ...
One of the defining purposes of the Pew program, and one that set us apart from other PhD programs was that while we were striving to create people who could produce policy, our emphasis was more on creating people who could use policy. In essence we were creating change agents.
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From page 273... ...
The RAND/UCLA program did very significant work with satisfaction, the Brandeis program contributed at a more micro level, but still a very significant level, to issues of Me(licai(l, reimbursement, and prospective payment. Overall the Pew programs made Tots of contributions on many different levels.
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From page 274... ...
The Pew Charitable Trusts really need to understand what positive feelings everyone has toward these programs. They have been very supportive.
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From page 275... ...
So that's what we did, and that proposal was obviously successful. And, yes, it continues in the sense that we have joint courses taught by faculty at both the RAND Graduate School and the UCLA School of Public Health.
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From page 276... ...
That continues and has grown so that is a base on which to build a strong program. We also had in the RAND Graduate School a structure of policy workshops that was well suited to the kind of people we attracted.
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From page 277... ...
The midcareer program did not continue after the Pew funding ceased simply because we did not have the funding. We offer them an intensive, didactic, almost tutorial with one teacher and no more than three to five participants.
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From page 278... ...
That turned out to be a leavening experience both ways. They learne(1 from the more aca(lemically and methodologically oriented doctoral students, and the doctoral students learne(1 from the real-wori(1 experience of the mi(lcareer fellows.
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From page 279... ...
We had essentially no one who didn't complete the midcareer program, but the question is how to measure success when completion rates do not apply. I think you simply Took at their career and you have the testimonial there.
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From page 280... ...
I think that as a whole the Pew fellows have gone toward policy in a more focused way than people in the past. It did emphasize policy.
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From page 281... ...
The legacy is a continued collaboration between the two institutions; there is also the legacy of continuing collaboration with former Pew fellows. Many of the fellows go through a transition period after they complete their degree.
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From page 282... ...
It's been such a huge advantage for me in the policy world, particularly since I've been back in Washington, just to call people up and say "what about doing this project," an(1 there is a lot of goo(1 examples of that which I'll talk about later. In terms of the overall accomplishments, the Pew pro grams as a set of programs set up a curriculum for the training of health policy analysts an(1 professionals.
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From page 283... ...
I really missed those, and I didn't find those desires satisfied in the private sector. So, I left private practice, a very lucrative career, to do my Pew fellowship.
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From page 284... ...
We didn't have a roundtable on reform, for example. Those were all touche(1 upon, of course, in the course work that we took, but we didn't have a regular, organized, high-level (liscussion on, for instance, health care reform, which was the hot topic at that time (1989-1990~.
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From page 285... ...
It was really fabulous and wild. I directly link that switch in my career path to being able to do the midcareer program for the year.
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From page 286... ...
It has had real, genuine, importent effects. I'd like to thank the Pew Charitable Trusts for creating the program and inclu(ling me as a participant.
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From page 287... ...
Some of this is selective memory, of course, but overall I had really positive feelings. There were some criticisms at the time, the major one being that lack of the big picture that I already discussed.
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From page 288... ...
There have been great changes in other health policy programs, and I think part of that is a result of what the Pew programs accomplishe(l. Can you name any particular programs?
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From page 289... ...
The most unique aspect of the Boston University (BU) /Brandeis program was the attempt to have a very accelerated program that provided a fair amount of program flexibility.
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From page 290... ...
How hasyon~ professional life chan,ged as ~ result of the Pew pro,gram? What value has Pew trainin,g added to your life?
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From page 291... ...
At the least they harbor some hope of completing it. I think that in any PhD program there are those who after the first few years don't complete the program, and then there is a small percentage of the noncompleters who then do finally complete it.
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From page 292... ...
Partly it is because when you're in government, at least when I was in government, and for what I (li(1 (leafing with the program, I was sort of the major policy and bu(lget analyst for a long time, but you are always sort of fitting in and just trying to keep up with a broa(ler administrative agenda for the Administration an(l/or for Congress. You can shape things, but you're shaping things within that context.
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From page 293... ...
Are there any important issues that this interview does not address? If so, please feelfree to add comments and/or concerns.
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From page 294... ...
There were four programs and each one had different goals but essentially it developed this cohort of people who could do health services research, who could do health policy, and who could talk the language and walk the walk and put them out there all over the place. Pew developed this huge network.
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From page 295... ...
It really was a dissertation seminar. Every other week there would be a presentation of different research methods and designs.
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From page 296... ...
I came out of a fantastic master's program and was very well prepared. So indirectly, the Heller School curriculum did not
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From page 297... ...
There was also a lot of fuss made about the Pew fellows which I didn't think was appropriate. · ~ rare · · rat · How hasyon~ professional life chan,ged as ~ result of the Pew pro,gram?
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From page 298... ...
I thought I wanted to be a policy wonk. But, the Pew program made me realize (even though it is a policy program)
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From page 299... ...
But, you have to really make a commitment to completing the program, and the dissertation needs to be a real priority. I teach a dissertation seminar, and I tell people this: "Don't plan on remo(leling your house in the next 2 years.
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From page 300... ...
It seems to me that the Pew programs provided some consistency to the whole arena of health policy in terms of the quality and expertise of people that may not have been there before. That was achieved through the educational mission and policy focus.
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Key Terms
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