The Lessons and The Legacy of the Pew Health Policy Program (1997) / Chapter Skim
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Part 2 Successes and Failures:
Part 2 Successes and Failures:
Pages 35-68
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From page 35... ...
Critical success factors are a "limited number of areas in which results, if they are satisfactory, will ensure successful performance" (Rockhart, 1978~. These factors, identified by the 25 interviewees, through discussions held at the Pew meetings, and by sifting through archival information, form the foundation of the Pew Health Policy Fellowship Program.
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From page 36... ...
Targeted for the Michigan program were highly successful, often high-profile, mi(lcareer professionals who were public sector representatives engage(1 in health policy formulation as either policy makers, policy analysts, or influential participants in the policy process, such as people in state legislatures an(1 consulting
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From page 37... ...
He conceded that although Brandeis was doing much state-of-the-art work in health policy that was being recognized and that was highly regarded, "students weren't just naturally coming to Brandeis." Stan Wallack stressed the need for active recruitment and the importance of having "program champions," people (leeply committed to maintaining a high-quaTity student body: We found ourselves still needing to get out there and do ~ lot of recrnitment....Steve Crane really took this program on as his mission. He was ~ key force....~on need ~ champion.
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From page 38... ...
more, DaVanzo indicated that Marion Ein Lewin, director of the Program Office, and her staff were always responsive to and supportive of the Pew fellows. Together, these experiences fostered a defined identity for the fellows and the Pew program.
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From page 39... ...
~ rid ~ ~w ~w ~ ~ ~ ~w ~ ~ ~ ~w ~ ~ ~ ~ ~ ~ ~w ~ Own The postdoctoral PHPP at UCSF emphasized the importance of recruiting the very best among the highly qualified pool of potential applicants. The collective mission of the Pew programs is to train the future leaders of the health policy field; therefore, only the best and most promising applicants are selected.
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From page 40... ...
Steve Crane expresse(1 the commonly held belief that one of the great strengths of the program as a whole was the individual faculty members who were committed to Pew's mission and who were accessible to the fellows: Canyon imagine sitting down in ~ room with Phil Lee, Stu Alt man, Stan Wallack, Dick Egdahl, Al Williams, Bob Brook, and .
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From page 41... ...
This was "inter" in every respect of the word. Marion Ein Lewin has the unique perspective of having been the overseer of PHPP as a whole and having been closely involved in the evolution of each program.
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From page 42... ...
Although this was not one of the questions specifically asked of the alumni who were interviewed, the information gathered showed a clear consensus that going back for more rigorous training in health policy was the best way that the fellows imagined that they could either empower themselves in their current positions or have greater influence on policy making and change in the future. 11 A good fellow-mentor relationship is one of the single most mportant determinants of a successful health policy fellowship.
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From page 43... ...
We had trendy -access. Although the seminars and course work are vital parts of the UCSF Pew Health Policy Program, for many fellows the most important reason for participating in the program was the opportunity to participate in multidisciplinary health policy and health services research with the faculty of the institutes.
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From page 44... ...
Faculty usually found In an effort to improve faculty-fellow interaction, all that the benefits of UCSF Pew fellows received guidelines listing the expected working with a fellow goals of the Pew fellow-mentor arrangements. This helped far exceeded the time them to know what was expected of them and what they of mentors provided could expect from their faculty preceptor.
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From page 45... ...
For example, Joan DaVanzo, who went through a combined doctoral program at RAND and UCLA, emphasized the value of the work projects in fostering close mentoring relationships. In addition to getting on-the-job, real-world experience, the work projects allowed for close contact with the faculty and project directors.
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From page 46... ...
Pew funding for faculty time spent mentoring and interacting with fellows on research teams fostered a secure and close community of scholars. Several program directors cited faculty commitment as one reason why the Pew Health Policy Programs are in a league of their own, and this is due in large part to the general support of the Pew Charitable Trusts.
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From page 47... ...
The (liversity and maturity of the PHPP student bo(ly created a situation ripe for community learning. Steve Crane discussed how at BU the weekly seminars would bring together faculty and fellows from various disciplines to work together to solve problems from many different perspectives: We proved that there is ~ place in an academic institution for the mature learner.
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From page 48... ...
Levine and Stan Wallack, then Steve Crane and Mary Hen (lerson took over, an(1 for the last 5 years of fun(ling land beyon(l) the seminar has been taught by Ton Chilingerian.
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From page 49... ...
Linda Simoni-Wastila believes that the dissertation seminars at BU/Brandeis were one of the most innovative and useful aspects of her Pew doctoral program. She explained that the weekly seminars were attended by second- and third-year students so that all were exposed to different processes and different levels of the process: We had ~ very,good idea of what to expect before we actually went thron,gh the process ourselves.
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From page 50... ...
Unlike the two other doctoral programs, RAND/UCLA emphasized an early focus on the dissertation from the outset. Kate Korman and Al Williams explained that at RAND/UCLA, the research projects discussed earlier and called on-the-job training were held with the same importance as the course work, because it was the project work that was supposed to lead to a dissertation.
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From page 51... ...
The PHPPs were designed with the understanding that to promote effective change, health policy professionals must One of the strongest aspects of the Pew program has been the networking among the fellows in each of the programs, between the fellows in the different programs, and between the fellows and those engaged in the policy process in Washington, D.C.
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From page 52... ...
gave the students access to the people who could use their communicating with research more quickly. Steve Crane reiterated the value of the colleagues from all multi(lisciplinary, multisector, real-wori(1 Pew network: areas and sectors of the health care arena.
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From page 53... ...
Bhalotra explained that being part of the Pew network meant interacting with some of the leading minds in the world of health policy. John McDonough explained that the Pew program was about acquiring skills Mark Legnini, John McDonough, Sarita Bhalotra, Terry Hammons, and Kathleen Eyre all discussed how becoming and making unique relationships: 1 ~ [Pew; exposed me to folks in the health policy community who have been very important and helpful and who I wouldn't have otherwise had the opportunity to meet.
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From page 54... ...
Carroll Estes stated that networking is essential to the growth of health policy professionals: Networking and socialization to the field, the norms of work, and networking of colleagues have loeen important parts of the educational process. Marion Ein Lewin expressed some concern about the future of the Pew network.
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From page 55... ...
cites the Robert Wood Johnson Foundation's Health Policy Fellowships and the Pew Charitable Trust's Health Policy Programs as the driving forces behind educating and training health care professionals about policy making and "bringing the synergy of an interdisciplinary approach to problem solving." He described the Pew Health Policy Program as "an effort to bridge the gap between health economists and other disciplines." Furthermore, Airman (1995) stated that PHPP "fosters a cross-fertilization of different theoretical perspectives, as well as different methodological approaches in solving concrete policy problems." HamiTton's 1995 evaluation states that PHPP "has had from its inception a single stated goal, which was expressed PHPP fosters a crossfertilization of different theoretical perspectives, as well as different methodological approaches in solving concrete policy problems.
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From page 56... ...
Change, says Steve Crane, requires interdisciplinary people who can talk and understand the complex and interdisciplinary nature of the current health care system: One of the defining purposes of the Pew HIP, 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 so on creating people who could use policy. In essence we were creating change agents.
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From page 57... ...
The concept of multidisciplinary education or training can take on several different meanings, depending on where one sits. Steve Crane explained that the PHPP approach to being multidisciplinary certainly slid not mean having people from many different disciplines sitting in the same room or housed in offices next door to one another.
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From page 58... ...
Kathleen Eyre stated that it was this aspect of the curriculum the integration of the different social sciences into a health policy framework that distinguished the Pew approach training from the traditional training approaches. Hal Luft explained that the innovative training approach used by PHPP enabled the fellows, once they entered the field, to continue interacting and communicating with professionals from other disciplines in their own or other sectors.
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From page 59... ...
Marion Ein Lewin remembers that when the Pew Charitable Trusts began looking for an organization to direct the program, IOM had responded but had not won the proposal. The Pew Health Policy Program was brought to IOM from the American Enterprise Institute in 1987; however, it was not officially called the Program Office until 1988.
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From page 60... ...
TOM and the program administration went to great lengths to instill in the Pew fellows a sense that they were all, regar(lless of their backgrounds and expertise, working toward a common goal, that is, to be more effective change agents in the health policy arena. Marion Ein Lewin reflected on the painstaking but enormously rewarding process.
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From page 61... ...
Leon Wys~ewianski from the Michi,gan pro,gram,got up and said that the purpose of being ~ Pew fellow is that yon,gain an understandin,g about how to be effective change agents in the world of health policy and the purpose of the Pew Health Policy Fellowship Pro,gram isfor people to become,good communicators and to work in the real world, not in some ideological world. Marion Ein Lewin explained that this was a real turning point for the program because it was the first time that there was a discussion about what it meant to be a Pew fellow, that it was something above and beyond just financing an education.
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From page 62... ...
Overall, the fellows were The Pew Charitable Trusts were also commen(le(1 for their mature enough to take on strong commitment to lea(ling and administering the Pew the challenge of a Health Policy Program. According to Marion Fin Lewin, nontrad~honal accelerated .
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From page 63... ...
The Pew doctoral program at the University of Michigan selects midcareer professionals who are active in policy formulation and upgrades their knowledge and skins, thus enabling them to participate more effectively in the policy process. Approximately t~vo-thirds of these individuals receive salaries that make the costs of tuition, fees, travel, and books for the program unaffor(lable without assistance.
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From page 64... ...
On a more positive note, the faculty and program directors at the University of Michigan are committed to sustaining the nonresidential doctoral program on their campus. Their primary concern, as highlighters previously, is maintaining the rich (liversity that makes their program so valuable to the health policy field.
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From page 65... ...
A major objective of the UCSF Pew postdoctoral program has been to (levelop the capacity to provi(le full financial support for core faculty and staff. However, this has been extremely difficult.
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From page 66... ...
As of 1993, at least four courses (levelope(1 through Pew funding were institutionalize(1 at Bran(leis (A(lvisory Board meeting, February IS, 1993~. Because of the excellence of the Heller School's PhD program and the national reputation of the Pew doctoral program, many more students who are interested in careers in health policy research are becoming attracted to the program (Raskin et al., 1992~.
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From page 67... ...
Although the schools were unable to maintain the midcareer program without support for the fellows, the Pew doctoral program in health policy studies became part of the regular doctoral program at the RAND Graduate School. RAND continues to train health policy fellows by using a multidisciplinary approach and with new funding streams.
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From page 68... ...
Two former Pew fellows, lames Robinson and Helen Schauffler, are teaching at UC-Berkeley and have car ried over some of their graduate training experiences. Al Williams stated, "Imitation is a form of endorse ment," and Dan Rubin agrees.
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