Developing A Resident Health Care Economics Curriculum: Perspectives and Advice
In the day-to-day crunch to gain clinical knowledge as a trainee, it’s tempting to put off learning the economic fundamentals. After all, health care economics isn’t tested on the Core exam and nobody will ask about it when you’re on call.
However, it is important to have a basic understanding before graduation about what happens behind the scenes after signing off that chest radiograph — Especially since it’s now an ACGME requirement.
When we developed a multi-institution health care economics pilot curriculum, there were many participants who brought expertise and experience which allowed it to succeed, including Frank J. Lexa, MD, FACR, and Anne Marie Pascoe at the ACR Radiology Leadership Institute®, and Harprit S. Bedi, MD and William A. Mehan Jr., MD, MBA, at Tufts Medical Center.
In addition to helping outline the components of the pilot, my role as a Tufts resident in the curriculum development group was to keep the perspective of a radiology resident at the forefront. It was important to consider residents on busy clinical rotations who need to absorb this material. The question in mind was, “What can we do to prevent residents’ eyes from rolling into the back of their heads when they need to grasp economics as well as study body MRI, do RADPrimer questions, and take call?”
We wanted the relevance of this topic to be clear to all participants and have them understand its significance for their careers. The key was to have a blend of didactic activities where knowledge is gained in the form of reading material and online webinars, combined with a practical component where that knowledge is put to practice. By having residents research and discuss the reimbursement process for something as common as a noncontrast head CT, this highlights that something residents do all the time contributes to the finances of their department and is intertwined with the larger health care system. I think putting this all into perspective helps cultivate genuine interest.
My advice for other programs seeking to institute a health care economics curriculum is to make it relevant to residents right now. Don’t delve too far into concepts that are beyond their knowledge and use examples from what they do every day to reinforce the idea that the health care economy is constantly churning and that residents are truly part of it.
Second, have some kind of activity, whether it’s individual or group based, where that knowledge is put to use. It’s easy to forget material we’ve read if we never have to apply any of it. The most important thing is try to get some real data to work with since it makes the exercise more tangible and less about abstract theory that affects someone else.
Third, impart passion for this topic. If you’re a working radiologist in the United States, this will affect you in a very real way for the foreseeable future.
Fourth, pay attention to changes that are happening in the government arena, and maybe even incorporate some of this into your curriculum. There are many health care policies that affect radiology, and in the past few years there have been major policy changes that affect reimbursement. More are always on the horizon.
By Allen Prober, MD, musculoskeletal imaging fellow at Beth Israel Deaconess Medical Center