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                        JeffNEWS, May 17, 1994
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New Jefferson Course on Health Policy Underscores Educational Need
in Healthcare Reform
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   By Daniel Z. Louis, MS
      Managing Director, Center for Research in Medical Education and 
      Health Care, and Research Assistant Professor of Family Medicine, 
      Jefferson Medical College


   When current first-year Jefferson Medical Colleges students receive
their medical degrees in 1997, it is clear they will be entering a
healthcare system vastly different from that of only a decade ago. This
will be true whether the healthcare reform proposals of the Clinton
Administration are enacted, whether what eventually passes is a variant
drawing on one or more alternative plans, or even without new legislation. 

   Anticipating this, Jefferson believes in the importance of preparing our
students for these changes, to help make them both knowledgable physicians
and informed private citizens.

   For this reason, the JMC curriculum committee approved a new course for
the January 1994 term - "Health Policy." Designed as "An Introduction to
the Healthcare System," David B. Nash, MD, MBA, director of health policy
and clinical outcomes and clinical associate professor of medicine, and I
taught the course to all 220 first-year students. We plan to offer it every
January to the first-year class, as well as to provide update courses for
the sophomore and upper classes each year.

   To our knowledge, Jefferson is one of only a very few medical colleges
in the country to provide such a required course.

   The goals of the introductory course are to provide an overview of the
current healthcare system in the United States, major issues in health
policy and a perspective on proposals for health reform.

   The course covers cost and financing of health care including the
current health insurance system (Medicare and Medicaid, private insurance
system and the issue of the uninsured), physician and hospital payment
systems including the current prospective payment system and DRGs and their
impact, issues of quality and outcomes, an introduction to practice
alternatives, especially managed care, and discussion of the future of
health care with focus on proposals for reform.

   Student reaction was very positive. A pretest confirmed the need for
such a course. Excellent attendance, including standing-room-only at some
sessions, and students' comments in formal evaluations make clear the
importance they give a topic so critical to their future. In fact,
"necessary and relevant to our future" was a frequent theme of student
evaluations. 

   After all, these physicians of tomorrow will be practicing medicine in a
healthcare system significantly revised from what we have known. Their
knowledge of that system will help determine their opportunites and the
style of practice available to them when they are providing patient care.
Further, one might say that as citizens, physicians have the right, and
perhaps responsibility, to influence how our healthcare system evolves
toward reform. Some may argue that what happens to the organization of the
healthcare system may have as much impact on the overall health of the
public as individual physicians do on the health of individual patients.


Editor's Note: Jefferson is grateful to Marion Merrell Dow, Inc., for 
printing the contents and providing binders for the 250 course books.


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Information provided by:  Editor, JeffNEWS
                          (215) 955-6204
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