LOS ANGELES – Campbell University Jerry M. Wallace School of Medicine was represented at the 2017 USC Keck School of Medicine Innovations in Medical Education Conference (IMEC) by second-year medical student Danny Koh. Koh was invited to compete in the research poster competition and present his team’s findings on how the legal changes in health insurance are impacting his generation.
“Health insurance has been in a state of constant change since I turned 18,” said Koh. “Our team was curious about how many individuals in my generation feel they understand the basics of healthcare policy and the healthcare insurance platform since the Affordable Care Act and how that is impacting their choices.”
With the average age of Campbell’s medical students being 24, Koh and his classmates felt they had a great demographic pool to begin surveying right here in their classroom.
“Our hypothesis is that medical students – a comparatively educated population – do not understand the Affordable Care Act and its impact on the health care insurance purchasing process and health care delivery, and if they don’t understand it, how can they properly advise patients? What hindrances are in their way? Is it the delayed maturity of our generation? Our level of knowledge as future practitioners will impact how we practice and potentially even impact our choice of specialty.”
“The healthcare climate is changing,” said research team member Matthew Scott (CUSOM 2019). “We were curious how health insurance is affecting us as individuals as well as our patients.”
So far, the students’ hypothesis is supported by their findings, and student doctor Koh shared their findings at IMEC.
“The conference was full of educators ranging from residency program directors and teaching faculty to medical students passionate about improving the quality of medical education. I received valuable constructive feedback, suggestions, and new ideas that will help our team to expand the project for the future,” said Koh.
The team plans to expand its research over the course of the next two years in three ways: 1) sending the survey to other medical schools to gather more data, 2) investigating further the correlation they found between health insurance purchasing experience and future medical specialty choice, and 3) exploring with Campbell Medicine’s administration and faculty possible ways to implement didactic and simulation activities addressing the issues expressed in their data. The international attendees at IMEC encouraged Koh to move forward in furthering this research.
“Some physicians I met at the conference were worried that future physicians may not be ready for the dramatic back-and-forth changes in healthcare policy and insurance platforms – especially as the current administration in Washington is working to replace “Obamacare.”,’ said Koh. “The educators and physicians I spoke with believe that if students are not ready now, then they certainly will lack the ability to be competent in administrative management and effective patient counseling as the system continues to change even more rapidly.”
“It was surprising to see a simple project like this interest residency program directors and students from other countries like Japan and Canada. For instance, a program director from Tokyo shared his concern with me about medical students in Japan; their government is experimenting with transformation of their current complex trio of insurance services. He’s not sure if students are able to ‘keep-up’ with the changes during school and be ready to take on the arduous task of juggling non-clinical duties with clinical work after graduation.”
The goal for the research results is to influence medical educators to include health insurance education in medical school curriculum. Koh’s team is not the only group of medical students researching the impact of the changes in medical insurance with this goal in mind.
“I connected with a medical student from UC San Diego School of Medicine about his project that is similar to ours; his team’s focus was more from the business aspect of the matter, and we are planning to discuss how we can benefit each other by sharing ideas for effective curriculum implementation. It was encouraging to see other medical students taking similar action to better our own medical education curriculum.” Dr. Greg Christiansen, former Chair of Emergency Medicine at CUSOM and current Dean of the Des Moines University College of Osteopathic Medicine, was the first mentor for the Campbell research team.
“The recent changes in health insurance make it possible for young people to remain on their parent’s health insurance until they are twenty-six years old – we were curious about how this is impacting their understanding of the health insurance market and policies, and what the team is finding is a delayed maturity of knowledge that can impact medical students personally and professionally,” said Christiansen. A similar study, “Medical Students and the Affordable Care Act: Uninformed and Undecided” published in Journal of the American Medical Association in 2012 identified the knowledge gap and its effects on the doctor-patient relationship. The Campbell team’s research indicates this persists nationwide, and leads them to the conclusion that it needs to be addressed by medical schools.
“Medical schools should consider incorporating health policy into didactics,” said Koh. “Students typically perceive how health policy can influence their residency choices and funding, but they have difficulty conceptualizing how it will affect them in practice. We believe a mix of didactic and simulation training will be an ideal modality for making these concepts a more tangible and interactive experience for students.”