I write this on my last day as a research fellow, reflecting on the last two fantastic years as well as the three clinical years ahead of me. I just finished two years as a National Clinician Scholar at the University of Michigan’s Center for Healthcare Outcomes and Policy (CHOP), and will be deep into my third clinical year at Brigham and Women’s Hospital by the time you are reading this.
My research years were a time of profound growth, both personally and professionally. I had plenty of room for improvement: I entered as a recovering English major, with virtually no experience designing studies or working with data. I realized that patients with insurance were still getting unaffordable medical bills, and I spent two years developing the skills to understand why. I got to work with a fantastic, diverse group of surgeons and health services researchers and developed immensely as a researcher and a human being.
But, just as much as our “lab” years seem to be about being productive and doing high-impact research, they are arguably more about developing ourselves as leaders and change agents. Though every research project is an opportunity to learn and grow, I realized that my last few months might be better spent applying what I’d learned as a health services researcher rather than writing yet another paper or abstract. So I started looking beyond the lab.
I thought about working for Congressional committees dealing with health policy, as well as the federal Centers for Medicare and Medicaid Innovation (CMMI) and Massachusetts Health Policy Commission. I wound up working as an intern for Blue Cross Blue Shield of Massachusetts, on projects that drew from and deepened my experience as a researcher studying out-of-pocket healthcare spending for commercially insured patients. I used the “health services research toolbox” frequently to measure potential surprise bills in the plan’s claims data, conduct qualitative interviews with people across the company about how to make out-of-pocket costs more manageable and transparent, and ultimately communicate these findings back to the plan’s senior leadership.
Working with an insurance plan to study insurance claims might not seem the most creative way to extend my skills outside the lab, but it provided me with valuable perspectives, connections, and the ability to speak the “language” of these important healthcare stakeholders. On their end, they were happy to have someone with unique clinical expertise (most physicians at health plans come from primary care specialties) as well as comfort with healthcare data and policy.
I was lucky to have research mentors who understood and supported my rationale for spending two months away from our projects, and colleagues who kept our efforts moving in my absence. I also benefited from the advice of many mentors on which experience to choose, and I would encourage anyone interested in a similar “extracurricular” project to discuss it often with their mentorship team. (Also—if there are any upsides to the COVID-19 pandemic, it’s that you can pursue these experiences without moving. I did my entire Blue Cross project virtually.)
Health services research naturally aligns with many important functions in the healthcare system and the broader community. If you’ve been studying Medicaid expansion, why not spend a few months in a state or federal Medicaid office? If you’ve been studying racial disparities and social injustice, why not work with a state or local Office of Civil Rights? The experiences you get will inform and expand your impact as a surgeon, leader, and researcher.
Are you a surgeon who has pursued your research interests in an unconventional setting? Share your story in the comments.
Karan Chhabra, MD MSc
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