History of Health Policy

Emergency medicine (EM) is largely a safety net specialty that cares for all patients. As such, many issues facing healthcare systems are often experienced by emergency physicians on a daily basis. Issues such as the Affordable Care Act, gun violence, Medicaid expansion, and more are a constant occurrence for the EM profession. Emergency physicians find themselves as advocates for patients, and as such are well suited for advocating on their behalf in hospital committees and the legislature. Health Policy is designed to provide the tools for EM physicians to become effective advocates and provide them experiences to become well-versed in political processes to affect positive change for patients and EM practice.

There are currently 11 fellowships in health policy offered by EM residency programs and departments, and graduates of health policy fellowships often develop a focus and continue their advocacy or research into this field. While there are limitations to academic positions that are focused on the production of health policy work, this also provides the opportunity to create a niche in your own institution. Further, academics trained in health policy may also serve in hospital leadership and committees that seek to address their health policy focus. Graduates can also find employment outside of their academic institutions with connections made during rotations. Most EM health policy fellowships offer rotations where fellows are embedded in health policy institutions including the Centers of Medicare and Medicaid, National Quality Forum, a congressional healthcare committee, National Institutes of Health (NIH), and working in a congressional official's or state legislature's office. These connections can provide additional opportunities to your academic position as approved by your Chair.

The Future of Health Policy

The interest in health policy among EM physicians and residents is increasing. The involvement of residents in health policy committees and advocacy within EM is a positive indicator for the future of this academic track as more EM physicians continue to advocate for their patients locally, among state legislatures, and in Congress. While the number of fellowships available have not necessarily increased over the last few years, the level of interest in the field has.

It is unlikely the Accreditation Council for Graduate Medical Education (ACGME) will provide accreditation to this fellowship in the coming years, however it is not implausible with growing interest. There are certainly benefits to being outside ACGME accreditation, such as flexibility for moonlighting, often higher salary, and less restriction to duty hours for fellow education and opportunities.

Another opportunity offered by the health policy fellowship is the ability to extend the fellowship from one to two years to obtain a Masters in Public Policy or Masters in Public Health. While some programs may offer a second year to obtain a Masters, other programs are two years with a Masters program already built into the curriculum.