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Roberto J. Fernandez, DO, MPH
Des Moines University-College of Osteopathic Medicine

They say that going through medical school can seem a lot like taking a drink of water from a fire hose. Having nearly finished my four years of undergraduate medical education, I can relate to that metaphor. However, I can honestly say in my short time as an Osteopathic Health Policy Intern (OHPI), having received only brief exposure to the vast scope of health sector policy knowledge, the continual advocacy efforts undertaken by various interest groups, and the sheer volume of daily information that must be processed and acted upon to be effective in the policy arena…well, it’s a lot like taking a drink of water from Niagara Falls! 

That said, I have absolutely loved my experience with AACOM. In many ways, it is the perfect capstone experience as I finish the last two months of medical education and prepare to begin residency training. As has been reported by other OHPIs, this internship literally does immerse the student in the complex, fast-paced, and exhilarating world of health policy-making and advocacy. AACOM’s government relations team is outstanding, and the intern will learn firsthand how incredibly challenging, yet truly rewarding, it can be to effectively navigate and report upon the most critical policy issues relevant to educating and training osteopathic physicians in the United States.

Arriving in D.C., an intern has to hit the ground running as his or her MS Outlook calendar soon becomes checkered with exciting meetings on a whole variety of relevant health policy topics, from Congressional briefings and hearings on Capitol Hill to various conferences and meetings of special interest groups, health and human service agencies, and research organizations. In my first three weeks alone, I observed the U.S. Secretary of Health and Human Services (HHS) Kathleen Sebelius as she presented testimony on the HHS budget to the Senate Finance Committee; spent two days covering the spring meeting for the Medicare Payment Advisory Commission (MedPAC); heard from a distinguished panel of health economists that included Dr. Mark McClellan (previous FDA Commissioner and CMS Administrator) at a Congressional briefing; and represented AACOM at the U.S. Chamber of Commerce, Veterans Health Administration, Kaiser Family Foundation, Reseach!America and Rally for Medical Research, March of Dimes, the National Institutes of Health (NIH), Health Resources and Services Administration (HRSA), and the Primary Care Organization Consortium (PCOC) spring meeting held at the Association of American Medical Colleges (AAMC), to name a few. The Government Relations Department truly treats interns as part of the team and relies on the intern’s coverage of these meetings and seminars to further advance their advocacy efforts on behalf of AACOM and osteopathic students throughout the country.

One of the additional benefits of the OHPI program is that interns are free to pursue research on an interesting health policy topic of the intern’s choice (provided it is also pertinent to AACOM’s mission). I chose to study an emerging health care delivery model that was authorized by the Affordable Care Act known as the Accountable Care Organization (ACO). Briefly, ACOs seek to achieve better care coordination, facilitate provider communication and collaboration, and improve population health outcomes all while decreasing costs to the health care system and generating savings for providers. At the core of the ACO are concepts such as the patient-centered medical home (PCMH) model; bundling provider payments for health services (going away from a fee-for-service, high-utilization model); more accurately measuring provider performance, cost benchmarks, and health outcomes (the accountability piece); achieving more “value” and efficiency out of the health care system; and essentially achieving what has been dubbed the “triple aim” (i.e., better care and better outcomes at a lower cost). While all of this sounds good on paper, there is still a lot of uncertainty about how ACOs will really operate once fully implemented, as they are still in a very young stage of development. My research will begin to consider how ACOs will intersect with academic medical centers and teaching health centers in the future; specifically, I am investigating how ACO implementation will effect graduate medical education (GME) and the clinical years of medical school.

The beauty of this internship is that it provides additional experience for individuals who want a bit more out of their medical education; it is for people who share a broader vision for their own medical career as well as consider broader responsibilities and roles for physicians in the future. It is perfect for anyone interested in areas such as health policy, public health, health care administration, leadership and governance, health systems improvement, health services research, and academic medicine. Interns are exposed to each of these areas throughout the internship. It is truly one of the best experiences I have undertaken during medical school.  

Please contact Dr. Fernandez with specific questions about his OHPI experience at  Dr.Rob2013@gmail.com.

Learn more about the AACOM OHPI Program.

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June 2013
Vol. 7, No. 6 / 8