Understanding Medicaid to Improve Patient Care: Reflections from an MD-MBA Student

April 10, 2017

The Bass Connections NC Medicaid Reform Advisory Team combines Duke’s expertise in public policy, law, medicine and business under the umbrella of the Duke-Margolis Center for Health Policy. On April 25, the team will host a breakfast presentation and discussion, North Carolina Medicaid Reform:
 A Bipartisan Path Forward, at the Museum of Natural Sciences in Raleigh.

Trey Sinyard is a fifth-year MD-MBA student at Duke. He reflected on his experience with this project; comments are excerpted from an interview with the Duke-Margolis Center.

Bass Connections appealed to me because it enables collaboration with people all over the university, and at a place like Duke, that is a very multidisciplinary approach. Currently, I have a foot in the medical school and in the business school, but with Bass Connections, I also get to work with the undergraduates, people in the policy school, and we even pull in people from the nursing school for this project. North Carolina Medicaid touches each of those representative groups, and it’s incredible to have stakeholders involved in a project that has that kind of proportional impact.

I have a foot in the medical school and in the business school, but with Bass Connections, I also get to work with the undergraduates, people in the policy school, and we even pull in people from the nursing school.

North Carolina Medicaid and health policy in general touches the people that I hope to take care of. As a medical student, I interact with patients on a regular basis, but such interactions are very limited in terms of how much I know about their insurance coverage. That will change somewhat next year as a resident, and likely continue to be more important as a practitioner in the future. So it’s imperative that I, as a provider, understand the mechanism for paying for the care. No matter what I prescribe, if it’s not available to be delivered to that patient, then it’s pretty useless in the long run.

The most exciting thing about the Bass Connections project that I’m on is that it has real potential to make an impact on a very important issue. Most of the time in academia, you’re working on topics that are theoretical or purely academic in nature. The North Carolina Medicaid Project through Bass Connections puts us in a position to impact real policy that’s going to affect people this year and in the years to come in the state of North Carolina. I have patients that would be impacted if we were successful in changing how North Carolina Medicaid is financed and structured.

Whenever you’re working with health policy, context can change very quickly. Academia, on the other hand, tends to move very slowly. Because of recent shifts in the North Carolina legislature and gubernatorial office, we’ve had to pivot multiple times our direction of thinking, our topics, and our intended audience.

There’s an energy amongst the faculty, the graduate students, and the undergraduate students that’s probably not paralleled by any other project I’ve participated in at Duke.

I think people often view policy research as a dry and ultimately dead-end type of work. You can put an incredible amount of effort into a project and come away with very few results, especially if the legislature disagrees with your policy recommendations. But with Bass Connections, it’s just fun, especially as a graduate student, because the undergrads that I get to manage on my team are so excited to have the opportunity to think about issues on this scale. There’s an energy amongst the faculty, the graduate students, and the undergraduate students that’s probably not paralleled by any other project I’ve participated in at Duke.

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