In Reply to Rysavy et al:
Roberts and colleagues1 discuss the need for increasing support for physician–scientists to improve the translation of biomedical research findings into clinical treatments. Expanding on this theme in their letter, Rysavy et al highlight the importance of including clinician–scientists with training in population-health-oriented disciplines in these translation efforts.
To these important points, I would add that supporting dual-degree training in population-health-oriented sciences and related fields such as health economics and health policy may also benefit the development of evidence-based interventions that target factors outside biomedical pathways.
Such factors are important. The Robert Wood Johnson Foundation Commission to Build a Healthier America noted that “although medical care is essential for relieving suffering and curing illness, only an estimated 10 to 15 percent of preventable mortality has been attributed to medical care.”2 Social and economic factors are also determinants of health outcomes, and interventions such as the Place Matters initiative3 attempt to address these factors through community-based collaborative partnerships. In the health system context, interventions targeting health care payment and delivery, such as value-based purchasing and patient-centered medical homes, have the potential to profoundly affect both the practice environments in which we care for our patients and also their resulting health outcomes.
As these interventions are designed, evaluated, and disseminated, the “realistic understanding of clinical practice” and the “tools and techniques of population-health-oriented disciplines” that Rysavy et al note to be the fruits of dual-degree training in population health science may prove to be important not only for the translation of basic science into medicine but also for bridging the gap between health care and health outcomes.
Elna M. Nagasako, MD, PhD, MPH
Mongan Commonwealth Fund Fellow in Minority Health Policy, (2011–2012) Harvard Medical School, Boston, Massachusetts; email@example.com.
1. Roberts SF, Fischhoff MA, Sakowski SA, Feldman EL. Perspective: Transforming science into medicine: How clinician–scientists can build bridges across research’s “valley of death.” Acad Med. 2012;87:266–270
2. . Robert Wood Johnson Foundation Commission to Build a Healthier America. Beyond Health Care: New Directions to a Healthier America. http://www.commissiononhealth.org/Report.aspx?Publication=64498
. Accessed June 23 2012
3. . Joint Center for Political and Economic Studies Health Policy Institute. Place Matters. http://www.jointcenter.org/hpi/pages/place-matters
. Accessed June 23 2012