Policy Prescriptions: A Future Medical Student’s Dive into Health Policy and Advocacy

While preparing for the 2023-24 medical school application interview cycle, during a mock interview, I was asked, “What would you do if you had a pediatric patient who needed an emergency blood transfusion, and their family were of the Jehovah’s Witness faith?” That’s when I quickly learned that many Jehovah’s Witnesses believe that receiving blood transfusions goes against their religion. I had so many follow-up questions. Eventually, I concluded that in addition to ethical and cultural considerations, there surely must be a law to provide further guidance in this scenario. I then went down a rabbit hole of researching various regulations that impact life-or-death decisions like this one that physicians must consider on a daily basis. This inspired me to learn more about health policy, both out of my own curiosity and obligation to my future patients.

I began this journey by taking an Intro to Health Policy and a Health Law and Health IT course while working on my Masters of Public Health (MPH) at George Washington University. These courses introduced me to the enormously complicated world of health policy and governmental health systems. As someone who’s wanted to become a physician for as long as I can remember, I can’t believe I’d never learned how systems like Medicare and Medicaid function. I really hope I’m not the only one who didn’t know there was a part A, B, C, and D to Medicare, and I’m an MPH student.

While taking in this information was like “drinking out of a firehose” – much like people famously describe medical school to be – I wanted to apply my newfound knowledge to a real-world experience. While doing my daily scroll through Indeed to find internship opportunities, I found a position as a government relations health policy intern at none other than the AAMC! At this moment, it felt like the perfect internship was tied up in a bow and sent my way.

Before starting my internship, my only experience with the AAMC was taking the MCAT and applying to medical school via the AMCAS application. Walking into the AAMC’s headquarters in Washington, D.C., my fight or flight response kicked in when I saw the logo that I associated with months of MCAT studying. However, after meeting all of the kind, brilliant staff on the Office of Government Relations team, I quickly forgot my past trials and tribulations with the MCAT.

I swiftly immersed myself in government relations, working alongside policy experts, meeting with key Capitol Hill health policy staff, attending congressional briefings and hearings, and writing advocacy letters to members of the House and Senate. I learned about key pieces of legislation and regulations on the horizon that have direct impacts on the way medical students and physicians learn, train, and practice health care.

For example, I had the opportunity to attend a briefing and write a congressional letter of support for the Safety from Violence for Healthcare Employees (SAVE) Act. The SAVE Act would create federal legal penalties for individuals with a sound state of mind who knowingly and intentionally assault or intimidate hospital employees, much like the protections offered to aircraft and airport employees. Through learning about this bill, I discovered that about half of nurses have said they’ve experienced physical or verbal abuse by patients. After hearing from physicians, nurses, and health care administrators, I came to understand how experiences of violence can induce trauma, cause health care workers to fear for their personal safety, or disrupt patient care due to distractions from violent patients or family members. After learning about legislation like the SAVE Act, I feel hopeful that incidents like these will decrease in the future.

I also worked on projects that support infrastructure and health systems in rural areas. Hailing from a rural area in Indiana and as an incoming medical student in the Rural Medical Education Program at the Indiana University School of Medicine, these initiatives mean a lot to me. I learned how increasing residency slots via the Consolidated Appropriations Act of 2021 has provided more support to rural areas. I also learned how the Conrad 30 Waiver program allows international doctors with J-1 visas to attain a waiver of their residence requirement by committing to work for three years in an underserved area, including rural areas, of the United States. These legislative actions serve as the foundation to allow health care providers to productively do their jobs and allow rural patients to receive the health care they deserve.

I feel incredibly grateful to the AAMC for providing me with an experience that will forever change the lens through which I see health care. When hearing about health disparities, disease burdens, etc., I now think to myself, “What policies could be beneficial or harmful in combating this issue?” or, “How can I be an advocate for this?” I feel inspired to have met so many amazing physicians, policy experts, and lobbyists who help pave the way for Congress to legislate on our nation’s health care issues.

While “boots on the ground” medicine is my first love, I now have a greater understanding of how legislative change, no matter how small, can have a huge impact on care for my future patients. 

Oh, and if you are still wondering what the protocol is when a pediatric Jehovah’s Witness patient comes into the emergency department, unresponsive, and in need of blood, well, the answer is still a complex one that requires care, cultural competence, respect, and consideration of state laws. However, in a life-threatening emergency, the child’s interest and those of the state outweigh parental rights to refuse medical treatment.