Cardiovascular Medicine Amid Evolving Health Policy: Training a Generation of Leaders

Cardiovascular professionals need to have a strong voice in health policy to improve cardiovascular health on a large scale. This requires reinventing traditional medical training programs and fellowship training to explicitly support the development of cardiovascular leaders in health policy, says Rishi K. Wadhera, MD, MPhil, in an article published Oct. 16 in the Journal of the American College of Cardiology.

Fellows in training (FITs) are immersed in a fast-changing national health environment. This makes it critical for them to be prepared to navigate, formally study and drive evidence-based changes in health policy to enhance cardiovascular health care at a population level. They also need to be equipped with the skills to inform and influence policy makers during periods of debate and uncertainty. Along with insurance issues, FITs need to be leaders in the creation, development and evolution of payment models that affect the practice of cardiovascular medicine.

Wadhera highlights the need for non-traditional, multidisciplinary skillsets to be effective health policy leaders. While noting the inclusion of health policy curricula in some medical school and residency programs, he suggests this be included in cardiovascular training programs. Additionally, he suggests establishing a health policy pathway within cardiovascular training programs, which would help FITS seek the tools, resources and mentorships needed to build their health policy skillset.

Further, he recommends that FITs get involved in diverse and collaborative mentorship teams to gain new skills, view different perspectives and engage in various opportunities to solve health policy issues. Interdisciplinary training, for example, gaining biostatistical training through a Master of Public Health program, should be supported by the training program and departmental leadership.

In a related response, John Z. Ayanian, MD, MPP, writes that Wadhera makes a strong case for cardiology fellowship programs to play a proactive role in preparing trainees to become leaders in the rapidly evolving fields of health policy and health systems reform. He adds, “The ideas that Dr. Wadhera has outlined will help to ensure that newly trained cardiologists are not just passive observers of changes in the health care system, but active participants in helping to lead and shape these changes.”


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