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AAMC 2014: A Handbook For Health Care


Medical students learn a lot about healing in school, but not the business of being doctors. Dr. Nathan Moore talks about how that led him to write the “Healthcare Handbook” all about the things they don’t teach young docs, but they should.          

Announcer: Broadcasting from the Algorithms for Innovation booth at the AAMC in Chicago. The Health Care Insider is on The Scope, University of Utah Health Sciences Radio.

Interviewer: Nathan Moore is at Washington University in St. Louis. He just handed me a copy of something called "The Health Care Handbook," and said, "Me and my friend wrote this." Explain it a little bit more, if you would, to me.

Nathan: Yeah, so when I was in med school, like most med students, our school did a very poor job of teaching us about the healthcare system - things like health insurance, Affordable Care Act, what an occupational therapist, basic stuff. So my classmate and I, Elizabeth Askin, we figured we could teach it to ourselves if we found a good book, but all the books out there are either really biased or really, really boring. So we were going to write a little something for our classmates and that's how it came about. The first edition came out in 2012 and our second edition comes out next week.

Interviewer: And how's it being received?

Moore: It's been crazy. We were hoping to sell a couple hundred copies but we got into The New York Times, it was on NPR, Double AAMC Reporter. There's, like, 40 schools using it, it's just been nuts.

Interviewer: Wow, that's crazy.

Moore: Originally the idea was we were going to write a little 10-page pamphlet for our classmates. We just started writing it and it turns out that the healthcare system is really complicated. Ten pages didn't cut it. So it ended up being 250 pages, but it's a small size of the book. Our school gave a loan to publish the first one and then we got a grant to publish the second one. The idea was to make this stuff as painless as possible, because it's really, it's a hard subject to get people interested in but it's really important.

Interviewer: So in med school you were finding that you were learning what you need to know about providing healthcare, but actually navigating the healthcare system and being in the business of healthcare, not quite so much.

Moore: Yeah exactly, I mean, once you get out into the real world you find this stuff is just as important as the clinical stuff. There's some studies showing that 45,000 deaths a year are associated with lack of insurance, more than kidney disease. When you think about the hundreds of hours we spend studying the nephron and the dozens of minutes we spend talking about health insurance, it's just . . . I think focus is needed.

Interviewer: Yeah, I don't even know what to say. I mean, I'm looking at this book that you wrote. A lot of schools are using it, what is your hope that at the end of this book that somebody would really get out of it?

Moore: I think our main goal is that if providers know how to navigate the system, they can take care of their patients better. That's our main goal. And then our secondary goal is that the system is changing rapidly, it needs to be improved and doctors and other healthcare providers have decided for a long time that that's not their role. "We're just here to take care of patients, some people elsewhere will handle that."

But if we do that, people who don't take care of patients don't understand that patients are making the decisions and bad things happen. So I think step one is if providers at least understand the system and the problems, some of them will take the second step to try and fix them. But if we don't understand it and you just ignore it, then things are not going to get better.

Interviewer: Yeah, that's interesting to think that this could hurt a patient. Not knowing this stuff as much as a physician not knowing the basics.

Moore: Yeah, I mean we see it every day when you work in the E.R. and you say, "Yeah, go see your doctor in a week," but people don't get it, you know?

Interviewer: Yeah. And how much is this book?

Moore: It's only $8 for the ebook on Amazon.

Interviewer: You did that intentionally, I imagine.

Moore: Yeah, Elizabeth and I said, "How much would we pay for this?"

Interviewer: And $8 was the mark.

Moore: The paperback is $16 because we had to pay for printing and stuff. I would just like to say that people who work in healthcare field, I think, you don't have to read our book, but get interested, get involved and you need to know the basics of the healthcare system. And by that I mean policy, delivery and economics. Every medical school now teaches patient safety and quality. Twenty years ago they didn't, and I feel like in 20 years everybody will be teaching this stuff too because it's just as important too.

So, I don't know, I've learned a whole lot by doing it. I thought I knew the healthcare system beforehand, turns out I didn't know anything. So yeah, it's been fun.

Announcer: Sparking conversations to transform academic medicine. For more, stop by our booth at the AAMC or go to The, University of Utah Health Sciences Radio.

By: Scot Singpiel

Scot Singpiel is a senior producer for University of Utah's Scope Radio