Wonk Heaven

wonk - n. an overly studious or hard-working person; a persnickety person who overly focuses on details; a nerd; an expert; often shorthand for a "policy wonk" - courtesy of wiktionary.

In an effort to enhance my vocabulary, (or adding a certain panache to my loquaciousness one might say), I have decided to learn a word a day throughout the summer. I don’t want this summer to go to waste, and so far it is off to a fantastic start. Monday I started my eight week internship at the Sheps Center for Health Services Research. Officially (well not officially, but I’m going to make it official from here on out), I am a “health policy analyst with a specialty in comparative-effectiveness research” (officially, I think I’m the Director’s “CER minion,” but I think “analyst” will probably add more to my CV, analogous to using the term “administrative assistant” instead of “secretary”). I know what you’re saying, “that must be an abject position; nothing but pure ennui, leading to a cornucopia of Facebook commenting, liking, stalking, and wall-posting.” And you would be completely wrong. Right in noting that that was a completely inappropriate use of the word “cornucopia,” but wrong, because I love my job.

I have been given two tasks in my first week. Priority number one is to write a report on how comparative-effectiveness research (CER) will be affected with the passing of the Patient Protection and Affordable Care Act (PPACA), signed into law by President Obama in late March. That report is due Monday afternoon. The consolidated bill contains 21 pages dedicated to CER, most notably containing provisions to create the Patient-Centered Outcomes Research Institute (PCORI) which will disseminated 1.26 billion dollars in CER funds over the next decade (if you thought Block IV or cardiology had a lot of acronyms, try the alphabet soup of government agencies). The second task, for which I already turned in a rough draft on Wednesday, is a report on the Dartmouth Atlas. This will be an ongoing project because of the amount of recent controversy in conjunction with their results. A lot more on this to come, but the basic gist of it all is that hospitals in certain areas of the country (e.g. Los Angeles, Miami, New York) are spending a lot more money on patients than providers in other regions, like Minneapolis, San Francisco, etc. with little change in patient outcomes. If you are living in Miami, you are likely to see more specialists, spend more days in the hospital, and receive more treatments than elsewhere. Good, right? But ample access to care and subsequent utilization doesn’t seem to correlate well with improved patient outcomes.

Perhaps more of an abstemious approach to divvying out interventions might be beneficial to the citizens of our polity. Hmmmm? (Sorry that was a stretch).

But the real key to this whole summer is being able to work off-site. The bottom line is I need to put in my 40 hours and I need to produce. Other than that though, the options are limitless. I have the opportunity to sit in on a few meetings (grant reviews, kick-offs, CE brainstorming events), and then I quickly abscond from the premises so the rest of the time I can spend in my favorite coffee shop, avidly perusing the New England Journal of Medicine and the Journal of the American Medical Association for tidbits, picking through this minutiae like a baleen whale filtering for krill.

So every day I wake up around seven, pack my lunch and either head to the office or across the street to Bean Traders. I read, I write, and I workout. It’s the simple life for me. Last night I even got to have dinner with my Medicine and Society patient, entertaining the family with pictures from the Baltic Sea and South America, and of course hooking up “5 Star Nerve” on their big screen. On the weekends I have plans to visit Kelly in Wilmington (tomorrow!), head home for Rachel and Chris’ wedding, and make trips to Troutman, Charlotte, and hopefully Atlanta in the weeks to come. I also am working EMS still, and I have my first shift in several weeks tonight at 7pm. Hopefully I’ll be able to get some reading done there as well.

It’s a tough life, but somebody’s got to do it.

Next up is a Perspective article in the NEJM, “Geographic Variation in Medicare Drug Spending.” More reading, a quick swim, then off to Parkwood. Tomorrow’s trip to Wilmington has major potential for burning, so I’ll load up on the 100 SPF in the morning. If you’re in the area, look for the kid under the umba-rella reading The Political Life of Medicare by Jon Oberlander. That dork will be the one with a smile.