Not your typical physician - Dr. Matt Davis uses policy to tackle health disparities
Dr. Matthew Davis is not your typical physician. Sure, he attended medical school and completed a residency, just like his peers. But while continuing his studies as a Robert Wood Johnson Clinical Scholar at the University of Chicago, Davis also earned a master's degree in public policy. Davis still sees and serves primary care patients through his practice with the University of Michigan Health System, but his public policy training, and what he's done with it over the years, is allowing him to serve the health needs of much larger communities, in much broader ways. These days, he's doing that as chief medical executive for the state of Michigan—a role he took on in March of this year.
What's in the job description for Michigan's chief medical executive? Simply put, informing policy decision-making in the Department of Community Health, the largest of the state's 18 agencies. For Davis, that's meant helping to craft the state's response to public health threats like heat waves, communicable disease outbreaks like whooping cough and Middle East respiratory syndrome, and, of particular interest to someone with a longstanding passion for policy, Michigan's statewide implementation of new legislation like the Healthy Michigan Act—the state's answer to the federal Affordable Care Act.
Davis's interest in health and health care policy is nothing new. Since 2000, the professor of public policy, pediatrics and communicable diseases, and internal medicine has developed and taught a series of well-received courses on health policy and health care reform for students at the Ford School, the Medical School, and the School of Public Health. While many of the students Davis teaches go on to serve the organizations that craft and refine health and health care policy, Davis jumped at the opportunity to play a leadership role himself—specifically in addressing one of the Affordable Care Act's larger goals, eliminating socioeconomic health disparities.
"Whole books have been written about why it's so difficult to reduce socioeconomic health disparities," says Davis. "But the persistent challenges relate mainly to variable access to timely, appropriate, and effective health care, and the choices that individuals and families make, or fail to make, to protect and improve their own health." To address these challenges, state legislators recently crafted the Healthy Michigan Act, signed by Governor Rick Snyder just a few months ago, that is intended to increase both the number of low-income residents covered by Medicaid and the range of services, including preventive services, these residents can access. As a member of the leadership team within the Department of Community Health, Davis was directly involved in working with the Michigan legislature to ensure that the Healthy Michigan Act has the best chance to benefit patients living in the state. Now that Healthy Michigan has been enacted, Davis is part of the team working to implement the plan for launch in 2014.
Davis is hopeful that the Healthy Michigan Act, and the increased coverage it offers, will help reduce the state's long-term struggles with socioeconomic health disparities. "Trying to move the needle in Michigan is tough; we rank in the bottom half, if not in the bottom third, of states when it comes to most racial, ethnic, and income-related disparities in health and health care," says Davis. "That said, there's a very strong commitment, from the Governor's office on down, to look unflinchingly at these disparities and commit to doing things differently than we have in the past."
Among the many socioeconomic health disparities Davis hopes to address is the state's deeply troubling infant mortality rate. For every 1,000 live births in Michigan, seven infants die before their first birthday—well above the national average. Among black infants, or infants born in cities with high poverty rates like Detroit, that number can be twice as high.
Asked if he thinks expanded Medicaid can solve the problem, Davis says he does. "Other states that already have more generous Medicaid coverage for adults (regardless of whether or not they're pregnant) have shown us that when you cover women prior to their pregnancies, you can address conditions—such as high blood pressure, diabetes, and depression—that need to be managed for a healthy delivery and a healthy baby."
Davis says his public policy training has given him a valuable perspective for addressing health and health care challenges. "Sometimes the questions that I ask, and the problems I find compelling, sound and look more familiar to my colleagues in policy than to my peers in health care," says Davis. "But that's not a problem…it's an asset. I really count on my formal background in public policy, and the expertise and discussions I've been part of at the Ford School, to help me do the best job I can in this still relatively new role." While working as chief medical executive, Davis will continue to serve on the faculty at U-M.
To help other health care professionals acquire this kind of broader policy lens, Davis is teaching a free online course through Coursera, a massive open online curriculum (MOOC) platform that the University of Michigan launched last year. Davis's course, "Understanding and Improving the U.S. Health Care System," enrolled more than 10,000 domestic and international students when it was first offered this fall—many of them health care professionals and administrators. The course includes video interviews with Ford School faculty members Helen Levy, a staffer for President Obama's Council of Economic Advisers, and Dr. John J.H. "Joe" Schwarz, a physician and former U.S. Congressman (R-MI), who bring their unique perspectives to the material. "Very few medical schools have the faculty base with which to provide health policy education," says Davis, but "for health care providers to be functioning at their best, they need to know how the health care system is supposed to work, and how they can help to improve it."
Below is a formatted version of this article from State & Hill, the magazine of the Ford School. View the entire Fall 2013 State & Hill here.