By Jennifer J. Salopek
While they were medical students at Washington University School of Medicine in St. Louis, Elisabeth Askin and Nathan Moore noticed that the curriculum didn’t include much information about the health care system overall—perhaps an hour-long lecture at best. Deciding that they should rectify that information shortage for themselves and their classmates, the friends planned an 8- to 10-page pamphlet. The first edition of The Health Care Handbook, published in 2012, numbered 256 pages.
The authors released a second edition in October 2014. Now internal medicine residents at UCSF (Raskin) and Barnes-Jewish Hospital (Moore) respectively, they collaborated using Dropbox and other technological tools to revise and update the volume. More than fifty content experts reviewed the material and provided additional references, which are numerous and extensive.
What with the demands of medical school and now residency, one has to wonder: Why? And where did they find the time?
“Had we known how much work the first edition would be, we never would have done it,” says Moore. However, perhaps approbation drives inspiration: “We got an overwhelmingly positive reaction, so our objectives are met.”
The book’s structure and the authors’ language is direct, to the point, and easy to understand. Moore reveals that the pair set a page limit early in the process and that a new topic is introduced approximately every two pages. Forty percent of the content in the second edition is new, including chapters on quality and technology, a discussion of interprofessional education and teamwork, and reviews of specific efforts to improve health care value.
Acknowledging that there is much about modern medicine that is controversial, Askin and Moore provide succinct point–counterpoint summaries on such topics as the physician shortage and work hour limitations. The book’s many illustrations, charts, and graphs make the information accessible. It is being used as a text in more than 60 academic programs.
Moore says the pair plans to update the volume every two to three years, and that they hope to work with future medical students in directing content, providing perspectives, conducting research, and writing.
The authors’ unique and close relationship with their dean, William A. Peck, MD, facilitated the project; Peck provided guidance and feedback, and suggested content reviewers. Support from Washington University made much of the book’s production possible, including loans to have the books professionally edited, fact-checked, and designed. In his foreword to the second edition, Peck, now director of the Center for Health Policy, writes:
Strongly motivated by the recognition that many students entering the health professions had little knowledge of the organization, financing, and delivery of health care, [Elisabeth and Nathan] wrote a comprehensive, compact, interesting overview that elicited rave reviews from many individual and institutional experts… They have already contributed to the health literacy of our profession and are now full-time caregivers. We do attract outstanding young people to the study of medicine.
Moore says that the experience of researching and writing the book has had an effect on the way he now delivers patient care as a second-year internal medicine resident. “It has made me more aware of how system factors affect patient care,” he says. “The health care system is important to patient care and the country in general. Every medical professional should know the basics.”
Jennifer J. Salopek is founding editor of Wing of Zock. She can be reached at firstname.lastname@example.org, or follow her on Twitter @jsalopek.