Health Care Handbook Helps Residents and Med Students Navigate the Healthcare Maze

Nathan Moore is a graduate of the University of Texas in Austin and a fourth-year medical student at the Washington University School of Medicine in St. Louis, Missouri. He recently co-authored a book with fellow med student Elisabeth Askin on the U.S healthcare system entitled, The Health Care Handbook: A clear and concise guide to the United States healthcare system. Mr. Moore spoke with CIR about his book and how it can serve  interns and residents in gaining better awareness and understanding of the complex and ever-changing healthcare system. 

Why did you write the Healthcare Handbook? Who’s the target audience?

We wrote the book out of our own frustrations. At most medical schools, they don’t teach you much about health care delivery or policy of business. When Elizabeth and I had gone to look for resources on our own, we just couldn’t find anything that was really what we wanted. Everything was really complicated and biased. So we just ended up writing it ourselves.

Our original audience was medical students and residents, but then we found out that no one knows this stuff either; whether they’re nurses, physical therapists, practicing physicians . . . .

As far as residents go, a lot of their daily activity is not clinical medicine, it’s trying to figure out what drugs can we get with this patient’s insurance, or what nursing home would take him/her, or what would a social worker do; how are things going to change with Medicaid.. Residents generally have to figure out most of these things as they go along, just by doing it. But there seemed to be a big need for some sort of easy to understand resource, for residents to deal with this stuff every day.

How are residents using the book?

We really think the book is a good reference guide for residents. They don’t have to read it cover-to-cover, but when certain things come up and a patient says, ‘well I’m on Medicare part C, how is that going to affect. how much this drug you prescribe me is going to cost?’ Or, ‘what the hell is Medicare part C?’ they can quickly flip to that part of the book and get a quick refresher.

Are there some examples of programs that are using it?

Washington University is where we reached out first, but a number of residencies in several different fields are using it. The most recent example, the one that I’m really excited about at the moment, is the University of Oklahoma at Tulsa. They basically bought copies for their medicine residents and actually use it as part of their curriculum. So they would have to read part of the book beforehand and then they come in to do case studies. For example, a patient comes in and his insurance is about to run out, and he’s got this medical condition — what do you tell him? As far as you know, you should get these drugs because your insurance covers them, or how are things going to change in two years with ACA, and how should the patient deal with it, and how do you as a resident navigate the system so you can give that patient the best care you can, given the circumstances.

They did three different two-hour sessions with that material, and residents really liked it. It really taught them a lot about how to handle these circumstances which they deal with all the time but they don’t really know what to do.

What audience that you didn’t expect has bought the book?

Well a lot of it has been lay public and people with chronic diseases, which has been really gratifying for us. I mean, if you think about it, someone with a chronic disease spends a lot of time dealing with the health care system. That could be really frustrating. A lot of folks in the laypublic have really like it as well.

I got an email the other day from a guy who had been a nurse for 25 years. He liked the book because it clarified some things for him that he had really tried to figure out throughout his career. My own experience, when I first went to a hospital for medical school, and you see all the ID’s with all these different letters after their names, I had no idea what any of them meant beside the MD. So I really wanted to provide that resource, especially to residents who deal with other professionals all of the time.

Can you talk about the myth and misconceptions some people may have about the Affordable Care Act (ACA)?

It is hard to say because its changing rather rapidly. There is a kind of widespread feeling that the ACA means that now the government controls healthcare. I think it’s important for people to realize that the ACA is primarily designed to get more people health insurance. Some of these people that are going on health insurance will be on Medicaid, but most of them are getting government money to buy private insurance.

The second thing to keep in mind is, I think we’re all worried about our own paychecks . . . The ACA is about controlling costs but it’s not explicitly about reimbursements. The ACA itself does not reflect a huge change in the way physicians get paid.

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