Generational Impact: Fifty Years of the PhD Program in Health Services Research and Policy

January 17, 2020

Michigan’s doctoral program in Health Services Research and Policy prepares students for careers in research, teaching, and policy analysis in health care services and health care policy making.

For fifty years, alumni of the program have served in health leadership positions across the country. Their long and illustrious careers demonstrate the innovative impact of professionals trained in both practice and academia—a testament to the educational value of the program for students and the broad influence the program has had on health care management and policy in the US and beyond.

Through a variety of communications—mostly digital—HSOP alumni have been collaborating to draft a history of the program, which in many ways mirrors the story of health care administration in the US. Health care has changed profoundly over the last half century, and the HSOP program has evolved under that external pressure to serve diverse populations across a dynamic American landscape.

As part of the history initiative, early alums of the program are meeting with current doctoral students to share experiences and insights about a career in that unique mix of scholarly and applied advocacy and research.

Real People, Lawsuits, and Not Knowing What You’re Doing

Mitch Greenlick, PhD ’68, a first-generation college graduate from Wayne State University, was teaching in the Wayne State University College of Pharmacy and researching prepaid drug insurance plans when he became increasingly frustrated with the status quo. “I often sent good policy recommendations to Capitol Hill, and my insights were often misinterpreted, sometimes severely, in the translation to actual policy,” he said.

Greenlick entered the HSOP program because he wanted to have a major impact on health care policy in the US in both academic and practice arenas. In particular, he thought health care policy too often got caught up in policy debates and partisan politics. “Academics have to remember that the world doesn’t end when you publish in a peer-reviewed journal. You are trying to help real people, and when you follow up on your research by ensuring it becomes good policy, you can affect people’s lives more profoundly,” he said.

Arnold Kaluzny, PhD ’67, was working as a lead administrator at Delaware Hospital in Wilmington and chose to return to Michigan for more research training to advance the evidence base for management and policy decisions. “Once I had seen up close and personal what it takes to run these kinds of organizations, it occurred to me that we didn’t know what we were doing. Evidence-based management was not a reality. We need to deliver health care based on evidence—it was a struggle then and it is still a struggle today,” he said.

David Smith, PhD ’69, was always curious about how health care organizations work and the kinds of care people receive. He liked the freedom to explore these dynamics and ask critical questions. He enrolled in the HSOP program to gain practical administrative and policy-making experience in health care. Smith shared how several class action lawsuits he was involved with were actually supported by the defendants because it allowed them to move forward on large, system-wide updates they needed to make but couldn’t push through on their power alone. “As an expert witness, I was able to ask and answer larger, more critical questions. These processes don’t have to be negative or contentious. Health policy systems are set up with checks and balances in mind, and when you understand these systems you can maximize benefits for all and reduce the health disparities that exist,” Smith said.

Public Health Might Need You Somewhere Else

Smith also encourages boldness in engaging the difficulties of improving policy in contentious atmospheres. “Don’t be afraid of having strong opinions and being critical of things in health care, even outside your comfort zone, whatever that might be,” he said. “Health care isn’t perfect, and it needs us to be bold if we are to change it and help move it forward.”

Kaluzny echoed Smith’s appeal to stepping outside of your comfort zone, noting that health care management and policy requires resiliency. “Careers always involve things beyond your control, and wonderful things can happen when you say yes to something that pushes you off the path you’ve set for yourself. Public health might need you to do something else. The academic setting isn’t always ideal for making change and you can get bruised up when you engage in conflict with business leaders and policy makers and challenge them to be better at what they do. They don’t always want to hear you, they push back. But you are fighting on behalf of the communities around you.”

Alumni shared briefly some of their key moments of pride over the course of their careers. Greenlick helped pass Michigan House Bill 2116 in 2009, which provided immediate health care for more than 100,000 children over the course of 12 months. Smith spent years on advocacy work that helped alleviate race-based health discrimination in certain regions of the US. And Arnold Kaluzny, working with colleagues across the University of Carolina, Chapel Hill, helped establish a PhD program at UNC’s Sheps Center for Health Services Research and helped launch the Carolina Population Center.

Connecting with Students

Students shared with the alums what drew them to the HSOP program. Their passions and educational backgrounds demonstrate the incredible breadth of health care administration and policy, from nutrition and food systems to information technology to epidemiology to decision science.

With a required cognate in one of the social sciences—economics, sociology, psychology, or political science—the HSOP program continues to develop leaders with diverse skills capable of tackling the complex challenges faced by the US health care system. Leah Abrams, a second-year student in the HSOP program, has studied and worked in the fields of anthropology, genetic research, and clinical community health work. Her current work is on social epidemiology, aging, mental health, and health equity, and she recently wrote about the public health connections between organized labor and health equity.

The HSOP program’s legacy of translating academic research into meaningful health care policy continues to animate the program today. Leading scholars and industry practitioners from across the country provide guest lectures. Students access Michigan’s clinical, academic, and professional resources in developing a more unified understanding of the organization and financing of health care.

Health services work becomes more important to the public’s health and more challenging to administrators and policy makers every day. Those with the curiosity to accept the challenges that come with health care leadership will benefit from the collective, intergenerational nature of Michigan’s HSOP program.

Sitting between academia and practice never seemed so promising for a career in health care services and for a lifetime of improving public health in the US and beyond.

^{Photo. Current HSOP students (l-r) David Suh, Anjelica Gangaram, Susan Parker, Mina Raj, Grace Chung, Kimson Johnson, Brad Iott, Amanda Mauri, Sarah Rozenblum, Karalyn Kiessling}

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