Category Archives: Social sciences
If you’re looking for peace and joy this holiday season, don’t invite a liberal and a conservative health economist to your holiday party. Health economists from the political left and the political right tend to have very different views on what ails the U.S. health care system – and what should be done to fix it. After a glass or two of punch, they are likely to become loud and argumentative—dampening the holiday spirit.
But if you’re Barack Obama and John Boehner, and you’re looking to heal our health care system this holiday, invite over a few strident health economists and let the eggnog flow. There are important truths being articulated by both extremes of the health policy spectrum. A wise policy-maker would harness this diversity of wisdom.
Every year, fourth-year medical students anxiously await “Match Day,” when they learn where they will complete their residencies. But long before they receive their sealed envelopes, an algorithm is at work matching them with schools based on their own rankings and those of the institutions to which they are applying. This week, two men responsible for that algorithm were recognized with the Nobel Prize in Economic Sciences.
In the 1950s and 60s, Lloyd Shapley, PhD, helped create the main concept of “pairwise matching,” or how individuals can be paired up if they have different views regarding who would be the best match. His model was the basis for the National Resident Matching Program (NRMP).
Alvin Roth, who worked independently of Shapley but had closely studied the algorithm as well as other countries’ medical markets, helped redesign the NRMP in 1995 to take into account married couples searching for residencies in the same region or at the same hospital, and to eliminate the system’s bias for hospitals over students.
The new system is still used today, and helps match more than 20,000 positions a year. The scholars’ work is also used to match students to high schools and to match up kidney donors.
The Robert Wood Johnson Foundation (RWJF) Human Capital Blog is asking diverse experts: What is and isn’t working in health professions education today, and what changes are needed to prepare a high-functioning health and health care workforce that can meet the country’s current and emerging needs? This post is by RWJF Investigator Award in Health Policy Research recipients Robert L. Wears, MD, PhD, a professor in the Department of Emergency Medicine at the University of Florida, and Kathleen M. Sutcliffe, PhD, The Gilbert and Ruth Whitaker Professor of Business Administration at the University of Michigan’s Ross School of Business.
There are many aspects to the problem of what is or is not working in health professionals’ education today, and the changes needed to address them. From our view as researchers studying issues of safety, resilience, and managing for the unexpected, some of the more important are that health professionals’ education is seriously deficient in the social sciences; is limited almost exclusively to largely positivist ideas about what counts as scientific activity; and is almost totally devoid of the humanities.
None of these deficiencies are new, and that is what concerns us. The lack of engagement with the sciences of safety, and of human and organizational performance, has implications for practice, for safety, and for understanding and creating actionable knowledge.
With respect to practice, for example, without sufficient exposure to humanities and social sciences we risk socializing people to become authoritative but inhuman techno-nerds, even if they didn’t start out that way.
With respect to safety, we risk training people in positivistic methods and research approaches that oversimplify and even miss local contextual specifics that create real threats to safety.
With respect to understanding and knowledge creation, we risk training people to revere scientific and technical rationality and ‘objectivity’ at the expense or even denial of any sort of constructivist or interpretive understanding.
Eric Klinenberg, PhD, is a professor of sociology at New York University and the recipient of a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research. He is the author of “Going Solo: The Extraordinary Rise and Surprising Appeal of Living Alone,” which examines a fast-growing trend of people in the United States living alone.
Human Capital Blog: Why did you decide to look at this topic?
Eric Klinenberg: The first book I wrote was about a catastrophic heat wave in Chicago that killed more than 700 people in 1995. One of the most powerful and disturbing features of the event was that hundreds of people died alone and were discovered hours, or in some cases days, after they perished. I became aware of how pervasive aging alone had become and grew very concerned about the health problems of social isolation. Through the RWJF Investigator Award in Health Policy Research, I was able to do more work on the topic. Their support was completely essential.
When I started doing research on the bigger issue of living alone, I realized that what I had studied in Chicago was its bleakest aspect. Social isolation is a big problem, and one that deserves far more attention and resources than we give it today. But I also realized that there’s much more to living alone than being isolated. Living alone and being alone are very different things. And Going Solo calls for a more sharp distinction between them.