Learning the Ropes: Seeing the Connection Between Policy and Patients

    • March 24, 2011

Context. Public policy often affects optometrists and their patients. Yet optometrists, and the faculty who teach them, may have limited understanding of major health policy issues and laws that influence their discipline and the care their patients receive.

Can an optometrist interested in public health learn more about helping people by being involved in the policy process in Washington? Does the experience of working on national public health issues influence the career of a health care professional?

Melvin Shipp, OD, MPH, DrPH wanted to explore those issues, and the Robert Wood Johnson Foundation Health Policy Fellows Program gave him that chance.

Since 1973, the Health Policy Fellows Program has given exceptional mid-career health and behavior science professionals an opportunity to better understand health policy at the federal level. After an extensive orientation, fellows seek work placements in government—most choosing a congressional office—where they contribute to research, drafting legislation, briefings and other vital policy-related activities.

Programee Background. By 1989, when he entered the Health Policy Fellows Program, Shipp had 12 years experience working as a faculty member at the University of Alabama at Birmingham School of Optometry, and had worked as a clinician in the United States Navy.

Shipp always believed that, as an optometrist, "you don't just examine eyes, you examine people." He was interested in his patients as part of the larger community, and wanted to understand more about what impacts people's health the most—public policy.

Health Policy from the Inside. When Shipp began his fellowship in 1989, his main goal was simply to learn. He knew he was passionate about public health and was eager to understand more about the legislative process to gain a new perspective. He says, "I applied because I wanted to see the policy process up close and personal."

During his fellowship, Shipp worked as a health legislative assistant for Senator Donald W. Riegle (D-Mich.), chair of the Senate Finance Subcommittee on Health for Families and the Uninsured.

"One of the main reasons I wanted to work for Senator Riegle was that he was very involved in an early version of health reform," recalls Shipp. Two years before Shipp started his fellowship, Senator Riegle established a bipartisan committee (Finance and Labor) working group on universal access to health care. Shipp had the opportunity to help with the committee's activities, analyzing proposed health reform options and coordinating hearings on health access.

In addition, like any congressional staffer, Shipp worked on "any and all issues that came across my desk." This included developing the Medigap Simplification Act of 1990, which eliminated confusion caused by a lack of uniformity in various Medicare supplemental insurance policies. It became law.

Shipp found concentrating on a variety of policy issues that were new to him both exciting and challenging. He also valued the opportunity to work alongside motivated and energetic individuals, including the other Health Policy Fellows, who were committed to making a difference.

The Results. While Shipp may have started his fellowship with modest expectations, he believes his participation significantly influenced his career and outlook.

Shipp returned to working in academia and is now dean of the Ohio State University College of Optometry. But he remains firmly dedicated to working on public health issues. His fellowship showed him how laws could improve primary prevention and reduce the probability of people having disease. "I tell my colleagues that overall health status and quality of life can be enhanced with a better understanding of optometry, policy and public health," says Shipp.

In 1995, Shipp authored an article in the Journal of the American Optometric Association entitled "Musings of a Robert Wood Johnson Health Policy Fellow." The article describes his experience and enthusiastic reflections about his fellowship. However, he also details his belief that the optometry profession needs to be more involved in national health policy discussions and contribute to the development of policy solutions. In addition, he encourages his association to develop its own fellowship program to allow more optometrists the opportunity to learn about health policy from a hands-on perspective.

Shipp continues to participate in the larger public health community. After working as an active member in the American Public Health Association (APHA) for 25 years and serving on a variety of committees, Shipp is currently the association's president-elect and will become president in November 2012. Shipp believes that as the largest public health organization in the United States, the APHA has an important role in public health—not just for this country but for the world.

"There's no question my fellowship experience will help me with understanding and appreciating the impact of emerging health-related public policy," reflects Shipp. As a leader at APHA, he will work on matters such as the new health care reform law, health care disparities, environmental health and disease prevention. He credits his year in Washington for giving him a better appreciation of how to work with people from different perspectives.

"Being a Health Policy Fellow was very influential and very important to my career. It is a great way to learn about the policy process in a special way," says Shipp.

RWJF Perspective. "The RWJF Health Policy Fellows Program is a flagship program for the foundation and one important way we seek to improve the health and health care of all Americans," says Michael Painter, JD, MD, senior program officer and himself a 2003 RWJF Health Policy Fellow.

"It is critically important that health care professionals—physicians, nurses, behavioral scientists and others—realize that they can and must play important roles in promoting impactful, positive, informed change. The program provides a great way to help them learn how to do that and to learn firsthand the important relationship between politics and policy."

"I absolutely could not do what I'm doing today without that experience," Painter adds.