Since his career began, Matt Davis has been interested in policy-relevant issues, and bridging the gap between academia and government using research. In the past three years, he had an unprecedented chance for direct involvement and impact on Michigan health policy.
A: Since before medical school, my goal has been public service. I actually joined Michigan’s faculty because the Child Health Evaluation and Research (CHEAR) group in the Medical School’s Department of Pediatrics had established relationships with the Centers for Disease Control and Prevention, and with Michigan’s Medicaid program, that focused on being responsive to current issues and asking policy-relevant research questions.
As I was building my research project portfolio, I tried to choose projects that would be as relevant to public policy as possible. As I worked on those projects, I developed relationships with health officials at the state and federal level. I made myself available to them as a person who would be happy to answer questions that would be of interest to them, including on a pro bono basis outside any contract. That offer turned out to be vital to establishing trusting relationships that were not about ideology, but about the importance of the questions that policymakers needed answers to.
A: In Michigan, and in the vast majority of states, the government does not have resources available to support rapid-turnaround research. And most academic centers are not familiar with a model of what I call opportunity-initiated research, rather than the investigator-initiated paradigm we all know.
In my experience, opportunity-initiated or state-initiated research spurs many related ideas in the future for investigator-initiated projects. In turn, those policy-inspired investigator-initiated projects have a higher chance of being policy-relevant in the future than your average investigator-initiated project.
A: Quite often, our career public health officials and the elected officials above them are going on the best possible estimates they can make from available evidence. We depend on them to safeguard the public’s health and optimize care across our state and country. Why not try to provide better evidence for them, for this essential task of theirs? One of my hopes is that in future, policy can be made based on more abundant, high-quality data from institutions like U-M. Gary Freed, my mentor and division chief for many years, is fond of saying, “They shouldn’t know your politics by your data.” As researchers, we must ask questions that are unbiased, and conduct analyses as highly rigorous as any research found anywhere.
A: If you want to conduct research on policy-relevant issues, it’s important to remember that policy context and political context are two different things. As a researcher it’s very important to understand how different stakeholders will perceive your policy-relevant findings based on their politics.
You also need to be prepared that even your best data may not influence a decision as you might expect. However, if you believe in the purpose of policy-focused research as a way to help inform decisions that will influence the health of the public, then you will see your research impact decisions down the road. Another reality is that policymakers don’t often know what will come next in their worlds. This means there’s a premium on being nimble.
With my state-level experience, I’ve been able to see new opportunities for the trainees in our Clinical Scholars Program to get involved in questions that are top-of-mind for healthcare decision-makers. Our scholars are in very special windows in their career where they can make a difference in the very short term.
We need to strike a balance between the strengths of the academic environment and the needs of the public, seeking better data to inform today’s decisions and tomorrow’s deliberations.
Matthew M. Davis, M.D., M.A.P.P., is professor of Pediatrics and professor of Internal Medicine at the University of Michigan Medical School, professor of Public Policy at the Gerald R. Ford School of Public Policy, and professor of Health Management and Policy at the School of Public Health. He is also the co-director of the U-M Clinical Scholars Program supported by the Robert Wood Johnson Foundation, soon to become the IHPI Clinician Scholars Program. Davis is the founding director of the C.S. Mott Children’s Hospital National Poll on Children’s Health and former Chief Medical Executive for the state of Michigan.