June 19, 2017
Shaquila Myers, legislative director for Michigan Senate Minority Leader Jim Ananich, makes it about 15 words — including a handful of acronyms — into her introduction before pausing.
"Can you explain what that is? You should assume the researchers know nothing about the policymaking process or its acronyms," interjects Marianne Udow-Phillips, stopping the flow of assorted letters amid a burst of laughter.
"It's true!" whispers a smiling Amy Suwanabol, assistant professor of surgery at Michigan Medicine and one of 13 people arranged around a table.
"And researchers, you should assume the policymakers know nothing about how research works," continues Udow-Phillips, director of the Center for Healthcare Research & Transformation.
If Udow-Phillips sounds like a teacher leading her pupils through their first day of school, it is because she is.
From left, Michigan Department of Health and Human Services staff members Phillip Kurdunowicz, Elizabeth Kutter and Erin Emerson, and tour guide Doug Bitoni Stewart of the Fisher Foundation listen during discussion about Federally Qualified Health Centers. (Photo by Heather Guenther, CHRT)
It's Feb. 3, the first day of the 2017 CHRT Policy Fellowship at the University of Michigan. CHRT is U-M's independent, nonpartisan impact organization that, among its areas of focus, helps policymakers and researchers speak the same language.
The fellowship is CHRT's signature program for helping bridge the research-policy chasm, supported by a host of sponsors: Michigan Medicine, Blue Cross Blue Shield of Michigan, the Michigan Department of Health and Human Services, Michigan Dental Association, Michigan Health & Hospital Association, and Michigan State Medical Society Foundation.
Over the next four months, this group of six U-M health services researchers and seven Lansing-based policymakers would meet for seven daylong, seminar-style presentations to learn from seasoned health policy experts and each other.
They would travel together to Detroit, Lansing and Washington, D.C., to see health care and policy in motion. And in May, they would graduate and became part of a network of nearly 70 CHRT Policy Fellowship alumni since the program's first class in 2012.
But in this moment, the researchers and policymakers, and their respective work, remain mostly a mystery to one another.
"This program provides invaluable continuing education," says Ted Makowiec, a former U-M senior director of benefits and 2013 CHRT Fellow. "You learn and talk about research and health policy, but when you visit Lansing and Washington, D.C., where research and policy collide, it adds a new perspective on what you're trying to impact."
A call to engage
In the fall of 2016, President Mark Schlissel reiterated his call for increased faculty public engagement, predicting that "U-M's future leadership will be evaluated in part by our ability to better focus our work externally and to share our scholarship and expertise with a broader public."
That broader public includes policymakers.
The CHRT Policy Fellowship is "an exchange program" for researchers and policymakers, says Sameer Saini, a gastroenterologist at Michigan Medicine and research scientist at the VA Ann Arbor Health Services Research and Development Center for Clinical Management Research.
Saini, a 2015 CHRT Fellow, credits the fellowship for his adapted approach to working with policymakers — and his fellow health services researchers.
"Now I understand that policymakers can't wait five years for research findings to be generated," says Saini. "But it's also interesting to work with my research colleagues because you can tell who's completed the fellowship. My co-fellow and I have a very different way of discussing what's going on and viewing our relationship with policymakers. In a way, we're educating our colleagues."
For Saini and other U-M researchers, the fellowship helped shatter their caricatures of policymakers and provided a crash course in understanding the pace and process of policymaking, and how they can enable more evidence-based policymaking.
Before becoming a 2014 CHRT Fellow, Peter J. Polverini, the Jonathan Taft Distinguished University Professor of Dentistry, former dean at the School of Dentistry, and professor of pathology at Michigan Medicine, "didn't have a clue" how research becomes policy.
"I knew the definition of health policy, but I didn't know the mechanics behind it. My assumption was that if it's good science, it's going to be in policy. I realized that wasn't the case," says Polverini, now chuckling at his past naivety. "It takes more."
Tools for change
A one-pager, with minimal text and judicious use of bullet points and graphs, is one way researchers in the CHRT Policy Fellowship learn to make often complex scientific findings more palatable.
"As policymakers, we realized we need to rely more on the researchers, but we also helped them understand that it's the one-pagers, not academic journals, that are informing our decisions. It's the quick sound bite that gets the attention," says Sarah Smock, a policy adviser for the Michigan Senate's Republican Caucus and a 2016 CHRT Fellow.
In Michelle Macy's case, it was her opinion piece in the Detroit Free Press that piqued interest from Lansing.
What began as an assignment for Macy, a pediatric emergency physician in C.S. Mott Children's Hospital and a 2013 CHRT Fellow, to fulfill her fellowship graduation requirement later led to her helping write legislation in 2015 to update Michigan's child-passenger safety laws.
The bill passed the state Senate before dying in the House. About a year later, in 2016, she regenerated legislative interest in child-passenger seats after publishing a second op-ed. That legislative effort also stalled, but she's found new momentum in conversations with a colleague in the state of Washington who wants to collaborate on a broader push for change.
"This type of work would not have occurred to me before the fellowship, but it brought me to a point where I was looking at things from a very different perspective. Now, I think about how research can have a policy impact instead of just becoming a line on a CV," she says.
"To our faculty members here, this has been great training," says Cynthia Wilbanks, vice president for government relations. It's May 19, graduation day for the 2017 CHRT Fellows. Wilbanks — U-M's liaison between research and policy — looks forward to the fellows' graduation each spring, where she presents each with their certificate of completion.
"The CHRT Policy Fellowship has created a cadre of people from the university and in the public policy arena who have the background and knowledge to promote the kind of public good that can improve lives," says Wilbanks. "The individual relationships you've formed are now the building blocks of further opportunities down the road."
Heads bob as the researchers and policymakers nod in agreement.
The hope with each class is that the camaraderie built over four months leads to new collaborations and evidence-based policies. Connections made among the 2017 class already have led to the introduction of new state legislation and informed other legislative text.
Shaquila Myers, the Senate minority leader's legislative director, and Stephanie Bogema, chief of staff for state Sen. Margaret O'Brien, spent two years working on opposite sides of the Senate, exchanging an occasional hello or goodbye. Since sharing the title of CHRT Fellow, they have shared more than simple pleasantries and recently, their bosses introduced a joint package of bills.
In May, as her fellowship experience neared its end, Bogema sought Michigan Medicine expertise on the female-mutilation legislation her boss introduced.
"It's important to continue to have these relationships," says Bogema as she accepts her graduation certificate. "It's so much easier to go to someone in this room and ask if you have the resources that can help inform the process when we move at such a fast pace. These relationships are already making a difference."