Studying and reading about a healthcare system in another part of the world is one way to learn new methods and best practices, but to visit, tour and explore it firsthand truly creates a deeper, richer learning experience. Students in the Kelley School of Business Physician MBA Program recently had the opportunity to do both during the Global Healthcare Experience course, which took them to various healthcare institutions throughout Italy.
“The structure of this course allowed us to anticipate what we’d learn by studying the healthcare system of another country – in this case, Italy – and then provided on-site visits to complement that learning,” said Peter Nalin, MD, FAAFP (MBA’19), associate vice president of university Clinical Affairs at Indiana University School of Medicine and Associate Dean for Educational Expansion. “The course reflects a legitimate, logical construction to it. Prior students who’d experienced the international course said they found it very valuable, and I also found that to be the case.”
Physicians spent several weeks prior to the trip studying the Italian healthcare system – how it is structured, the political and cultural influences, how it differs from our own system or how it is similar. Then students took a nearly two-week trip to Italy, where visits, meetings, tours and cultural trips were planned for 18 students and their travel partners.
“I saw this as an opportunity to learn and travel at the same time,” said Lisa Nolen, MD (MBA’19) chief medical officer of Heartland Women’s Healthcare of Southern Illinois. “Professor Reed Smith was absolutely amazing as my accounting instructor and I knew he would be teaching this iteration of the Global Healthcare Experience. I knew he had lived and taught in Rome and had unique insight into the culture. As expected, his guidance and teaching were exceptional!”
While in Italy, the group toured a pediatric hospital, the European Institute of Oncology and heard from officials from the Italian Ministry of Health.
“Their healthcare system is incredibly interesting,” said Pat Purcell, MD (MBA’18), a pediatrician from Louisville, Kentucky. “Anything I can learn about someone else’s healthcare system might be beneficial toward being a change leader in ours. The more we learn about someone else’s system, the better care we can provide for our patients.”
A second-year student, Dr. Purcell also completed the Global Healthcare Experience elective that traveled to Cuba in 2017. Being able to compare the two countries’ healthcare systems as an outsider provided unique insights, such as the more restricted access in communist Cuba, compared to more open opportunities to explore healthcare in Italy. The two countries also contrasted in available technology.
“In Italy we toured Bambino Gesù Children’s Hospital in Rome, the largest children’s hospital in Europe. It was incredible to see what equipment and facilities they had available,” said Dr. Purcell. “They had an ECMO – a cardiovascular bypass system for infants and children—which was much more cutting edge than what was available in Cuba, where practitioners got by on whatever few resources they had. It was interesting: while they didn’t have as much available in Cuba, they were far more intuitive and far more advanced in terms of limited resources. I noticed a huge contrast between the two systems.”
The pediatric hospital in Rome was a highlight for many of the physicians, as they were allowed unique access to various departments at the facility after the group tour.
“We were able to expand our visit in that hospital to tailor areas of the hospital delivering enhanced services,” said Dr. Nalin. “A few of us visited the pediatric psychiatric behavioral unit, others visited emergency medicine or group care units. Being able to customize the visit to areas of particular interest was a highlight for me.”
Dr. Nalin also noted the Italians’ innovative pilot program in community health that uses medical homes comprehensively across a whole region to care for patients in their own communities, with the goal of expanding to other regions.
“Initial indications are this approach to care in the community seems to be attractive – it’s relational, it’s available and it emphasizes social support systems and behavioral medicine to complement and extend beyond the medical disease model. They understand what people suffer from and then answer the human suffering or social and health needs at the level that’s most suitable for making a difference,” said Dr. Nalin. “It’s an example of how the private health system is still dedicated to advancing population health, which isn’t solely a public hospital or national health system priority, but rather a goal of all health professionals and the entire healthcare system.”
The experience gave the Physician MBA students the opportunity to consider their own healthcare system in a new light, and to bring home fresh ideas for tackling problems that may be universal.
“You think other countries are further behind you, but they may not be as far back as you’d think. In Italy, they work very closely with pharmaceutical companies to reduce medication costs to patients; something we don’t do here in the U.S. I thought that was huge,” said Dr. Purcell. “We heard physicians complain about the same things we do, such as not having enough time to do research. I think you see not only differences but also similarities that let you know some challenges are universal.”
“Back in the United States, it’s easy to get caught up in the daily operations within the only healthcare systems most of us have ever worked, so being able to see a different approach gives us ideas for improving our own practices and helps reinforce that we do some things very well.”
While the trip to Italy also included guided tours of historic sites and cultural destinations in Rome, Florence and Milan, physicians on this trip of March 2018 experienced something incredibly unique: snow in Rome.
“While not expected, I’m able to say I was in Rome for the snowstorm of 2018, which shut down the city with four to six inches of snow, when it snows in Rome only once every five to 10 years,” said Dr. Nolen.