Physician, researcher, teacher Arnold Epstein assumes new duties

By Bob Brustman

Special to the Gazette

Arnold Epstein makes people healthier. A multifaceted man, he is not content to perform this service through a single means, choosing instead to employ a variety of methods. He is a practicing physician at Brigham and Women's Hospital, where he appreciates the immediate rewards of treating patients and seeing them feel better. He is an accomplished researcher with training in political science, math, and economics who enjoys the prospects of longer-term health improvements for people through his investigations of access and quality of care. He is a teacher, both at Harvard Medical School and in the Clinical Effectiveness program, helping to train others who also want to improve people's health.

Beginning this month, Epstein adds to his responsibilities as he takes on the duties of chair of the Department of Health Policy and Management.

In his research, Epstein applies the paradigms and methodologies of economics and other social sciences to clinical medicine. He attributes the use of these tools, in part, to his father: "He was a lawyer, and he, his friends, and his colleagues were always looking at things happening in the world in terms of their social and behavioral dimensions. I internalized these perspectives." When turning his attention to medicine, after his postgraduate training in political science and economics, "it seemed natural to apply the rudimentary questions of social sciences to health, and ask questions like 'How does the organizational structure of medicine affect the care that patients receive?' or 'How do a patient's social characteristics affect the health care they receive?'" Epstein's expertise at answering questions such as these led to his being called to serve on President Clinton's health care reform team in 1993-94.

In addition to his professional activities, Epstein is also a dedicated family man with three young girls. Given the already-heavy load of professional and personal demands for his time, why does he want to undertake the responsibilities of chairing one of HSPH's largest departments? "Because it's important," he says.

"The school's mission, including the work of the Department of Health Policy and Management, is important from a societal point of view," Epstein continues. "The department is home to many outstanding faculty, and a lot of excellent work has originated there. Nonetheless, I think there is an opportunity to take a good thing and make it even better.

"Chairing the department will certainly be a new set of challenges for me. I think of the job as being one primarily of coordination, along with leadership in an atmosphere where one must lead by right of reason, rather than by some sort of divine right."

When asked in what direction he would like to take the department, Epstein replied: "The field of health policy is going to continue to be important and dynamic. Nationally, we are moving towards a medical system that is more privatized, a system in which physicians are asked to take on increasingly managerial roles. Health policy research in the future will be directed more at the private sector and the states. Cutting-edge work will depend on interdisciplinary teams of investigators and national consortia. Physician managers will need training programs dedicated to their needs. Training in organizational behavior, cost accounting, technology assessment, and quality improvement techniques are important building blocks that we can consolidate and provide.

"Also, I'd like to continue Bob Blendon's work in creating a cordial sense of internal community for people within the department. I want people to feel supported and to have a sense that we are headed in the right direction. Basically, I want to make it an even better place."

Reprinted from Around the School of the School of Public Health