Sehj Kashyap, "Almost" MD

Sehj Kashyap is a first year MD candidate at Duke University. He’s interested in disruptive mHealth and healthcare technologies, and also in healthcare start-ups and policy. On his study breaks, he’s learning to code or create apps, or designing websites. He’s currently working on a social venture called Let’s Be Well Red that is introducing its 16-cent solution to anemia in India. Sehj has been a finalist for the Civic Data Challenge, and served as an AmeriCorps City Year corps member teaching high school students in Boston

Do You Know How Much a Blood Test Costs?

If the answer is no, look it up! I admit, I had no idea how much a blood test cost. But I bet most of you reading this article—aspiring docs and almost MDs—did not either (otherwise, why would you open this article?). Don’t worry. You are not alone. Study after study shows that the overwhelming majority of physicians and residents are in the dark when it comes to the price of care. This gaping hole in our medical knowledge is a big problem, especially in the changing landscape of U.S. healthcare. You’ve probably heard that our healthcare system is making a big push away from ‘fee-for-service’ and more towards ‘pay-for-performance’ or ‘quality-based care.’ This sounds nice on paper and it should– let’s hope– curb costs in the long-term, but it will pinch in the short-term. Whether we (future physicians) like it or not, conversations on costs will likely become a fixture as we step into the hospital. In the short-term, quality-based care is essentially a euphemism for cutting costs, which means pressure on physicians from patients and administrations. Our future patients will see insurance policies that have higher deductibles, larger co-pays, and more restrictions on care. They will be forced to pay more up-front and out-of-pocket. There are plenty of arguments for why this is good, but the bottom line (no pun intended) is that patients will increasingly question...

Let’s make ‘Domestic Health’ as Cool as Global Health

Medical schools can better mobilize students to fix U.S. healthcare problems. U.S. healthcare is undergoing a sea change of transformation. The ACA (how ever you feel about it) was a major step in focusing our attention on issues like streamlining care, improving value, and expanding access. Yet, as these issues of domestic healthcare come front and center in the minds of many Americans, an increasing number of U.S. medical students are looking to solve health problems in countries abroad. This is not only manifesting as a shortage of physicians interested in practicing in underserved populations of the U.S., but also a dearth of innovation in our healthcare, compared to what we’re seeing in global health. The way our medical schools are currently going about cultivating and mobilizing student interest in innovating solutions to domestic health issues is misguided and can be improved to follow a similar model of global health. Student interest in global health has been rising for at least a quarter of a century. Compared to 1978 when only 5% of medical students participated in international health experiences, 30.5% of graduating medical students now participate in a health project abroad. When polled in 2013, 63% of matriculating medical students said they expected to participate in global health education or service experiences at their medical schools, and 46% talked about global health issues in their applications. Medical schools...