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A Valuable Year Exploring Value-Based Health Care

July 15, 2022

This post is authored by Zoe Trutner, 2021-2022 Orthopaedic Value-Based Health Care Fellow.

When they first heard about my year-long leave of absence from medical school, quite a few family members asked if everything was alright. With the path to orthopaedic surgery already long and foreign to them, they assumed that an additional year indicated some sort of turmoil.

I laughed and explained that the Orthopaedic Value-Based Health Care Fellowship at Dell Medical School was in fact an exciting opportunity to explore my longstanding interest in health care transformation. Not satiated by vague buzzword explanations, family and friends volleyed back a barrage of questions that I had only cursory answers for. Whether from these queries or from anticipating the 105-degree Austin heat, I broke into a small sweat: What was I getting myself into?

After a year at Dell Med, answers to such questions remain elusive, but for a very different reason. Having immersed myself in this role, buzzwords still seem inadequate to describe how unique Dell Med is and how transformative — for lack of a better word — the fellowship has been for me.

The “what” of the fellowship is both simple and expansive. Beyond a few responsibilities coordinating research projects and managing the collection of patient-reported outcome measures in clinic, I was invited to pursue any clinical, operational or research activities of interest to me. One previous fellow described the environment as a playground, and I have to agree. I honed my clinical orthopaedic knowledge by learning from a multidisciplinary team widely recognized for its excellence; joined discussions with national players on designing novel condition-based bundles that better incentivize appropriate care; built a network of contacts through local and national meetings; and learned to productively lead a team of researchers while being mentored, myself, by renowned leaders in the field.

Yet it is the “how” in all these activities that truly differentiates Dell Med. Through a myriad of factors, including inspired leadership and intentional recruitment of kind, talented people with real buy-in for value-based health care principles, a unique culture pervades Dell Med. Faculty and staff know that the medical world is watching this young, innovative medical school, and they take pride in rising to the challenge.

For instance, rather than balking at extra work, the clinical team spends valuable time prepping information on every patient for a pre-clinic “huddle” so that the full team knows, contributes to and learns from every case. The operations team is constantly improving the patient-reported outcome measures collection system, not just to check a regulatory box but to amplify the patient voice. Researchers debate terminology with a goal of intentionally shaping the vernacular of our relatively young area of research on how to shift both disease models and care delivery models from a traditional medical framework to a biopsychosocial one.

Throughout all these teams, the knowledge that Dell Med is innovating on a national stage creates a strong sense of shared responsibility and teamwork that makes the environment surprisingly fun. The best analogy that comes to mind from my experience is — unsurprisingly for orthopaedics related to sports. After my final collegiate soccer game, I mourned the loss of playing for a team that genuinely, in actions and words, believed collective goals trumped individual ones. I felt lucky to have had even one experience like this, but joining the multidisciplinary research, clinical and operational teams at Dell Med has been an unexpected sequel. Whether a testament to Dell Med itself or the potential of value-based health care to really change the medical field, I’m excited to bring what I’ve learned into each new phase of my career.