Leaders in Medical Education

Dr. Nathan Moore, Co-Author of The Health Care Handbook

Thasin Jaigirdar
Mar 16, 2015

Dr. Nathan Moore is currently an internal medicine resident at Washington University in St. Louis. He received his Bachelors from University of Texas - Austin and his Medical Degree from Washington University in St. Louis. During his time in medical school, he created and co-authored The Health Care Handbook: A Clear and Concise Guide to the US Health Care System, which has sold more than 10,000 copies. The book has also been featured on many media outlets including the New York Times, Reuters, and NPR.

Can you share your background? How did you get interested in medicine/internal medicine?
I attended University of Texas – Austin as an undergrad. When I was in college I worked for a couple of years, working with the Veteran Affairs hospital. There began my exposure to medicine and driving my interest. I then applied to medical school.

I wanted to go into Emergency Medicine initially, but through the process of research for a book, The Healthcare Handbook, I realized primary care is the most effective way to increase health of the population for the least amount of cost. This is not to say specialty care isn’t important, but the United States has far more specialty care physicians versus other industrialized countries, driving a big imbalance between specialty and primary care. This is a major driver for why our system ranks so poorly.

What was the most important piece of advice you received during your medical education?
The most important piece of advice I’ve ever gotten from my education was “don’t be late.”

I think in terms of medical education, the most important piece of advice I have received was to treat it like a job. A lot of people treat medical school like its college, but it’s a professional school and managing people’s lives requires a full-time commitment. You need to take it seriously and treat it as professionally as possible.

What compelled you to write the Health Care Handbook?
It was just based on a need of ours. Our medical school didn’t do a good job in discussing the real world side of medicine. They only had a 1 hour lecture covering all of that. At the end of the hour we had no idea what was going on. We were initially going to write a 10 page guide for our classmates and the book grew out of that.

There are about 60 programs using the book now in their curriculum. Individuals have heard about it and have reached out to us. We then made some curriculum material and case studies.

What direction do you see healthcare moving to in the future?
I think with the implementation of the ACA, depending on how much is implemented and changed, is really going to affect how things will develop. Some things won’t be stopped like movement of paying for value vs volume. Incorporating IT to healthcare and the realization of more financial restraints on what care can or cannot be provided.

What are two or three changes you would like to see in how Healthcare is managed in the United States today?
I think moving to a value based system has been an important step for a long time. We paid healthcare professions to treat sick people. You should pay them to keep people healthy and not get sick. It’s an important concept. However, this is easier said than done.

An IT system that operates between different systems is important. Information from a huge hospital in St. Louis cannot be accessed from other places. The data is only accessed via fax.

From a personal prospective, I would like to see increasing effectiveness of primary care.

Do you have any additional final thoughts?
I think as far as medical education goes, learning about the healthcare system is really important for medical students because it affects patient outcomes. More deaths are associated with health insurance than with kidney disease. Medical students spend hundreds of hours spent with kidneys and kidney disease versus no time at all spent on learning about health insurance. Even though the stuff isn’t on the test, it’s important in their future careers so they should know the basics.