Nora Becker – The ACA, Women’s Health, and Contraception (Podcast #5)

Though Nora is now officially Dr. Becker, and has begun her internship at Brigham and Women’s, I had the opportunity to sit down with her while she was still a student at Penn. We had a great conversation about her research, which focused on the Affordable Care Act’s impact on women’s health. We went more in depth on a specific project looking into the ACA’s effect on women’s overall contraceptive usage.  This work was tweeted out by then President Barack Obama, which led to a media frenzy, and almost immediately made her work political.

Nora received her bachelors in Public Policy from Pomona College in 2007. Before going to Penn for med school, she deferred a year to work as a staffer on Barack Obama’s presidential campaign, and as an administrative assistant in the White House.

Some major takeaways from our conversation:

1.) Though uncommon, you can do your MD/PhD in something outside of basic science

When I think of MD/PhDs, I immediately assume the person is doing biomedical research. However, it is definitely possible (at some schools) to do your PhD in many other fields! As you will probably want to have it relate back to healthcare, healthcare economics is an increasingly important field for future physicians to appreciate! There are plenty of other ways to delve into that world without dedicating 3-4 extra years of research – such as a master’s degree, certificate, or by getting involved with a specific research project. But if you are really drawn to the field, the PhD is an option!

2.) Research gives you the rare opportunity to be genuinely ambivalent

I loved Nora’s attitude when she said that if the ACA was repealed, she would study the effects of it being repealed. I personally had been interested in studying and working in health policy, but the 2016 election really made me question whether to get involved or not. It had less to do with politics as much as my realization of the transient nature of policy, the high failure rate in passing legislation, and that by picking a side, half the country will immediately decide that you are wrong. Perhaps it’s a cynical view, but I would have expected that Nora would have been terrified that her research, which she spent years on, would become essentially irrelevant if the ACA were to be repealed.

Instead, Nora maintained her positivity and insisted she would adapt. Though she also works in advocacy and has policies she would like to see implemented, when it comes to research, there will always be questions to pose and answers to discover. This is the benefit of being a researcher, I suppose. If you’re on the sidelines, you have the benefit of studying something regardless of what happens in policy. If you only work trying to get specific legislation passed, or in advocacy for specific cause, you are far more likely to be disappointed, or feel like you aren’t making progress. Combining research with advocacy may be best for your overall sanity and morale. This in mind, it’s impossible to be unbiased and have no opinions on health policy matters, but as a researcher you are (hopefully) able to put those feelings aside, and search for the truth. However…

3.) Explaining complex research to the public and media outlets can be frustrating, especially when it becomes politicized

Nora was both blessed and cursed when President Obama tweeted out her research. While it is incredible to see people take an interest in your work, it can be equally frustrating to watch as people either misinterpret it, or use it for their own political messaging. Sometimes this can’t be avoided – media coverage usually necessitates explanations for the layman. Yet, so much can be lost in translation when you simplify the language of your work, or distill it down to 500 words. After all, you can’t sit down with every reader and talk them through your paper, and the complicated economic analyses you performed. This is true for most research, but especially for biomedical research – media outlets LOVE blowing findings out of proportion. That’s why we need websites like www.healthnewsreview.org – to keep a leash on irresponsible healthcare reporting.

The best we can do if we are fortunate enough that our work draws widespread attention is to control our own messaging, but understand that some things are simply out of our control.

 

You can find some of Nora’s work listed on PubMed here.

I’m excited to find out what Nora researches next – there are some whispers of looking into opioid usage. We’ll just have to wait and see!

 

– Ryan is a second year medical student at the Perelman School of Medicine. He is the co-VP of curriculum for Penn Health-X, the co-host of the Penn Health-X podcast, and founder/editor-in-chief of the Penn Health-X blog. You can contact him at ryan.o’keefe@uphs.upenn.edu –