My Stanford Health Policy PhD Statement of Purpose

A question I’m often asked is, “why pursue a PhD in health economics if your background is in engineering and management?” The truth is that I have many interests and it took me a few years to determine what I wanted to pursue with my career. I started my undergrad at Cal Poly, San Luis Obispo as a biomedical engineering major because I excelled in math and science, and I aspired to improve the world by developing novel medical devices. Within a year I switched to industrial engineering because thinking in terms of systems, management, optimization, and applied math appealed more to me, and I could still contribute to the medical device or healthcare sector. I tested this through numerous internships in the medical device (Relucent/Medtronic), hospital (Stanford Healthcare), and biotech (Cepheid) industries. I found the analytical work compelling, but felt uninspired by the primary goal of maximizing company profits, with the improved health of individuals simply being a byproduct.

Despite my reservations with the private healthcare industry, my summer with Medtronic was transformative, as this is where I learned how healthcare is bought and sold in the U.S. Coming from an industrial engineering background, where waste is the ultimate enemy, I was astounded to learn how inefficient the U.S. healthcare system was, and how misaligned the financial incentives of providers were with society’s interests. I became intrinsically motivated to educate myself on the countless issues in U.S. healthcare through books, articles, and podcasts. Before long, I earned the title of “Healthcare Student Representative” and found myself giving a lecture on value-based healthcare to my department.

These experiences led me to Stanford’s Master’s program in Management Science & Engineering, where I am concentrating on Health Systems Modeling. This program has allowed me to deepen my knowledge of healthcare, decision sciences, and economics, while enhancing my analytical toolkit. While I have thoroughly enjoyed my courses on cost-effectiveness analysis and operations management in healthcare, I have determined that these are not the subjects I wish to study through a PhD. These disciplines focus on more “acute” problems, as in problems relating to a particular hospital or disease, whereas the research questions that I find most compelling relate to the systemic issues affecting the entire healthcare system. This is not to say the acute problems are unimportant. The fundamental issue is that they are not valued as much as they should be due to the economic incentives structures that exist for healthcare providers and insurers. This leads to rising healthcare costs that hamstring other sectors of the economy and disproportionately affect those who are less well-off.

My research experience has convinced me that market power among providers is one of the most pressing health policy issues, and a topic I’d like to continue exploring as a PhD student. Through my senior project at Cal Poly and as a graduate research assistant with Stanford Medicine’s Clinical Excellence Research Center, I had the opportunity to study the market competition and pricing practices of California hospitals with Stanford’s Dr. David Scheinker and Dr. Kevin Schulman. This research has led to a working paper, of which I am the first author, analyzing the relationship between list prices and actual payments received by hospitals. As a research assistant with Systems Utilization Research for Stanford Medicine, working with the Lucile Packard Children’s Hospital, I’ve been able to observe from the inside how large healthcare providers make financial and operational decisions. Additionally, I examined the impacts of hospital outpatient expansions on spending, access, and care utilization as a summer fellow with the Market Oversight & Transparency team at the Massachusetts Health Policy Commission. Here I got to see first-hand how academic research influences policy decisions, and where there are critical information gaps to be filled. For example, during a literature review it occurred to me that little is known about ambulatory surgery centers owned exclusively by hospitals, yet there is a growing trend of hospitals building these facilities. It would be a privilege to study these sorts of issues and collaborate with Dr. Laurence Baker and Dr. Maria Polyakova, whose work I’ve reviewed extensively in my research.

Other areas of great interest are the development and adoption of advanced health technologies, particularly involving AI and biotechnology. It is imperative that we understand how to incentivize the companies that cultivate this technology so that the benefits are distributed in an equitable manner. At Stanford, I’ve led a quantitative study of the adoption of telemedicine among Stanford cardiologists during COVID-19 (abstract submitted to American College of Cardiology Conference) and used machine learning to predict carotid stenosis using ultrasound data (paper submitted to Vascular Medicine). I’d be eager to facilitate interdisciplinary research collaborations on this topic with professors and research groups across Stanford’s prestigious medical, engineering, and economics departments (including Dr. Heidi Williams and the Stanford Institute for Economic Policy Research).

Stanford is one of the few universities that offers a comprehensive PhD program in health economics along with world-class faculty and research centers, making it an ideal location to continue my academic career. The extensive economic curriculum is exactly what I am seeking to become a competent health economist. To be clear, while my specific interests fall under industrial organization, I want to leave my PhD program well-versed in a multitude of economic disciplines and health policy issues, as it is far from certain which issues will require attention over the career of an academic researcher in this field.

Pursuing a PhD is a serious commitment and something that I have thought deeply about. I am confident that I have what it takes to be successful as a doctoral student in this program for a number of reasons. Through work on three papers, including two as first-author, as well as many course projects, I have gained experience contributing to all aspects of the academic research process. Throughout my Master’s program, I have worked in two research assistantship positions while maintaining near perfect grades in all of my courses. My background in engineering, supplemented with graduate coursework in microeconomics, data science, and causal inference has prepared me to take on complex mathematical and analytical problems. My broad array of experiences working in private industries and the public sector have instilled a unique perspective to bring to my academic work (particularly the industrial organization of healthcare providers). By the time I begin my PhD program, I will already have course assistantship experience through Dr. Scheinker’s healthcare operations and health systems design courses. And finally, I have been actively engaged in university life, having served as president of a 150+ member biomedical engineering club at Cal Poly, and currently as an organizer for Stanford Effective Altruism.

The academic environment is where I excel the most, and it’s where I’d like to stay. My ultimate goal is to pursue a career as an academic health economist, researching the most consequential issues that arise. One day I hope to apply my management experience to running an effective and impactful university research organization, like the many centers that Stanford has to offer. I’d also like to share my passion for health economics with students and inspire them to pursue this work, as my mentors have done for me. Achieving this won’t be easy, but Stanford’s doctoral program in Health Policy is an excellent place to start.