For a fascinating close-up of the impact of policy decisions on individuals and teams, I step onto the nursing home unit. For a fascinating zoom-out of the impact of policy decisions on the healthcare system in general, I follow the Twitter feed of David Grabowski, Ph.D., professor of health policy research at Harvard Medical School.
Dr. Grabowski has studied the economics of aging for decades and, due in large part to the pandemic-related attention thrust upon long-term care, his work has been in the spotlight now more than ever.
His studies early in the pandemic focused on nursing homes’ need for PPE and other assistance. As the months wore on, he detailed the toll of separating residents from their families. His latest articles address the impact of high nursing staff turnover and call for increased financial transparency within the long-term care industry.
He holds researcher superhero status in my mind: He’s writing with scientific authority about things we observe in the field every day, often taking on issues we aren’t in the position to discuss.
Dr. Grabowski and I spoke recently about his research and about developments in the field. I took some time to reflect upon this discussion, lightly edited, below.
EFB: What do you like about this work?
DG: Everything! Everything that is studied in health policy is present in long-term care and more so — the response to payment incentives, quality of care, the need to support the workforce.
Reflections: Even though long-term care isn’t a “sexy” topic to research, or a “sexy” job to be in, those that can get past this barrier find it a vital and exciting field, whether they are researchers, administrators or direct care staff. Vocal enthusiasts can draw other people to the field, as Dr. Grabowski has done.
EFB: It seems like the pandemic has increased the visibility of your work.
DG: Definitely. I’m getting more interest from students and faculty and more people are calling for interviews. I’m very excited that people are interested in it. Once you see how this works, or doesn’t work very well, it makes you see the need to devote more resources to it and to put forward better policies. I do have some fear that we won’t follow through on the work we need to do, that the media will shift focus and people will move on to something else.
Reflections: Of my 20-plus years in the field, this is the closest I’ve seen the country come to recognizing how crucial it is to make substantive changes to better meet the needs of residents, families and staff and to address payment inequities. If the devastation of the pandemic can’t do it, it’s hard to imagine what could. This is our moment.
EFB: Is there anything that people who work in nursing homes can do to foster these changes?