As the newly elected chair of the Association of American Medical Colleges' (AAMC) Organization of Student Representatives (OSR), David Bernstein (MD ’19, S ’16) is tackling the biggest concerns of medical students here and across the country.
These include reducing loan debt, improving diversity in medicine, addressing health care disparities, and understanding the impact of ever-evolving health care policies and cost reimbursement models on their patients and careers.
But it’s all in a day’s work for this ambitious and articulate doctor-in-the-making.
For Bernstein, the national leadership role is a chance to do what he does best: be a voice for his colleagues, sharpen his diplomacy skills, and deepen his knowledge of the business and politics of health care.
“My friends tease me about how I’m always ‘ambassador-izing,’” says the MD/MBA candidate who earned his MBA at the Simon School of Business in December and is finishing his second year at the UR School of Medicine and Dentistry. “I take that as a huge compliment because I love meeting people and learning something from every person I meet. Every relationship is a pathway to a new experience or idea.”
The AAMC/OSR position is a three-year term. During this time, he will lead the OSR administrative board, and sit on the AAMC group on student affairs (GSA) steering committee (chaired by Johns Hopkins School of Medicine associate dean of Student Affairs Thomas Koenig, MD), where he’ll help guide national efforts to improve academic medicine and devise long-term strategies for success within the organization. In addition, he will be a sounding board for medical students across the country with concerns or queries regarding academic medicine.
“The medical school is thrilled to have one of our students in this major national leadership position,” said David R. Lambert, MD, senior associate dean for Medical Student Education. “It will allow the ‘Rochester voice’ to be heard on a national platform. The school works to facilitate student involvement in national organizations and prominent research programs, and David will represent us well.”
Bernstein says he is most intrigued by how the science, art and business of medicine interconnect and how the goals and objectives of each area can be aligned more closely.
“The solutions lie in being able to see the issues from all perspectives, the financial side, the patient side, the provider side, and the researcher side,” says the tech-savvy and personable 26-year-old who prides himself on returning emails within an hour, if not a few minutes. “That’s something I hope to bring to all my student endeavors and my future career.”
A Boston native, Bernstein had an early role model in his father, pediatrician Henry (Hank) Bernstein, DO, now chief of Pediatrics at North Shore University Hospital and professor at Hofstra Northwell School of Medicine in Long Island, N.Y. His mom Sophie was a nurse.
“My parents are my heroes,” says Bernstein. “I was always around health care, but I never felt any pressure to pursue it,” he says. “I chose it because it’s a field where you can have a direct impact on a person’s life during their biggest time of need. My father fights for kids like no one else, and I saw his impact on children and families on a day-to-day basis. No other field is quite like that.”
When it came time for college, Bernstein chose Bowdoin, a tiny (about 1,800 students) private liberal arts college in Brunswick, Maine. There he studied economics and anthropology—and played college baseball too—but always kept his eye on a career in medicine.
“The push at Bowdoin is to become a problem-solver and critical thinker, and it gave me a perfect foundation for medical school,” he says. “One of the things we would have to do there is put forth what we think is a good idea, and then look at it completely from the other side, and write about why it’s not a good idea. Being able to see all sides is ingrained in me. Bowdoin also teaches that you should try to make a positive impact for the common good, rather than just personal gain.”
In Rochester, Bernstein found an environment to nurture that pay-it-forward attitude.
“Bowdoin teaches it, and Rochester loves it…it fuels the engine here,” he says, “When my father connected me with (clinical professor of Pediatrics) Dr. (Lawrence) Nazarian, I knew right away this was where I wanted to go. It just had a different, more intimate feel. The biopsychosocial model is 100% lived here. You’re in a small community, but you get to do the highest level of research. There are world leaders in major areas, but without major egos. People recognize and engage with each other in a patient-focused way. That’s a difference–maker.”
He was so confident in his Rochester choice that he took advantage of the early assurance program between his sophomore and junior year to lock in attendance. Since arriving on campus, he’s found a way to pay-it-forward to the local community by volunteering for the student-run, free clinic UR Well, where he is junior coordinator for the musculoskeletal care specialty.
He has also channeled his energies into summer internships—one in Rochester between his year at Simon and first year of medical school, and one at Dell Medical School in Texas last summer. Both were focused on orthopaedics, an area rife with opportunities to learn about the integration of evidence-based and value-based care.
At Dell, Bernstein had the unique opportunity to learn from chair of Surgery and Perioperative Care Kevin Bozic, MD, MBA, a hip and knee surgeon at the forefront of research in healthcare technology assessment, cost-effectiveness analysis, shared medical decision making, and the implementation and evaluation of value-based (i.e. bundled) payments and delivery models. He was also mentored by associate dean for Comprehensive Care David Ring, MD, PhD, (with whom he co-authored several papers), and Karl Koenig, MD, MS, medical director of Dell’s Integrated Practice Unit for Musculoskeletal Care, an innovative endeavor to improve patient-centered, value-based care.
In his Rochester internship, Bernstein expanded his knowledge base and conducted research under URMC orthopaedic surgeon Addisu Mesfin, MD,whom he met in a Simon School class. Mesfin focuses his research on spine surgery trends, risk factor analyses and clinical outcomes of patients following spine tumor removal and surgical treatment of scoliosis. Under Mesfin’s mentorship, Bernstein had a first-author abstract selected for a podium presentation at the International Meeting on Advanced Spine Techniques (IMAST) in Cape Town, South Africa, and will present there in July. He has also been mentored in his research interests by Judith Baumhauer, MD, MPH, professor of Orthopaedics and director of URMC’s Orthopaedics Foot and Ankle Institute, and other URMC orthopaedic surgeons including Benedict DiGiovanni, MD, and Warren Hammert, DDS, MD, whom he was connected with by David Ring, MD.
“I couldn’t have asked for better guidance and support than I’ve received from the Orthopaedics faculty here,” he says. “The attention they’ve given me has been incredible.”
The Rochester internship convinced him he had made the right choice for medical school. But while preparing to don his white coat in the fall of 2013, he learned at the last minute he was an alternate for a Fulbright scholarship to attend the University of Luxembourg.
When he was bumped from alternate to a Fulbright grant recipient, he postponed medical school a year—with the support of professor and associate dean for Admissions John Hansen, PhD—and hustled to get his travel papers processed in under two weeks.
Luxembourg was “an amazing experience,” he says, where he gained insight into the European health system, while earning a master’s degree in entrepreneurship and innovation.
“It grew my interest even more in healthcare finance and administration, and I learned about disruptive digital startups and emerging technologies, including biotechnology and medical devices,” he says.
He credits his teachers and mentors—at Bowdoin, Dell, in Rochester, and Luxembourg—with solidifying his interest in finding ways to forge a better relationship between health care and business policy.
“There are many people who understand the science, art or business of medicine but very few understand them all,” he says. “That’s what I aspire to.”
With health care having the largest consumer base of any business in the world, the stakes are high, he says.
“Everyone needs health care that is affordable, but it also needs to be profitable,” he says. “Traditionally, finance and medicine have been at opposite sides of the table. They have different objectives and perspectives. So what happens is one side often gets mad at the other and they walk away without solving the problem.”
For example, says Bernstein, hospital finance personnel might ask a surgeon why they need a certain instrument for a procedure, and if there might be a less expensive way to do it.
“The surgeon wants to do what he thinks is best for the patient regardless of cost, and the tendency is for emotions to get in the way of exploring new possibilities and resolving issues,” he says. “Medicine is changing and will continue to change, and we need more people who can see both sides.”
Bernstein was chosen by his first-year SMD classmates to be an AAMC representative, where he attended national meetings, weighed-in on policy and business issues, and was tapped as a delegate to the AAMC’s Northeast Group on Educational Affairs.
“The next thing I knew my colleagues said ‘Why don’t you run for chair of the student representatives group?” he recalls.
His advisory dean, professor of Surgery David Kaufman, MD, concurred.
“He said, ‘Go for it,’ so I threw my hat in the ring,” he says. “The more I thought about it, the more I wanted to do it.”
In the late fall, Bernstein gave a five-minute speech, and answered questions from an AAMC panel of student representatives. After votes from over 100 participating U.S. medical schools were tabulated—he learned he won the post—and began his duties in January.
These include attending AAMC/OSR administrative board meetings in Washington, D.C., as well as regional and national meetings, serving on numerous committees, and “ambassador-izing” with faculty and hospital leaders from across the country.
“To represent my peers like this is a real honor,” he says. “As medical students, we don’t have much leverage in the health care system and can feel very powerless. But we often demand a lot of things without offering solutions. With this opportunity, I realize I need to bring good ideas to the table, rather than just say ‘I want this or that.’ I think that’s critical.”
Bernstein—who was also selected to be a 2017 Fulbright Alumni Ambassador—hopes to use his platform to advocate for more education about health systems in medical school.
“How will health care regulations and insurance reimbursement policies guide the way we practice in the future?” he says. “That’s something we don’t learn enough about as medical students. For example, you may know a certain drug is the greatest, but if it’s not covered by insurance, your patient can’t afford it. Understanding medicine is at the core of every physician, but possessing a working knowledge of the influential outside factors as well...that's what drives genuine change.”