Washington, D.C. -- Dan Merenstein, M.D., professor in the Department of Family Medicine at Georgetown University School of Medicine, a part of Georgetown University Medical Center, is the recipient of a Fulbright Scholar grant to conduct research in Israel, the J. William Fulbright Foreign Scholarship Board and the U.S. Department of State announced.
Recipients of Fulbright awards are selected on the basis of academic or professional achievement, as well as demonstrated leadership potential in their fields. Merenstein joins the ranks of distinguished Fulbright alumni including heads of state, judges, ambassadors, cabinet ministers, CEOs, university presidents, journalists, artists, professors and teachers.
As a Fulbright grantee, Merenstein will undertake a six-month research project in Israel to study the over use of medical tests on patients, known as “over-testing”, in a health care system that “bundles” reimbursement to doctors as opposed to a fee-for-service system seen in the U.S.
“Over-testing in the U.S. is believed to be a result of defensive medicine triggered by malpractice lawsuits and physician reimbursement schedules with fee-for-service leading to improper incentives for ordering tests,” explains Merenstein.
Merenstein says results from his study could help inform public policy. He says combining over-testing that doesn’t improve health outcomes with a fee-for-service health system is an untenable model that should be examined as the U.S. healthcare system undergoes significant changes.
Merenstein will study the medical records at the Clalit Health Services, the oldest and largest Health Maintenance Organization in Israel. Over the past 10 years, patient data has been de-identified and entered into an electronic medical record allowing for longitudinal analysis. Also, Israel is a robust research opportunity because of the various similarities in medical practices between Israeli and American doctors, since the majority of physicians in both countries are trained in the U.S.
The U.S. Preventive Services Task Force (USPSTF) recommendations on preventive screening will be used as the comparative measure for appropriateness of testing. Assembled by the federal Agency for Healthcare Research and Quality, the USPSTF is a panel of experts that systematically reviews scientific evidence and provides grades for the strength of evidence for the various screening measures.
Merenstein’s grant is made possible through funds that are appropriated annually by the U.S. Congress and in many cases, by contributions from partner countries and/or the private sector. The J. William Fulbright Foreign Scholarship Board is a presidentially-appointed 12-member board responsible for establishing worldwide policies for the Fulbright Program and for the selection of Fulbright recipients. The Fulbright Program is sponsored by the Bureau of Educational and Cultural Affairs at the U.S. State Department. Under a cooperative agreement with the Bureau, the Council for International Exchange of Scholars (CIES) assists in the administration of the Fulbright Scholar Program for faculty and professionals.
In addition to his appointment in the Department of Family Medicine, Merenstein has a secondary appointment in the Department of Human Science in Georgetown’s School of Nursing & Health Studies. As a member of the Georgetown facutly, Merenstein teaches an undergraduate course on how to critically evaluate medical literature.
About Georgetown University Medical Center
Georgetown University Medical Center is an internationally recognized academic medical center with a three-part mission of research, teaching and patient care (through MedStar Health). GUMC’s mission is carried out with a strong emphasis on public service and a dedication to the Catholic, Jesuit principle of cura personalis -- or "care of the whole person." The Medical Center includes the School of Medicine and the School of Nursing & Health Studies, both nationally ranked; Georgetown Lombardi Comprehensive Cancer Center, designated as a comprehensive cancer center by the National Cancer Institute; and the Biomedical Graduate Research Organization (BGRO), which accounts for the majority of externally funded research at GUMC including a Clinical Translation and Science Award from the National Institutes of Health. In fiscal year 2009-2010, GUMC accounted for nearly 80 percent of Georgetown University's extramural research funding.