1a. Based on your experience and familiarity with the fellows and the programs, what did we really accomplish? What were the most important contributions?
We trained a lot of people in research findings from health services research, and we trained the last three or four cohorts pretty well in methods. We helped quite a few careers, and as with any program, we gave some degrees to people who probably should not have them. A program like this is particularly vulnerable because you hope that people will either stay or go into the health policy field instead of becoming academics. This is a real risk when you give a doctoral degree without requiring residence. You wind up giving a degree to people who are not really academics, but who are now qualified to teach. That is a downside of our program and something about which we are constantly vigilant.
The most obvious [contribution] is career development. You can clearly see that and more or less count it. Many alumni were promoted or got better jobs in the policy field as a result.
There is much about the policy process that is still happenstance and convenience—who is around. You can only improve the chances that rationality will play a part in policy by having around a lot of people who are trained rationally. So, the more people you put out there, the better chance you have to formally or informally influence the policy process. We train a lot of people who are interlopers or daily workers in the policy process. Therefore, we increase the chances that what comes out the other end will be better informed than it would have been if people had been shooting from the hip. Yet, it is hard to quantify that.
1b. What is the Pew ''legacy'' in terms of:
We made a lot more people aware of the power of the literature to answer a lot of the questions in a systematic way rather than guessing, as they were doing before. We helped with the diffusion of the health services research findings. I am always struck when I go to meetings and talk to folks who are making major policy decisions or influencing policy decisions without reading the literature. These foundation types and policy types have almost never read the literature. It's shocking. They are trying to move forward the state of