Every morning of his “Advanced Topics in Econometrics” class this fall, Myles Wagner ’17 could expect to receive an apple from his professor, Douglas Staiger, plucked fresh from the apple tree in Staiger’s yard. Not only does Staiger capture his students’ attention — and stomachs — with fruit, but he has also captured the interest of the National Academy of Medicine. Staiger, Dartmouth’s John French Professor of Economics, was one of the 80 members newly inducted to the National Academy of Medicine with his work.
The National Academy of Medicine is an organization of professionals hailing from various fields including health and medicine and natural, social and behavioral sciences. The NAM seeks to address critical problems in health, medicine and related policy and promote positive action across sectors.
Every year, the NAM elects 70 regular members and 10 international members. The criteria for membership is, according to the NAM website, distinguished professional achievement in a field related to medicine and health; involvement with the issues of health care, prevention of disease, education or research; possession of skills and resources likely to contribute to achieving the Academy’s mission and a willingness to be an active participant in the Academy’s work.
All candidates must first be nominated by two current NAM members who are familiar with the candidate’s work.
The principal focus of Staiger’s research has been in health economics, and he said that he is happy to be recognized and noticed by other academics.
Montana State University nursing professor Peter Buerhaus said he first met Staiger in Boston in the early 1990s during an economics seminar. They have been colleagues for over 19 years and have worked on health care-related projects.
Buerhaus, also a NAM member, said that being a member brings a number of benefits not only to Staiger but also to the College and its economics department.
“It boosts [your] marketability and your ability to walk into a new organization where people are usually quite excited to have you there,” Buerhaus said.
Buerhaus said that Staiger has great insight on research-related matters in addition to being a pleasant colleague with a good sense of humor.
“Overall, he’s a colleague who provides a lot of knowledge and skills to our team that other people don’t have,” Buerhaus said.
Staiger started his career ABT Associates, a public policy consulting firm in Boston, where he worked on projects concerning Medicaid and Medicare. Within two years of arriving at ABT, he was already writing hospital payment regulations for New Mexico and looking at the effects of payment to hospitals on patient outcomes.
“When you cut payments to hospitals, you see mortality and complications in the hospital go up a little bit,” Staiger said. “That got me interested in what kind of things affect patient outcomes that we can control, whether it’s insurance or what we pay hospitals.”
Soon after, Staiger started working with patient outcomes in the health care system and measuring mortality and complication rates in hospitals. Some of his early collaboration was with Mark McClellan, who later served as Commissioner of the Food and Drug Administration and director of Medicare and Medicaid.
Staiger earned a Ph.D. in economics from the Massachusetts Institute of Technology in 1990 and came to the College as a professor in 1998.
“It was really natural for me to come here to Dartmouth, because the Dartmouth Institute and the Dartmouth Atlas like to measure patient outcomes,” Staiger said. “I got to work with John Birkmeyer, who is a surgeon thinking about why surgical outcomes vary across different hospitals.”
Out of his collaboration with Birkmeyer came the birth of ArborMetrix, a company co-founded by Staiger, Birkmeyer and Justin Dimick from the University of Michigan.
“It’s a company with software that creates performance measures and feeds it back for groups of doctors who are trying to improve quality and also insurers and hospitals that are all interested in how to measure and track performance,” Staiger said.
At Dartmouth, Staiger has worked with fellow economics professor Jonathan Skinner to tackle the economics of the health care system.
“The economics of this is very similar to thinking about why some countries are rich and some countries are poor,” Staiger said. “It’s all productivity differences.”
He said that the worst 10 percent of health care providers have double the mortality rate of the best 10 percent.
Staiger feels that one of the most interesting projects of his career was studying why variations in patient outcomes exist and developing the theory that it is due to specialization in particular types of treatment. Some hospitals may be very good at doing complicated surgery, Staiger said, but not as good at simple medicine.
Although Staiger has completed countless projects and papers in his career, a paper he co-wrote on the nurse shortage in 2000 had “the biggest impact for the simplest point.” This paper documented that since the 1960s, very few women and young people were entering nursing.
“We just made the point that if people don’t start going into nursing in huge numbers, we’re actually going to have an absolute decline in nurses, and there’s going to be a big shortage,” Staiger said.
Soon after the publication of his influential paper, huge campaigns were started to call for more nurses and many nursing schools throughout the country were opened, he said. Over the 15 years since then, the number of nurses across the country has more than doubled and the threat of a nurse shortage no longer exists.
Staiger said that the most challenging aspect of his work is trying to communicate technical yet important messages to a broad audience.
Staiger only teaches one class per year — “Advanced Topics in Econometrics” in the fall.
Wagner said that Staiger is a very energetic professor with a good sense of humor.
“He gives very flexible lectures, so his lectures always begin with some idea and anyone can jump in with a question — it’s very much like academic talks in economics,” Wagner said. “He knows a ton about everything, any kind of statistical or econometric method that you’d want to use to answer some question, he has great intuition for.”
Wagner said that the class has helped him develop an intuitive understanding for how data fits together and how to apply tools to actual data sets. Rather than a purely theoretical or technical course, Staiger’s class is more practical and hands-on, Wagner said.
In class, Wagner said that Staiger’s vast knowledge about the health care system “leaks through.”
“Every time he wants to give an example or some sort of situation where you might want to use this particular technique or where this technique wouldn’t work, there’s some sort of example from the health care system or the hospitals,” Wagner said. “It’s really impressive how much he knows about that system.”
Harvard University professor Amitabh Chandra, a former Dartmouth faculty member, has been working with Staiger for 15 years. Together, they have collaborated on projects trying to understand productivity in health care.
Chandra, himself a NAM member, praised the Academy as one of the greatest honors that can be bestowed on any scientist.
“It is the premiere scientific society in medicine,” Chandra said. “I just can’t think of a better person to be inducted in the NAM than [Staiger].”
Chandra described Staiger as the “Obi-Wan Kenobi of economics,” also adding that his mastery of economics is breathtaking.
“[Staiger] understands the complexity in the structure of economic theory better than anyone else that I know,” Chandra said.
Beyond Staiger’s professional qualities, Chandra also said Staiger is always open-minded and humble.
“The room is always lit up with [Staiger’s] humility and curiosity,” Chandra said.
Sonia is a junior from Ottawa, Canada. (That is the mysterious Canadian capital that no one seems to ever have heard of.) She is a double major in Economics and Government, with a minor in French. She decided to join The D’s news team in her freshman fall because of her love of writing, talking to people, getting the most up-to-date news on campus, and having a large community of fellow students to share these interests with.
