Third-year law students Bennett Wright, Chuck Matula, and Scott Boisvert each arrived at Duke with experience in a distinct aspect of health policy — biomedical innovation, economics, and global health, respectively. In addition to deepening their expertise through coursework at Duke Law, each has also undertaken cross-disciplinary research as Margolis scholars at Duke University’s Robert J. Margolis, MD, Center for Health Policy (the Duke-Margolis Center).
Open to Duke graduate and professional students from the Law School, Sanford School of Public Policy, Fuqua School of Business, School of Nursing, and School of Medicine, the Margolis Scholars Program in Health Policy and Management engages them in evidence-based research, symposia, and seminars in the field, and facilitates mentorship and guidance from experts and practitioners at Duke and elsewhere. Wright, Matula, and Boisvert formed the 2018-2019 cohort of Margolis law scholars.
Wright, who is pursuing an LLM in law and entrepreneurship along with his JD and aspires to a career as a patent litigator, researched improvements for medical devices such as those used for gamma radiosurgery and kidney-stone removal while majoring in biomedical engineering at Baylor University. Through the Margolis program, he worked with Elvin R. Latty Professor of Law Arti Rai, an internationally recognized expert in innovation policy and intellectual property, administrative, and health law, to craft and implement research into trade secrecy and accountability in artificial intelligence-enabled health care that she is doing with colleagues at the Duke-Margolis Center. Along with Rai, who co-directs the Law School’s Center for Innovation Policy, he also looked at how recent Supreme Court decisions might be affecting investment in the biotech sphere. And Wright, who worked in the patent litigation group of Alston & Bird in Charlotte over his 2L summer, collaborated with other Margolis scholars in research both on new privacy regulations pertaining to health care and new U.S. Food and Drug Administration rules.
“Those are regulations that the businesses I plan to help in my career are going to encounter,” said Wright, who after graduation will clerk on the U.S. Court of Appeals for the Federal Circuit, which hears appeals of patent cases. “These projects have been very helpful to me in terms of getting a deeper understanding of the field.”
Matula, who holds a BBA from the University of Texas at Austin, entered law school after working as a health care consultant in the Chicago area, where he assisted state governments and private health companies in developing, implementing, and evaluating health care program reforms. Interested in how to improve the efficiency and economics of providing health care services, Matula focused a portion of his Margolis research on the scope of administrative discretion of the Centers for Medicare and Medicaid Services, an agency within the U.S. Department of Health and Human Services that oversees health care coverage for elderly, disabled, and low-income citizens.
“I looked at what the law says about the discretion they have and the sorts of choices that can be made legally by the people heading those agencies,” said Matula, who spent his 2L summer at Vison & Elkins in Houston.
Along with Vidhya Aroumougame, a physician enrolled in the Fuqua School of Business, Matula also researched the performance of accountable care organizations (ACOs), which were operationalized through the Affordable Care Act to boost health outcomes and cut costs by having health care providers and hospitals voluntarily coordinate on patient care. “We found that, broadly, the program hasn’t really worked,” he said, observing that the program’s voluntary nature undercut its effectiveness, as providers who find it unprofitable can opt out and return to a fee-for-service model under the Medicaid and Medicare systems. “We recommended that Medicare increases incentives for the types of practices that were proven to be efficient under the ACO system — smaller practices, those led by physicians as opposed to hospitals, and rural practices. We also recommended that the providers take on more risk and face some sort of financial consequences if they aren’t able to generate savings.”
Boisvert, who is pursuing an LLM in international and comparative law along with his JD, worked internationally on matters of health policy both during and after earning a BS in biology and a BA in global health at Duke. In Cambodia after his sophomore year, he ran a program at a community health center and local high school to help people learn about such matters as nutrition and preventing sexually transmitted diseases. In Sri Lanka following his junior year, he worked with the University of Ruhuna to implement lab procedures for testing new strains of the mosquito-borne dengue virus, with a view to more efficiently predicting and fighting possible epidemics. And as a Hart Fellow before entering Duke Law, Boisvert worked in Bulgaria with the Bulgarian Council of Ministers on Roma community health initiatives.
Boisvert initially worked with Duke-Margolis Center researchers based in Washington, D.C., after his first year of law school on legal research comparing some international venues and the United States to identify regulatory hurdles that might prevent transplantation of successful health interventions abroad to the U.S. market. “I was particularly focused on interventions in Nepal,” said Boisvert. “In addition to looking at regulatory hurdles to transplantation, I was looking into other aspects of the intervention that would have to be shifted to be more appropriate for the U.S. market and the U.S. health care scheme in particular.” During the academic year, Boisvert, who meshes his engagement with health care policy with an interest in human rights, also worked with other scholars to organize a seminar focused on drug pricing and access and sustainable pharmaceutical development. Boisvert divided his 2L summer between the New York and Washington offices of Skadden Arps.
All three Margolis law scholars say that health care issues remain central to their career plans and have appreciated close relationships with such faculty scholars as Rai and Barak Richman, the Bartlett Professor of Law and professor of business administration, who is a leading scholar of health care policy. They agree that interacting with students and scholars from different disciplines through the Margolis program has helped to broaden their perspectives in their varied areas of interest.
“Each discipline has very different approaches to health policy, and I didn’t realize until I started the Margolis program how little I actually knew about the health care industry,” said Wright. “Each group has a different focus and approach to policy — lawyers may be looking for regulatory solutions, doctors may be looking for improvements at the point of patient contact, and people in the business school might be looking at how adjustments to insurance regulation might improve health policy. Without cross-pollination, it’s very easy to get siloed within your one little area and think you understand it, but in health care, things are incredibly complex and intertwined.”
Elaine Nguyen ’21 and Thain Simon ’21 have been named Margolis law scholars for 2019-2020. Nguyen worked in a Boston research lab studying the genetics and neurodevelopment of eye movement disorders after earning her degree in neuroscience at Brown University in 2015. She is interested in issues of access to medicines, drug pricing, health disparities, and how health care is affected by intellectual property law. Simon holds a BS in commerce from Santa Clara University, where he majored in finance and international studies, and an MSc in social science of the internet from the University of Oxford. Prior to enrolling at Duke Law, he worked in the technology and health care industries, most recently as a product manager at One Medical in San Francisco. He has also worked in corporate development at Blue Cross and Blue Shield of North Carolina and is interested in exploring matters at the intersection of law, business, and health care.