In elke editie van onze alumninieuwsbrief spreken we met een alumnus/-na over zijn/haar studietijd aan Erasmus School of Health Policy & Management (ESHPM; voorheen iBMG en SAG) en wat ze tegenwoordig doen. Deze keer spraken we met Erik Schut. Hij is één van de eerste promovendi van de faculteit. Hij is nu nog steeds werkzaam bij ESHPM.
What did you study?
I studied general economics with a specialisation in development economics. One of the themes is the pursuit of income equality in the world. This study is based on the ideas of Jan Tinbergen. On campus, opposite the Spar, there is a wall with Jan Tinbergen's most famous quote: Profit comes from distribution.
And how did you end up at our faculty after your studies?
I was interested in health economics and was put in touch with Wynand van de Ven by my teacher Jan Veenbergen, who was looking for a student for a paid thesis. After graduating, Wynand asked me if I wanted to do scientific research and obtain a PhD. So, I joined the company and in 1995 I obtained my PhD with the thesis ‘Competition in the Dutch Health Care Sector’. Wynand was my supervisor. I belonged to the second group of PhD candidates after the first group in the 1980s with Jan Moen and Aad de Roo. In 1993, Yvonne van Kemenade was the very first PhD candidate who also followed the BMG programme herself.
After that, I went through the usual steps in an academic career from University Lecturer to University Associate Professor to Professor, all within ESHPM. In 2003, I gave my inaugural lecture ‘Healthcare is not a market? Tacking between market failure and government failure in healthcare’. In addition, I was Director of Research from 2010 to 2014 and Section Leader of the Health Systems and Insurance section from 2014 to 2022.
As a ‘veteran’, do you have any anecdotes from the past?
Yes, for example in the field of technology. As teachers, we used to go to the Audiovisual Department with texts and they would make slides from them. Duo slides were very advanced at the time. If the cassette got stuck in the projector or fell out, your entire lecture would be messed up. Then came the overhead projector. I have always been a great advocate of a blackboard with chalk. That once earned me the following comment: “Schut gives good lectures, but a bit old-fashioned, because he still uses a blackboard and chalk.” Then the blackboards disappeared, and whiteboards came along, where it often happened that someone had covered the entire board with a permanent marker. Nowadays, of course, I use all multimedia resources during my lectures, such as Mentimeter and Kahoot.
I have also experienced all kinds of different trends in lecturing. We went from just keeping your mouth shut and copying to problem-based learning (PBL). I had no idea how to do that with students who were bouncing in all directions. So, I literally followed the lecture hall pocket of Schmidt (the later rector of the EUR) and Bouhuijs about PBL. The student evaluations at the time said: “He sits there and lets us solve everything ourselves.” After that I started to steer more, and my evaluations improved considerably. Now it is a mix of collective knowledge transfer, independent thinking, self-reliance, and guidance.
Initially, studying was absolutely not allowed to be performance-oriented, and we were only allowed to assess exams with insufficient, sufficient, and good. Then we created 3 categories per insufficient, sufficient, and good. As a result, you had 9 different assessments at your disposal, which is the same as a grade from 1 to 10. Because you always get a 1 for your effort. So, then we switched to the usual decimal system…
On 11 October, ESHPM is organising a Homecoming Day for alumni. You are going to give a lecture there. What will that be about?
There is a lot of dissatisfaction about how healthcare is paid for. The current system leads to overproduction and fragmentation and a lack of good coordination of care. There is broad consensus in healthcare that we need to switch from volume-driven to value-driven funding, where reward is related to the outcome of care for the patient: good care and good treatment and not based on the number of medical procedures. But how to shape and implement this is a stubborn issue. We have been doing research into financing healthcare differently within ESHPM for 30 years and it has still not been arranged. During the lecture I will tell something about the background of this and two PhD candidates will talk about their research: Frédérique Franken will discuss hospital financing and Celine Hendriks will talk about bundled funding, which is funding for the entire care pathway of a patient in which the care providers decide together on the distribution. To make this a real trip down memory lane, I would like to use a blackboard and some chalk for this lecture, but unfortunately, we don't have those anymore.
Are you excited to come to the Alumni Homecoming Day 2024 after reading this interview? Then sign up via this link.
