Mays Student Aims To Provide Better Care For All
The first semester of his freshman year, Sunjay Letchuman ’22 was volunteering in the emergency room of CHI St. Joseph Hospital in Bryan when a mother came in with abdominal pain.
While taking her vital signs, Letchuman realized the patient and her family members spoke little English – he also sensed that they were on edge. In an effort to make them more comfortable, Letchuman used his basic Spanish skills to ask what made them nervous about being in the ER.
They told him that not only were they worried about what was ailing their mother, they were also anxious about the cost of the visit. On top of that, they also feared that the language barrier would affect the quality of care she would be provided.
Letchuman said their answers were indicative of the troubles that millions of Americans face in the U.S. healthcare system. “Medicine is so much more than what you can do clinically,” he said.
Now a senior at Texas A&M University, Letchuman said this interaction was one of several moments that spurred his interest in health policy.
By the time he arrived in College Station as a freshman, Letchuman had already shadowed the mayor, district attorney, and other political leaders in his hometown of Shreveport, La., to learn how to improve the lives of others. It was at the Mays Business School that he decided he wanted to do so by meeting the healthcare needs of as many people as possible.
With a year left in his undergraduate studies, Letchuman is already well on his way to achieving this goal. He recently became the first Mays undergraduate to have a manuscript published in a major medical journal. This summer, he is a health policy intern for the U.S. Senate on the Committee on Health, Education, Labor and Pensions. Upon graduating next spring, he’ll attend the Icahn School of Medicine at Mount Sinai in New York City.
“Everybody needs healthcare, and that’s what draws me to the field,” Letchuman said. “From the moment you’re conceived, health policy plays a role in your life. It’s this broad, impactful scope that makes me want to dedicate my life to healthcare.”
Healthcare is one of three Grand Challenge areas set forth by former dean Eli Jones in 2017 to build the business school’s research presence. A class Letchuman took his first semester about the business of healthcare is where he realized the extent to which policy affects health outcomes.
Later, he took a class he describes as “everything I could have dreamed of.” Taught by Leonard Berry, the M.B. Zale Chair in Retailing and Marketing Leadership, the course on making the healthcare experience better and safer for patients was formative to Letchuman’s understanding of the field.
Berry taught him that healthcare in the U.S. is a “need service, not a want service.” He also learned about the ways that healthcare can better prioritize “patients over profit, and healing over hurry,” an issue demonstrated by the increasing role of private equity in healthcare and the rush doctors often face when treating patients.
“Our nation’s healthcare system is riddled with high costs coupled with quality outcomes that often don’t measure up to other developed nations,” Letchuman said. “And we have a system dominated by a fee-for-service payment model, which generally means that the more care you receive, the more your providers get paid. That sometimes incentivizes healthcare institutions to over-test and over-treat… it is one of the ways in which healthcare has become such a big business.”
His ultimate goal: making an impact on a broad scale through healthcare policy, which affects virtually every American. To get there, Letchuman said he wants to start with one patient at a time.
After medical school, he hopes to enter a residency program that’s affected by policy, such as emergency medicine. After that, he is considering serving in the military as a physician, and then wants to practice medicine and do health policy work in his home state — a promise he hopes to keep with Louisiana Gov. John Bel Edwards.
“I want to become a physician so that I truly understand the issues that patients face,” he said. “I want to see what the problems are before I try to fix them, and right now, I want to do that in Louisiana, which is a state whose health system has significant room for improvement.”
He co-authored the paper with Berry – Texas A&M’s most-cited faculty member on Google Scholar – along with Rana L.A. Awdish, director of the Pulmonary Hypertension Program for the Department of Pulmonary and Critical Care Medicine of the Henry Ford Health System, and Karina Dahl Steffensen, a medical oncologist and director of the Center for Shared Decision Making in the Department of Clinical Oncology at Vejle Hospital in Vejle, Denmark.
In the article, they suggest that empathetic creativity, discretionary effort, seamless service, and fear mitigation are central to fostering trust-based partnerships in healthcare. “We can systematically dismantle these negative forces that inhibit the level and quality of trust, thereby strengthening the care that most physicians want to provide and most patients need,” they write. “This effort will require commitment from inspired health care organization leaders who seek a positive financial margin for the primary purposes of keeping the doors open and investing in innovation and improvement, rather than placing financial performance above all other aims.”
It’s the first article that Berry has published with an undergraduate. After Letchuman took his course, Letchuman asked Berry if he could be involved in one of his research projects. Berry had never collaborated with an undergraduate in writing an academic paper, but if he was ever going to do it, he said, Letchuman “was the one.”
“Sunjay is one of the finest students I have taught in my entire career,” Berry said. “He is extremely smart but what impresses me most about him is his intellectual curiosity, work ethic and kindness.”
They recently received acceptance for a second paper in the Mayo Clinic Proceedings on the risks of outsourcing in healthcare, and the pair is already laying the groundwork for more projects. “I am so proud of him,” Berry said. “Every professor should have the privilege of teaching students like Sunjay.”
Letchuman says professors like Berry have given him opportunities he doubts would be available to him outside of Texas A&M.
As a freshman, he wanted to dedicate time to his love for medicine and science, so he found a place in the Department of Biology, where he conducts spinal cord injury research alongside Assistant Professor Jennifer Dulin. In her lab, Letchuman and other researchers investigate the use of stem cells to restore locomotive function after injury. He has also conducted research with Clinical Assistant Professor Kayla Cline in the James Benjamin Department of Accounting, looking at infections in patients during hospital stays.
Letchuman said Texas A&M faculty members have been more than willing to collaborate with him – all he had to do was ask.
He brings this same approach to his healthcare blog, where he has published interviews with leaders in the health policy field. Letchuman credits Berry with connecting him with “superstars” like Dr. Donald Berwick, the former administrator of the Centers for Medicare and Medicaid Services. Interviews with Harvard Medical School professors opened even more doors to medical and health policy professionals.
“The professors and doctors who I have the privilege of talking with do not have a lot of time, but they somehow carve out a little bit of time so that they can make a much larger impact on my life than the 30 minutes that they’re spending to chat,” he said. “The interviews have shaped my understanding of healthcare, and I am grateful that these leaders want to invest in students.”
On top of his lengthy curriculum vitae, Letchuman has also found time to get involved on campus.
He served as president of Texas A&M Moderates, a political organization that aims to facilitate healthy political discussions. And as a Maroon Coat for the Texas A&M Foundation, he has enjoyed telling donors about the university that “has invested in me beyond what words can describe.”
But among his many accomplishments, he says one of the most rewarding parts of his college experience has been getting to know fellow Aggies.
Starting his freshman year, Letchuman made it his daily goal to get to know a new person, often striking up conversations in dining halls and the Memorial Student Center. He never missed a day until the COVID-19 pandemic began.
Before he graduates, Letchuman hopes to complete the research projects he is involved with and develop relationships with other Aggies before he leaves the state for medical school.
“Every Aggie I meet has a remarkable destination in mind,” he said. “We all have these big goals, and Texas A&M has taught us to value the journey there. For me, that has been really special.”