At the intersection of medical practice and evaluation

The x’s that marked every day on a calendar accounted for an entire year of lost quality of life for patients suffering from urologic and gynecologic conditions, senior Alexander Konigsberg told an audience at a fundraising event last summer. But, he added, for only $475, a simple surgery could correct a patient’s condition, fully restoring their quality of life.

This compelling pitch grew out of Konigsberg’s efforts to assess the impact of Global Surgical Expedition (GSE). The Richmond-based medical charity sends U.S. surgical teams to underserved nations to deliver life-enhancing and life-saving surgeries. The Jepson School of Leadership Studies awarded Konigsberg, a leadership studies and biology major, a Burrus Fellowship to support his Jepson internship at the nonprofit last summer.

One of his major projects as an intern entailed researching the organization’s financial impact.

“By attributing the Medicare rate — the cheapest medical rate in the U.S. — to the 1,000-plus procedures GSE has performed since 2014, I determined it has provided the equivalent of $3 million of surgeries. Then I calculated the volunteer hours medical professionals have donated at close to $2 million. I also researched the economic impact of medical conditions that impair individuals’ ability to work at capacity.”

Doing this kind of economic analysis ensures accountability and buttresses GSE fundraising. Yet Konigsberg said he was proudest of the survey he designed to assess patients’ quality-adjusted-life years. If, for example, a medical condition curtails a person’s ability to function by 20 percent, the senior said, in five years that person loses the equivalent of a year of quality-adjusted life.

“My research showed that GSE has returned 2,500 quality years of life to patients since 2013,” he said.

The Wyckoff, New Jersey, native said he decided in high school to become a doctor, but his summer internship sparked an interest in evaluating and improving the health care system as well. “I loved my internship work and would like system evaluation to be part of my career,” he said.

So before attending medical school, he will pursue a Master of Science in Health Service Improvement and Evaluation at the University of Oxford on a full scholarship as a Jepson Scholar. “I think I owe my acceptance to this program to the work I did in my Jepson internship,” he said. “My final master’s program project will focus on identifying and evaluating a problem in the health system and developing a funding proposal to address it.”

But at the moment, Konigsberg, who received a merit-based Presidential Scholarship to the University of Richmond, is working on his senior honors thesis on gender-affirming care for adolescents. He will present his research at the Jepson Research Symposium on April 18. Dr. Jessica Flanigan, who teaches his Ethical Decision Making in Health Care class, serves as his faculty mentor for the project.

“Who has the right to decide what’s best for adolescents?” he asked. “If they ask for puberty blockers, should we give them? Most existing disagreements stem from fundamentally different theories of well-being. I argue that these different theories at their core actually support the use of puberty blockers for adolescents.”

Konigsberg said his Richmond education has prepared him well for a future career in pediatric medicine: “My biology major gives me the hard science and technical skills and my leadership studies major gives me the people skills I will need to practice medicine. I probably won’t have to explain the Krebs cycle to patients, but I will have to know how to communicate with patients.

“I want to help people and make an impact. I can’t think of a job I’d rather do.”