Michael Trainer, MD

Dr. Trainer is a PGY-4 Adult Neurology Resident at the University of California – San Francisco (UCSF).

So much of medical training focuses on the pathophysiology of disease and the delivery of healthcare, all the while staying relatively insulated from the harm inflicted on patients by the cost of having disease. My clinical interests center on reducing suffering in chronic neurologic disorders, and I’m thrilled to join the Costs of Care team as a 2023-2024 Fellow to learn more about engineering systemic change to address the financial hardships placed on patients.

I became interested in healthcare value as a medical student after seeing Don Berwick speak on healthcare reform. As I continued to read and learn, I was surprised at how many conversations about value centered on costs to the health system, and how so few focused on the out-of-pocket costs of patients. At no point was I taught that medical debt accounts for a vast majority of bankruptcies, and my dream is for medical training to include a more nuanced understanding of the sensitivity, cost, and indication for the tests that we order. In improving healthcare delivery, I am particularly struck by pharmaceutical costs driven by evergreening and the industry abuse of the Orphan Drug Act.

I am so excited to learn from the amazing faculty at Costs of Care and my predecessors who have done incredible work with this fellowship. I hope that this will serve as a launch pad for my ability to add to the body of research on cost-effective care, especially within neurology. In the next year, I will complete my formal medical training, after which point, I hope to focus more time on contributing to national policy around reform in the pharmaceutical industry.

I’m an avid reader, competitive tennis player, amateur baker, and lover of all types of puzzles. I grew up in the metro Atlanta area and moved to San Francisco for residency, and I hope to stay in the Bay Area as early career faculty. The photo is from a hike in the rainforest in Ecuador, where I spent a week on vacation in February 2023.

Dr. Trainer is a 4th year neurology resident at the University of California – San Francisco (UCSF). He is interested in palliative and end-of-life care for patients with neurologic disease.