Monday, September 8, 2008

Recommended Reading

Quint Studer starts his book Hardwiring Excellence with a discussion of what he calls “Fire Starters.” These are people who have had a great effect on the lives of others, or, in the health care field, those “who are committed to transforming health care through compassion, imagination, and often, sheer determination.”* The author’s description of “Fire Starters” immediately made me think of a book that I read over the summer entitled Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World, by Tracy Kidder. I know that each of you is very, very busy with course readings and assignments, but I would recommend that during your time at the School of Public Health, you read this book.

Dr. Paul Farmer is a physician, a professor at Harvard University, and currently the Executive Vice President of Partners in Health (PIH), an organization he helped found in 1987. Mountains Beyond Mountains tells the story of Farmer’s life and the formation of PIH, which began in 1983 when a community-based health project called Zanmi Lasante was established by Farmer and others in Cange, Haiti to deliver quality care to residents of the country’s Central Plateau. Since the establishment of PIH, the organization has expanded, and is now involved in projects in nine countries around the world.** If any of you would like more information about PIH, their website is http://www.pih.org/home.html. This site is full of information on the organization itself and the projects it is carrying out, and also has a comprehensive “Recommended Reading” list for issues of interest related to PIH and its activities, as well as a listing of jobs available with the organization.

Mountains Beyond Mountains is an amazing book about a truly inspirational individual; Dr. Farmer’s determination to ameliorate the health conditions of those in Haiti, and later in countries around the world, is remarkable. Kidder’s description of the man is almost hard to believe, and at times, Farmer seems super-human. He is a man who puts the well-being of his patients above all else, and who has contributed immensely to building an outstanding organization dedicated to ameliorating the health outcomes of the world’s less fortunate. This book gave me renewed hope that global health disparities can be tackled, and reaffirmed my desire to pursue a degree in public health. If, over the next two years, any of you find some spare time, reading Mountains Beyond Mountains would definitely be a good way to use it up.



* Quint Studer, Hardwiring Excellence (Gulf Breeze: Fire Starter Publishing, 2003): 1.

**PIH has projects in Haiti, Peru, Russia, the United States, Rwanda, Lesotho, and Malawi, and “supported projects,” to which it contributes monetary resources, in Mexico and Malawi. For more information on PIH’s projects, click on the “Where We Work” link on PIH’s website (http://www.pih.org/home.html).

Welcome to Fall 2008 HPM Class

Hi everyone - here is the class blog.....I hope you all will find it a useful forum to share ideas, react to articles, postings etc. Please review the blog posting guidelines handed out in class (and in Resources area on bspace).

To kick things on a content front, I attach a link to a recent article in the NYT http://www.nytimes.com/2008/09/09/health/09essa.html?ref=health
that touches on P4P - something we surfaced in class last week. As you can see it can look very different depending where you come at this from. This essay from a cardiologist points out some very real pitfalls.

Kim

Monday, December 3, 2007

A Follow up to Our Ethics Session

Hello everyone - I hope you all enjoyed the session with Paul Hoffman last week. It is amazing how broad a range of ethical issues there are to consider/manage as a healthcare professional - from any vantage point.

I saw this article come over the AP new wire today and it made me thing about Paul's point about inconvenient truths. Here is a link to the article and a small piece of the intro. What do you think is driving this behavior by physicians and what would it take to compell have a more ethically appealing approach?

Kim

http://news.yahoo.com/s/nm/usa_doctors_incompetence_dc

Nearly half of all U.S. doctors fail to report incompetent or unethical colleagues, even though they agree that such mistakes should be reported, researchers said on Monday.
They found that 46 percent of physicians surveyed admitted they knew of a serious medical error that had been made but did not tell authorities about it.
"There is a measurable disconnect between what physicians say they think is the right thing to do and what they actually do," said Eric Campbell of Massachusetts General Hospital and Harvard Medical School in Boston, who led the survey.
Doctors are also surprisingly willing to order unnecessary -- and often expensive -- tests such as magnetic resonance imaging or MRI scans. Just 25 percent said they were looking out to ensure they did not unintentionally treat someone differently because of their sex or race, the survey found.

Monday, November 26, 2007

Dr. Drug

Hi everyone - hope you all had a nice holiday. I really enjoyed the comments on the last post - people had a range of reactions to the hospital CEO's blog. I think it can definitely be viewed on multiple levels ranging from a personal vanity project to a teaching tool for emerging health care leaders.

Below is a link that Amy asked me to post - this article appeared in the NYT yesterday and it is a very interesting look into the pharma-MD world and covers some ethical ground that may be relevant to the guest lecturer this week. http://www.nytimes.com/2007/11/25/magazine/25memoir-t.html?pagewanted=1&ei=5087&em&en=14f86674a4b9bfd7&ex=1196226000

Kim

Wednesday, November 14, 2007

Interesting Blog...

I was surfing around and came across a blog by a hospital CEO in Boston. He offers a unique lens into his hospital and his life as a CEO. Check out his 11/12 post on being a patient in his own facility. What do you think of his blog? Would you like having this type of access to a leader in an organization you are working for? What does it say about his leadership style and why else might he be maintaining a blog such as this one? http://runningahospital.blogspot.com/

Kim

Sunday, October 28, 2007

Transparency of Quality Data in Hospitals

I came across an article in the October 2007 edition of HealthLeaders Magazine on the issues facing hospitals around sharing their quality data:

"Reporting quality scores on certain core measures is common practice for hospitals, but senior leaders across the country are encountering mounting pressure from board members, regulators, competitors and customers to take their data reporting a step further: full transparency. Hospital leaders and quality departments meet regularly to debate the whys and why nots of such disclosure, but few have pulled the trigger. With a small but growing number of hospitals opting to report quality data on their own Web sites, however, that could be changing."

What are your thoughts on how transparent a facility/system needs to be? Can you think of valid reasons why a facility might not want to share its data?

The full article can be found at http://www.healthleadersmedia.com/magazine/viewmagfeature/content/92899.html

Kim

Wednesday, October 10, 2007

SCHIP and Broader Debate

Thanks to everyone for the comments on the SPH dinner. Many of you brought up the SCHIP veto so I thought we could extend the dialogue using this NTY article that speculates about how the broader debate on healthcare will fare in the election year given the inability to enact something for low income children. The article can be found at: http://www.nytimes.com/2007/10/06/washington/06health.html

Your thoughts?

PS - Did anyone see the SCHIP parody on the Colbert Report the other day that panned back and forth between a group of children and legislators talking about SCHIP - hilarious!