Leadership
Clip
Finding the Resources to Resolve Public Health (02:51)

To what extent do health departments find the necessary community resources to solve public health problems, and to what extent do they need to build from scratch?

“The issue of funding in public health is a big one,” says Joneigh Khaldun, Director and Health Officer for the Detroit Health Department. “We never quite feel that we have enough to do what we need to do.”

Despite the lack of resources, Khaldun is excited that health systems are focusing more on population health and prevention.

John Ayanian, Director of the Institute for Health Policy and Innovation at the University of Michigan, asks where those resources come from. Voting and advocacy? Partnering with communities that can advocate on their own behalf?

“Absolutely,” says Khaldun. “There’s nothing more powerful than a physician in a white coat going up to their congressperson to advocate and say what they see when they’re seeing patients. You don’t have to be a big public health leader to do that; people do actually listen to you as a physician.”

In addition to that political will, she says, “we also just need to work with the community.” Public health funding comes from many places: federal, state, local, and private.

“I can add a resource,” says Michael Englesbe, Professor of Surgery at the University of Michigan. “If there’s any single theme or topic that brings together young medical students, it’s around care for at-risk populations.” Medical curricula need to do better at fostering education in that area, but Englesbe is optimistic about progress in the future.

Building on that point, Ayanian asks about interprofessional education — nursing, pharmacy, dental, social work, public health, and other students of health care. “Does our academic system have more responsibility to bring teams together at that early stage of training so that they’re prepared to function more effectively as team members and partners in their careers?”

Day one of medical school is introduction of interprofessionalism and equal partnerships, says Englesbe. He believes this comes naturally to the generation currently attending medical school. For example, a first-year medical student recently greeted him with a wave and, “Hey Mike, how’re you doing?”

“There’s an informality,” he says. “They don’t necessarily see these hierarchies, which is a great thing for our patients going forward, because the silos will break down.”

From the NEJM Catalyst event Essentials of High-Performing Organizations, held at the University of Michigan’s Institute for Healthcare Policy and Innovation, July 25, 2018.

More From Leadership

From the Commonwealth to Obamacare: Reflections on 10+ Years of Expanding Health Insurance Coverage

The former Executive Director of the Commonwealth Health Insurance Connector — a model for the Affordable Care Act and other state marketplaces — reflects on what worked, what didn’t, and what could be done differently in both Massachusetts and at the federal level.

Time Spent Engaging Directly with 16 Camden RESET Participants or Coordinating Care on Their Behalf

“Putting All the Pieces Back”: Lessons from a Health Care–Led Jail Reentry Pilot

The Camden Coalition’s jail-based reentry program illuminated the necessity and challenges of engaging people with complex health and social needs and helping to transform the systems that serve them.

Sands01_pullquote clinical research partnership for learning health care

Real-World Advice for Generating Real-World Evidence

If envisioned and implemented properly, a partnership between clinical delivery systems and clinical research programs can get us closer to the goal of achieving learning within the care continuum and discovering evidence that is available when it is needed.

The Largest Share of Organizations Do Not Have a Formal Strategy for Clinician Engagement

Leadership Survey: Why Clinicians Are Not Engaged, and What Leaders Must Do About It

Clinician engagement is vital for improving clinical quality and patient satisfaction, as well as the job satisfaction of clinicians themselves. Yet nearly half of health care organizations are not very effective or not at all effective at clinician engagement.

Rowe01_pullquote - clinician well-being - fighting clinician burnout and creating culture of wellness takes all stakeholders

Defending the Term “Burnout”: A Useful Tool in the Quest to Ease Clinician Suffering

Health care leaders must take a preemptive approach to clinician well-being that is supported by all stakeholders and prioritized on an equal footing with essential clinical and financial measures.

Screenshot from the NewYork Quality Care Chronic Condition Dashboard

Success in a Hospital-Integrated Accountable Care Organization

How NewYork Quality Care achieved shared savings — by strengthening collaboration, enhancing care management with telehealth, and transparently sharing performance data.

Miller03_pullquote social determinants whole-person

How a State Advances Whole-Person Health Care

Pennsylvania addresses social determinants of health by bringing together managed care and social services organizations to expand access to vital resources.

Abigail Geisinger Scholars Program for Medical Students -Ryu02_pullquote

Why a Teaching Hospital Offers an Employment-Based Tuition Waiver Program

Geisinger Commonwealth School of Medicine subsidizes medical students’ education in exchange for their willingness to practice at Geisinger Health System.

Michael Dowling and Charles Kenney headshots

Rebooting Health Care: An Optimistic Outlook

The U.S. health care system may seem broken, but it’s on its way to greatness, according to the authors of Health Care Reboot. They discuss their optimism for U.S. health care reform, particularly on the social determinants of health, payment, consumerism, and technology.

Action Steps for Risk-Share Contracts for Medical Devices

Challenges and Best Practices for Health Systems to Consider When Implementing Risk-Share Contracts for Medical Devices

When done right, value-based contracting for medical devices can ameliorate shrinking margins at health systems, leading to a virtuous circle.

Connect

A weekly email newsletter featuring the latest actionable ideas and practical innovations from NEJM Catalyst.

Learn More »

Topics

Leading Transformation

284 Articles

From the Commonwealth to Obamacare: Reflections…

The former Executive Director of the Commonwealth Health Insurance Connector — a model for the…

Physician Burnout

52 Articles

Survey Snapshot: How Do You Know…

The NEJM Catalyst Insights Council discusses strategies for clinical engagement.

From the Commonwealth to Obamacare: Reflections…

The former Executive Director of the Commonwealth Health Insurance Connector — a model for the…

Insights Council

Have a voice. Join other health care leaders effecting change, shaping tomorrow.

Apply Now