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
Health Care Organizational Culture Emphasizes Patient Care Only Slightly More Than the Bottom Line

Survey Snapshot: Who Should Lead Culture Change?

NEJM Catalyst Insights Council members feel that culture change at their organizations is heading in the right direction, but differ on who it should come from, and reveal too much balance between emphasis on bottom line and emphasis on patient care.

Culture Change Within Health Care Organizations Is Changing for the Better

Leadership Survey: Organizational Culture Is the Key to Better Health Care

Although three-quarters of Insights Council survey respondents say culture change is a high or moderate priority at their organizations, survey results show a lot of work on organizational culture remains to be done.

Metraux01_pullquote - dinners to combat burnout in the health care community

“Breaking Bread” to Combat Burnout

Can a simple dinner create community among health care providers?

IHI HPMS Visual Management Board Example

The Answer to Culture Change: Everyday Management Tactics

Adoption of a clear rhythm-of-performance measurement and communication via huddles and visual management can affect a culture of staff engagement and continuous value improvement.

ajor Themes from Cleveland Clinic Town Halls 2016

Reigniting the Passion to Practice Through a Multi-Pronged Approach

Cleveland Clinic formed the Practice Innovation and Professional Fulfillment Office to create and sustain an environment that allows clinicians and scientists to thrive through barrier removal, culture change, and support for personal well-being.

Percent in Highest Bracket in Patient Satisfaction Scores - Pre-Post Arm Differences for Hospitalists - Duke Coaching Communication Skills Study

Coach, Don’t Just Teach

The effect of one-on-one communication coaching on clinicians’ communication skills and patients’ satisfaction.

Two-Thirds of Organizations Have a Nurse Leader Career Path

Survey Snapshot: Do Nurse Leaders Need Advanced Degrees?

Though NEJM Catalyst Insights Council members acknowledge a lack of advancement opportunities for nurse leaders, two-thirds of their organizations have a nurse leader career path.

Nurse Leaders and Physician Leaders Should Be Considered Equals in Care Delivery - but Views of Nurses and Non-Nurses Differ

Leadership Survey: Nurses as Leaders: Broad Acceptance, Room to Grow

Nurses are traditionally the backbone of patient care. They form the largest percentage of the health care workforce, far outstripping physicians. But are nurses leaders as well as doers?

The CMO Role of the Future - Baptist Health Survey Results

Examining the Continuously Evolving Role of the Chief Medical Officer

Hospital and system leaders need to sharpen the focus of CMO roles to include system-wide considerations beyond the walls of the hospital.

Meyer01_header - Seven Challenges and Seven Potential Solutions for Large-Scale EHR Implementation

Seven Challenges and Seven Solutions for Large-Scale EHR Implementations

Salient lessons learned over multiple electronic health record implementations.


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

Learn More »


Leading Transformation

261 Articles

Event This Thursday and Friday: China’s…

Join us for our free livestreamed event Thursday from 1:00 – 5:00 p.m.…

Team Care

103 Articles

Reigniting the Passion to Practice Through…

Cleveland Clinic formed the Practice Innovation and Professional Fulfillment Office to create and sustain an…

Quality Management

169 Articles

The Answer to Culture Change: Everyday…

Adoption of a clear rhythm-of-performance measurement and communication via huddles and visual management can affect…

Insights Council

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

Apply Now