health policy primer (a.k.a. physician activism basics)
DESCRIPTION
Health Policy Primer (a.k.a. physician activism basics). Department of Internal Medicine Morning Report 19 March 2007 Ryan Buchholz, MD. “Knowing is not enough; we must apply. Willing is not enough; we must do.” —Goethe. Aims. Convince you that health policy is doctors’ business* - PowerPoint PPT PresentationTRANSCRIPT
Health Policy Primer(a.k.a. physician activism basics)
Department of Internal MedicineMorning Report19 March 2007
Ryan Buchholz, MD
“Knowing is not enough; we must apply.Willing is not enough; we must do.”
—Goethe
Aims
• Convince you that health policy is
doctors’ business**…and that health policy is particularly
important for the poor
• Provide you with a few resources
and contacts
• Strike a chord within you
Non-Aims
• A partisan political discourse
• An excuse for a nap
Introduction
• Health policy, broadly construed−Macro-level:
• Global health• National / federal policy• State / regional policy
−Micro-level:• Your community• Your institution or practice
Proximal
Distal
Introduction, continued
•Have you ever…•Signed a petition?•Sent a letter to a politician?•Visited a politician’s office?•Attended a city council meeting?
•Participated in quality improvement efforts?•Voted?•Volunteered for a campaign?•Read the newspaper?•Are you a member of ACP, AAP, AMA, SGIM?
Agenda
• My journey from apathy to advocacy (i.e., health policy is doctors’ business)
• ~ 5 minutes
• Case discussion• ~ 5 minutes
• Q+A/Resources: Health policy opportunities
• ~ 10 minutes
My journey• Childhood: Apathy + Cynicism
• “Student government doesn’t matter”• Politicians are selfish• Sports are cooler anyways
Michael Chang Brian McBride
Dana Carvey
My journey: influences
• University: Apathy Service
Drew Hansen
“Social Justice”
later wrote
My journey: influences
• University: “Poverty, Culture, and Infectious Disease”
Paul Farmer
“Large-scale social forces…”
Subject of
>
MD = natural attorney for the poor
My journey: influences
• Post-University: Fighting Hunger
Tony Hall
“You’re my eyes and ears in the field…”
Author of
+
Dan GlickmanFounder of
Case presentation
• Jorge C, a 45 year-old man with−uncontrolled diabetes mellitus x 20
years,−morbid obesity, and−h/o recently broken tibia
presents to your office for hospital F/U after a near below-knee amputation, asking how he can lose weight and control his diabetes.
Case presentation, continued• SOCHx: former truck driver (now blind),
immigrated from Cuba at age 16, married and LW wife (IHOP waitress) and children
• PMHx: diabetic retinopathy legally blind; near-BKA after fractured tibia
• ROS: gaining weight, can’t see, polydipsia/polyuria/polyphagia
• PE: consistent with history as described
Case presentation, continuedAssessment /
plan?
1. DM, uncontrolled& complications
2. Morbid obesity
3. Poverty
1. OHA/insulin + diet
+ exercise, labs
2. Eat healthy
3. Refer to Farm
Share
Farm Share
Jorge C
+ =
•Learned to eat healthy
•Lost 150 lbs.
•Glycemic control
•Volunteering
•New lease on life“Farm Share saved my
life.”
— Jorge C.
Resources and Opportunities
Resources• People all around you!
− Jane Henney, MD: VP of UC Academic Health Center and former FDA Commissioner ([email protected])
−Robert Graham, MD: UCFP Professor and former Ass’t Surgeon General ([email protected])
−Stephen Wilson, MD: UC Internist and Pediatrician, Cincinnati Board of Health ([email protected])
−Melissa Saladonis, CCHMC Director of Government Affairs ([email protected])
−Sarah Corathers, MD: Chair (ex officio), AAP Resident Section ([email protected])
Opportunities
Conferences and Seminars
• Health Foundation of Greater Cincinnati
seminars−Strategic planning: Jul. 12, Nov. 15−Working with the media: Mar. 8, Sep.
10−How a piece of paper can catch a
policymaker’s eye: Oct. 5
Opportunities: 2
Conferences and Seminars−Center for Closing the Health Gap: April
13 and 14, 2007 – David Satcher will keynote!
−April 19-21, 2007: Internal Medicine 2007
−June 3-5, 2007: AAP Annual Legislative Conference in Washington, DC
−October 11-12, 2007: Ohio ACP in Columbus
Opportunities: 3• Online petitions
• Health Care for all Children• The One Campaign
• Vote• Congressional elections• Ohio legislature elections• Local elections
• Get out• Cover the Uninsured Week 2007: April 23-29
Opportunities: 4• Books:
−White Coat, Clenched Fist (Mullan)−Pathologies of Power (Farmer)−Mountains Beyond Mountains (Kidder)
Opportunities: 4• Books:
−White Coat, Clenched Fist (Mullan)−Pathologies of Power (Farmer)−Mountains Beyond Mountains (Kidder)
• Articles:−This past week’s JAMA
Porter and Teisberg. JAMA 2007;297:1103-11.
Opportunities: 5
Rotations−Initiative on Poverty, Justice, and
Health: September, February, and April 2007-8
−Advanced Healthcare Improvement: Spring 2008
−Cambridge, the Amazon, southern Africa: do an elective abroad, or “on the rez”
Summary
• Primer on health policy: doctors’
business
• Resources and opportunities: strike
a chord?
“Knowing is not enough; we must apply.Willing is not enough; we must do.”
—Goethe
Special Thanks
• Christine + Jonathan Buchholz
• Caroline Mueller• Brian Volck• Tiffiny Diers• Carl Fichtenbaum• Stephen Wilson• Mia Mallory• Melissa Saladonis
Health Indicators
WHO, World Health Statistics 2005.
U.S.: #43 U.S.: #29
Health Expenditures
U.S.: #1
OECD Indicators 2005
A world distorted by AIDS…
Dorling D. PLoS Medicine 2007;4(1)13-8.
People Living with HIV, UNDP 2004
…is distorted by social structures
Dorling D. PLoS Medicine 2007;4(1)13-8.
Physicians Working, WHO 2004