Leah Binder 12/20/12 FiDA highlight added to indicate my particular heroes!
When I have a health problem, I talk to my doctor or nurse. But when our nation has a collective health problem, doctors aren’t the only ones who know best. While I could write a year’s worth of blogs about inspirational physicians or nurses who are transforming our health care system from the inside out, today I want to highlight some of the largely unsung heroes changing health care from the outside in: these are influential leaders who don’t wear stethoscopes or see patients, but have some important answers for us, from pilots and business leaders to game show titans and soccer moms.
Their influence comes through social media, conferences, publishing and even some peer reviewed medical journals. My prediction: they will make some history in 2013.
1. John Nance
Did you know that a checked bag on an airline flight is still exponentially safer than a patient in an American hospital? John Nance is a former airline pilot and veteran, who has taken lessons learned from airline safety to dissect hospital safety – and found the latter wanting. His books on the subject, most recently, “Charting the Course,” co-authored with his wife Kathleen Bartholomew (a national change maker of major influence herself, but a nurse so not on this list of outsiders), create a fictional situation where hospitals are run with the same safety rules and procedures as airlines. The entertaining book challenges almost everything we assume about proper hospital administration.
2. Al Lewis
This Harvard-educated policy specialist is considered by many the father of “disease management” — and like all good parents, he’s the first to note when his offspring are misbehaving. Now he’s imposing some discipline. He’s concerned that the benefits of prevention initiatives are often oversold by overzealous consultants and vendors, so he wrote a category bestselling book “Why Nobody Believes the Numbers” to show how the rosy scenarios don’t always add up.
3. Suzanne Delbanco
Many self-insured employers have an astonishing little provision buried in their contract with their health plan: they aren’t allowed to reveal the prices they are paying for health services. The employers are allowed to pay the bills, of course, but they just can’t tell employees how much they paid. Thanks to Suzanne Delbanco, and her organization Catalyst for Payment Reform (CPR), ridiculous restrictions like that will soon be a thing of the past. CPR helps purchasers — large employers and unions — set rules for health plans on issues like pricing and quality of care.
4. Francois de Brantes
Your hospital usually makes money if a patient gets an infection during their stay and your doctor stands to gain financially if he gives you the wrong care. As a businessman, Francois de Brantes was outraged by the perverse incentives in health care that drive costs up and drive quality down. He formed a non-profit called the Health Care Incentives Improvement Institute to try to deal with the incentives problem, and his terrific collection of essays highlights his blunt and logical ideas for addressing them. Although de Brantes is not alone in calling for better economic incentives in health care, he is unrivaled in piecing together and even applying detailed strategies to the health care system, undaunted by the complexity involved.
5. Rosemary Gibson
A study by the Harvard School of Public Health and the Rand Corporation concluded that one-third of people who were told they needed heart bypass surgery did not need it. Studies have also shown inappropriate CT scans, other heart surgeries, back surgery, pap smears, carotid surgery to prevent strokes and among others. Rosemary Gibson is a quiet and highly effective opponent of these rampant practices that harm millions and cost billions. Her much-discussed book, “The Treatment Trap” had a significant impact in the health policy world and put the issue of overtreatment into the spotlight where it belongs.
6. Dave deBronkart
Often better known as “e-Patient Dave,” Dave deBronkart survived stage 4 kidney cancer and today is a social media superstar who speaks nationally and internationally on how patients should be treated in the U.S. health system. His compelling TEDx Talk, “Let Patients Help,” is in the top half of most-watched TED talks of all time. He tends to turn health care’s conventional wisdom on its head. “Why is it when patients do the right thing it’s called ‘compliance,’” he asks, “But when doctors do the right thing it’s called ‘quality?’”
7. David Goldhill
If you are raised to think the combination of TV and health care equals Marcus Welby, meet David Goldhill, whose day job as head of the Game Show Network (GSN) belies his other self, a controversial thought leader in health care who is getting a ton of attention. Watch for Goldhill’s book to be published in the New Year: “Catastrophic Care: How American Health Care Killed My Father.” Until his father’s death, Goldhill never considered why the normal market competition rules that apply in other industries don’t apply in health care. He recommends some unusual policy ideas.
8. Tom Emerick
When Tom Emerick was a global benefits executive for Wal-Mart, he discovered (with advice from Mayo Clinic and other leading medical experts) that thousands of his employees had been given transplant procedures when they didn’t need them, an unfathomable amount of suffering for people to endure. I wrote about the improvements that Tom made in a previous post, but it’s worth calling out again – Tom is a leading crusader for employers to protect the American public from unnecessary and dangerous procedures. There is no disagreement in the medical community that such harm exists; a recent consensus report from the Institute of Medicine found that one third or more of health services are wasteful. Tom helps employers address this issue.
9. David Knowlton
David Knowlton is a highly influential behind-the-scenes guy in New Jersey, who is a maverick in the best sense of the word, and has gained national attention as a result. He’s a leading advocate for transparency, safety and quality and has been awarded numerous national appointments in recognition of the respect he’s earned in his home state and the value of his ideas — and his ability to turn them into policies. For instance, he’s the co-chair of The Leapfrog Group’s Hospital Safety Score Committee. In addition to being a key influencer behind significant New Jersey legislation on quality and transparency over the years, he’s been unafraid to do what was right. He published prices of common hospital services long before anyone else in the country was doing so, and he did a survey of New Jersey nurses to get their reputational ratings of hospitals. Keep an eye out; he has plans for 2013.
10. Maureen Corry
Maternity care in the U.S. has serious problems, including a rapid growth in the rate of Cesarean sections, now comprising more than 30 percent of all births in the U.S. Procedures that are known to be unnecessary or even harmful – like scheduled deliveries prior to 40 weeks gestation – remain
common in American hospitals. Maureen Corry and her 94 year old organization, Childbirth Connection, bring together researchers, clinicians and patients to come up with solutions. Maureen is a strong policy advocate, but also a thoughtful and purposeful researcher who brings all sides together in very constructive ways, which is why many of the issues she has raised over the years are now on the top of the policy agenda in Washington. Look for her report next year on mothers’ perceptions of the childbirth experience.
11. Regina Holliday
My fellow Forbes.com blogger Michael Millenson has called Regina Holliday the “Rosa Parks of health care.” A young widow with two small children, Holliday speaks eloquently of her husband’s cancer and the terrible ways the health care system added to his suffering. Her cause: all patients should have immediate access to their medical records. She wouldn’t move to the back of the bus when the hospital refused to share her husband’s records, and we shouldn’t be forced to either. This effort is getting traction, with a group of leading physicians now launching a movement called “open notes.”
12. Wendy Lynch
Wendy Lynch is a respected thought leader in the world of health benefits executives, and she’s a bit fed up. Now leading a unit of the think tank The Altarum Group, Wendy wants to see more boldness by employers in incentivizing employees to seek quality providers. Lynch and Altarum are likely to have significant impact in 2013.
13. Gary Taubes
This science journalist and author spent five years of his life plowing through every known study linking lifestyle factors to conditions like heart disease, diabetes and obesity, and he then wrote a book detailing all of it, “Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health.”
The bottom line: the science doesn’t support conventional wisdom on saturated fat, diabetes, obesity, diet and exercise. With his remarkable colleague, Dr. Peter Attia, he started a new organization called Nutrition Science Institute to support more research and assure that Americans hear directly from the scientists. Given the heavy emphasis on lifestyle and wellness under Obamacare — including a provision allowing employers to incentivize employee wellness with up to 30 percent of their health insurance premium — look for Gary to help dispel some unscientific myths that undermine these programs.
So as you clink your glasses and wish your loved ones a Happy New Year, remember to look out for these trailblazers who will likely make a true impact on health care in 2013.