Population health is the new public health | David Nash – Chief Healthcare Executive

America can move toward a transformed health system responsible for our wellness and the new paradigm of population health, led by medical professionals.

COVID-19 has crashed the U. S. healthcare system and blasted a searing light on the social determinants of wellness.

In doing so, the virus — and more importantly, its consequences — exposed a truth that my colleagues and I have been preaching for over a decade: the public health paradigm is outdated and insufficient. Its major tenets — including general public health, epidemiology, behavioral science, and the environment — are important but reactive.

We must also consider the quality plus safety of the care we deliver, the cost of that care and an array of shifting open public policy considerations.

The business of health

Healthcare is the particular biggest business in this country, but all of us rarely stop to consider what, exactly, that business has become.

Are healthcare providers in the business of improving and maintaining wellness? Or is our purpose to simply perform more procedures plus fill all of those beds?

The vast majority of doctors I know feel too disconnected from the program to answer. They see themselves as pawns or, worse, because victims while they should be leading the charge into the particular population health paradigm, which balances treating the sick with keeping people healthy.   Widening care disparities and precarious SDOH demand it.

Consider the social determinants in a city like Philadelphia, where I have worked with regard to the past three decades. Ours is the poorest from the top ten cities by populace. One-quarter associated with Philadelphians live in poverty and one-half are in deep poverty, meaning that will they can’t put food on the table. During the height of the pandemic, the particular lines regarding food exceeded the lines for medical help.

No surprise, then, that the death rate for people of color was much higher than for other demographics associated with patients. The particular inherent inequality in our system guaranteed a lack of access, the lack associated with resources, plus a lack of insurance for those who were constantly being uncovered to the virus because they must work public-facing jobs.

Leading from within

Doctors are usually not sociable workers, yet we can still function to shut down illness at the particular source, when it’s still a drip, rather than wait to address it downstream, whenever it’s become a flood.

Imagine if the population of Philadelphia was healthier pre-Covid; if we all had less inequality, we could have reduced the unbelievable death rate in minority populations. If only we had paid attention to obesity, smoking, heart disease, exercise, nutrition — softer issues that the system largely ignored because there were no incentives in order to do otherwise. Indeed, the particular flood fills up a lot of beds.

As an academic, I have been pushing towards a population health paradigm for a lot more than a decade. This means changing undergraduate and graduate healthcare education curricula. Let’s bring the tenets of human population health to UME plus GME.

Is it possible that the pandemic offers given us a rocket booster in order to finally get this information into the particular curriculum? I’m hopeful that the answer is “yes, ” and that we will soon observe pharmacy schools, nursing colleges, and medical schools incorporate the tenets we’ve already been preaching pre-Covid. I’m also hopeful that will we’ll notice digital healthcare that continues to reduce marginal costs. Both changes will enable us to reach much larger populations at a lower cost than ever before.

There is a caveat: change will only come through the inside. The healthcare system has become so big, so convoluted, and so fortified by company interests that its revolutionaries, like the colleagues who advocate intended for population wellness practices, will need to build the equivalent of a Trojan Horse to effect change.

Fortunately, plus unfortunately, Covid taught us that the system is not nearly as strong since it appears. Failures associated with leadership, racial inequities, community health mistakes, and institutional collapses — including in public health — exposed a fragile core surrounded by thick, high walls.

Let’s get previous those walls, assess the rot and identify the root causes of how COVID-19 crashed the health care system, killing over 1 million Americans . Even without new laws or even government policies, I am confident that will America may move toward a transformed health program accountable for our wellness and a new paradigm of population health, led simply by medical professionals. Failing in order to do therefore would be malpractice.

— David B. Nash, MD, MBA, is an advisory board member at MediGuru, as well as the particular Founding Dean Emeritus associated with the Jefferson College of Population Health and the Dr . Raymond C. and Doris N. Grandon Professor associated with Health Policy, on the campus of Thomas Jefferson University within Philadelphia, Pa.


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