The Upstream Doctors: Medical Innovators Track Sickness to Its Source (Kindle Single) (TED Books)

California, for instance, recently launched a Health in All Policies initiative to factor health into a wide swath of state decisions.

Mitch Katz directs the Los Angeles County Department of Health Services, the second-largest county health care system in the country. He described to me how economic incentives can stack up against upstream care. “Because there’s been little money toward prevention, there’s no payer or mechanism for prevention research like there is for medical res

“A conceptual model that includes partialists, comprehensivists, and upstreamists makes sense for the work of population health management in health care. Each of those three key functions must be performed. For this to be wieldy, though, there would also need to be coordination among those three functions. But the nature of how we currently segmen

Focus on food insecurity and slum housing, they said. And create a patient-centered medical home to deal with people’s medical and social issues.

from David M. Lawrence, former chairman and CEO of Kaiser Foundation Health Plan Inc. and Kaiser Foundation Hospitals:

As a result of regulatory, cultural, and financial obstacles, doctors and nurses who aspire to be upstreamists on the front lines face challenges in five key areas. To remember these, think of the acronym TRIDNTT (pronounced “trident”): 1. Time and Resources (both human and capital) 2. Incentives (at individual and system levels) 3. Data that’s acc

Third and finally, it’s urgent that we go beyond utilitarian arguments to continue to stake moral claims for improving access to quality health care for all. Increased efficiency and lower costs, though important, are not the alpha and the omega of health care improvement, and they are still less of a factor in the improvement of health itself. The

first began to understand health as a social phenomenon that starts and ends outside the clinic walls.

There are three basic elements of this cultural challenge: a lack of sociocultural competence; the skewed demographic composition of our health care workforce and its cultural implications (that is, a lack of diversity); and a lack of mentorship.