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Center for Policy Studies
Public Affairs Discussion Group

The Generalist Function in the Evolving Health Care System

Kurt Stange M.D., Ph.D. - Distinguished University Professor and Editor, Annals of Family Medicine at Case Western Reserve University
Friday January 27, 2017
12:30-1:30 p.m.

***Alternate Location: Guilford House, First Floor Lounge***
Case Western Reserve University

Dear Colleagues:

Within the health policy community, it has long been conventional wisdom that health care in the United States relies far too much on specialist and sub-specialist care, in which treatment focuses more on parts of patients than on whole persons. Many studies argue over-specialization is one reason the U.S. system offers poor value for money, compared to other nations' health care. Related arguments claim care needs to be "integrated" through management by "Accountable Care Organizations" and far more emphasis on "teamwork" both outside and inside hospitals. Some versions expect generalist physicians – from pediatrics, family practice, or internal medicine - to coordinate care. But others expect organizations to coordinate, through routines such as use of electronic health records and shifting work to members of "care teams" or other sites, such as "minute clinics."

Will the generalist function come into better balance with specialty care? And, if so, will that be through relying on or downgrading generalist physicians? Dr. Stange brings his expertise from practice and as Editor of the Annals of Family Medicine to considering this crucial issue about the future of U.S. medical care.

All best regards,
Joe White
Luxenberg Family Professor of Public Policy and Director, Center for Policy Studies

About Our Guest

Kurt C. Stange, MD, Ph.D. is a family and public health physician, practicing at Neighborhood Family Practice, a federally-qualified community health center in Cleveland, Ohio. For more than two decades he’s been learning and applying complexity science principles to try make sense of a world that just doesn’t seem to fit neatly into little boxes and straight paths. He uses complexity science to guide and interpret mixed qualitative and quantitative research, and more recently he has been working on participatory methods to advance community health and to develop agent-based models of primary health care and patient-centered and population health outcomes.

He serves as editor for the Annals of Family Medicine, and is an American Cancer Society Clinical Research Professor. At The Institute for Integrative Health, he is a Scholar. He is working on Promoting Health Across Boundaries, and is active in practice-based, multimethod, participatory research and development that aims to understand and improve primary health care and community health. He is a member of the National Academy of Medicine.

Where We Meet and Parking Possibilities

Guilford House is at 11112 Bellflower Road, a pretty yellow building with a porch in the Mather Quad. The Lounge is on the first floor. The closest parking is the Severance garage or the lot at the Church of the Covenant.

Schedule of Friday Lunch Upcoming Topics and Speakers:

February 3: Democracy and Demagogues: Lessons from Ancient Greece and Rome. With Rachel Sternberg, Ph.D., Associate Professor of Classics, and Timothy Wutrich, Ph.D., Senior Instructor of Classics.

February 10: Immigration Policy and the Trump Administration. With David Wolfe Leopold J.D., Past President, American Immigration Lawyers Association.

February 17: The New Health Education Campus and the Future of Health Care. With James Young M.D., Executive Dean, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University.

February 24: Challenges Facing the U.S. Intelligence Community. With Vincent E. McHale, Ph.D., Marcus A. Hanna Emeritus Professor of Political Science.

March 3: Staffing and Organizing the Trump Presidency. With David B. Cohen, Ph.D., Professor of Political Science, University of Akron.

March 10: Nuclear Weapons. With William J. Fickinger, Ph.D., Emeritus Professor of Physics.

March 17: No program, Spring Break.

March 24: Energy Storage: A Key to Sustainability. With Daniel A. Scherson, Ph.D., Frank Hovorka Professor of Chemistry and Director, Ernest B. Yeager Center for Electrochemical Sciences.

March 31: Program to be Determined

April 7: Merkel’s Challenge: Managing Trump, Putin, and a Million Syrians. With Mark K. Cassell, Ph.D., Professor of Political Science, Kent State University.

April 14: Brazil’s Political Crises. With Juscelino F. Colares, Ph.D., Schott-Van den Eyden Professor of Business Law and Associate Director, Frederick K. Cox International Law Center.

April 21: Program to be Determined

April 28: Putin’s Russia. With Kelly M. McMann, Ph.D., Associate Professor of Political Science and Director, International Studies Program.

January 23, 2017

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Upcoming Events

The Big Sale: Elk Hills, the Energy Crisis, and the Invention of the Neoliberal Market, 1969-1998

A discussion with Peter Shulman, Ph.D., Associate Professor in the Department of History, Tuesday, February 21, 2017, 4:30 p.m. - 5:30 p.m., Clark Hall Room 206, 11130 Bellflower Road, Cleveland, Ohio 44106. Pre-Lecture reception begins at 4:15 pm. Free and open to the public. This talk is sponsored by the Baker-Nord Center for the Humanities.

In his talk, Peter Shulman will discuss the Elk Hills Naval Petroleum Reserve. In the middle of the 20th century, the most valuable piece of federal property was California’s Elk Hills Naval Petroleum Reserve, set aside decades before to provide oil for the military in future emergencies. In 1998, the Clinton administration sold the field for $3.65 billion–still the most expensive divestiture of a single piece of public property in American history. Yet selling this field, a process that actually took over a quarter-century, reveals the fraught ways Americans reconciled increasing national security concerns with a drive to withdraw the federal government from the private economy.

Dr. Shulman is an associate professor in the Department of History. He studies technology, science, and American politics in the 19th and 20th centuries, with special interests in the history of energy, environmental history, communication and transportation, the history of intelligence, and the history of American foreign relations. He teaches courses in the history of technology, energy and the environment, historical methods, and contemporary history. His current book project is a history of ideas about intelligence in twentieth century.

American Sickness: How Healthcare Became Big Business and How You Can Take It Back

A discussion with Elisabeth Rosenthal, a nationally-renowned columnist and editor-in-chief of Kaiser Health News, Monday, March 6, 2017, 4:30 p.m. - 5:30 p.m., Moot Courtroom (A59), Gund Hall, Case Western Reserve University, 11075 East Blvd., Cleveland, Ohio 44106.

In this lecture Elisabeth Rosenthal will diagnose one of the underlying flaws in the American healthcare system - the sizable price tag.

American healthcare is a big business, leading to expenses for procedures and drugs that are higher than in any other developed country. How did we come to have our high-priced healthcare system, and what can we do about it?

Rosenthal, author of the NY Times' series Paying Till it Hurts, will preview her ideas from her upcoming book, An American Sickness: How Healthcare became Big Business and How You Can Take it Back.

Elisabeth Rosenthal, Editor-in-Chief, joined KHN in September 2016 after 22 years as a correspondent at the New York Times, where she covered a variety of beats from healthcare to environment to reporter in the Beijing bureau. While in China she covered SARs, bird flu and the emergence of HIV/AIDS in rural areas. Libby's two-year-long New York Times series "Paying Till it Hurts" (2013-14) won many prizes for both health reporting and its creative use of digital tools. She is a graduate of Stanford University and Harvard Medical School and briefly practiced medicine in a New York City emergency room before converting to journalism.

January 2017







































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