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Center for Policy Studies

Public Affairs Discussion Group

The Future of Primary Care

George Kikano, MD - Chair, Department of Family Medicine at Case Western Reserve University
Friday October 12, 2012
12:30-1:30 p.m.
Dampeer Room
Kelvin Smith Library
Case Western Reserve University

Dear Colleagues:

If you follow health policy it can seem like primary medical care is a lot like the weather – everybody talks about it but nobody does much about it.

A great deal of commentary claims that the U.S. has too many specialists and not enough generalist physicians. Policy-makers continually at least claim to be adopting reforms to redress the imbalance. Passage of health reform in 2010 was followed by many claims that there aren’t enough primary care physicians to serve the newly-insured patients. Meanwhile, the proportion of medical students who choose primary care residencies is if anything declining. What causes the shortage? Some believe that lower incomes for primary care physicians explain preference for specialties, but there is also evidence that the work and working conditions for primary care are especially unattractive to students. What are the consequences? Possibly a medical care system that treats parts of a patient but not the whole patient, and that is both lower quality and higher cost than it should be.

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

About Our Guest...

George Kikano is the chairman of the Department of Family Medicine and Community Health at University Hospitals Case Medical Center and Case Western Reserve University. Dr. Kikano is also Vice Dean for Community Health, the Director of the Weatherhead Institute for Family Medicine and Community Health and the Dorothy Jones Weatherhead Professor at Case Western Reserve University. Under his leadership, the department of Family Medicine and Community Health is recognized as one of the best departments of Family Medicine nationally. Dr Kikano holds other administrative positions at University Hospitals including the directorship of UH HomeCare Services and UH Connect. With over 20 years of clinical practice, Dr. Kikano has a vast array of experience in family medicine and a strong interest in wellness initiatives.

Dr. Kikano attended the American University of Beirut in Lebanon. He completed his residency in Family Medicine at University Hospitals Case Medical Center and earned his CPE at the American College of Physician Executives. Dr. Kikano has been involved in teaching future physicians at Case Western Reserve University since 1991. Dr Kikano is very active in organized professional associations and served as president of the Cleveland Academy of Family Physicians (2001-2003), president of the Academy of Medicine of Cleveland/Northern Ohio Medical Association (2005-06), and was District 5 Director of the Ohio Academy of Family Physicians, as well as on the board of the Association of Departments of Family Medicine (national chairs). Since 2002, he has been annually recognized as one of the Best Doctors in America; Area’s Top Docs in Northern Ohio Live Magazine and Cleveland Magazine; and has received many teaching awards and honors.

Dr. Kikano has published numerous medical articles in peer-reviewed journals and has been an investigator on several federal grants focusing on education and research. Dr. Kikano is passionately committed to teaching and community outreach. He is the founder of the UH House Calls program which provides home visits and services for disadvantaged elderly in urban Cleveland neighborhoods. This program also serves as a unique teaching model for medical students and residents. Dr. Kikano has been able to secure millions of dollars from foundations and individuals in order to support this initiative.

Where We Meet

The Friday Public Affairs Lunch convenes each Friday when classes are in session, from 12:30 p.m. to 1:30 p.m. We usually meet in the Dampeer Room of Kelvin Smith Library. The Dampeer Room is on the second floor of the library. Occasionally we need to use a different room; that will always be announced in the weekly e-mails.

Parking Possibilities

The most convenient parking is the lot underneath Severance Hall. We regret that it is not free. From that lot there is an elevator up to street level (labeled as for the Thwing Center); it is less than 50 yards from that exit to the library entrance. You can get from the Severance garage to the library without going outside. Near the entry gates - just to the right if you were driving out - there is a door into a corridor. Walk down the corridor and there will be another door. Beyond that door you'll find the entrance to an elevator which goes up to an entrance right inside the doors to Kelvin Smith Library..

Friday Lunch Upcoming Topics and Speakers:

October 19: Biblical Rhetoric in the 2012 Elections. With Timothy K. Beal, Florence Harkness Professor of Religion.***Special Location: Mather House 100***

October 26: Special Event in Memory of Alec Lamis – “Insecure Majorities: Congress and the Permanent Campaign.”
With Frances E. Lee, Professor of Government and Politics, University of Maryland ***Special Location: Wolstein Medical Research Building auditorium, first floor, 2103 Cornell Road. Lunch and Mama Jo’s pies provided.***

November 2: Political Science Department Pre-Election Forecasts.
With Justin Buchler, Associate Professor of Political Science, and colleagues.

November 9: What Just Happened? Open discussion about the election results,
with Joe White, Chair, Department of Political Science.

November 16: Learning from Mad Cows.
With Dr. Pierluigi Gambetti, Professor and Director, Division of Neuropathology and Director, National Prion Disease Pathology Surveillance Center.

November 23: No Session - Thanksgiving Break

November 30: The Medium is the Message: What Happens When Universities Digitize Course Evaluations.
With Timothy J. Fogarty, Professor of Accountancy.

December 7: The “Chicago Boys” Without Pinochet: Privatization and Protest in Chile.
With Diane Haughney, Ph.D.
October 8, 2012

If you would like to reply, submit items for inclusion, or not receive this weekly e-mail please send a notice to:

Upcoming Events

Physicians as Advocates for Patients or Wise Resource Use: Can They Do Both?

A Discussion With: Christine Cassel, MD, President and CEO, American Board of Internal Medicine and ABIM Foundation, Tuesday, Oct. 9, 2012, 4:00 p.m., Reception to follow, Iris S. and Bert L. Wolstein Research Building, Case Western Reserve University, 2103 Cornell Road, Cleveland, OH 44106. Sponsored by the Department of Bioethics.

A substantial bioethics and health policy literature asserts that physicians should ensure that medical care resources are used wisely, so spending is controlled or "value" maximized. Yet physicians worry that responsibility to limit costs could contradict their duty to serve individual patients. One of the leaders of organized medicine addresses this fundamental question.

Insecure Majorities: Congress and the Permanent Campaign

A Discussion in Honor and Memory of Professor Alexander P. Lamis Featuring: Frances E. Lee, Ph.D., Professor of Political Science at the University of Maryland, Friday October 26, 2012, 12:00 p.m., Wolstein Medical Research Building Auditorium, 2103 Cornell Road, Cleveland, OH 44106. Sponsored by the Department of Political Science and the Center for Policy Studies at Case Western Reserve University.

Much of the discussion of party alignments in the past claimed either that one party was dominant (such as the Republicans after 1896, or Democrats after 1932) or that voters were becoming less aligned with either party (supposedly in the 1970s). But the current party cleavage is different. Voters and interest groups are not “dealigned” at all. Most are closely tied to one or the other party. But the cleavages are quite severe – the parties have very different policy positions – and the balance is very close. That greatly raises the stakes in each election, and so may add to the tone of extremism and “winner take all” refusal to compromise that many believe characterizes Congress today.

Professor Lee is one of the leading scholars of parties in Congress, a fellow-alum of Vanderbilt and a personal friend of Alec Lamis from her time in the political science department at CWRU. So she is both a leading expert who would be a great visitor to campus in her own right, and a very appropriate person to honor our late colleague by discussing the field about which he cared so much.

October 2012








































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