"Of all the forms of inequality, injustice in health care is the most shocking and inhumane."
During his plenary address on April 25, James Galloway, M.D., urges his audience of family physicians to harness their leadership skills to effect positive change in the U.S. health care system.
That quote, attributed to Martin Luther King Jr., set the tone for a message delivered at the opening plenary session of the 2013 Annual Leadership Forum/National Conference of Special Constituencies held here April 25-27.
Speaker James Galloway, M.D., urged a room packed with family physicians to develop a sense of confidence in their work as physician leaders because doing so would enable them to face formidable challenges presented on any front -- be they from senators or hospital CEOs -- with courage and conviction.
Galloway, board-certified in internal medicine and cardiology, has a rich resume in federal government service, including a stint as assistant U.S. surgeon general. But it was his 22 years as a physician providing health care to American Indians and Alaska natives that solidified his credentials as an expert on disparities in health care.
- James Galloway, M.D., an expert on health care disparities in the United States, presented the plenary address at the 2013 Annual Leadership Forum/National Conference of Special Constituencies opening plenary.
- Galloway presented a plethora of facts and figures to back up his contention that inequality in the U.S. health care system is still rampant.
- Galloway urged physicians to hone and harness their leadership skills to help end health care disparities.
"In Navaho country," said Galloway, "there was a severe access issue. Health care to Indians was being funded at half the per capita level of (inmates in) federal prisons."
How to identify and resolve inequities was a key focal point in Galloway's message to family physicians. "We're here today to address those issues," he said. "We all have a passion, a calling, to make those things right."
Galloway shared facts from the CDC's 2011 Health Disparities and Inequalities Report(www.cdc.gov) that highlighted
- black infants are as much as three times more likely to die than infants born to other races or ethnicities, and
- black men and women are much more likely to die of heart disease and stroke than Caucasians.
The same report pointed out that the elimination of health care disparities would prevent about one million hospitalizations each year and save $6.7 billion in annual health care costs.
Galloway said passage of the Patient Protection and Affordable Care Act was a good start to help family physicians reduce disparities in health care. "I want us to understand the opportunities here," he said. The Affordable Care Act promises to focus on preventive care, improve care coordination, increase the number of physicians and other health care professionals in underserved communities, end insurance discrimination, and provide affordable insurance coverage.
The speaker noted the urgent need to fortify the primary care workforce by increasing funding that would create additional primary care residency slots as well as support training of physician assistants and nurse practitioners.
According to Galloway, the Affordable Care Act offers new opportunities and incentives for improved care by
- expanding team-based care,
- rewarding physicians for care outside of traditional face-to-face visits,
- focusing on aggressive management of chronically ill patients,
- expanding access to home-based care and
- ensuring that clinicians have secure methods by which to share patients' medical records.
The transition to electronic health records has been a rough journey for many physicians, Galloway acknowledged, but he encouraged the audience to keep at it. "We see the benefits of health IT when we get there, but the process of getting there is pretty painful," he said, as heads in the audience nodded in agreement.
Preventive medicine is the surest way to make America's health care system work for everyone, said Galloway, turning to the vision of Healthy People 2020 -- the fifth iteration of a program that first was created in 1979 as a means of establishing meaningful national health objectives. The program uses real data to help achieve stated objectives. Galloway urged audience members to visit the Healthy People website(www.healthypeople.gov) to learn about the 600 objectives and more than 1,300 measures outlined in the 2020 version.
He also spoke at length about the Million Hearts campaign(millionhearts.hhs.gov), an initiative launched by HHS in 2011 with a goal of preventing one million heart attacks and strokes by 2017. Heart disease and stroke are leading killers in the United States. They cause 800,000 deaths and cost more than $440 billion dollars annually in health care costs and lost productivity, said Galloway. Heart disease is "the greatest expression of racial disparity in life expectancy," in the United States.
"I invite each of you to take the pledge at Million Hearts and move this (effort) into your clinical practice and your leadership roles," said Galloway.
While encouraging the audience to get involved in these campaigns, however, the plenary speaker also acknowledged that family physicians have a lot on their plates. "Our average work hours per week are somewhere close to 70 or 80. We can't fit much more in. Trying harder won't work," he said. Instead, by joining with others in public health campaigns, we can expand our influence.
Galloway closed by putting his own spin on a quote attributed to singer/songwriter Jerry Garcia. "Somebody has to do it -- it's just amazing that it has to be us," said Galloway, referring to the hard work physicians must embrace if they are to lead the country toward a healthier future.
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