Magazine article Drug Topics

Provost Gives His Take on How to Reengineer Health Care

Magazine article Drug Topics

Provost Gives His Take on How to Reengineer Health Care

Article excerpt

What's on the immediate horizon for the health-care industry? Expect more consolidation, just as the early automobile industry eventually went from small independent makers to large corporations with multiple divisions.

There are still too many health maintenance organizations, too many hospitals and beds, and too many hospital-based registered nurses and dispensing pharmacists. And when it comes to pharmacy colleges, they must reorient professional training toward pharmaceutical care and team delivery and enhance the pharmacist's role as a leader who supervises delivery of that care. So said William R. Brody, M.D., keynote speaker at the opening session of the annual meeting of the American Association of Colleges of Pharmacy, in Sparks, Nev., last month.

Brody, who is leaving his post as provost of the University of Minnesota Academic Health Center this fall to take an appointment as president of Johns Hopkins University, is intimately acquainted with the subject of reengineering sectors of academic health care.

While serving as radiologist in chief at Johns Hopkins Hospital, Brody chaired the Committee for the 21 st Century, which was charged with thinking through what Hopkins needed to do to stay at the forefront of higher education. In his current provost post at the University of Minnesota, Brody oversees 5,000 students, seven professional schools, 14,000 employees, and an annual budget of $700 million.

Brody took over as provost at a crucial time for the University of Minnesota. The state legislature had passed a law in 1992 paving the way for integrated service networks, and within 18 months, massive consolidation had resulted in 90% of residents of the Twin Cities of St. Paul and Minneapolis--half the state's population--being enrolled in managed care.

That was just the cutting edge of a national trend toward health-care change. "The old system was broken," said Brody. Costs were rapidly rising, and there was little emphasis on preventive care; at the same time, patients were asking the industry to provide more services. The price of health care, however, was the major issue, Brody said, and while the Administration's national health-care reform campaign didn't succeed, the Clintons' efforts forever changed the market mind-set by creating the expectations that costs would be lowered.

In the Twin Cities, four major HMOs now provide health care, and costs have fallen to 80% of the national average. But, in certain respects, HMOs don't really work, Brody said. Health care is rationed, and, besides, most HMOs are for-profit, he said. …

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