A reflection on one year at @StanfordHP , and a bit of what I have learned over the last year studying US #HealthPolicy at one of the top universities in the world. (And a photo tour.)
During my time here I learned about health policy in the classroom, through my own research, and by being both a patient and resident doctor in one of the most expensive health systems in the world. I have experienced US healthcare from all angles.
1. No health system in the world is perfect. Each system is designed for the outcome that it gets. The USA has the most expensive systems in the world, this means that some people get the absolute best care, others get absolutely no care.
2. The US health system is designed to meet the needs of individuals with excellent insurance and/or (usually and) with money. It isn’t designed to meet the needs of all Americans. Your health outcomes when needing care almost entirely depend on your insurance.
3. The high cost of this system is also what feeds innovation in medicine, drug development and technologies. The rest of the world benefits from the innovations that Americans pay for both financially and with their health.
4. When designing a health system or changing a health system, it is necessary to consider the outcome that is to be achieved and what the possible unintended consequences or byproducts of a different system might be.
5. Canada can learn something from the US. Such as we can learn how to utilize more innovative provider payment models to drive outcomes and support primary care. We can also take note that privatization doesn’t mean less cost, better access or better care.
6. Canada can also learn that people matter. Some of the best US health systems work hard to retain their staff and show their staff that they are valued. This partly requires compensation, but also seeing healthcare providers as humans. @StanfordHealth does this well.
7. Health Human Resources can be one of the greatest strengths of a health system. Canada needs to see this, the provinces need to value this, and we need to recruit and retain physicians, nurses and allied health. People, combined with adequate resources make health systems.
8. Countries with excellent health outcomes don’t just have good healthcare. They provide extensive social supports and safety nets. >80% of health is driven by the social determinants of health. This includes income, education, housing and access to nutritious foods.
9. Health is a continuum that includes healthcare, but also everything else in our environment. Want a better health outcomes? Yes, build a good health system, but also build environments for people to thrive in, not just survive in. This also means focusing on climate health.
10. Finally, building better health systems is a wicked problem, but not an impossible one. I’m thankful to be surrounded by so many leaders working to make it better. Together, we will make it better.
I want to give a shout out to those who made this year possible for me. Thank you to my incredible main advisor and mentor @dkowens who always goes above and beyond. And for all the support I received from @StanfordHP.
A big thank you to the @UAlberta_FoMD Division of Neurology for their support, for believing in me and my mentor @penvs17 for always being there for me even when I’m in a different country.
While this wasn’t really part of my plan, thank you to @StephaniePunMD and @Stanford_Ortho for fixing my hip. I learned a lot about myself during the past 12 weeks and it is immensely humbling to be a patient as physician. I’m beyond happy to be back on my bike before leaving!
And last but not least, thank you to @Stanford_Neuro for allowing me to join your Stroke and Neuro Crit Teams this past month. It was incredible to how you deliver neurological care and conduct leading research. It was also extra amazing to have all female attendings for 4 weeks!
I am so grateful to have been able to be here this year. I now have the opportunity to take what I have learned and fulfill the promise I made to my brother, to build a better health system for all people in Canada (and to finish my thesis 🫣). End/
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