Category Archives: Miscellaneous

Looking back: a health care talk from the 1980s

The Department of Health Care Policy at Harvard Medical School is celebrating its 25th anniversary this year. In 1989, when I was the deputy assistant for Domestic Policy and director of the White House Office of Policy Development, I spoke, along with others, at the department’s inaugural celebration.

Joseph Califano, Jr., LLB, then Senior Partner of Dewey Ballantine, Bushby, Palmer, and Wood and I gave a talk about “Health Care in the ’90s: The Impending Revolution.” The Department recently uploaded video of this talk to their website, which you can view here.

The passing of Bill Friday

Bill Friday was a giant in American higher education and in North Carolina public life. And as we celebrate the 219th anniversary of the University of North Carolina at Chapel Hill, we remember his countless contributions to the state and the University.

In his three decades of service to the University, he guided the rapid expansion of the system – giving North Carolina a greater ability to provide its students with higher education opportunities.

Dr. Friday also was a friend of the UNC School of Medicine and UNC Health Care, and encouraged expanded research and clinical experiences for our students. Because of his dedication to higher education, our medical school continues to expand, allowing us to serve more communities across the state.

Dr. Friday’s contributions to North Carolina are immeasurable and will continue to be felt for generations to come. The state of North Carolina and the University of North Carolina are much the better because of his sustained leadership.

In support of PassFir5t

On Sunday afternoon, North Carolina’s starting point guard, Kendall Marshall, suffered a fractured wrist during the Tar Heels’ 87-73 win over Creighton. The Tar Heels advanced to the Sweet 16 and will play Ohio University on Friday, but even after a successful surgery on Monday, it is questionable whether Marshall will play. An anonymous student started a Twitter account on Monday to support Marshall, called @PassFir5t, and asked fans to write a “5” on their right wrists, and send photos in support of Marshall and his recovery. So from my wrist to yours, Kendall, here’s to a speedy recovery and good luck to the Tar Heels this weekend.

Normandy and Home

Our flight from Kigali, Rwanda to Brussels was uneventful and pleasant.

In addition to our week in Africa, we added on two days in Europe.

We rented a car in Brussels and drove over to Normandy.

I’ve long wanted to tour the D-Day sites, and it was everything I had thought it would be, and more.

We had an all day tour with a very experienced guide, and Will and I learned a lot about this important chapter in American and world history.

The D-Day landing, on June 6, 1944, is something I’ve read a lot about and seen in several movies.

Recently I read a new book, D-Day, by Antony Beevor — I heartily recommend it.

And we had planned to see Saving Private Ryan again, but didn’t get that done — but we will soon.

Will and I saw Arromanches, where some of the key events occurred, and then Omaha Beach — the most celebrated of the landing spots.

The beach is very broad — and it was incredible to stand there and imagine running up onto the shore, and trying to find cover from the shots raining down.

We then went to the American Cemetery — an awesome and impressive spot — with rows and rows of crosses.

Finally went went to Pointe du Hoc, where the American Rangers scaled the cliffs — an act of heroism that is almost beyond belief.

I strongly recommend that you do such a tour if you possibly can. We are changed because of this experience.

Then we drove back to Brussels and flew home — arriving safe and sound.

Will and I are already talking about the 2012 trip — lots of discussion and planning to come.

Stay tuned for more!

UNC Hospitals Achieves Magnet Status

Today we are celebrating an important achievement for UNC Hospitals. The American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program®, the largest nursing credentialing center in the country, awarded UNC Hospitals with Magnet designation for excellence in nursing services.

This designation honors organizations that meet stringent standards — placing UNC Hospitals among only 378 facilities in the world and only 6 percent of hospitals in the United States to receive this acknowledgment.

UNC Hospital’s Magnet status would not be possible without the dedication of our nurses, and entire staff, to provide superior quality care to all patients every day. It is also a result of our truly collaborative efforts during the application process. Our Magnet initiative committee worked together to compile and submit a 1,400-page report to ANCC reviewers, and to host a panel of ANCC evaluators.

To everyone who took part in this endeavor — thank you. Our success is a reality because of you and your desire to further UNC Hospitals’ mission to be a leader in providing excellent care. Congratulations!

Post election — where do we go from here?

A month ago we had a national election — and it brought about major changes in the political landscape, nationally and in North Carolina.

In our state the Republicans will control the House and the Senate in the General Assembly — for the first time in more than a century.

The new leaders are getting their teams in order, and getting organized for the important work ahead — within each chamber, between the chambers and with the Governor.

North Carolina’s state budget is in great difficulty, and they all have their work cut out for them.

As a private citizen and as a leader of a major state institution, I surely hope all our leaders are successful with this effort.

In Washington, where I am as I write this, change is afoot too.

The Republicans will soon control the House of Representatives, and their numbers are substantially expanded in the Senate.

The Nation’s House is not in order — as you can tell in a variety of ways. One clear metric is our huge annual budget deficits and the staggering accumulating national debt.

The plan that Erskine Bowles and Alan Simpson have laid out is bold and controversial — but I really like it. It gores everyone’s oxen somewhat — and moves us a long way toward fiscal responsibility.

We just have to relearn how to live within our means — as individuals and as a country.

But the days and weeks and months ahead will be difficult and challenging, for our elected officials and our senior appointed leaders.

I am in DC for a board meeting of the National Quality Forum, which I chair. Health Reform passed into law eight months ago — and the recent political changes will make the path toward implementation even more problematic. I continue to support overhaul of our Nation’s health care delivery and financing system.

Monday evening I had dinner with my friend Don Berwick, the CMS Administrator, and yesterday I visited at the White House with my friend Nancy-Ann DeParle, President Obama’s health reform advisor. They each are realistic about the issues ahead, but very committed to getting the important work done.

As CEO of UNC Health Care, the largest provider of uncompensated care in North Carolina, we really need to do all we can to help them get it done and done right.

There is a lot at stake in our country and our state right now — in health care and in our public life together. This is serious work, and it deserves our collective best efforts.

Stay tuned!

UNC Health Care Hosts HealthLeaders Rounds

Several weeks ago, UNC Health Care was honored to be the site of the most recent HealthLeaders Rounds event on women's health. Participants included our own Drs. Daniel Clarke-Pearson and Nancy Chescheir, Mary Anne Graf from Bon Secours Richmond and Sue Korth from Methodist Women's Hospital in Omaha. The half-day panel discussion was shared with a live audience of local health care professionals, and also streamed virtually to more than 100 health care organizations across the country.

I am proud that our organization is taking steps to foster collaboration between various partners, and pleased we are afforded opportunities to learn from one another. Without working together, better health care for women would be significantly harder to achieve. Although there may be changes in health care in the coming months and years, the way we advance the care we are able to provide will not change it will always be driven through coordination among providers, and continued progress in access, research and health education. These topics are what the panelists spent most of their time covering.

Women's health is particularly important, because making continued progress to keep women healthy throughout their various life stages is vital to ensuring the long-term health of our communities. And by its very nature, women's health care demands multi-disciplinary, coordinated care.

During the panel, we shared our collegial approach to advancing the care we provide to patients with the audience.

For example, over the past 10 years, the UNC Center for Maternal and Infant Health has supported multi-disciplinary care teams remotely and in-person and that trend continues to grow. As academic medical centers, we are able to benefit from our access to a multitude of specialty caregivers. Women's care teams can include care coordinators, genetic counselors, sonographers, and maternal-fetal medicine, general ob/gyn, neonatology, genetics, pediatric surgery, pediatric cardiology and pathology practitioners.

Women's health care at UNC has been leading the way for coordinated women's health care by working closely with public health departments throughout the state, especially to support mothers from pre-conception to birth. And we work closely with referring providers on complex cases. We are also continuing to develop infrastructure and resources such as technology and a site, called which gives providers resources for care to better support the discipline throughout the state. The UNC Center for Women's Health Research also works to advance women's health research, prevention and health education efforts.

I look forward to our continued work with our staff and health care leaders across the country as we work to provide patients with the best care possible.

For more information about our work with women's health, please visit he Department of Obstetrics & Gynecology's website, follow the department on Twitter, read its blog or visit its Facebook page.

Leadership Changes in the Med School

Because of several unrelated developments, we have the opportunity to reload the senior ranks of the UNC School of Medicine.

I welcome this — and see it as a chance for us to prepare ourselves and the institution for the next phase of our work together.

Last month, Etta Pisano left UNC to go to the Medical University of South Carolina, where she will become dean of the College of Medicine, July 1. We celebrate her accomplishments and all that she has given us. We wish her the best in this new endeavor.

This means we need to fill her position here — Vice Dean for Academic Affairs of the med school. Separately, she has also served as director of the NC TraCS Institute, which manages our NIH-CTSA grant. So we need to identify the right person to do that as well.

This spring we also launched searches for two other senior positions — Executive Associate Dean for Faculty Affairs and Faculty Development, which Gene Orringer has ably done for almost fifteen years, and Executive Associate Dean for Research, which Bill Marzluff has ably done for fifteen years. We are very grateful for their service and accomplishments, and they will continue to contribute as leaders among the faculty.

We posted these positions and yesterday the posting closed. I am in the process of interviewing people.

I am really grateful that a number of talented people have stepped forward and offered themselves for these important roles. That is not easy to do — and I thank them.

I am seeking wide input on these decisions — believing that we have a unique opportunity to position the School for success.

We want to continue our path of excellence and leadership — our aspiration is to be the leading public medical school and leading public academic medical center in America.

We want people who work well together as a team — but who each are strong and talented in their respective areas, not timid or quiet.

We want a diverse team of people — we have made progress in recent years in diversifying the School and the UNC Health Care System, but we have much more we can and ought to do in this area.

We have lots of challenges — but also lots of opportunities. I believe these new leadership decisions are major opportunities.

Stay tuned.

A few more photos

I’m sending a few more photos of our trip while we are waiting in the Brussels Airport.

This is of Will making bricks at the Dufatanye Co-op.

Will with the pitcher he made at the Co-op.

The entrance to the faculty of medicine (the med school) at the National University of Rwanda in Butare.


The rector of NUR (our chancellor's counterpart), Prof. Silas Lwakabamba


Bishop Nathan Gasatura, his wife, Florence, their son, Daniel, and Will and me, in their home


St. Paul's Cathedral, Butare


Godfrey Kalema, his wife, Diane, a student, Theonest (with the UNC hat I gave him!) and Will, near the Dufatanye Co-op


John, who drove us all over Rwanda, and Will ? in the Kigali Airport, just before we left


About to leave for home

This may be my last blog entry written from Rwanda. It has been a simply fabulous trip in every respect.

Will and I are the Hotel des Mille Collines, made famous by the film, Hotel Rwanda. It is a very nice upscale hotel. We stopped here because we are early for the airport, and we are using the WiFi connection here for a couple of hours.

For the past two days I have been in Butare, which is the home of the National University of Rwanda. It is a university town ? think the Chapel Hill of Rwanda.

It is also home for St. Paul's Cathedral, the main Anglican church in the diocese of Butare. It is the sister congregation for our church back in Chapel Hill.

I visited with Bishop Nathan Gasatura and his wife Florence ? whom I first met when they were visiting Chapel Hill about a year and a half ago. They are very warm and engaging people. He has long been a church and NGO leader, and she is a nurse. Florence got her masters in nursing in Scotland several years ago. When she was in Chapel Hill recently, she toured the North Carolina Cancer Hospital.

Florence took me around the medical school ? and I was also hosted by the vice dean. I had met the dean in Kigali last week. We saw the entire complex ? and I am quite impressed with what they do with limited resources.

We also visited the teaching hospital in Butare, which is known by its French acronym CHUB. It is about 500 beds ? and, again, I was very impressed with what they are doing. A major challenge for them is physician recruitment and retention, especially for specialists. For example, they told me there are no oncologists in the nation of Rwanda, and only a hand full of orthopedists, ophthalmologists, ENTs, etc.

Yesterday afternoon Will came back from his day at the Dufatanye Co-op, dirty, sweaty and tired, but very happy ? he has some great pictures that they took of him making bricks! He also made a clay pot ? like he learned to do in his ceramics class at Wingate University! He says they were fascinated with his making it.

Last evening we ate at Nathan and Florence's house ? it was a delicious meal of traditional Rwandese food. The dish I've grown to love is rice with what we would call English peas and carrots, with a sauce poured over it that looks like thin tomato soup. It is very tasty and filling.

I think I've lost a few pounds on this trip ? because I'm eating good food but not many snacks.

I really feel great.

Today I visited a bit with the leaders at St. Paul's Cathedral and then we started back to Kigali.

We stopped en route at Nyanza, to say thanks and farewell to Godfrey and Diane, his wife, at the Dufatanye Co-op. They gave us some gifts to take back, Rwandan crafts.

So … A few hours from now we hope to be on the plane headed home.

This has been a wonderful experience.

I will be able to post some pictures in a day or so.

Stay tuned.