From the Chair

Jefferson and Change-Redux “Laws and institutions must go hand in hand with the progress of the human mind…” – Thomas Jefferson, July 12, 1810 Our American health care system is under pressure to change from many directions: the government, the media, the economists, and others. In a recent Surgical Grand Rounds, I discussed my Baker’s Dozen list of key topics: (1) health care spending is flattening out, (2) physicians and hospitals will be paid less for what they do, (3) payers are getting aggressive on cost and quality, (4) hospitals are targets for cost cuts, (5) cost reduction will entail standardization and elimination of variations, (6) waste control will be crucial, (7) current payment systems are mal-aligned with quality, health and wellness improvement, (8) Accountable Care Organizations exist, (9) the 5-50 rule reigns (the sickest 5% of the population consume 50% of the resources), (10) hospital systems will necessarily morph to Total Care systems, (11) physician elements are under transition, (12) physician integration (and leadership) will be crucial, (13) aspirational items for hospital corporate leaders have evolved. We have much to do. The mantras will no longer be – “business as usual” or “increase volume to cover expenses”. The focus needs to be on individual health, wellness and population health… We’re working toward a new paradigm – “Livewell Jefferson” – a cooperative venture of Thomas Jefferson University Hospital, Thomas Jefferson University, Jefferson Medical College, the Jefferson Women’s Board, Jefferson Health System and our communities: eliminate unhealthy cafeteria and vending choices, expand our non-smoking perimeter, increase wellness services, institute a maximum 30-minute meeting rule and mandate daily 30-minute on-the-job treadmill walking, freshen our stairways and label them “vertical exercise corridors”, track BMI quarterly, and work with the city to design and maintain safe, measured walking routes around our campus. We have much to do to effect change! To view Dr. Yeo’s recent mini-Grand Rounds lecture on this topic visit: www.jefferson.edu/surgerylecture