Issue link: http://viewer.e-digitaledition.com/i/273931
David Herman, MD: Rethinking the Emergency Department (ED) ED utilization patterns should guide the development of better models of care. E XCESSIVE RELIANCE ON the ED is generally viewed as a significant and costly problem. For that reason, healthcare organiza- tions across the country have tried to persuade patients to reserve the ED for emergencies. Those efforts have arguably met with limited success: Patients a nnua lly ma ke more than 120 million visits to EDs in the United States, the CDC notes. Many of those visits are for conditions not requiring emergency care. Dr. Herma n, President a nd CEO of Vida nt Hea lth, believes that by assuming patients are simply not get- ting the message about appropriate ED use, the healthcare system is missing something obvious. He points out that patients visit the ED because they feel it provides what they want most from health care — affordability, accessibil- ity, accommodation, availability and acceptability — better than a primary care practice. Rather than trying to curb ED use, he says, health systems should adapt the ED function to suit the clear patient preference for health care on demand. "We need to take a step back and listen to what people are telling us," Dr. Herman says. "Because behaviors are so hard to change, build the side- walks where the paths are worn." Gary Slutkin, MD: Elephants in the Room Cure Violence takes a public health approach to violence reduction. For m a ny A mer ic a n y out h s — particularly males — violence is the greatest threat to health and one of the most common causes of death. In some communities, violence is so pervasive that young people frequently view injury or death by violent crime as inevitable. Dr. Slutkin, Professor of Epidemiology a nd I nt er n a t ion a l He a lt h a t t he University of Illinois at Chicago School of Public Health, Founder and Executive Director of Cure Violence, says that by failing to acknowledge violence as a major health issue, the health sector is ignoring the elephant in the room, and missing an opportunity to effect positive social change. "Violence is actually a contagious disease," Dr. Slutkin says. "Treating violence as a contagious disease has already been demonstrated to have very powerful results." By reframing violence as a public hea lth epidemic, Dr. Slut k in posi- tions the health sector as the primary a gent in prevent ing t he spread of violent behaviors. He notes t h at v iolence spread s throughout communities in patterns resembling those of epidemics such as cholera, tuberculosis and AIDS. Individuals who are exposed to violence tend to respond in kind; as one violent act leads to another, violent behavior eventually becomes the norm. TRANSFORM 2013, A MULTIDISCIPLINARY SYMPOSIUM HOSTED BY THE MAYO CLINIC, UNITED A DIVERSE GROUP OF CLINICIANS, EXECUTIVES AND OTHER LEADERS TO REIMAGINE THE EXPERIENCE AND DELIVERY OF HEALTH CARE — AND PROPOSE INNOVATIVE SOLUTIONS TO SEEMINGLY INTRACTABLE PROBLEMS. READ ON FOR HIGHLIGHTS OF JUST A FEW OF THE THOUGHT-PROVOKING PRESENTATIONS AT THE ROCHESTER, MINN., EVENT. form 2013: Reimagining Health Care SPECI A L FE AT UR E By Jonelle Todd 2 4 | Minnesota MD NEWS ■ M D N E W S . CO M