As Don Berwick steps down today from his position as head of the Centers for Medicare and Medicaid Services, it is time to offer him a simple and heartfelt "thank you." It takes a high degree of courage and selflessness to throw oneself into the political maelstrom that exists in Washington, DC. Don had no need to leave his comfortable and highly regarded position as head of the Institute for Healthcare Improvement. He did so because he thought he could make contributions to the development of sensible health care policy, in service to the people of this country. He carried out that job admirably, with honesty and good spirit, notwithstanding attacks on him personally that were inaccurate, mean, and uncalled for. A political climate that thrives on the demonization of such a person and his dedication to the public good is an indication of deep problems in our body politic. That a fine person would nonetheless choose to serve in that environment is an indication that there is still hope, a reservoir of people who are willing to be tapped to help our country. Bravo to Don!
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Paul, couldn’t agree more. As I read last night the thoughtful Health Affairs piece on Don I thought of my personal thanks for his mastery of the “aim” as well of the core value of respect; Don’s dogged persuit of what’s right in the name of, in partnership with, and out of respect for those he (and we) are privileged to serve. It’s not easy but it’s were we need to go out of respect and in service.
I’ve already sent along my “analog” thank you card but I think the greatest thanks each of us could give Don is by paying his work forward in the spirit of “if not me, who? If not now, when?”
Just imagine what could happen on Capitol Hill. Thanks Don and thanks Paul
http://healthaffairs.org/blog/2011/12/01/don-berwicks-legacy/
Well said! I am curious to see where Don will land.
In addition to thanks, I would also like to offer Dr. Berwick a sincere apology. I am truly sorry that we in healthcare were not capable and courageous enough to live up to the challenges of travelling with him toward improving our patients' lives. We have again allowed politics and selfish interest to win the day. We can only hope that, when we are ready, there will be another leader willing to take up the challenge. How many will die before then?
I'm also curious to hear what is next for Dr. Berwick. I greatly admire his work in the quality improvement realm. His focus on systems and all of the great lessons from Dr. W. Edwards Deming (reducing the reliance in merely drumming out "bad apples") has saved countless lives through his advocacy. His promotion of Lean and continuous improvement principles (going back to a 1989 NEJM article on Deming, "kaizen" (continuous improvement) and Toyota was prescient about trends we see today in healthcare. Thanks to Dr. Berwick for his service to our country and best wishes to him always.
Mark Graban
author, "Lean Hospitals"
Very well said. Although his tenure was cut short, I think one of the more important aspects of his legacy is the glimpse of truly visionary leadership that he gave those at CMS and elsewhere in the government, not usually known for this quality. Although it may not yet be evident, I bet he has moved the needle and the future will tilt toward where he was nudging us. Yes, thank you, Dr. Berwick. Well done.
nonlocal MD
Dear Don, from the Netherlands: we have a lot of respect for your courage to 'save' the US healthcare. Thanks to Don from CKO in Jeroen Bosch Hospital, and we wish him the best.
Kees Smulders
Sadly, to those of us who champion improving the quality of care, the Republican intransigence that has forced the apolitical Dr. Donald Berwick to step down as CMS Administrator speaks volumes about patient safety as a political priority. No one has done more to advance the cause of quality health care than the talented Dr. Berwick, and President Obama’s appointment of him lauded that fact.
It’s sad commentary indeed on the state of American politics today that political considerations trump patient safety. So long as the McConnels & Boehners of the world advocate for their special interest supporters, we middle class Americans will continue to receive far less value for our exorbitant expenditures on health care than will the rest of the developed world. And our less fortunate uninsured will be forced to seek universal health care where they’ve always found it – in our hospital E/Rs.
John Dalton, FHFMA
I shocked the hell out of someone once when they asked me if I was democrat or republican. I answered, "I don't believe in politics. I do believe in governance."
The beltway mindset seems to have almost completely lost touch with the governance part of government (as opposed to a venue for hyper-partisan issue ping-pong).
Dr. Berwick had two fatal flaws (for a political career) with regard to this current climate. The first was that he very demonstrably put governance above politics. The second was that he approached governance from a systems standpoint and not a 'balancing existing constituencies' perspective. While perhaps one of these might be able to be overlooked in a confirmation process, two was clearly beyond the capacities of the current machine.
I like to think that - at some other time - the US political system would have been better prepared to capitalize on the great skills and talents of Dr. Berwick.
Thank you Dr. Berwick, for your vision, your effort, and for putting a sustainable vision of quality healthcare at the forefront of all of your work.
Bring Back Berwick!
Bring Back Berwick!
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