Notes on community health, population health leadership, and building systems that last.
Inclusive growth is not a slogan. It is a design choice, made or missed at the level of a single neighborhood, a single clinic, a single hiring decision. In four decades of running health systems, I have watched well-funded regional strategies stall at the last mile because they were never built with the people closest […]
The biggest health gains I have seen in any market rarely came from a new piece of equipment. They came from a program built small enough to fit the neighborhood it served. A hospital-based diabetes education class that meets during business hours will reach the patients who already have the least trouble navigating the system. […]
Every year, healthcare and civic leaders are asked to headline a gala, sign a check, and move on to the next commitment. That kind of giving matters. But it is not the same as community giving, and treating the two as interchangeable is where a lot of well-intentioned philanthropy loses its impact. Community giving is […]
I am often asked, after a keynote on evidence-based delivery systems, some version of the same question: what can one person actually do? The honest answer is that most of the change I have seen in forty years of healthcare leadership did not start with a policy. It started with one person who showed up […]
Lasting change and one-time generosity are not the same thing, and healthcare organizations often confuse them. A single volunteer day generates goodwill. A sustained partnership generates outcomes. The distinction matters because population health is, at its core, a long game. The Triple Aim — better outcomes, better patient experience, lower cost — is not achieved […]
The healthcare turnarounds I am most proud of were rarely the ones with the biggest ribbon-cutting. They were the ones where, a year later, the change had become invisible — simply how the organization operated, because enough people had made it their own habit rather than a mandate from above. Everyday involvement is unglamorous by […]
Access is not the same as availability. A health system can have an open appointment slot and still be functionally inaccessible to the family that cannot get there, cannot afford to miss a shift to attend, or does not trust the institution offering it. Closing that gap is rarely something a hospital can do alone, […]
Most of the population health outcomes I am asked to help fix as a consultant were shaped years, sometimes decades, before the patient ever walked into a clinic. Early childhood is where the foundation for lifelong health is laid, and it is also one of the areas where public funding consistently falls short of what […]
Writing a check is the easiest form of community engagement, and it is also the one that keeps a donor furthest from understanding whether the money is actually working. I have sat on enough boards to know that the leaders who stay purely in the donor role tend to fund what sounds good. The ones […]
The smallest grants I have seen awarded in community health work — a few hundred to a few thousand dollars — have often produced a disproportionate share of the results. That is not an accident. It is a function of who gets to apply for them, how fast they move, and what they are trusted […]
