Reflecting on the Report of the
Task Force on Medical Care
The charge to the Task Force on Medical Care for the MIT Community was ambitious and the work prodigious. It was an extremely thoughtful and thorough endeavor. I appreciate the opportunity to comment on the process, the report and the next steps as I see them. The last edition of the Faculty Newsletter (Vol. XVIII No. 2, November/December 2005) contained an excellent summary of the work of the Task Force and of the findings.
The process was a major time-consuming commitment for Task Force members (especially the Chair, Paul Joskow), the advisors, and those who supported this endeavor (especially, Janet Snover and Israel Ruiz). The meetings, discussions, and related activities were well organized, focused, and driven by the need to fully understand the communities served, the services offered, and the flow of funds that support the care of this special community. Over a year of very hard work resulted in the production of a very informative, helpful report that is, in my view, very supportive of the Medical Department and our model of care. The Task Force report also acknowledged and supported our increasing role in the health and wellness of the community. To have these activities appreciated and encouraged is very gratifying.
There are 42 recommendations enumerated in the ~27,500 word, 120-page report. Within the body of the report there are additional recommendations and suggestions for change or support for continued provision of services.
Many of the recommendations overlap with each other and several are aligned with efforts already underway within the Medical Department, within Human Resources, and within the Offices of Finance and Budget.
President Hockfield has asked Executive Vice President Sherwin Greenblatt to lead a process to review and assess the recommendations of the Task Force. Quoting President Hockfield’s e-mail to the community:
“The report of the task force (http://web.mit.edu/task-force/medical/) makes clear that high quality, accessible and affordable health care is a matter of great importance to the members of our community. While the task force makes a number of recommendations, it concludes that the basic model of health care and insurance that has been in place for several decades has served MIT very well.
I want to assure you that we intend to retain the present basic model of on-campus health care for our community, even as we examine the specific recommendations of the task force. As a next step I am asking Sherwin Greenblatt, our interim Executive Vice President, to undertake an analysis of the financial and operational implications of the report's recommendations.”
Sherwin has launched a coordinated approach to this charge from President Hockfield. He has convened a working group – Laura Avakian, Israel Ruiz, Patricia Brady, and me – to review and assess the recommendations, to consider implementation strategies, and to provide reports to the community on progress. Representation from the Medical Department, Human Resources, the Office of Finance, and Senior Administration will power a process that can deal with the widely ranging recommendations of the Task Force. The group has already met on four occasions. At the end of the first meeting we got to recommendation number six (and President Hockfield had already begun work on items one and three)! I could see that there was an enormous amount of work ahead. By the end of the fourth meeting the recommendations of the Task Force and the associated endeavors and projects had been sorted and assigned with timelines providing a measure of prioritization, coordination, efficiency, and structure.
Within the Medical Department, several initiatives are and have been in place to improve accessibility, to better understand our fiscal operations, and to expand our health and wellness activities; some of these activities anticipated the recommendations of the Task Force, and others will meet or exceed those recommendations. Importantly, the Task Force report was delivered in time to have significant impact on the generation of the Medical Department’s Fiscal Year 2007 budget request. As part of an ongoing process, the clinical and administrative staffs of the Medical Department have renewed their commitment to enhance the services we provide to everyone in our community.
Over the next several months, the operational and fiscal analyses needed to implement the recommendations will be well underway. My hope is that the work of the Task Force will evolve into an ongoing process, not simply a campaign to enhance some services or to repair identified issues. We need to establish a set of feedback loops that allow the Medical Department to meet the needs of the community with agility and timeliness. My wish is that as we analyze and work on the implementation of the recommendations of the Task Force we can, together with Senior Administration, integrate the roles of the Medical Management Board, the Medical Consumers’ Advisory Council, and the Student Health Advisory Council.
There are some questions I believe we need to address:
- Going forward, how can we be sure that the Medical Department remains in tune with the needs of our community?
- How will the Department’s evolving role as a community health center play out?
- How can we continue the work and the spirit of the Task Force process going forward so that feedback loops are chronically in place and in play?
Our model is uncommon and some might say anachronistic, but it is largely effective and appreciated. It is not gold-plated, nor is it a concierge practice.
Our role is to provide access to high-quality care while also working with the communities of MIT to enhance the wellness that is essential to our health as individuals and to the health of the entire MIT community. We clearly must also provide these services in an effective, efficient, accessible, and financially responsible fashion.
We are and should be held to a very high standard; a standard that supports a very special community – providing convenient, on-site, high-quality care that enables the work of the Institute to be carried out. In my 30 years of teaching on the faculty of HST and the over 13 years I have worked at the Medical Department, I have grown increasingly passionate about the importance of the work MIT does as a center of learning, research, innovation, and scholarship, and the work we do to keep the MIT community healthy and well.
I very much appreciate the work of the Task Force and all those who supported this major effort, all those who responded to the surveys, and all those who provided input. Thank you.