NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, February 3, 2011

By Bill Taylor

In a recent issue of The New Yorker, Atul Gawande, the gifted writer and accomplished doctor, published yet another of his must-read accounts of the health-care crisis and the innovators trying to change things for the better. One of the organizations he highlighted was a physician practice in Atlantic City, N.J., that has “reinvented the idea of a primary-care clinic in almost every way.”

The Special Care Center does all kinds of things differently from other medical practices, including hiring full-time “health coaches” who work with the doctors but spend almost all of their time with the practice’s low-income patients, helping them manage chronic illnesses and improve their lifestyles.

How does the practice’s leader, Dr. Rushika Fernandopulle, find the right people for these unusual (but critical) jobs? “We recruit for attitude and train for skill,” Dr. Fernandopulle told Dr. Gawande. “We don’t recruit from health care. This kind of care requires a very different mind-set from usual care. For example, what is the answer for a patient who walks up to the front desk with a question? The answer is ’Yes.’ ’Can I see a doctor?’ ’Yes.’ ’Can I get help making my ultrasound appointment?’ ’Yes.’ Health care trains people to say no to patients.”