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Revisiting the Top 25: Georges Benjamin says apathy and political agendas are threatening to roll back progress on public health

By | October 6 th,  2016 | climate change, payers, population health, Top 25 Minority Executives in Healthcare, clean air, clean water, Flint, gun violence, lead, Modern Healthcare, providers, Blog, American Public Health Association, APHA, zika | Add A Comment

 

Classic content: One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Georges Benjamin has led the American Public Health Association as executive director since 2002, but he has never been busier or more vocal.

 

“I think we’re in an environment where the forces doing things that are opposed to the public’s health are more active, and so we’re more active,” he says.

 

The issues are numerous, from climate change to gun violence -– and a few things that didn’t used to be controversial at all.

 

“When you look at clean water and clean air, there’s an effort to push back on a lot of the things that public health has done over the years to make the environment safer for us and to make us healthier,” he adds. “We’re having to weigh in on things that, in our minds, were settled.”

 

Some threats he sees as audacious.

 

“The misinformation around the Affordable Care Act continues to be a concern and the lack of national recognition of the prevention aspects of the law are absolutely amazing,” Benjamin says.

 

Others, he says, are the result of apathy and inattention.

 

“We lost 40,000 public health workers across the country through the last recession and they haven’t been replaced,” he notes. “We’re losing programs because the funding has been cut. And then there’s public health preparedness. We spent a lot of money getting ourselves prepared after 9/11. Not only have there been reductions in funding for the preparedness of our nation to deal with biological attack, but our preparedness for everyday emergencies is not as good as it used to be.”

 

Benjamin's words may be finding an audience. On April 19, President Obama appointed Benjamin to the National Infrastructure Advisory Council.

 

The water crisis of Flint, Mich., is one example of the decay of public health, Benjamin says. So is a lack of funding to deal with mosquito-borne disease – not just zika, but dengue and chikungunya. Give him 10 minutes and he can tick off a variety of issues that need addressing, particularly in the corridors of Washington, D.C., where APHA is based. And, yes, he’d like to see hospitals and health systems get a little more vocal and visible on these issues too.

 

“The healthcare delivery side of the house needs to weigh in on a range of things that historically they have not weighed in on,” Benjamin says. “They always show up for the Medicaid hearing or the healthcare financing hearing. But we need them to show up at the hearing for the public health budget on lead, we need them to show up for the hearing on clean water. We need them to spend their healthcare dollars in a more objective way to address climate change.”

 

In many communities, hospitals are one of the biggest employers and have a large footprint. While some have made moves to address their carbon-dioxide emissions, it’s often done from a business perspective to get better energy rates, Benjamin says. “They also need to do it from a health perspective because it makes their community healthier. And they need to see it through that lens.”

 

If providers can become more public-health-conscious, he says, then they can begin to make a difference via population health.

 

“We have to make sure ‘population health’ isn’t just a buzzword and people don’t take what they’re already doing and rename it ‘population health,’ ” Benjamin says. “We want to make sure it doesn’t go the way of ‘managed care’ – the idea of the moment that, when it doesn’t achieve its goals because it wasn’t done right, people call it a failure.”

 

APHA works with payers as well, including partnerships with the UnitedHealth Foundation and the Aetna Foundation, and isn’t shy about criticizing insurers and providers alike. “When we think they’re off-track, we scream and yell and holler at them -– but we generally have the same goals around health and the well-being of our communities.”

 

With that community health in mind, Benjamin says he is glad to see more of his fellow clinicians stepping up to accept the mantle of leading administratively as well. “Having made decisions around patients gives you a unique perspective that you bring to the table. When you’re the COO or the CEO, the buck stops with you and you get to use those skills differently than you would if you were the medical director and in a more advisory role.”

 

But physician executives need to learn that leadership “is not giving people an order and expecting them to follow,” says Benjamin, himself a former military leader. “It’s setting goals, getting people aligned to go in a particular direction, and then giving them freedom.”

 

It’s a far different role than simply being a clinician, he says.

 

“One of the reasons I enjoyed being in an emergency position was that, most of the time, you saw results of your work right away. But in management, things are like a big battleship and they don’t turn very quickly. And so the gratification is much more delayed, much more subtle, and you’ve got to really understand what a win is.

 

“Sometimes a win is not what you would like. You have to accept progress and be comfortable with that. And then, realize you have to come back another day and try to move the boat a little further along.”

 

 

Georges Benjamin: Apathy, political agendas threaten progress in public health

By | April 22 nd,  2016 | climate change, payers, population health, Top 25 Minority Executives in Healthcare, clean air, clean water, Flint, gun violence, lead, Modern Healthcare, providers, Blog, American Public Health Association, APHA, zika | Add A Comment

 

One in a series of interviews with Modern Healthcare's Top 25 Minority Executives in Healthcare for 2016.

 

Georges Benjamin has led the American Public Health Association as executive director since 2002, but he has never been busier or more vocal.

 

“I think we’re in an environment where the forces doing things that are opposed to the public’s health are more active, and so we’re more active,” he says.

 

The issues are numerous, from climate change to gun violence -– and a few things that didn’t used to be controversial at all.

 

“When you look at clean water and clean air, there’s an effort to push back on a lot of the things that public health has done over the years to make the environment safer for us and to make us healthier,” he adds. “We’re having to weigh in on things that, in our minds, were settled.”

 

Some threats he sees as audacious.

 

“The misinformation around the Affordable Care Act continues to be a concern and the lack of national recognition of the prevention aspects of the law are absolutely amazing,” Benjamin says.

 

Others, he says, are the result of apathy and inattention.

 

“We lost 40,000 public health workers across the country through the last recession and they haven’t been replaced,” he notes. “We’re losing programs because the funding has been cut. And then there’s public health preparedness. We spent a lot of money getting ourselves prepared after 9/11. Not only have there been reductions in funding for the preparedness of our nation to deal with biological attack, but our preparedness for everyday emergencies is not as good as it used to be.”

 

Benjamin's words may be finding an audience. On April 19, President Obama appointed Benjamin to the National Infrastructure Advisory Council.

 

The water crisis of Flint, Mich., is one example of the decay of public health, Benjamin says. So is a lack of funding to deal with mosquito-borne disease – not just zika, but dengue and chikungunya. Give him 10 minutes and he can tick off a variety of issues that need addressing, particularly in the corridors of Washington, D.C., where APHA is based. And, yes, he’d like to see hospitals and health systems get a little more vocal and visible on these issues too.

 

“The healthcare delivery side of the house needs to weigh in on a range of things that historically they have not weighed in on,” Benjamin says. “They always show up for the Medicaid hearing or the healthcare financing hearing. But we need them to show up at the hearing for the public health budget on lead, we need them to show up for the hearing on clean water. We need them to spend their healthcare dollars in a more objective way to address climate change.”

 

In many communities, hospitals are one of the biggest employers and have a large footprint. While some have made moves to address their carbon-dioxide emissions, it’s often done from a business perspective to get better energy rates, Benjamin says. “They also need to do it from a health perspective because it makes their community healthier. And they need to see it through that lens.”

 

If providers can become more public-health-conscious, he says, then they can begin to make a difference via population health.

 

“We have to make sure ‘population health’ isn’t just a buzzword and people don’t take what they’re already doing and rename it ‘population health,’ ” Benjamin says. “We want to make sure it doesn’t go the way of ‘managed care’ – the idea of the moment that, when it doesn’t achieve its goals because it wasn’t done right, people call it a failure.”

 

APHA works with payers as well, including partnerships with the UnitedHealth Foundation and the Aetna Foundation, and isn’t shy about criticizing insurers and providers alike. “When we think they’re off-track, we scream and yell and holler at them -– but we generally have the same goals around health and the well-being of our communities.”

 

With that community health in mind, Benjamin says he is glad to see more of his fellow clinicians stepping up to accept the mantle of leading administratively as well. “Having made decisions around patients gives you a unique perspective that you bring to the table. When you’re the COO or the CEO, the buck stops with you and you get to use those skills differently than you would if you were the medical director and in a more advisory role.”

 

But physician executives need to learn that leadership “is not giving people an order and expecting them to follow,” says Benjamin, himself a former military leader. “It’s setting goals, getting people aligned to go in a particular direction, and then giving them freedom.”

 

It’s a far different role than simply being a clinician, he says.

 

“One of the reasons I enjoyed being in an emergency position was that, most of the time, you saw results of your work right away. But in management, things are like a big battleship and they don’t turn very quickly. And so the gratification is much more delayed, much more subtle, and you’ve got to really understand what a win is.

 

“Sometimes a win is not what you would like. You have to accept progress and be comfortable with that. And then, realize you have to come back another day and try to move the boat a little further along.”

 

 

Georges Benjamin advocates for a better health system

By | August 7 th,  2014 | Affordable Care Act, Furst Group, Georges Benjamin, Healthcare, politics, Top 25 Minority Executives in Healthcare, executive, health system, Modern Healthcare, Blog, diversity, leadership, public health, affirmative action, APHA | Add A Comment

 

One in a series of profiles of Modern Healthcare’s Top 25 Minority Executives in Healthcare (sponsored by Furst Group)

 

Georges Benjamin had a wonderful experience as a military physician, eventually rising to become chief of emergency medicine for Walter Reed Army Medical Center in Washington, D.C. But the diverse environment he experienced in those days bore little resemblance to what he encountered when he returned to life as a civilian.

 

“I was a beneficiary of a time when we had active affirmative action programs and had a significant number of minority students in my medical school classes as well as my residency,” he says. “There were many leaders who were part of a minority when I served in the military. When I went out to the private sector I noticed that I was far too often the only minority leader in the room. Thankfully, that’s begun to change.”

 

Today, as the executive director of the American Public Health Association, Benjamin is a strong advocate not only for the public health workers his organization represents, but also for diversity at every level of a company.
“In a country like ours, which has such a variety of experiences, the value in having a diverse workplace is that people bring in different ways of thinking,” he says. “We bring our experiences to the problem-solving process, and I think it helps create different solutions.”

 

In today’s political climate, he says, “we’re all kind of living in a type of echo chamber where we will only tune in and listen to people who agree with us. If you talk to yourself and answer your own questions, you’re less likely to get the most inclusive and innovative answers.”

 

Benjamin and the APHA are a non-partisan organization. They have both extolled and chastised Republicans and Democrats on issues that affect public health. But Benjamin says he’s seen a change in how politics can affect public health.

 


“Increasingly, politics is playing a role in healthcare, for better or for worse,” he says. “Many of my colleagues just want to follow the science, and we should. But public health practice is both an art and a science that often uses the policy process to make broad system change. That makes it political. It’s increasingly difficult to appeal just to science when people are camped out in their ideology, so we also have to convince them on the merits of the evidence when it does not line up with what they believe. I tell students we should not be afraid to engage in the political process and to be an advocate. Recognize also, that sometimes you have to compromise and that negotiation is the most powerful tool in your toolkit.”

 

Benjamin is a leader well-versed in the nuances of the D.C. beltway, and a student of its history. During a recent sabbatical at Hunter College, where he stayed in the former home of President Franklin D. Roosevelt, he spent time collaborating on a coffee-table book that compiled political cartoons on healthcare during the past 100 years. “The Quest for Health Reform: A Satirical History,” was released in 2013.

 

“The thing that struck me was really how the rhetoric against health reform has not changed all that much,” he says. “Some of these arguments against it have been around for a long time and have mostly proven to be false.”

 

If consensus around broad health reform was hard to achieve over the past century, Benjamin bore witness to at least a temporary change in the aftermath of the 9/11 attacks for a more narrow reform of the public health system. At that time, Benjamin was the secretary of health for Maryland and was thrust into the national spotlight as his state and the nation grappled with deadly anthrax-laced letters.

 

Funding and support for public health reform was increased, and APHA, which Benjamin joined in 2002, was supportive of the Bush administration’s national public health preparedness program. But when the recession hit a few years later, budget cuts forced many of these public health programs to be curtailed, Benjamin says.

 

“The potential was there to build our public-health defense in a robust and organized manner, but then the recession came, and resources were withdrawn,” he says. “We have our first Middle Eastern Respiratory Syndrome (MERS) cases here in the U.S. right now. We’re always going to have new diseases that emerge; having an adequate health and public health system to address them is our challenge.”

 

Public health, Benjamin says, “is a leadership exercise.” As such, APHA works with the Department of Health and Human Services on the report for the nation’s Leading Health indicators, and partners with UnitedHealth Foundation on America’s Health Rankings. It’s also been in the forefront of warning of health risks associated with climate change, and the need for sophisticated health information technology. “We are also strong supporters of the Affordable Care Act,” he says.

 

While Benjamin believes the U.S. healthcare system has made progress in reducing readmissions and hospital-acquired infections, his military discipline shines through when he talks about what it will take for the industry to get where it needs to be.

 

“What we’d like to do,” he says, “is get a health system that is predictable and raises the bar over time.”

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