A number of influences have drawn me to work on better systems of care for vulnerable populations. The important elements of the story are less about me and more about the huge shift in human health and disease during my lifetime. In the era around my birth in 1958, the scourges of measles and polio were being tamed in the developed world through vaccination and it became possible to contemplate the global eradication of smallpox. I grew up in a middle-class, residential suburb of NYC on Long Island and I remember standing in a long line at school to get the oral polio vaccine “sugar cube”. My playmates and I were happy and healthy, protected by the modern preventive marvel of vaccines.
My mom, an artist and art teacher, lovingly raised me by herself with support from extended family, friends, and neighbors. Throughout my education and training at public schools, college, medical school, and post-graduate medical training I have been incredibly blessed to have remarkable teachers, guides, and role models. As a young physician, my early career was significantly shaped by the AIDS epidemic. I was a med student at Columbia University in NYC as the epidemic was unfolding in the early 1980’s. By the time I completed my internal medicine residency in 1987, a time when there was no end to the ravages of the epidemic in sight, I decided to specialize in Infectious Disease and serve the HIV population. I provided care to HIV/AIDS patients at the remarkable institutions of Jacobi Hospital and Montefiore Hospital, in the Bronx, NY.
In caring for HIV/AIDS patients with an integrated team of incredible nurses, physicians, nurse practitioners, social workers, HIV tester/counselors, community health workers, addiction and behavioral health counselors, patient educators, and administrators, it became very clear that the health of this vulnerable population depended on much more than technically accurate and timely medical diagnoses and treatments. A vast array of barriers to and determinants of health exerted themselves outside of my 20-30 minute visits in the clinic; at home, within families, in communities, and in the hearts and minds of those affected. This recognition shifted my professional interest toward health system redesign – because of the huge opportunity to dramatically improve care to vulnerable populations. In preparing for this new direction, I obtained an MPH in Health System Management from the Columbia Univ. School of Public Health.
As highly effective anti-retroviral therapies were beginning to mercifully convert HIV infection from a death sentence into a livable, chronic disease in the late 1990’s, I realized that there were other vulnerable populations afflicted with chronic diseases and for whom our system of care is inadequately designed. It is now clear that the biggest challenges to human health and health care costs globally are non-communicable chronic illnesses. I am certain that we can design and implement better systems of care to prevent avoidable suffering and complications among such populations. After moving to southeast Pennsylvania, I had the chance to work at Health Partners Plans, the University of Pennsylvania Health System (Disease Management), and PennCARE (an 11 hospital consortium in eastern PA), in pursuit of such health system redesign opportunities. Risk bearing contracts with payers compelled many of these organizations to aggressively develop population management systems. But most of these contracts were soon terminated due to financial losses by health systems – temporarily extinguishing the burning platform to build better systems of care for population-based preventive services.
So, in 2000, an intrepid group of colleagues and I started Health Quality Partners (HQP) as a non-profit health care quality R&D organization to continue to advance this important work. By virtue of the team’s remarkable hard work and courage, a superb and unwavering all-volunteer Board, and multiple guardian angels along the way, the work of HQP, where I am honored to serve as President, CEO, and Medical Director continues productively today. HQP’s purpose is to design, test, and disseminate new, more effective models of Advanced Preventive Care for vulnerable populations in order to improve the quality and experience of health care for patients, their families, and health care providers. To learn more about the work at HQP, click on http://hqp.org.
I continue to work to become a more effective champion for this cause through formal education (I received a DrPH degree from the UNC Gillings School of Global Public Health in 2016) and by learning from a collaborative network of diverse, talented, and creative kindred spirits. Today as has been true for many years, my most unwavering source of support comes from my wife, Youngsook Choi, MD, and my fabulous kids, Borah, Bosook, and Luke.
A copy of my full resume is available using the link below: