On February 20th, Dr. Jack Cochran, MD, Executive Director of the Permanente Federation spoke to the National Governors Association (NGA) in Washington, DC. I had the pleasure of watching him, along with best-selling author Dr. Atul Gawande, provide the nation’s governors with real solutions that many of them could implement; solutions that could move our nation toward important health care reform whether the Congress and the President figure out a national solution or not.

Dr. Cochran explained how the Kaiser Permanente model of integrated care, large multi-specialty group practice, fully integrated information technology solutions and a strong partnership with labor has created an increasingly successful model, the components of which could be adopted in communities all around the nation.

Governors have a more controlled field on which to experiment with innovation; governors have more direct relationships with providers, consumers, unions, physicians, and can quite directly incentivize health care delivery and payment reform on a community or statewide basis.

It was clear from the Q&A session after the presentations that Drs. Cochran and Gawande created a lot of energy.

I was particularly struck by a question asked by Governor Lingle of Hawaii. She asked Dr. Cochran if physician leadership skills were something that medical schools taught. She was clearly impressed with Dr. Cochran’s assertions that physicians must lead transformation. He said that it is easy for a physician to complain about the challenges that he/she faces in providing care: too much red tape, low payments, in essence feeling victimized by a broken system. Governor Lingle stated that medical schools need to teach leadership, which they currently do not.  In the meantime, physicians like Dr. Cochran can help provide the leadership to the nation’s current practitioners.

Dr. Cochran was quite declarative in stating that it was time for physicians to lead on health care reform, to stop sounding like a victim and act like a leader. He said that the patients deserved that.  He said that caring for individual patients is great work, but it could be made greater if physicians would speak out and demand  the changes that are attainable as shown by Kaiser Permanente and others so that all patients could have access to more affordable, more reliable high quality care.

Dr. Cochran will be a featured keynote speaker at our annual Coalition Delegate Conference on March 14, 2010.  It will be great for our 800 attendees to interact with him and work together to advance the innovation that he speaks of together. More and more front line physicians are becoming part of or supporting unit- based teams. 

Finding solutions for chronic conditions like diabetes, coronary disease, and osteoporosis are team sports. Surgical procedures, medicines, and diagnostic testing are very expensive and often necessary for chronic conditions. But, we are making huge improvements for patients in these and other chronic conditions by relying on the entire care team, working and learning together in unit- based teams.  These learnings are keeping Kaiser Permanente members out of the hospital by helping them to understand how to care for themselves with monitoring, education, and follow up. Improving outcomes for chronic conditions is one of the essential building blocks of transforming health care in the nation.  Our unit- based teams are helping to lead this effort.

We are very proud of Dr. Cochran’s championing of the Kaiser Permanente care model to the nation; and truly proud of his decisive and declarative assertion that partnership with labor is one of the necessary parts of the entire transformative journey for affordable high quality care for all.

Watch the National Governor's Association Meeting on C-Span.