June 19, 2023
By Dr. David Blumenthal
In many ways, my entire career and personal experience have led toward joining the Aledade Team.
I practiced primary care for 35 years in Boston. I experienced the hamster wheel first hand. During my primary care training at Massachusetts General Hospital, I rotated through community health centers in Boston and rural practices in southern New Hampshire. Later, I functioned as a primary care gatekeeper during the managed care era and experienced the frustration of having the responsibility for managing specialty care without the authority.
As a researcher, I studied primary care practice. One of my projects demonstrated that primary care physicians (PCPs) confront a far greater range of problems and diagnoses than any other medical specialty: an intellectual and clinical challenge for which the system and their specialty colleagues give them scant credit.
As a commentator, I have written extensively on the promise and opportunity that private investors offer primary care, but also, how critical it is to protect and preserve the professionalism and values of service that PCPs bring every day to their work.
Source: The Commonwealth Fund, “Mirror, Mirror 2021: Reflecting Poorly Health Care in the U.S. Compared to Other High-Income Countries.”
As the CEO of a foundation that studied international health systems, I concluded that effective primary care is foundational to an efficient, high quality health system. One of the main reasons that virtually every industrialized country spends less and gets more from health care than the United States is that they have strong primary care. I have visited primary care centers in the United Kingdom that were remarkable for their ability to manage population health – not because the professionals there were any different than the primary care professionals in our own country, but because they actually had the resources they needed.
As a policymaker I have watched the repeated failures of policy interventions designed to improve the viability of primary care practice in the U.S. I share the hope that value-based care can enable PCPs to do well by doing the right thing for their patients, because I know firsthand the commitment these primary care professionals bring to their work every day. I distinctly remember my visits as a policymaker to community health centers throughout the U.S. on a variety of fact-finding missions where I observed the values and commitment that CHCs bring to serving the most vulnerable among us. It’s their work that is the foundation of my hope for the future – a hope that Aledade is now realizing every day.
On a more personal note, my daughter is a primary care internist who runs a small group practice in Somerville, Massachusetts. I hear of her challenges in recruiting new physicians and nurse practitioners and meeting the needs of her patients and the professionals she leads.
The most frequent request I get from non-medical friends and colleagues is to help them find a primary care physician. Even for a PCP who has worked in Boston for most of his life, and whose daughter is a PCP, I find this request challenging. No one is taking new patients.
As a patient, I have repeatedly lost my own PCP either to non-clinical administrative roles or to
concierge practice. Something has to change.
On a personal note, I know the Aledade leadership up close and personal. Farzad was my deputy at the Office of the National Coordinator when I served as head of that office. I saw his incredible leadership ability and commitment to the values of patient care and public service first-hand.
When he succeeded me as National Coordinator, I knew the Office was in good hands. I knew I could count on him to put patients first in all his work.
Farzad hired Mat Kendall, now Aledade’s president, to lead many of the operational programs at ONC. Mat brought to ONC the same upbeat, outgoing, capable leadership that he exhibits at Aledade. How can someone be so effective and so engaging at the same time?
As for Mandy Cohen, Aledade’s soon-departing Executive Vice President and CEO of Aledade Care Solutions, I was her attending when she was an intern on the Massachusetts General Hospital medical inpatient service. Now that is the way to get to know a young physician. Her career has been and continues to be extraordinary, and I know she will serve the nation well as director of the Centers for Disease Control and Prevention.
As I list these experiences, I have to shake my head in wonder at the ways my life has prepared me for this opportunity to work with Aledade on making primary care – and thus the U.S. health care system – better for patients and the professionals who care for them. I am deeply thankful for the privilege of working with them on this great quest.