Dr. Louis Sullivan

Dr. Louis Sullivan, former U.S. Secretary of Health and Human Services, encouraged delegates attending the National Grange convention in Reno to continue pressing to make health care more accessible for rural residents. In his Nov. 14th keynote speech he recognized the Grange’s role in advocating for improved medical care for America’s rural citizens.

“We need to increase our commitment to providing access to quality health care services to those living in rural settings,” he stressed. “If we care about the future of our communities, we need to make certain that access to physicians and the latest treatment options that are available in populated metropolitan areas are also available in America’s rural areas. As more people gain access to health care, and more people utilize health care services, let us pledge not to give in to short-term fixes, especially when they come at the cost of our long-term health.”

Dr. Sullivan likened our health care system to a symphony orchestra where the physician “leads with vigor, timing and expertise.” He confessed that our current medical system was “not in sync,” and that the resulting outcome is dissonant and dysfunctional – not all parts of the health care “orchestra” are playing their parts as they should in order to create a harmonious result.

He called for a return to our top priorities, correcting the dissonance and blending the collective intellect of the medical community for the best possible health outcome.

Dr. Sullivan pointed out several necessary reforms in order to make sure all patients receive the best possible treatment.

William A. Steel and Dr. Louis Sullivan looking at a copy of the National Grange Legislative Policy book.

“In today’s health care marketplace, many decisions are being made that are based on private studies with no public understanding of how the research was conducted,” he said. “In this day and age, that is unacceptable. We need to increase the openness and awareness of research on costs and quality-driven health outcomes. Doctors, patients and other interested parties should be directly involved in the undertaking and oversight of research and the evaluation of its findings.”

Research and decision-making must be open and public so as to guarantee the best outcome for the patient, he feels. “We all need to know how research is designed and how different components are weighed and valued as well as how the data is interpreted.”

Also, he stated that much research today has as its objective “the minimizing of current expenses, regardless of the cost to the society.” Often this research doesn’t reveal how conclusions are reached. “This isn’t right,” he said. “Organizations can’t do this behind closed doors and then expect us to adopt (their stated result) as the new standard. Unfortunately, this practice is common.”

A possible solution Dr. Sullivan advanced to the Grangers is a new federal agency that objectively evaluates the clinical effectiveness of medical treatments and pharmaceuticals.

Another essential component for proper medical care is effective communication – “an open dialogue between the patient and physician so that decisions can be made, based on unbiased research and clinical data,” Sullivan added. “Patients who share in their health care decisions show better outcomes and, ultimately, more knowledge about their treatment. Patients who are adequately informed are better prepared to participate in the decision-making process with their physician.”

He emphasized the importance of communicating health care information in clear and understandable terms, conveying information so the patient thoroughly understands and trusts the advice. In a press conference following his address, Dr. Sullivan confessed that “As we’ve developed more technology and therapies in health care, one of the mistakes we have made is to get away from that doctor-patient relationship.” The need to return to that is evident.

An aspect of communication that Sullivan stressed is the need to recognize that patients require unique care. “Race, age, health, literacy, socio-economic status, genetic factors, and genetic and geographic diversity make us all unique. Effective medical treatment delivers value to the patient based upon these and other individual considerations. One size does not fit all,” he said.

In answer to a question from a Granger from Colorado, Dr. Sullivan agreed that many areas of the country do not have physicians close by. However, these less-populated areas cannot support the wide array of health specialties that are available in the cities. Instead, he proposed systems that would help rural folks get to the urban facilities where these services are available.

Sullivan is on a campaign to initiate a national dialogue about reform of our health care delivery system and he stressed that rural citizens can be important participants in this debate. “The Grange can be effective in urging state legislators and members of Congress to put health care reform as one of their most important areas of concern,” he said.

Currently, there are too many people without health insurance. “We have a health care system with many strengths, but also with glaring deficiencies,” he said. “We have the most robust research enterprise of any nation for developing new drugs. We have a very strong medical education system. But we have a system where the costs are out of control.”

One important way to cut those costs is wider reliance upon preventive health care. “Having all of our citizens recognizing the responsibility they have in protecting their health and that of their families is extremely important,” he said. As examples he cited the proven benefits of diet and exercise for preventing heart attacks and strokes, and the value of immunizations to avoid illness and disease.

In the press conference Dr. Sullivan expanded on his vision of extending health care to more rural residents. Modern telecommunications advances, often called “telemedicine,” can allow doctor-patient interaction even when they are hundreds of miles apart.

“Telemedicine can enhance the quality of care for people living in rural areas,” he said. “It allows patients to have access to the medical professionals with the greatest experience with their particular issue. We need, first, to make sure our health professionals are trained and familiar with telemedicine. Second, we need to have each medical facility connected. Telemedicine not only increases the quality of care, but it makes care more immediate and less costly.”

Acknowledging that private money can go a long way toward getting telecommunications infrastructure into rural areas, Dr. Sullivan does see government having a role to play in seeing that this technology is widespread.

Dr. Sullivan was appointed U.S. Secretary of Health and Human Services by President George H.W. Bush. He is a graduate of Morehouse University in Atlanta and he received his medical education at the Boston University School of Medicine. He has taught there, at the Harvard University School of Medicine and served as the first president of Morehouse University School of Medicine.