EARLY DETECTION SCREENINGThe Benefits, Risks, and Debate

J. Jacques Carter, MD, MPHAssistant Professor of Medicine

Harvard Medical School

Beth Israel Deaconess Medical CenterBoston, Massachusetts

Premise:Providing the HIGHEST

possible STANDARD OF CARE to the communities and

patients we serve

Key ---

Being able to offer a BROAD RANGE of Clinical Services to meet the needs of your patients

QUALITY

VALUE

Keep in mind:

Quality and Value

Are NOT mutually

EXCLUSIVE

Avoid

“CHEAP”

“NO FRILLS”

is quite acceptable to most

Honestly assess your

capabilities

….And the scope of services you COULD offer with the right

ALLIANCE

For some, this GAP is a mere crack…..

...For Others, it may be a…..CHASM!!!

Important factors to consider when looking to develop an

alliance

ALLIANCEversus

AFFILIATION

Factors to consider in developing an alliance

• Location

• Cost of Services/Procedures

• Reciprocity

Look for partners with INNOVATIVE programs

• Innovations -- Often HARD to implement

• Even when implemented are often more DIFFICULT to diffuse throughout an organization.

Carter’s Story:• Interest in Public Health and Medicine

• Role as a Primary Care Internist in an Academic Practice

• Care of Patients from Bermuda and the Caribbean (Jamaica, Barbados, Trinidad, Virgin Islands

The HMFP - Family Hospital Corporation Relationship

Affiliation vs. Alliance

Reasons FHC wanted Relationships with Major

Medical Center

• Clinical Expertise

• Cutting edge Technology

• Training opportunities

Examples of Technologies

• Patientsite• Video Conferencing• On-line Continuing Medical Education

(CME)• Minimally Invasive Surgical Center• Joslin Vision Network (JVN)

Successes

• Emergency Medicine Training for Panama

• Liver Transplantation in Boston• Neonatal Cardiac Surgery• Emergency Medicine and ACLS

Training in Honduras• Visiting Professorships

Why Do Academic Medical Center develop Alliances?

• Access to New Markets• Expanding the scope of Clinical

Pathology for it Staff, Trainees• Name Branding• Mission-Driven

These Relationships are :

• NOT a piece of cake!• NOT short-term• Take lots of work and perseverance

if either party hopes to reap any sustained benefits

Lessons Learned

• Program must be Doctor-supported and Doctor-Driven at the local level

• Must Have reliable, efficient Doctor to Doctor Communication

• Educational Opportunities are an important component for the local Physicians

Wrap Up

• Seek a BROAD range of Clinical Services

• Look for QUALITY with VALUE• Aim for INNOVATIVE programs• Recognize the importance of

DOCTOR to DOCTOR Collaborations• REMEMBER: This is a Two-Way

Street