In honor of Women’s History Month, Healthcare Finance News has asked some of the women leaders in the nation’s healthcare industry to talk about the role of women in healthcare. Contact HFN associate editor, Stephanie Bouchard, on Twitter @SBouchardHFN if you have suggestions for women that should be included in our series.
Today, we hear from Barbara McNeil, MD, PhD, a radiology professor at Harvard Medical School and at Boston’s Brigham and Women’s Hospital. She also is the founding head of the Department of Health Care Policy at Harvard Medical School. Much of McNeil’s research has focused on quality of care. Her recent work has included two studies for the Department of Veterans Affairs: one examining the quality of care of veterans with cardiac disease and the other the quality of care of veterans with cancer. The work McNeil and her colleagues did on the quality of care for veterans with cardiac disease led the VA to make changes in how care is provided to veterans with the disease.
Q: What role do women have as decision-makers/leaders in today's healthcare sector?
A: Women have risen to major roles in many of the large healthcare insurers or delivery systems. Angela Braly is one of the most notable in this category as CEO of Wellpoint, the country’s leading health benefits company. Sr. Carol Keehan is president and CEO of the Catholic Health Association (CHA), a trade association of hospitals, nursing homes, surgical centers and clinics. Other women serve as leaders of large corporations (e.g., Xerox, IBM) that buy health insurance for their employees. The National Business Group on Health is also headed by a woman (Helen Darling). These examples illustrate the enormous scope of influence women have had in the past two decades. Other women have led major philanthropic organizations that are interested in health (e.g., Commonwealth Fund, Robert Wood Johnson Foundation) or academic departments like mine (Department of Health Care Policy, Harvard Medical School).
Q: What do women bring to the table to shape the future of healthcare?
A: I don’t believe that gender should specifically influence how healthcare should evolve in the future. However, experiences of women who are leaders in industry, academics or the delivery of healthcare may be different from those of men in these same industries. Thus, their interests and areas they emphasize in debates about healthcare may cause changes in various aspects of the financing and delivery system to change. Examples here might include approaches to the care of the frail elderly (where daughters play a huge role), to the care of acute but not urgent issues with young children, to the scope of dental benefits for children, to issues of access of care for those insured (e.g., late hours, weekend hours), to use of different types of healthcare providers for those with chronic diseases, etc. These examples are meant to illustrate the kinds of problems that women are more likely to encounter than are men. Hence, their first-hand experiences as leaders in healthcare and as patients or consumers can provide a unique lens on which the system can or should be changed.
Q: What do you personally believe should be the path forward to better care and lower costs?
A: I think that the best way to improve care and lower cost is to ensure that only the right services are provided to patients – no overuse or underuse. Obtaining information on what is right is an enormous challenge, however. The scope of advances in the pharmaceutical and device world is staggering. Yet, it is very difficult to know which of these advances, alone or in combination, will work for which patient type. Results from randomized clinical trials that lead to FDA approval of these advances typically are based on very well defined patient types, and thus they do not necessarily apply to subgroups of patients not studied in the RCT. This is the dilemma. How do we get relevant data for all types of patients to whom new health services will be applied in a timely enough manner to prevent overuse and underuse? We do not yet have a good answer to this question.