WHCC20 | Articles

Nancy W. Dickey, MD
Executive Director, A&M Rural & Community Health Institute
President Emeritus, Texas A&M Health Science Center


I am extraordinarily optimistic about the future of health care. If you look at the last 200 years, which is a relatively brief time in human history, the progress that we have made in health care is remarkable. We have eradicated smallpox, for example, and we are close to eradicating polio.

It's exciting to think about new discoveries in research. The results of a genetic swab test can tell a patient whether to take one blood pressure medication or another. Genomic research can also help us identify the best treatment options for patients with rare diseases. Ten years ago, we had to try the first treatment, and then wait, and then try the second treatment, and then wait, and then try the third treatment, and then wait - and as patients waited, they might not be getting better.

Spreading knowledge to those in need

I am optimistic that we will make continued progress. The next step is to spread that knowledge to the populations that are in need. A conversation I hear frequently focuses on the increasing distance between the poorest of the poor and the richest of the rich, whether it's across the globe or within an individual country.

This distance is representative of one of the biggest challenges of health care. In the United States, we invest a lot in research. We're looking for new cures, better interventions, and improved management of chronic disease so everyone will live longer. But there's a piece of me that wants to say, "Can we take a minute and assure we are utilizing everything we already know before we continue to push the boundaries of science?"

As I have worked with vulnerable populations in the U.S. and around the world, I have seen substantial information gaps across populations. We need to find ways to shorten the gap between the push for continued research and the application of what we already know. Sharing information such as the importance of using vaccines or cleaning drinking water can have a profound impact on public health.

Leading with awe and compassion

How can health care address this challenge? The most effective leaders I know have both awe and compassion - awe regarding the breadth and potential of health and health care, and compassion for those who are in need of it. In this case, it's awe at the groundbreaking scientific research that is happening, and compassion for sharing the results of that research to the entire population.

Addressing this challenge is like managing a chronic condition; it's not something that is going to have a fast solution. As leaders, we need to wake up, use our energy to move the needle a little bit, and then get out of bed tomorrow and do it again.

Our individual impact may seem small at a federal, state, or even local level. But if there are enough of us who are willing to take individual bites - whether it's providing care for patients or impacting regulatory changes - then pretty soon the entire piece is eaten.


Nancy W. Dickey, MD is the executive director of the Texas A&M Rural & Community Health Institute. She is also the president emeritus of the Texas A&M Health Science Center.



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