WHCC20 | Interviews

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

What is the top challenge or obstacle facing health care today?
One of the things that people talk about a fair amount is the increasing distance between the poorest of the poor and the richest of the rich. In the United States, we invest quite a lot of money in research, looking for new cures and better interventions and improved chronic disease management, and yet as I work with vulnerable populations I see substantial gaps in using the proven knowledge that has already been proven but it is not yet routinely used or prescribed.

How are you preparing your organization for an uncertain future?
As an organization, we try to preserve a small portion of our time, about 5 percent to 10 percent, to examine the issues that are on the horizon and the things that we need to be ready for that we have not previously dealt with. Sometimes we do this on a program-by-program basis, and sometimes we do this with an umbrella perspective.

What is the most promising development in patient care that you have come across, and why?
I think it’s the progress that we have made, through a variety of steps, to increase the number of people who have some form of coverage. It’s not enough to know that there’s health care out there – you need a ticket to get in the door – but whether it’s Medicare, Medicaid, or co-ops, progress in the direction of increasing the number of people who have a ticket to get in the door is extraordinarily important.

What has you most optimistic about the future of health care?
If you look at the last 200 years, the progress that we have made in health care is remarkable. We have eradicated smallpox, and we are close to eradicating polio. My youngest grandchild just left the NICU after three-and-a-half weeks. I was pulling my hair out – but what would have happened to that child 40 years ago? I am extraordinarily optimistic about our capacity to improve people’s health and wellness. But if we do not make similar progress toward creating access, then the scientific progress will be relegated to only a portion of the population.

What’s the one piece of advice you would give to an aspiring health care leader?
The most effective leaders I know have maintained their perspective of awe and compassion – awe regarding the breadth and potential of health and health care, and compassion for those who are in need of it.

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