A version of this story by Kathleen McCoy appeared in the Anchorage Daily News on Aug. 31.
When is the last time you opened a medical bill, and smiled.
Instead, our complex, expensive health care system is more likely to induce something else—consumer anxiety, burdensome debt, uncovered citizens who end up in high-priced ERs.
Now imagine you’re teaching the next generation of doctors and nurses, health care technicians, social workers and policy makers. How would you help them think through, remake, adjust and improve this system, hopefully before it does us all in.
That’s Bill Hogan’s job. He is dean of UAA’s newly formed College of Health. The regents named the university in Anchorage “the health campus” for the entire UA system, charging it with raising an army of homegrown doctors, nurses and medical workers, as well as battling public health problems wherever they surface.
Alaska’s long history of substance abuse, clashing cultures, geographic sprawl and challenging Northern environment make that task daunting. Now, add newer complications like climate change and health care reform.
I visited Hogan and the associate dean, Susan Kaplan, to learn how the new college plans to tackle these persistent and developing problems, and why he was willing to take it on.
New to UAA, Hogan is a social worker. Mental illness, substance abuse and developmental disabilities are troubles he was trained to tend.
The CEO job for a mental health center in Wasilla brought him to Alaska. By 2003 he was director of the division of behavioral health for the state, then eventually deputy commissioner and commissioner for health and social services.
He says the state role did a good job prepping him for delivering Alaska’s next generation of health care workers.
“DHSS has the biggest budget in the state, $2.6 billion dollars. Their scope is large—public health, seniors, disabilities, behavioral health, children, juvenile justice. As commissioner, you have to have a systems perspective, but the way I made sense of it all was to keep the individual child or family in mind.”
Kaplan, who brings occupational therapy, research and teaching skills from a long career in Florida, said a key asset for UAA is Hogan’s deep familiarity with this place, its problems and its players.
“He knows absolutely everybody in the state,” she said. “That’s invaluable.”
The new college includes allied health, home to seven of the fastest growing job sectors in Alaska—everything from medical billing and coding to radiology techs to paramedics.
The college’s grow-your-own ambitions show up in the medical school (WWAMI), with eventual plans to add 10 more students for an annual cohort of 30. By 2015 medical students will have the option of studying all four years in Alaska instead of moving around the northwest.
“We think this will lead to more doctors staying here,” Hogan says.
UAA also hosts 13 rural sites—from Nome to Valdez—where nursing students work their labs with onsite instructors but attend lectures via videoconference. Instead of relying on itinerant traveling nurses to meet the state’s insatiable demand, this network aims to graduate them in the communities where they live.
The campus’s home in the U-Med District places it within a half-mile of most of the major health agencies and services—Providence, Alaska Regional, the Native medical center, the Tribal Health Consortium, Southcentral Foundation, CDC, API, Anchorage Neighborhood Health, Anchorage Community Mental Health, Cook Inlet Tribal Council and JBER.
That proximity is great for internships and fieldwork, but it’s also expected to open doors to jointly funded research. Already a new UMED District Research Alliance, championed by WWAMI director Jane Shelby, has gathered area leaders to discuss the state’s biggest health questions.
This comes on top of seed money the health college is offering local researchers, hoping to focus their work on top state priorities: interpersonal violence, childhood trauma, substance abuse, health care systems policy and environmental health.
Hogan has been monitoring the Affordable Care Act and what it will mean for Alaska. To date, Governor Sean Parnell has declined to set up an exchange or partner with any northwest state that has one, so the federal government will set up ours by October 1.
To help the public work with the new regime, United Way and the Alaska Native Tribal Health Consortium were awarded contracts to act as exchange “navigators.”
Advocates like this are in demand. Research shows that patients who have help with “the system” get better quicker. He and Kaplan are investigating a certification program for the new role.
“There’s a much greater focus on health outcomes,” Hogan said. “It’s how primary care clinics and practitioners will get paid in the future—did the patient actually get better?”
What a concept.