Anonymous donor gives $1 million to CECS
There are a million reasons why Dartmouth's Center for the Evaluative Clinical Sciences (CECS) shouldn't have succeeded. Its premise 16 years ago was counterintuitive and its findings since then have clashed with conventional wisdom. And that's just for starters.
Now there are a million new reasons why the center will continue to succeed in spite of all odds. CECS recently received an anonymous $1-million gift as part of the Transforming Medicine Campaign for DMS and DHMC.
"Transforming medicine," as it happens, could be CECS's mantra as well as the campaign's. The center's founding director, Dr. John Wennberg, has been making medicine rethink itself since the early 1970s, when he began to study variations in treatments and outcomes in Vermont. The variations, he discovered, were due not to differences in patients' conditions but to uncertainty among doctors about treatments' value. CECS, which was established in 1989, is now nationally and internationally recognized for its research on health outcomes, decision-making, and policy.
Outcomes: "CECS has led the nation and the world in improving our understanding of both determinants and outcomes of health-care practices," explains Dr. Albert Mulley, chief of general internal medicine at Massachusetts General Hospital and a longtime collaborator with many CECS faculty. "The work of CECS and the professionals it trains, today and in the future, offer our best chance of seeing to it that people get the care they need and no less—and the care they want and no more," adds Mulley. "And in a country that spends 15% of its gross domestic product on health care, nothing could be more important." As vice chair of the campaign executive committee and chair of its CECS working group, Mulley is among those charged with helping CECS find the resources it needs to expand its impact. A 1970 graduate of Dartmouth College, he is also a Dartmouth Trustee and a DMS Overseer.
Paradox: The CECS faculty includes clinicians, epidemiologists, economists, sociologists, cognitive psychologists, statisticians, management engineers, and health-services researchers. Their
research ranges from the widely quoted Dartmouth Atlas of Health Care to numerous studies showing that more health care often leads, paradoxically, to poorer health outcomes.
CECS's clinical outcomes group, for example, aims to reduce scientific uncertainty about the impact of medical care on patients' lives. The cover feature about cancer screening in the Summer Dartmouth Medicine is an example of such work.
The center also runs a number of educational programs, including master's and doctoral programs in the evaluative clinical sciences; an M.P.H. program; postdoctoral fellowships; two joint degree programs; a National Quality Scholars Program at the White River Junction VA Medical Center; and, in partnership with DHMC, the largest preventive medicine residency program in the U.S.
The recent gift, Mulley says, "has inspired those of us who are committed to securing the future of CECS to raise the funds necessary to ensure that CECS can continue its vital work—which has tremendous, positive implications for the health of populations, as well as individuals."
It hasn't yet been decided exactly how the $1 million will be used, though the possibilities include an endowment to support the work of senior CECS faculty and a discretionary account to provide current-use funds for emergent research opportunities.
Katharine Fisher Britton
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