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Vital Signs

New program aims to "make an impact tomorrow"

By Jennifer Durgin

Eric Isselbacher, associate director of Massachusetts General Hospital's Heart Center, is one of the inaugural students.

For too long, U.S. health care has been plagued by a three-headed monster—high cost, variable quality, and unequal access. Nobody seems to know exactly how to kill the monster and achieve high-quality, affordable, accessible care. But a new Dartmouth degree program, for mid-career health-care professionals, is giving a sword to those trying to battle the beast.

This past summer, the inaugural class in the master's of health care delivery science program arrived on campus. The 47 enrollees have an average of 23 years of work experience and come from all sectors of the health-care industry. They include practicing physicians, health-insurance and hospital administrators, government officials, and even a state senator from Oklahoma.

Impact: "We're looking for people who already are in positions of leadership," Katy Milligan, the program's director, told Dartmouth's student newspaper. "They can make an impact tomorrow with the things they've learned today."

The 18-month program is run by Dartmouth College's Center for Health Care Delivery Science. It combines the strengths of the Dartmouth Institute for Health Policy and Clinical Practice with those of Dartmouth's Tuck School of Business. In all, 23 faculty members from DMS and Tuck are teaching the program's 12 six-week-long courses.

Just five months into the program, students are already seeing an effect. For example, one course exercise consisted of confidential evaluations of the students' leadership skills by their bosses, coworkers, peers, and clients. For Dr. Mark Moon, a physician at the Mayo Clinic in Jacksonville, Fla., the exercise was transformative.

"I found that I was generally viewed in a positive light by those working for me," Moon says, "but I tended to emote when frustrated more than I should. Under stressful situations, I now consciously think about how and when I have potentially difficult conversations with employees. Staff [now] describe me as calmer, generally more positive and constructive."

The Mayo Clinic's Moon has seen some very measurable results, too.

Moon has seen some very measurable results, too. "There is no question that the staff in any clinical microsystem take their behavioral cues from leaders within that system," he says. "My more positive approach has translated to like behavior among my staff." Patient satisfaction scores in his section jumped 35 percentage points in three months, and he's sure that "staff attitude was a major driver of this improvement."

Gain: Another student, Robin Lunge, is finding the program's range of topics helpful in her role as director of health-care reform for Vermont. The state is moving toward a single-payer system, and Lunge, an attorney, is coordinating the effort. The program "has allowed me to gain additional understanding and depth in areas like finance and clinical trials and clinical effectiveness," she says, helping her make sure "we're on the right track."

The fact that professionals as busy as Moon and Lunge can make time for the program is due to its hybrid format—brief but intense residential sessions at Dartmouth plus enhanced distance learning. Using web-based tools, students interact with classmates and faculty in real time and asynchronously. This flexibility is key to attracting students who are already leaders.

Hope: The hope is that the program's graduates, armed with new knowledge and expertise, will be an army of change agents within the health-care system. Perhaps one day soon, they will defeat the three-headed monster and achieve health care's holy grail—high-quality, affordable, accessible care.

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