The Tennessean | November 24, 2014

By Bill Frist

In traveling the country I love to brag on Nashville as the "Silicon Valley" of health services. And that's not an affectionate epithet — it's true.

The Nashville health-care industry contributes $30 billion locally and $70 billion globally. With this amount of health-care dollars in Nashville, and with Nashville as a rising "it" city, one would expect to see a reflection in the health of Nashville. But this is simply not the case.

Currently, Tennessee holds the ignoble distinction of being one of the unhealthiest states in the union: 42nd out of 50. And Nashville/Davidson County specifically ranks 13th out of Tennessee's 95 counties, according to the Robert Wood Johnson Foundation Healthy County Rankings.

Davidson County is also not competing with our peer cities. Compared with Austin, Texas; Charlotte, North Carolina; Cincinnati, Ohio; and Raleigh-Durham, North Carolina, Nashville ranks fourth among the five, according to researchers at the University of Wisconsin. Specifically, Nashville has the worst rates of obesity, children living in poverty, children living in single-parent homes, premature death, injury deaths and violent crime of all five cities.

Poor health carries a cost, and the price of inaction over the next decade will cost us at least $10 billion.

We absolutely have to do something about this.

In taking a closer look at the $70 billion in health-care dollars coming out of Nashville, we see that it comes from the work product of more than 250 health-care companies operating in Nashville and working on a multistate, national and international basis. Nashville is also home to more than 300 additional professional service firms (e.g. accounting, architecture, finance, legal) working in the "peri health care" space. Of these corporations, more than 260 of them are members of the Nashville Health Care Council, which is also something unique. This nonprofit organization holds together a coalition of the most powerful names in health care.

We are sitting on a powerhouse of health-care resources and dollars. So how did this happen to us?

We know that health care does not equal health, and 80 percent of how healthy we are depends on social determinants like local environment, education, diet and culture. For example, 72 percent of Davidson County Metro public schoolchildren suffer from economic disadvantages. We may be succeeding in these large business arenas, but the well-being of our population is not following.

If we consider actual health-care dollars spent on avoidable illness and loss of productivity of our workforce — either because they are sick or are caring for an ill loved one — the price of an unhealthy community over the next decade will cost us at least $10 billion, and maybe as much as $20 billion. It will be more expensive to live and raise families here, and more expensive for employers to build here or even continue to stay here. Inaction will result in lost jobs over time, a stagnation of our economic market, rising unemployment and a rising cost of health care for our population.

If we want to build a thriving and successful city and state, this has to change, because the health of our workforce and citizenry are paramount to the success of the region.

The good news is there is something we can do.

Already in Nashville there are public health champions doing incredible work every day. But our city is large and our problems complicated. No one organization working alone or even with a few others is capable of the scale of change we need to reset the trajectory of our city. But together we can do this work. We must organize as a citywide collaborative, leveraging the relationships we already have and the dollars we know are here. This way we can attack the problems from multiple angles, focus resources on the neediest areas and, in making these changes, save the city millions of dollars over the next decade.

In my opinion, this is the most important thing we can do for our city and our state right now and for the next 10 years. If we truly want to ensure Nashville stays an "it" city for years to come, and more importantly remains the place we all love and want to raise our families, we have no choice.

William H. Frist, M.D is a nationally acclaimed heart and lung transplant surgeon, former U.S. Senate majority leader, and chairman of the executive board of the health service private equity firm Cressey & Company.

In my third week at Karapitiya Hospital I was introduced to Dr. Kumara, senior lecturer in Surgery. Participating in various surgical cases was what I was most looking forward to on my rotation in Sri Lanka. Walking into the OT I noticed it was quite a different set up from the operating rooms back in the states. Patients were lined up on a bench right outside of the open theater doors with their medical chart in hand.
Last month I sat on a panel hosted by the Center for Strategic and International Studies (CSIS), the Vanderbilt Institute for Global Health, and Hope Through Healing Hands. I want to share some notes from the discussion.
After a long journey to the other side of the globe, I was finally in Sri Lanka. It was 1:00 am when I landed then I arrived at my lodging at 4:00am. I had 4 hours to sleep and be ready to work! When I woke up to monkeys howling and playing in the trees 20 feet away, I knew I would like this place.
I had plenty of time to contemplate all that I had seen during 12 hours of travel back home from a medical mission trip to Georgetown, Guyana. I had just spent three weeks working in the Accident & Emergency (A&E) department at Georgetown Public Hospital and using my training as an Emergency Medicine resident in the United States to help teach new ER doctors core material such as EKG reading, airway management, and the approach to shortness of breath and chest pain. I had not realized when I arrived how much of my time would be dedicated to sitting in the metaphorical trenches and caring directly for patients coming to the A&E. I was prepared for a foreign experience in a distant land, but instead I found myself right in my element.
As I was packing for my first international medical trip to Guyana, South America, my wandering mind conjured image after image of third-world medicine based on popular notions and dramatic stories I have heard over the years. I imagined a row of soiled cots where emaciated children without IV access spent their final hours. I pictured a sweltering tent full of tuberculosis patients collectively coughing up blood; or a bathroom-sized emergency department packed with fever-stricken, jaundiced, indigenous peoples dying of AIDS, malaria, and other ailments while overwhelmed healthcare workers looked the other way out of emotional self-preservation because they had nothing to offer. As described to me by some physicians who had been there in recent years, some of these were features specific to the hospital I was heading to in the capital city of Georgetown.

I am delighted to tell you how antiquated and cynical my preconceived notions had been.
by Senator Bill Frist, MD
November 12, 2014
FoxNews

When crisis strikes, the world looks to the United States for leadership. And that holds true for public health emergencies.

As the Ebola epidemic takes its toll in West Africa, we are witnessing our exceptional national character in action.

Thousands of Americans — civilian, military and private citizens — are selflessly deploying to the front lines in Liberia, Guinea and Sierra Leone. They are working to halt the virus’ spread, save lives and keep us safe at home. Unsurprisingly, no country is doing more; this is the spirit, the can-do ethos that sets our country apart and makes us the indispensable nation.

Even while the virus rages on, we are seeing glimmers of hope. In Liberia, where the U.S. response has been concentrated, some counties have experienced fewer cases, just as the transmission rate appears to be slowing. But now is not the time for complacency; we saw similarly hopeful signs earlier this year, only to realize they were illusory when the virus roared back, ultimately invading Liberia’s largest city and capital, Monrovia. All the while, Sierra Leone and Guinea today remain in the throes of the outbreak.

That is why it is critically important for the United States to remain on offense. To this end, the Obama administration last week requested $6.2 billion in emergency funding from Congress for the Ebola response.

This request supports what we know we must do to counter this disease: tackle it on the front lines, fortify our domestic health infrastructure, pursue vaccines and therapeutics and improve our capacity for rapid diagnostic testing, among other key steps.

Some of these funds would be spent at home, while part would go toward the international response. But to be clear, every single dollar would help protect the American people from this threat, which must remain the priority.

Some have urged for the imposition of a travel ban to protect against additional Ebola cases reaching our shores. As a doctor, however, I know that our strategy must be guided by science. And as a former U.S. senator, I strongly believe we must not institute policies chock full of unintended consequences. A travel ban would run afoul of both principles.

As a practical matter, there are no direct flights between the United States and West Africa. And approximately two-thirds of those traveling from the region to the United States are U.S. citizens or legal permanent residents. Impeding their access to this country — their country — would upend the Constitution in the name of fortifying against a threat that has claimed exactly, though sadly, one life on U.S. soil.

Experience also tells us that a travel ban would make us only more vulnerable. Travelers from the region, regardless of nationality, are subject to stringent screening protocols in West Africa, at many transit points in Europe and again upon landing in the United States. Any ban would incentivize would-be travelers to mask their point of origin, take irregular travel routes and evade the robust screening measures now in place.

The Obama administration has made this argument, but this is not a partisan finding. The administration of George W. Bush — during whose time in office I served as the Republican Senate majority leader — also deemed travel bans to be ineffective in the face of communicable disease. This is about sound science and smart policy, not politics.

All the while, we know the most effective way to protect the American people is to extinguish this fire at its source. The U.S. military is playing a major role in doing so, but the U.S. and international response must appropriately remain civilian-led.

Since the first Ebola cases were reported last spring, hundreds of American health care workers have heeded the call to serve in West Africa. And we will need many more to follow in their footsteps in order to control this epidemic.

I’ve spent a lot of time over the years personally delivering medical and surgical care throughout Africa. So I agree with President Obama when he commends those doing what he termed “God’s work” in West Africa. To be sure, we owe them our collective gratitude. But we also must not deny them the support and backing they need to fulfill their mission, to protect the American people and to keep themselves safe.

The axiom holds true that we must isolate Ebola, not countries. And the dedicated and brave Americans who serve on the front lines will be key to helping us do so.

William "Bill" H. Frist, M.D. is an American physician, businessman, a former U.S. senator from Tennessee and the former Republican majority leader in the U.S. He is the chairman of global health non-profit Hope Through Healing Hands.
H. would probably be at the top of her class no matter where she went to medical school. Like most of the Ecuadorian medical students I have had the privilege of working with she is curious, dedicated, and focused. She attends a prestigious medical school and has had the opportunity to complete clinical rotations at some of the largest hospitals in Cuenca and Quito. Her dream is to study internal medicine.

by Jen Todd, [email protected]

November 9, 2014

Doctors, professors and former Senate Majority Leader Bill Frist invite the public to discuss the base of worldwide fear: Ebola.

“Ebola is a modern plague, which sorely tests U.S. leadership at multiple points,” said J. Stephen Morrison of the Center for Strategic and International Studies in a statement. “It requires grappling with considerable unknowns, and preserving the confidence, trust and support of the American people.”

The two along with William Schaffner, professor of Preventive Medicine in the Department of Health Policy at Vanderbilt University School of Medicine, and Sten H. Vermund, director of the Vanderbilt Institute for Global Health, will begin the conversation, addressing four points.

These subjects are: the U.S. approach to cases entering the United States, the mobilization in Liberia, the growth of the epidemic in West Africa and how to stop transmission, and efforts to develop new vaccines and treatments.

Then, Muktar Aliyu, associate director for research for the Vanderbilt Institute for Global Health, and James E. Crowe, Jr., director of the Vanderbilt Vaccine Center, will jump in to consider what changes need to be made in the U.S. approaches, both short and long-term.

The free event is open to the public and begins at 10 a.m. Nov. 21 at Vanderbilt University Medical Center, Light Hall Room 208, 2215 Garland Ave.

Valantina is the granddaughter of my host family in Riobamaba.  The family is middle class and well educated, both parents having attended university.  As is common in Ecuador, Valantina’s parents started having children very young and continue living with their parents.  Before the recent death of my host mother’s mother, four generations had lived in the house.  Valantina is 9 months old and the delight of the entire family.  As you will note in the pictures she is generally healthy and adorable.  There are some things that her family does that help her grow and stay healthy.  Though her mother is in college full time, Valantina has never received formula.  Her mother frequently breastfeeds at the table or in public places.  This is common practice in this provincial capital and during the Easter parade, there were women openly feeding their children as they marched through downtown, an unlikely sight in the U.S.  After I moved to Cuenca I noticed that more babies were drinking formula from bottles.  Multiple people explained that this as a consequence of wealth.  Cuenca is more affluent then Riobamba and formula is considered proof of economic security, an unhealthy trend.  I was fascinated by these changes because they seemed opposite to what I have observed in the U.S. where it is often well educated, more privileged women who tend to have the control over their lives that allows them to breastfeed. 

Subscribe to our newsletter to recieve the latest updates.