In this first of a three-part video series, Managed Healthcare Executive® Managing Editor Peter Wehrwein recently interviewed Kulleni Gebreyes, M.D., director of Deloitte's new Health Equity Institute about her career, healthcare disparities and equity issues and the work of the institute.
The transcript below has been edited for length and clarity.
I actually grew up wanting to be a public health worker. And the first few years in college, I spent a lot of time both here in the US and, internationally, looking at public health systems, infrastructure development and economic development. And what I learned during that time as I would go someplace (where they had a public health program) and we would look around and there would be no clinicians in sight.
So I thought, wouldn't it be interesting if I actually became a clinician and I could do public health work as a clinician.
So went to medical school, and then practiced emergency medicine for little bit over 10 years, because it was such a portable skill that you could take anywhere. And as I was practicing in Baltimore and Washington, D.C, what I learned is I could fix individuals and help them while they were in pain — or having a stroke or having a heart attack — but you would see the same folks, that it was a revolving door.
I was looking upstream and thinking what else can we do, which led me to what I do now in professional services, which is look at problems that organizations or consumers or we as a society have and try to move to a solution that's as far upstream as possible, instead of just putting bandages on cuts, after the injury has already happened.
So I guess your move to Deloitte had to do with to looking at things in a systematic as a way, as opposed to a patient at a at a time.
Exactly. And I'll tell you, seeing people a patient at a time is extremely fulfilling and gratifying. But it's also extremely frustrating when you see the same person coming back in because they couldn't get their medication fulfilled or because they lived in poor housing and their housing was insecure
Quite frankly, the genesis of my transition (out of practice and to Deloitte) was that CMS was looking at pay-for-performance in the ’90s and 2000s.What I saw is healthcare organizations struggling with how do we actually solve for this in a way that puts the consumer at the center and allows us to also continue to be financially durable. I called CMS and had a conversation and joined a committee, and then a second committee, that's how I kind of got pulled out of doing clinical work into finding ways to solve these systematic issues.