Collaboration Is Critical Julie Bolen, a senior scientist and epidemiologist at the CDC, is impressed by the unique approach taken by SPARC. First, they came to the CDC for funding and technical assistance once the program was up and running, which is not usually the case. Secondly, they have provided the CDC with compelling data on a local level that would have been difficult for the CDC to collect. "SPARC's initial surveys found that the majority of people over 40 were insured and had doctors, but they weren't receiving all of the preventive services they needed," Bolen explains. "This is not what you would have expected. One of SPARC's greatest strengths is from the start they have done what the people in the community wanted and needed, and they have included everyone you can think of who could have anything to do with the delivery of care to promote collaboration and efficient delivery of services." In a market economy, Shenson is quick to point out, collaborations are "unnatural acts." "But we're not pie in the sky about creating collaborations among health care agencies. You have to figure out ways to make the collaboration in your partner's self-interest. Our approach is to say to the people we work with, 'You know your community better than we do. Tell us what you need to do a better job. There are enough people who are not getting preventive services so that each of you can come out ahead.'" Shenson feels this approach is especially important in the area SPARC serves, with its mix of urban, semi-rural, and rural populations. A single system will not work for the diversity of people and agencies in the region, and the input of those already serving the area is crucial. Shenson is assisted in his work by Exeter alumnus John Pope '52, who joined the SPARC board three years ago. Pope owns a house in Columbia County, New York, just west of Great Barrington, and is retired from his job as editor-in-chief of the non-fiction books program at Reader's Digest. Pope writes and edits the SPARC newsletter and has been instrumental in setting up a hepatitis B immunization project at an alternative high school in Hudson for disadvantaged youth who have been expelled from the public schools. "These are kids from families who are very hard to reach," Pope says. "They are a high-risk population. The program is aimed at helping them survive adolescence. If we can add a public health aspect, that's great, because they are unlikely to get care otherwise." The beauty of SPARC rests in the simplicity of what the organization is trying to accomplish and the application of a basic but overlooked idea, that preventive care can make a difference to the overall health of a population. Shenson's achievements — and his plans for the future — are rooted in basic concepts like collaboration and avoiding duplication of services. He brought the same clear-sightedness to the founding of a U.S. chapter of Doctors of the World (DOW) in 1991. With a group of colleagues, he established an autonomous affiliate of the international humanitarian organization that has as its slogan: "Our doctors don't just come and mend the broken bones, they stay and mend the broken spirits." Shenson led a DOW project that took him to the U.S. Naval base in Guantanamo Bay, Cuba, to mediate a hunger strike by HIV-infected Haitian refugees in 1992. Currently he serves as vicechair of the organization and directs the Human Rights Clinic at the North Central Bronx Hospital, where he assists residents in documenting and treating torture survivors who are seeking political asylum in the United States. Man on a Mission As if all this were not enough, Shenson is also enrolled in a master's program in health care management at the Harvard School of Public Health. Somehow he manages to divide his energies between SPARC, his work with the Human Rights Clinic, and periodic intensive class residencies at Harvard, while still finding time for his wife, who is a psychiatrist, and their 4-year-old daughter. Shenson was motivated to enroll in the Harvard program by his ambitions for SPARC. "I think we've got a model here that's replicable," he explains. "I'd like to see it extended elsewhere and would like to take a leadership role." The skills Shenson is acquiring at Harvard will help him as he works to expand funding for SPARC and determines whether the SPARC model can be duplicated and sustained. Programs in Connecticut and in New York state have already modeled preventive care initiatives on SPARC, and the CDC is interested in continuing to work with Shenson on the development of a national model. SPARC was chosen as one of two projects to be highlighted at the national convention for the Healthy Communities Initiative in New Orleans last year. Shenson says, "Preventive medicine should be a community-wide responsibility. We have to convey this idea." He is poised not just to convey this idea but to translate it into reality. — Katherine K. Towler Katie Towler is a former George Bennett Fellow, freelance writer, and frequeent contributor to The Bulletin. |
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