David Buchanan, professor and chair of the department of health promotion and policy, recently gave the keynote address at the Organization Theory in Health Care Association (OTHC) annual conference held June 6-8 at the Johns Hopkins University campus in Baltimore.
The OTHC annual meeting brings together individuals interested in organizational research in health care to provide a forum for more extensive interaction and an opportunity to network.
Buchanan's keynote address, “Tall Tales in Accountable Care: The Moral and Political Challenges of Shared Responsibility for Health,” explored recent developments in the field of public health ethics for insights into the moral and political challenges of shared responsibility for health. Public health ethics refers to a shift in the framework for ethical analyses from concerns about the individual, to the rights of, and potential harms to, the population as a whole.
His presentation argued that the key to protecting and promoting health is to create or strengthen the institutional infrastructure of moral responsibility for health. Accountable care organizations must transform their self-understanding from a service delivery model to one that recognizes their mutual interdependency with their patient population, fostering a culture of mutual respect and accepting responsibility for mobilizing communities to act in solidarity to redress the social determinants of health.
As examples, he highlighted the potential roles of community advisory councils, patient advisory boards in patient-centered medical homes, community coalitions, municipal or county health commissions, and community health workers in fostering trust, mutual respect, responsibility and accountability. In the new social contract, he stated, the challenges of health administration must go beyond optimizing the trade-offs among cost, quality and access, to include outreach and engagement with communities.
Buchanan has spent more than 35 years in the field of public health. His primary research interests include public health ethics, promoting social justice, community-based participatory research, program evaluation, and international health.