UNF's Global Health-care Think Tank

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Nearly 20 percent of Americans under the age of 65 have no health insurance, according to The National Coalition on Health Care.  That amounted to 46 million Americans in 2007 — and experts anticipate the figure will rise to 53 million by the end of this year.  Coupled with skyrocketing health-care costs, insurance fraud and drastic shortages of physicians and nurses, the nation’s health-care system is in critical condition.

“The system’s been broken and it needs fixing,” said Dr. Yank Coble, director of UNF’s Center for Global Health and Medical Diplomacy and past president of both the American Medical Association and the World Medical Association.

Although Coble believes the United States could improve the situation by modeling its health-care system after the Swiss health system, getting everyone on the same page is the tough part. “It’s a very complicated topic,” he admits.

This is just one of many weighty health-care issues that regional, national and international medical providers and health-industry leaders have been addressing at UNF’s annual Caring Community Conferences since 2007.  The Center for Global Health and Medical Diplomacy organizes the conferences to provide a forum for local and regional health-care professionals “to get together and look at our issues and assets and develop recommendations that would most effectively enhance our individual and economic health of this region,” Coble said.

When the center was founded in February 2007 with the mission of promoting global understanding and collaborative action for improving health and medical care, UNF President John Delaney dubbed it a think tank, a place for dialogue where internationally known experts in the health-care field could address complex issues and involve the community.

“UNF is a neutral territory to allow a perfect forum to formulate strategies and address health-care concerns,” he said.

Just seven months later, the center hosted its inaugural Caring Community Conference to explore local and global health-care issues, assets and opportunities.

“The conference was built on the premise that Northeast Florida has enormous and highly effective health care, medical care and biomedical assets,” said Coble, a retired endocrinologist who practiced in Jacksonville for more than 35 years. “Through enhanced community understanding and collaborative action, Northeast Florida should be better able to address serious health issues in the community and enhance health care, medical care and bioscience industries.”

Leaders from various health-care organizations convene annually for the conferences, participating in relevant panel discussions and learning about global health-care trends and challenges from experts like Dr. Otmar Kloiber, secretary general of the World Medical Association.

“He [Kloiber] talks about how the United States is looked to as a role model around the world and he cautions us to get it right because even when we have it totally wrong, others have a tendency to want to emulate us,” said Dr. Pam Chally, dean of UNF’s Brooks College of Health.  “So what we do is very important.”

Two major outcomes of the first conference were the creation of regional recommendations in education, health and medical care, research and bioscience to enhance the individual and economic health of Northeast Florida; and the formation of a Healthcare and Bioscience Council comprised of volunteer leaders to address the recommendations, initiate collaborations and implement programs.

Council members eventually streamlined 12 regional recommendations to four primary goals: to enhance medical education and research in Jacksonville; foster the health-care and bioscience industry; improve health and patient care; and advance health information technology.

Each year conference participants hear from experts, receive updates from council workgroups and are presented with the results of the most recent Economic Impact Report, a collaborative effort including UNF’s Coggin College of Business and the Jacksonville Chamber of Commerce.  

The original report unearthed some surprising data, including the fact that one of every six employees in Jacksonville works in a job related to health care — and that the direct economic impact of the region’s health care, bioscience and related industries is $24 billion annually. This is very good news for the economy of Northeast Florida — and the future of health care in the region.

Another positive discovery is that progress is being made toward increasing the number of physicians in Northeast Florida. At the 2009 conference, council member Susan Black, a Federal Judge of the U.S. Court of Appeals for the 11th Circuit, said the key to a vibrant medical community in Jacksonville is to increase medical residency programs here — because 65 to 75 percent of medical residents typically stay in the cities where they complete their residencies or fellowships to practice medicine.  Black identified more than 500 active residency programs locally — a higher figure than the council originally anticipated — and the number of programs continues to grow with the continuous enhancement of medical education in Northeast Florida via its regional medical campuses and health-science centers.

“With regard to our academic science centers — UF/Shands and Mayo Clinic — it turns out we’re the fourth in the country in terms of size, medical-resident production and research going on,” Coble said.

“The whole point of the academic health center is to provide the very best clinical care to patients in the community, but it also represents an economic engine that drives the opportunity to do research and to succeed in education,” said David Guznick, senior vice president for health affairs at the University of Florida. “It’s really the health of the community that we are obligated to really impact.”

Coble couldn’t agree more — and he strongly supports collaborations with institutions like UF. “We were very eager from the beginning to get started with participation from all the institutions that wanted to be involved,” he explained.

In addition to its local and regional efforts, the UNF Center for Global Health and Medical Diplomacy participates in and collaborates with health-care and medical-care organizations around the globe, including the World Medical Association, the World Health Organization, the American Medical Association, the U.S. Department of Health and Human Services and the Institute of Medicine.  

The center is the first global-health organization to include a focus on medical diplomacy, with initiatives to focus on reducing the global burden of disease and disability, illuminate emerging threats to international health and enable health professionals around the world to better advocate for their patients and their profession.

As the center’s director, Coble travels internationally to speak on the center’s work in global health and medical diplomacy, striving to make connections and form partnerships, explore and address global concerns in health care, develop leadership and advocacy skills courses and inspire positive change worldwide.

“Yank is well thought of locally, nationally and internationally and he can use those connections to really identify the right people to bring in to help us with our issues,” Chally said.  

“The input of outsiders gives us perspective and helps us confirm or discard our perceptions,” Coble said. “The center finds itself primarily as the trusted neutral facilitator of these wide discussions that bring more fact and clarity to the very important issue of health and medical care.”

Still in its infancy, the center may not be able to instantly resolve disparities in health care here or abroad, but proactively addressing these concerns is a step in the right direction.

“Our seeking solutions through caring, ethics and science are fundamental to the mission of the center, just as they are to excellent health and medical care throughout the world,” Coble said. “Discussions and actions based on the best science available and the best expertise — as well as a caring approach — are critical to providing hope and trust.”