Dr. Fine’s mission- delivery reform and splitting wood
Dr. Michael Fine is sticking around as the Director of the Department of Health. I chatted with him on the phone yesterday and here are the highlights of our conversation-
What changed his mind?
First, I had the opportunity to work here and work with a bunch of great people who really are pretty astounding. And then the other thing was the opportunity to begin to think about the delivery system.
What does he mean by the delivery system?
That means how we deliver health care services- hospitals, physicians and physician practices. We don’t have a health care system. We have, as I’m fond of saying, a wealth extraction system. And so, we need somebody charged with the responsibility to sit and think about what services we need, how they ought to be organized and how they ought to get to the people who need them.
And Dr. Fine thinks he’ll be able to do that?
I’m hoping. That’s kind of the thing that made it interesting to me.
Dr. Fine says he plans to do this by collecting data about Rhode Island’s health care system. How does it operate? How much waste exists? What can we do better in a way that “reduces costs but improves outcomes.”
Dr. Fine only recently considered staying at the Health Department. He says a few weeks ago, the Governor’s office asked if he would stick around-
Not very long ago. At a certain point they said, would you take a look at this, and we had some conversations and it led to this.
He says he was surprised when he got the offer- he’d been happy working as the medical director at the state prisons and expected to be there for a long time. For now, Dr. Fine will continue to split his time between the prisons and the department of health, while the state looks for his replacement. He says he can hold out for about another month or two. I asked him what his hours are like.
Let’s not discuss them. I was an intern once and they now have work rules for interns, but they apparently don’t have work rules for folks in state government.
Dr. Fine says he’s getting “just enough” sleep, but he’d like to eat better and exercise more.
Oh, I split wood. I bring in 15 cords of wood a year, so I’m in the woods every spare moment. Bringing down trees and bringing trees in and getting ready for long winters.
No plans so far to do that kind of exercising at the Department of Health. He says there’s really no good place for wood splitting over there.