At the first Quality Leaders Forum (QLF) meeting of 2022, held virtually on April 14, Michelle Morse, MD, Chief Medical Officer at the New York City Department of Health and Mental Hygiene (DOHMH), told attendees that the COVID-19 crisis, as crushing as it’s been, has also created new opportunities to bridge public health and health care. “The most challenging thing we’ve all faced in our careers also created the space, momentum, and clarity to make changes in the quality and mission of health care.”
Dr. Morse was named the first Chief Medical Officer of the NYC DOHMH in February 2021, in the midst of the pandemic. In a virtual chat with UHF President Anthony Shih, MD, she said her main goals in her new role are to improve coordination between the NYC DOHMH and the many health institutions in New York City, and to address racism in medicine.
She is well-suited to her new role—Dr. Morse, an assistant professor at Harvard Medical School and an internal medicine hospitalist, is a co-founder of Social Medicine Consortium, a global coalition of 50 universities and organizations seeking to address the miseducation of health professionals on the root causes of illness.
Dr. Morse has been on a listening tour of hospitals and clinics throughout the city since her appointment and said the experience has been “eye-opening.” She learned of the barriers that health systems and public health have faced in the past in aligning their work. In addition, public health departments have been under-resourced for decades. “There are definitely cultural barriers and structural barriers,” she said.
However, she is encouraged by the newly appointed Commissioner of the New York State Department of Health, Mary T. Bassett, M.D., M.P.H., who, she says “really understands local public health and opportunities to get delivery systems on board. This is a new era of potential collaboration, especially for marginalized populations.”
Dr. Morse acknowledged that there are no easy fixes for health inequities. “We are fighting forces that have been around for generations. We are playing the long game.” She lamented that there has been “shockingly little progress” in ridding medicine of racism since the Institute of Medicine published Unequal Treatment: Confronting Racial and Ethnic Disparities in Medicine in 2003.
However, she noted that the city is making headway. For example, by focusing outreach efforts specifically on those neighborhoods with the lowest COVID-19 vaccination rates—primarily consisting of Black and Hispanic people—the DOHMH was able to raise the proportion of people vaccinated in those communities from the 20 percent range last summer to the 60 percent range now. “When we are intentional with resources, we can really make progress on health equity even in a six-to-eight-month horizon.”
She also pointed to DOHMH’s Coalition to End Racism in Clinical Algorithms, launched in November 2021 to end long-standing racial categories in clinical algorithms—tools used by clinicians to guide medical care decisions. Also called “race adjustments,” these algorithms often negatively affect the treatment and care of patients of color. For example, the “adjustment” factor for Black patients, in reference to kidney function, calculates Black kidney function levels to be healthier than white patients for the same measured result, sometimes delaying needed care.
QLF is a group of emerging and established quality leaders committed to improving the delivery of high-quality care in the greater New York area. Members are invited to four meetings that UHF hosts each year to network and discuss current issues in health care quality with nationally recognized quality leaders, and to share best practices.
There are about 70 members in this year’s Quality Leaders Forum, including graduates of the UHF/GNYHA Clinical Quality Fellowship Program and honorees from the UHF Tribute to Excellence in Health Care. The next meeting, scheduled for June 28, will feature guest speaker Tejal Gandhi, Chief Safety and Transformation Officer at Press Ganey. She will be joined in conversation by Peter Silver, MD, a QLF member and Senior Vice President and Chief Quality Officer of Northwell Health.
Past Forum summaries can be found here.
UHF is grateful to Elaine and David Gould, whose generosity supports the Quality Leaders Forum.