The Shared Context: Kaiser Permanente and the Columbia-Bassett Program
Perm J 2016 Winter;20(1):91-94
Editor's note: This commentary provides context for the commencement address delivered on May 17, 2015 in Cooperstown, NY, at a ceremony honoring the medical school graduates of the Columbia-Bassett Program of Columbia University's College of Physician and Surgeons.
The Columbia-Bassett Program, begun in 2010, is a unique medical school program within Columbia University's College of Physicians and Surgeons. The 4-year experience of the students in this program occurs in 2 sites: 1) in New York city at the College of Physicians and Surgeons and its affiliated health care facilities, situated in an urban community of roughly 14 million people spread over several hundred square miles; and 2) in Cooperstown, NY, at the facilities of the Bassett Healthcare Network (Bassett), serving a rural community of approximately 200,000 people living across 5000 square miles. The 2 communities are a striking contrast to each other, as are the health care systems serving them. The College of Physicians and Surgeons operates in a traditional academic health center with a fee-for-service reimbursement model, whereas Bassett operates a network of geographically dispersed facilities with a salaried model that is similar in many respects to that of Kaiser Permanente (KP). In 1931, Bassett briefly established the third prepaid health plan in the US, insuring individuals and families for a set annual fee. Henry Kaiser, American industrialist and cofounder of KP, was born and raised in Sprout Brook, NY, just 19 miles from Cooperstown.
This marriage of longitudinal physician-patient relationships and system improvement aligns the Columbia-Bassett Program with the approach to health care at KP. Not surprisingly, the Columbia-Bassett students are deeply interested in the findings and implications of the KP/Centers for Disease Control and Prevention Adverse Childhood Experiences Study,3 which provides physicians with valuable information about the root causes of many common and costly health problems. Recent research by Whitaker and his colleagues4 showed that dispositional mindfulness conferred resilience to the impact of adverse childhood experiences on adult health. These findings aroused interest and optimism among the students at Columbia-Bassett. These students understand the relevance of past adversity for current health and are exploring ways to communicate compassionately with patients about these matters and to alter the health system to address them.5
The author(s) have no conflicts of interest to disclose. The views expressed in this article are those of the author and not necessarily of the author's institution.
1. Ogur B, Hirsh D, Krupat E, Bor D. The Harvard Medical School-Cambridge integrated clerkship: an innovative model of clinical education. Acad Med 2007;82(4):397-404. DOI: http://dx.doi.org/10.1097/ACM.0b013e31803338f0.