Population Health – The Unfinished Journey Podcast with David Kindig: Episode 4, “The Lonely Years”

In nine podcasts, David Kindig MD, PhD, a population health thought leader, is interviewed by Sanne Magnan MD, PhD about Kindig’s 50-year population health scholarly and policy journey, including many stories, anecdotes, and takeaways. In our corresponding blog posts, we highlight some of the key moments and take-aways as a reminder for you to tune into previous and future podcasts. You can listen to the Episode 1: “Once Upon a Time,” here; Episode 2, “The Story Behind the Book” here; and Episode 3, “What is Population Health?” here.

Overview

In this episode, Dr. Kindig tells Sanne why he initially felt discouraged after his book was published, and he reveals what ultimately inspired him to continue his work—rather than give up and become a fly fishing guide in Montana.

At first, despite Dr. Kindig’s efforts, his book wasn’t generating much policy attention, which he says made for some lonely years. Finally, his article “A Pay-For-Population-Health Performance System” was published in 2006 after initially being rejected. The article asked key questions around mortality and health-related quality measures, incentive structures that could reward improvements, the importance of breaking silos, and resistance to resource reallocations.

Kindig explains why he felt his second-most-cited paper, “Understanding Population Health Terminology,” was necessary, and how he’s clarified key concepts, such as separating outcomes from the determinants of those outcomes, and the challenges of establishing the causal impact—per unit of resources expended—on population health outcomes.

Episode Highlights

1. Complex ideas take time to gain broad understanding.
2. Measures, financial incentives, and coordination across sectors are the key challenges for a pay-for-population-health model.
3. A key challenge is always balancing investments across determinants.
4. It’s important to have a common language and understanding across disciplines.

Listen to Episode 4 Here

Please join us next week for Episode #5, “Picking Up Steam,” as we continue exploring Fifty Years of Pursuing Population Health with Dave Kindig: The Unfinished Journey.

References

Kindig D. AHSR Presidential Speech: Beyond Health Services Research: Health Services Research 34:1 (April 1999, Part II) .pp 205-214.

Kindig D. 2006. A Pay-for-Population Health Performance System. JAMA 296:2611-2613

Kindig D. 2007. Understanding Population Health Terminology. Milbank Quarterly 85 (1): 139-161.