Network News Excerpts
(EXCERPTS TAKEN FROM THE WINTER 1997-98
EDITION OF THE NETWORK NEWS)
From the Director
By Mort Wasserman, MD, MPH
Retreat '98
In early February, the PROS Steering Committee held a retreat - the second
in the twelve-year history of the network. Why does the PROS Steering Committee,
which already meets twice a year, need a retreat? The committee needs a retreat
because regular steering committee meet-ing agendas are so packed with specific
discussion items that there is rarely time to reflect on more global network
issues.
The first PROS Steering Committee retreat was held in 1994. At that time,
PROS already had been operating for eight years and had embarked on many research
projects, but still lacked a mission statement and clearly established goals
and objectives. That retreat proved very useful to the committee and PROS
staff, clarifying the PROS mission and setting standards against which to
measure network performance.
Briefly stated, the objectives of the second Steering Committee retreat were
(1) to review where PROS has been; (2) to assess how PROS is doing; and (3)
to imagine where PROS might go in the immediate, and not-so-immediate future.
In order to help stimulate some dif-ferent perspectives on PROS and its efforts,
we deliberately framed many of the retreat discus-sions in the language of
the business world - eg, seeking to define PROS products (current and future)
and PROS customers.
A comprehensive summary of the retreat is being completed and will be circulated,
but some of the major issues bear mentioning at this point. With respect
to achieving the PROS mission, "to improve the health care of children
by conducting national collaborative practice-based research addressing
primary care issues," the consensus was that PROS has been very successful
in generating new knowledge, but has not focused on translating that
knowledge into improved care.
From The Steering Committee Chair
By Gordon Glade, MD
Since my first PROS chapter coordinators meeting about 12 years ago, I have
enjoyed listening to bright academicians talk about proposed research projects
in office practices so that I could point out to them the flaws of their study
designs. After all as a full-time general pediatrician I know best what questions
NOT to ask about primary care and also how NOT to run studies in my busy office.
With some discomfort I served on the PROS Steering Committee for a few years
and missed the joy of criticizing what came my way in the general meetings.
Instead I felt this new responsibility to share ownership for projects. Wisely
the designers of the PROS rules of governance limited the terms of steering
committee members, and for the past few years I have been back where I am
happiest.
In the meantime, Barbara Starfield and Mort Wasserman coaxed me into involvement
with the Referrals study. That involvement made me look in the mirror at my
own past behavior. It showed me the challenges of working with a broad spectrum
of intelligent practitioners on a project. They better expressed the questions
that needed to be asked and the mechanics of running this study in their offices.
I was surprised by something else. Throughout the dozen or so PROS studies
that I have done in my office, I have found my curiosity tweaked to the point
that new questions are coming much faster than the answers to the study questions.
I have altered my practice style significantly, not only because I learned
that I could do things better (like track immunizations), but also because
some issues were more constantly on my mind. For example, during the Child
Behavior Study, after asking myself 70 times in a row whether or not a mental
health problem was present during an encounter with a patient, I developed
a new habit.
I have identified some heroes in PROS during the past decade. Tom McInerny
is one. As a chapter coordinator, he succeeded in blending the expertise of
a practitioner with the curiosity of a researcher and the critical mind of
a chapter coordinator. He asked a question about how mental health of children
has evolved over the past twenty years. He has persisted with Kelly Kelleher
at seeing a landmark study through to publication. As our Steering Committee
Chair, he has used wisdom and candor to lead the organization out of its infancy
to maturity. I am really grateful for Tom.
Mort Wasserman is another hero. In my mind he has made the most important
contribution to PROS. He has stubbornly insisted that studies meet the most
stringent criteria for academic rigor. He has overseen the expansion of PROS
to include a broader base of practitioners and patients. He has attracted
top-notch academicians to advise the steering committee and champion studies.
Under his leadership PROS is more financially sound, has a full-time well-trained
staff, and is recognized as a model for collaborative, office-based research
organizations. His exhortations have propelled many of us out of the gallery
into the research rink, leading to some fantastic PROS studies. Thanks Mort.
There are many other heroes: Evan Charney who led PROS in its early years;
Gretchen Fleming that has overseen its development within the Academy;
and a bunch of really good docs that serve as chapter coordinators or
collect data and give feedback as PROS practitioners. I am delighted
to be involved.
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