Medical Side
Awaits "Change"

Mike Field
Staff Writer

Intended as a frank and open forum for the discussion of any issues affecting patient care and research, the paper will welcome letters to the editor and encourage opinion and commentary from members of the Hopkins community.

"So much is changing now in medicine, both nationally and here on site, that it has become apparent we need some sort of vehicle to keep people informed about what's going on," said Edith Nichols, who will edit the new biweekly paper. "Our physicians and other health care professionals need to be kept up to date on all these things that are happening. We want to try to help them be participants in this process, rather than feeling like they are victims of it."

Change will be a three-quarter-sized tabloid of four pages that will be mailed directly to senior staff, faculty and administrators throughout the East Baltimore medical campus as well as other Johns Hopkins Medicine sites. Its mission will be to communicate the need for significant change--and describe the shape of those changes as they occur. It will not shy from issues where differences of opinion abound.

Nor are those opinions likely to go unnoticed. The impetus for Change comes directly from new university president Bill Brody himself. Brody helped launch a similar publication, This Thursday, at the University of Minnesota Academic Health Center when he was provost there, charged with restructuring the center to respond to the highest rate of managed health care of any state in the union.

Since arriving at Hopkins, one of President Brody's stated goals has been to foster free and open discussion about suitable responses to the challenges of managed care. "I am convinced that this is an issue we all need to be thinking about and talking about," Brody said. "No one can sit back and safely assume we can continue with business-as-usual."

Unlike The Dome and The Gazette, which are distributed free from newsstands located throughout the East Baltimore campus--and consequently claim a wide range of readership including patients and community members--Change will be targeted only at Hopkins employees faced with having to contend with the new world of managed care and other financial constraints.

"By keeping focused on our intended audience we can make this paper a very personal kind of tool that speaks directly to work-related concerns," said Nichols, who will continue her other duties as editor of the Hopkins Medical News and director of publications in the medical institutions' Office of Communications and Public Affairs. The publication will try to frame the issues to help readers understand why these changes are occurring.

Nichols has hired former Baltimore Evening Sun staffer Patrick Gilbert, a reporter with 27 years' experience on a number of beats, to act as the paper's chief writer and managing editor. "He'll be going out and sitting in on meetings, talking to people about what they think and identifying the concerns that people have as we go through this process of change," Nichols said. "We want to get feedback not only on what's happening, but also on how we're doing at keeping people informed."

Change will serve as the spearhead of a larger movement to communicate administrative decisions and encourage discussion on the East Baltimore campus. "It's not the only tool we'll be using," said Elaine Freeman, executive director of Communications and Public Affairs at the medical institutions. "The leadership will continue to schedule town meetings and departmental meetings to try to foster open discussion. In some cases the changes that are occurring are very painful and may sometimes seem contrary to Hopkins tradition. Yet they are meant to protect the mission of the hospital and the medical enterprise. We need to put that into perspective."

Designed in an easy-to-follow five-column format, the paper will contain a regular column of short notices about the business side of Hopkins' medical enterprise, titled "Inside Hopkins." A second column, "Eye on the Nation," will track regional and national stories relating to developments in the health care industry. In addition, the third page will be devoted to news concerning the School of Medicine's Clinical Practice Association.

"We also want to encourage letters," Nichols said. "Our primary mission is to create a forum, rather than a one-way communications device."

The emphasis, she said, will be on creating a publication that eschews "bureaucratese" and tries, insofar as the readers are concerned, to "give it to them straight."

"The idea of candor is appealing," she said. "So often it's easy to couch what we say or write in order not to provoke." But with a clear mandate for new ways of doing business, free and forthright conversation, said Nichols, is an essential component of Change. "People love the idea and have been very willing to talk, perhaps because they know the impetus for this is coming from the top."

In the coming months, Nichols hopes the new publication will contribute ideas and excitement to a process that, ultimately, cannot be avoided. "Our basic philosophy is that we are addressing opportunity," she said. "People are going to have to work together in ways they never have before. It will be challenging, and sometimes difficult, but in the end I think we'll have a better organization because of it, so long as we use this opportunity to talk and think and work through the change ahead."

When the winds rise and storm clouds threaten, it's time to start talking loud and clear. Now is just such a time, said Nichols, "after all, it's a lot harder to get people to jump on board a moving ship if they don't know where it's going."