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HL20: Brad Stuart, MD—Reducing Costs the Right Way

Joe Cantlupe, for HealthLeaders Media, December 3, 2013

In our annual HealthLeaders 20, we profile individuals who are changing healthcare for the better. Some are longtime industry fixtures; others would clearly be considered outsiders. Some are revered; others would not win many popularity contests. All of them are playing a crucial role in making the healthcare industry better. This is the story of Brad Stuart, MD.

This profile was published in the December, 2013 issue of HealthLeaders magazine.

"This is advanced care: helping people live the best they can and stay out of the hospital."

Nearly four decades ago, as a third-year medical student in California, Brad Stuart, MD, didn't want to give more chemotherapy to a dying patient who had bone marrow cancer. Stuart argued against the care plan, pleading with his superiors: Please talk to the patient and his family to determine "what was in store for them."

His bosses rejected Stuart's suggestion, saying they should finish the research protocol and not discuss the patient's status or treatment with him. Just give him the chemo, they told Stuart. Two days later, the patient died, sooner and with less comfort, Stuart believed, than if he had not given the chemo.

" 'I killed him,' I said to myself. 'I am never going to forget this. There's got to be a better way,' " Stuart recalls.

The incident was a turning point in a new doctor's life. Over the next decades, Stuart turned to hospice and palliative care to treat very sick patients, people who didn't want more tests or more procedures, but just sought peace.

Until recently, Stuart was CMO at Sutter Care at Home, part of Sutter Health system's network in Fairfield, Calif. He left Sutter in October to start Advanced Care Innovation Strategies, an Alamo, Calif.–based firm that will consult for hospitals, health systems, and medical groups on advanced illness–related issues, and increase the quality of care for advanced chronic illness and reduce its cost by promoting the dignity, choice, and responsibility. Such programs are meant to partner with families and patients for better coordinating care for those who are very sick, have chronic conditions, or who are dying.

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