HL20: Patrick J. Quinlan, MD—Reducing the Disease Load

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 Patrick J. Quinlan, MD.

This profile was published in the December, 2011 issue of HealthLeaders magazine.

 "We recognize that the major driver for these problems is lifestyle. It’s a set of behaviors learned early on and is a part of the family history—the behaviors are contagious. "

When you hear the personal philosophies of Patrick J. Quinlan, MD, CEO at Ochsner Health System in New Orleans, it's clear why Change the Kids, Change the Future is a program created and championed by his organization. Quinlan believes the path to happiness is found by helping others and that everyone needs "a prepared mind and healthy body to be poised for success." That is why back in 2001 after he looked at some staggering state health statistics, he and his executive team set out to improve the health and wellness of the entire community—starting with the children.

"I'm very concerned about the wrong turn healthcare reform has taken. It's put our focus on expenditures," he says. "We need to focus on reducing the disease load. If we look at those individuals that have particular risks, we recognize that the major driver for these problems is lifestyle. It's a set of behaviors learned early on and is a part of the family history—the behaviors are contagious."

With the hospital already treating scores of patients with chronic conditions and the likelihood of more in the future, Quinlan asked his executive team to look at the problem during an executive retreat. The team acknowledged that working with adult patients with these problems was insufficient to solve the problem, just treating the symptom.

Quinlan wanted to get to the root of the problem. He and his team decided obesity, which often leads to hypertension and diabetes, was a lifestyle issue, and the habits were formed in childhood. A look at the stats confirmed it. At 35.9%, Louisiana has the seventh highest rate of overweight youth in the nation. And the number of children ages 2–19 given a primary or secondary diagnosis of obesity nearly doubled from 1999 to 2005.

"This is an epidemic," says Quinlan. "To reduce chronic disease in our community, we decided to change the behavior of our children and their families."

The system puts $250,000 in annual direct costs toward creating its school-based program designed to educate children and their families about the long-term impact of nutrition and exercise choices on their health. The money funds onsite nurse practitioners at schools and a mobile fitness unit that travels the region to teach parents and kids to incorporate healthier foods and behaviors into their lifestyle. The mobile fitness unit reached more than 2,500 students this year.

"We needed to work with the whole family, because when these kids get home they don't have control of the menu. We could help the school offer better food choices, but we needed to get the family involved if we were going to make a total change," says Quinlan

"We let our principles guide us to do what we are best at, and when a project goes beyond that scope we look for a partner. We can't step in for everyone; solving a problem like this is too big for just one organization," Quinlan explains. "We looked at where our presence would make the most a difference. … We know how to run clinics and we know we already have great food service and chefs and dietitians and the state's largest fitness center. So we said, let's start there and see if there's a willing audience."

Although they have covered a lot of ground, there's still plenty of work to do. In pilot programs, the fitness assessment baseline data showed that 35% of students were obese, 20% were overweight and only 16% met the minimum standards for aerobic capacity. Quinlan and his team are prepared for the challenge, and he is hopeful that other hospitals and health systems nationwide will follow suit in establishing such programs.

"We're not in banking or manufacturing; we take care of people. It's my hope that if we lead by example we can change the understanding of health in our community," says Quinlan. "We have to ask ourselves, 'what are we as a society doing to change the risk factors that give rise to disease?' Because in healthcare reform there is a debate about how to save money, and we rush past the problem. … If you're worried about cost, nothing is cheaper than a healthy person."