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. They are making a difference in healthcare. This is the story of Manny Sethi, MD.
This profile was published in the December, 2014 issue of HealthLeaders magazine.
"I really believe in that old-school version of a doctor, where you are very much involved in the community. I think today that is what we lack in healthcare."
Growing up as the son of two physicians in the small town of Hillsboro, Tennessee, Manny Sethi, MD, developed a strong sense of the important role doctors can play in improving the health of their community.
"My parents went to this small farming town with plans to stay for two or three years, but then they became part of the fabric of the town and were so intertwined with the community that they stayed," Sethi says. "My dad was a primary care guy, but he was involved in all facets of peoples' lives because that was his view of medicine. Because of that experience of watching him, I really believe in that old-school version of a doctor, where you are very much involved in the community. I think today that is what we lack in healthcare."
After attending Harvard Medical School in Boston and spending a year as a Fulbright Scholar working with children with muscular dystrophy in Tunisia, Sethi decided to return to his roots in Tennessee and is now in his fourth year as an orthopedic trauma surgeon at Vanderbilt University Medical Center in Nashville.
"When I came back home to Tennessee and I was on call as a trauma fellow, I saw all these victims of shootings, stabbings, and beatings, and I wanted to understand what was happening," Sethi says.
With the help of a medical student, Sethi searched through the medical charts of everyone who had presented in the emergency room over the previous 10 years; he realized that the victims of violent injuries, particularly gunshot wounds, were largely between the ages of 18 and 22.
"The fact is that in this world today with Facebook and Instagram and Twitter, things heat up so quickly and publically, and things with these young people get really hot, really fast," he says. "I realized we needed a community-based intervention to prevent the violence from happening."
Funded by two grants with a total of $65,000 from the Robert Wood Johnson Foundation, Sethi set out to tackle the problem of youth violence by bringing an intervention program called AVB—aggressor, victim, bystander—to the schools. Students participate in the program for one hour per week over a three-month period.
"It's a case-based kind of program where people act out these conflicts in 12 different scenarios," Sethi says. "Students play the conflict out, then they have a discussion about what happened, why it happened, who had a role to play … and how the bystander could help to calm the situation down by understanding the dynamics."
Sethi piloted the program in one Nashville school and has since rolled it out to 10 schools throughout the city. To gauge the program's impact, students were given a pretest and a posttest to see if their ideas about violence had changed over the three months.
"The tests analyzed their behavior, their views on violence, and how they would react in a bad situation," he says. "We saw dramatic improvement as far as students tending to go towards nonviolent behavior as a way of trying to solve the conflict."
Roughly 2,500 students have been through the program to date, with significant improvement being shown on 70% of the test questions, Sethi reports. Additionally, 35% of the students said they would make an effort to bring calm to a situation if they saw violence happening, and 24% said they now feel safer in their school.
Encouraged by these results, Sethi expanded the program to five Memphis schools in October with hopes of having the same positive influence.
"We can save a person's leg, and we can save a person's life, but by the time it gets to us, it's too late," he says of his desire to work with students to curb aggressive behavior. "I think the most powerful thing that I have come away with is that mobilizing the community is the answer to most problems."