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Baylor Attacks Health Care Inequality: Hospital Chain is One of First to Hire Equity Administrator

Posted on: Sunday, 30 April 2006, 00:00 CDT

By Bob Moos, The Dallas Morning News

Apr. 29--When Baylor Health Care System created a chief health equity officer job this spring, Dr. Jim Walton had the perfect resume.

The 48-year-old physician has devoted his career to caring for the poor and neglected.

Now it's his responsibility to make sure Baylor offers the same access to health care and delivers the same quality of care to all patients, regardless of race, ethnicity or other personal characteristics.

"My mission is to reach people who have been difficult to reach," he said.

The nonprofit Baylor system is one of the first health care providers in the country to hire a high-profile administrator to find and root out racial and ethnic disparities in care.

Dr. Walton will examine data from Baylor's 14 hospitals and work with administrators to correct any problems.

He'll also build coalitions with minority communities to tackle problems such as diabetes and heart disease.

"We intend to provide leadership," he said. "We need to talk about these problems every day."

The issue of equity began percolating in health care four years ago, when the Institute of Medicine released a national report that said minorities tended to receive lower-quality care, regardless of income and insurance.

Those differences in treating cancer, heart disease and HIV infection partly contribute to higher death rates for minorities, the institute found.

"The real challenge lies not in debating whether disparities exist, because the evidence is overwhelming, but in developing and implementing strategies to reduce and eliminate them," the study said.

Dr. Walton said the Institute of Medicine's report on unequal treatment, and an earlier institute study on the quality of health care, have prodded his profession to address the sensitive topic of equity.

"The only way to deal with it is to admit to it," he said. "It is, after all, the world we inherited."

Broader effort

Baylor's equity project is part of the hospital system's broader quality-improvement effort.

Quality improvement has become a major initiative for hospitals nationwide, as the federal government and private insurers demand better performance for their health care dollars.

The Institute of Medicine has declared equity to be a key leg of that effort.

"For Baylor Health Care System, that means equity in access to health care, equity in health care delivery and equity in health outcomes," said Baylor spokesperson Wendy Walker.

Chief operating officer Gary Brock said Dr. Walton was "a perfect choice" for overseeing the hospital system's equity project because of his work as Baylor's director of community health improvement.

Colleagues say Dr. Walton has long been known as a physician with a missionary's zeal who jumps into a difficult situation, enlists the help of other health care professionals and gets the job done.

"Jim's the real deal," said Larry James, chief executive of Central Dallas Ministries and a friend of Dr. Walton's for 10 years. "His compassion, his faith and his intellect are a powerful combination."

Dr. Walton worked with Mr. James to transform the agency's family clinic at 801 N. Peak St.

"We started with a few volunteers seeing patients four hours a week and, with Baylor's support, built it into a full-fledged family practice clinic that's open 40 hours a week and has 20,000 patient visits a year," Mr. James said.

Volunteers in Medicine

From what he learned at the East Dallas clinic, Dr. Walton developed Baylor's Volunteers in Medicine program. About 150 Baylor doctors donate $2 million in health care to the needy each year.

He's also overseen the Dallas County Medical Society's Project Access, a network of 650 physicians who have pledged to provide free services for thousands of working-poor patients without insurance.

"The public health care system is jammed up -- one in every four Dallas County residents is uninsured," he said. "Project Access takes at least a little weight off the shoulders of Parkland's system."

Mr. James said Baylor's decision to create the post of chief equity officer shows that "it's willing to commit whatever it takes to level the playing field for low-income people and minorities."

Dr. Walton is still settling into a daily routine. But he says his promotion won't interfere with his weekly house calls to immigrant families referred from Baylor hospitals. Every Tuesday, the doctor packs his bag and visits neighborhoods where people can barely afford their next meal, let alone their medications.

"I help them however I can," he said. "They're the fuel that keeps me going, because they remind me how much more we have left to do."

E-mail bmoos@dallasnews.com

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Source: The Dallas Morning News

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