What does the title of this post mean? Well,that it's a small world and that Twitter is of course shrinking time and space. Thanks to a retweet by my Dutch colleague Lucien Engelen, @zorg20 of a BMJ post, I learned that Alain Braillon, whom we appreciate, amongst others, for his newsletter on the quality of care and the elegance with which he manages it, always clearly citing his sources -- which is rare, despite the recommendations of the HONCode to cite your sources-- lost his job at the Amiens teaching hospital. Various reasons for this dismissal are suggested in the article by Paul Benkimoun. The author's gamble that a BMJ post would create a public dialogue has led to this first post and possibly others. The French medical news Panorama also reported the story.
We read on BMJ's site that François Bourdillon of the French Public Health sociéty, that this type of dismissal of a public health specialist for lack of Return on Investment is a first in France. This raises the whole question of ROI, of course ! If something is useful for Public Health, how could it not have a good ROI, by virtue of lives preserved in the long run, but that depends on the definition of ROI. Public health prevention does not often fill hospital beds and consultations and is ordinarily present in a different budget of course.
Another theory is that the public financing of the program had simply come to its end.
Or were there also personal conflicts, which is human?
Alain Braillon's concern is for the patients in the programs. What will become of their follow-up?
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Denise, Social Networks (or Social Media : SoMe) is about sharing, so we do ;-)
On the ROI : There is a parallel between the ROI on Public Health as there is on ROI of SoMe. How to quantify, when is it good, when isn't it. Website traffic is measurable, number of times tweets have been read isn't (besides the number of followers could tell something)
We have to sort out what the new measurements will be for these kind of matters.
In my opinion Public Health will be increasingly needed since we have to get to the front of many problems, BEFORE a disease exposes to someone. So prevention, disease-management and creating a healthy environment.
When boards start to evaluate, based on fee-for-service, departments in terms of costs and profitcentres, it might be a good and strong idea to classify Public health somewhere in the middle. From my point of view though these departments over the last years could have done a better job in the marketing of their work, and may be start more to think about business-case-reporting on issues than they did up until now.
Then it might turn out that Public Health even could be one of the greatest profit-centres of all.
Exciting will be this same discussion about SoMe, since it is sometimes resembled as "a nice little chatbox, but without any impact on health in real world". Luckily there's some evidence already to prove this wrong, but we have a long way to go still.
Anyway we are vastly moving into the direction to more interaction with our patient-community : http://lucienengelen.posterous.com/today-weve-poured-some-concrete-for-our-digit
Posted by: Zorg20 | 10 February 2010 at 11:35