Health Policy Gurus Gather: The UCSF Philip R. Lee Institute for Health Policy Studies at 40

At the recent 40th anniversary dinner of the UCSF Philip R. Lee Institute for Health Policy Studies (IHPS) at San Francisco's beautiful City Hall rotunda, a tablemate remarked "If the big quake hit now and this place collapsed, American health care would have to start all over."

Well, at that might be at least partly true (and the rotunda has been seismically-updated, thankfully). The IHPS is a local and national treasure that has been at the forefront of so many important health issues -- health reform, access to care, AIDS, professional education, medical economics -- well, the list is too long. And while the recent and ongoing heated debates about "Obamacare" and the like are chronically politicized, those in the know look to the IHPS -- and a very few other such sources -- for data-based, historically astute, rigorously-developed research and position papers. While it can be extremely frustrating to have ill-considered episodes such as the "death panel" remark of Sarah Palin derailing better end-of-life policy and care and contributing to much ongoing suffering, these professionals of many disciplines keep cranking out their state-of-the-art work to (hopefully) guide health practice, education, and law.

But who is Philip R. Lee? For those who have not been involved in health policy debates over the past half century, here's a capsule bio: Suffice it to say that he has been at the forefront of many improvements in our nation's health, and is often referred to as a true living legend. Or, as longtime science editor and journalist David Perlman of the San Francisco Chronicle told me recently, "Phil Lee is one of the greatest people I ever encountered -- even more so than all the Nobelists I got to interview or schmooze with!!"

I'm a minor player in this realm, but have had the pleasure of knowing Phil for decades, ever since, as a lowly undergraduate studying microbiology, found a book he co-authored titled Pills, Profits, and Politics and sent him a letter asking his opinion on the politics and economics of antibiotic overuse. I didn't really expect to hear back, but he replied with a long and thoughtful letter -- invaluable for my thesis. Much later I was honored to co-author a piece on this topic with him and yet another living legend, Lester Breslow, and a number of other essays and papers as well on topics such as medical education, health professionals' participation in torture, environmental health, San Francisco's universal health access plan and more. It was Lee's name on these papers that gave them weight. And when I was co-chairing a conference on environmental health at UCSF with Lee, a speaker who was now a renowned senior health researcher and official recalled "The last time I was here to see Phil Lee I was terrified -- I was an applicant to this very medical school and was told the chancellor was going to interview me!" (This is somewhat akin to a Fortune 500 CEO interviewing applicants for internships).

The guest speaker at the IHPS dinner was Harvard surgeon and New Yorker author Atul Gawande MD, who recalled that, as a young trainee during the Clinton administration years, he would sit in on high-level health policy meetings with Phil Lee in attendance as United States Assistant Secretary of Health: "Somebody would bring up a proposal that sounded really good to me. Phil would clear his throat and say, 'Well, that's been tried three times -- didn't work.' I learned to just keep my mouth shut and listen and learn when he was around." Looking out on the large audience of fellow "health policy superstars," Gawande, who talked about new systems approaches to improving both quality and cost-efficiency as outlined in his own influential book The Checklist Manifesto, concluded "You are the group that I'm really happy to be part of and that will change healthcare."

Phil -- as he is known to almost everybody who's met him -- reflects that, over the past four decades, "The most important contribution of our institute are the many people who have been trained there, considering what they've gone on to do. We've made many important contributions in research, family planning, medical education, pharmacology practice and policy, the health professions, and more. In some areas we haven't been quite as influential as we might have liked, but we've kept trying all along."

And on behalf of countless professionals and patients, thank goodness -- and Phil -- for that.