Position: Director, Arkansas Center for Health Improvement; Associate Professor, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital; Surgeon General, Arkansas
Clinical Scholar: 1993–1995, University of North Carolina, Chapel Hill
Research Projects: Cost Effective Analysis of HIV Treatment Protocol for Pregnant Women," and "Examination of the Quality of Care Provided through Managed Care"
Clinical Specialty: Pediatrics/Preventive Medicine
In the early 1990s, Arkansan Joseph W. Thompson, MD, was on his way to a high-flying career as a pediatric intensive care physician. Literally.
Several nights a week Thompson flew helicopter transport, picking up and treating kids injured in accidents or suffering some other medical emergency. Then one Friday night, on his way to rescue a boy who had fallen out of a pickup truck, Thompson says he had an epiphany.
"I really enjoyed the technical aspects of individual care," he recalls. "I realized that I could keep doing what I was doing, one kid at a time, or try to have a broader impact."
But in order to make a "broader impact," Thompson needed a different a set of skills than he had gained in his clinical training. He found what he needed in the Robert Wood Johnson Foundation Clinical Scholars program, in one of its training sites at the University of North Carolina at Chapel Hill.
Thompson's first project with the Clinical Scholars program was a cost-effectiveness analysis of an HIV treatment protocol for pregnant women. "In the early 1990s, we discovered that treatment could reduce the mother-to-baby transmission of the HIV virus by two-thirds," says Thompson, "but the policy question was, should you have all women screened or just voluntarily? Where do you come down on that question depends on your assumptions."
"That first project helped me develop a set of skills that I still use today to evaluate different policy options," says Thompson.
His second project—an early examination of the quality of care provided through managed care—took him even further into the realm of health policy. "This was back when the country first turned to managed care to contain costs," Thompson recalls, "and obviously there were concerns that the quality of care might be compromised.
"We demonstrated that the quality of care was far below what most people expected," he says. "There were gaps in quality. It was really a systems issue that as a nation we are still struggling with. How do we balance the iron triangle of affordable cost, high quality and accessibility to needed medical care? You can have two out of those three. Which ones do you want to trade off?"
Thompson went on to work with North Carolina Blue Cross Blue Shield to create quality indicators for their provider network—a project that was among an early wave of managed care quality improvement projects across the country.
By the end of his tenure as Clinical Scholar in 1995, Thompson was "hooked" on using his medical background to address the broader systems issues in health care.
Today Thompson heads the Arkansas Center for Health Improvement, a health policy research center jointly operated by University of Arkansas for Medical Sciences and Arkansas Blue Cross Blue Shield.
Under Thompson's leadership, the center has scored some important successes for the state of Arkansas. It helped secure all of the tobacco settlement funds for new health programs, launched one of the most comprehensive child and adolescent obesity initiatives in the nation and just began a public-private partnership to expand access to health insurance in the state.
In 2005, the governor of Arkansas tapped Thompson to serve as his surgeon general, an advisory, cabinet-level position that advocates for health improvements for the state. "It's exciting and productive to have the governor interested in implementing the policies that you think are going to advance the health of the state," says Thompson.
Now Thompson's window on the world is not unlike the panorama he once saw from the bay of a helicopter—except now the landscape is health policy research and development that he hopes will make a difference in many individual lives. The Clinical Scholars program gave him the "right-angle turn" that altered his view and shaped his career, Thompson says.
"I got four unique things out of the Clinical Scholars program," says Thompson, "a set of skills unequaled by any opportunity out there, integration into a network of thought leaders who challenge what your paradigm is and the challenge that you can make a difference and a charge to try and go do it."