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Wennberg Steps Down at Dartmouth

By John Reichard, CQ HealthBeat Editor

June 29, 2007 -- Just as his decades-long research has reached its pinnacle of prominence in the health care debate, John E. Wennberg is stepping down as director of the center at Dartmouth College where he did his pioneering work relating geography and health care. Wennberg isn't ending his affiliation with the center, however.

Dartmouth announced Friday that the 73-year-old Wennberg has stepped down as director of its Center for the Evaluative Clinical Sciences (CECS), after a research career of more than 40 years in which he demonstrated that where one lives is key in determining how much health care one gets—and that regions of the country with more health care have lower, not higher, quality of care.

Congressional Budget Office Director Peter R. Orszag recently testified that Wennberg's work offers the nation a way out of the fiscal crisis it faces because of unsustainable health care spending increases, in that it suggests spending growth can be cut without sacrificing quality.

The Dartmouth Atlas of Health Care developed by Wennberg shows sharp regional differences in the amount of care patients receive and in its resulting costs. The research compendium "has revealed consistently that more medical spending and more health care services are not associated with better outcomes for patients," the center said in a press release announcing Wennberg's departure as director. "In fact, patients in high-care, high-cost areas fare worse than those living in areas where more conservative care is the norm." Were high-cost areas to adopt more conservative practices, "the Medicare system could reduce spending by at least 30 percent while improving the medical care of the most severely ill Americans," Wennberg and his colleagues say in the most recent issue of the Atlas.

Succeeding Wennberg as director is James N. Weinstein, who has worked with Wennberg at the center since 1996. Weinstein also is the chairman of the department of orthopedic surgery at Dartmouth Medical School. With Weinstein taking over, the center will be renamed the Institute for Health Policy and Clinical Practice as of Aug. 1. Under Wennberg, "CECS has transformed not just our understanding of the problems within our health care system, but the manner in which we practice medicine, train effective health care leaders and physicians, and approach the tough questions around variations in the provision of care," said Stephen P. Spielberg, dean of the Dartmouth Medical School. "With a new, unique institute dedicated to these efforts, Jim Weinstein will continue and expand on this critical work."

Wennberg praised the choice of Weinstein as his successor. "More than anyone, he understands how our research can be applied in the real world to improve patient care, reform our health care system and produce a new kind of health care leader," Wennberg said. An aide to Wennberg said he will continue to work on the Atlas as emeritus center director. "He's going to be involved," she said. "He's just getting out of the administrative side."

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