David A. Ansell

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David A. Ansell (born 1952) is a Chicago-based physician and author whose efforts at both the national and local levels have advanced concerns about health inequities and the structure of the US health care system. His thirty years as a provider to the medically underserved have made him a vocal supporter of single-payer health care. He spent seventeen years at Cook County Hospital currently known as John H. Stroger Hospital of Cook County upon which the medical T.V. drama ER was based. Ansell was inspired by his time at Cook County Hospital to write a memoir and social history entitled, County: Life, Death, and Politics in Chicago’s Public Hospital. County was hailed as a “landmark book”[1] by Julia Keller of the Chicago Tribune, aiming “to inform and to inspire”[1] readers about the disparities in health care. In the book, Ansell argues that only a single-payer solution that provides access to all US residents regardless of circumstances can provide relief for those closed out of the health care system.

Early years[edit]

Ansell spent his formative years in Binghamton, New York a small city of 50,000 people, 160 miles Northwest of New York City where he was one of five children born to English-immigrant parents. After high school, he attended Franklin and Marshall College (B.A., 1974) and medical school at the SUNY Upstate Medical University (M.D., 1978) He received his Masters of Public Health from the University of Illinois School of Public Health.

Medical education and training[edit]

A photo of a Cook County Hospital doctor's strike in 1975

After finishing medical school in 1978, Ansell and four classmates trekked across the country to train at Chicago's Cook County Hospital, one of the nation's most renowned, infamous and oldest public hospitals. It had once been the pinnacle of medical and surgical training in the US, but had suffered under political corruption, inept management and ongoing racism. Three years before his arrival, County had been the site of the longest doctor’s strike in US history when over 400 house staff walked off their jobs in protest of the terrible patient-care conditions at the hospital. The striking doctors sought the most basic patient-care essentials including towels and soap for the patients, interpreters and working electrocardiogram machines. Although their demands were eventually met, ten of the striking housestaff leaders were jailed in Cook County Jail for defying a back-to-work order.

When Ansell and his colleagues arrived three years after the strike, they discovered a hospital described by Scott Simon of NPR in 1994 as “huge, grey and battered as a vanquished and abandoned old battle ship run aground on the shattered streets just west of Chicago's Loop,"[2] and inside, "hallways thick with sick people who have also run aground and seem[ed] abandoned to waiting, limping, straining, coughing sighing and sweating, bleeding, crying."[2] Ansell recounted on NPR’s Fresh Air how the first time he went to the restroom at Cook County Hospital he could not use it because it was so filthy. “I ran across the street and had to use the bathroom there. It was quite an introduction to my first day at County."[3] He and his colleagues fulfilled their residency training, fighting to keep the hospital open and fully funded. After residency, Ansell served at County as attending physician for 13 years, joining other physicians in a new Division of General Medicine/Primary Care. For both patients and staff alike, the experience was marked by open wards with no privacy, broken systems and non-functioning air conditioning in the summer. Despite the conditions, Ansell and his colleagues developed deep and lifelong relationships with patients, many of whom were unable to receive health care at other Chicago institutions because of their lack of health insurance.

Efforts against patient dumping[edit]

Since the beginning of his career, Ansell has articulated that health care is a right not a privilege.[4] In the early 1980s, Ansell and colleagues noted a marked increase in the numbers of patients transferred to public hospitals around Chicago and the US, due to a lack of health insurance. This time-honored practice was known as patient dumping. In 1984, Ansell joined a project led by Robert Schiff, M.D., to expose the practice of patient dumping which had risen at an alarming rate in Chicago. He contributed to the article “Transfers to a Public Hospital” that appeared in the February 1986 edition of the New England Journal of Medicine, criticizing patient dumping and the unnecessary deaths it caused.[5] Congress responded earlier the same year by passing the Emergency Medical Treatment and Active Labor Act, which requires hospitals and ambulance services to provide care to anyone needing emergency healthcare treatment regardless of citizenship or insurance status.

Career and continuing education[edit]

Ansell continued his pioneering efforts with one of the first programs in the US to battle race-based disparity in health care, the Breast Cancer Screening Program at Cook County Hospital. In 1995, Ansell left Cook County Hospital to become Chairman of the Department of Internal Medicine of Mount Sinai Hospital in Chicago, the city's largest private safety-net hospital. Among other activities at Mount Sinai, he founded the Sinai Urban Health Institute a major health-disparity research and intervention center led by Steven Whitman, PhD.

In 2005, Ansell was appointed the Chief Medical Officer at Chicago's Rush University Medical Center where he leads patient safety and quality efforts. In 2008, he was appointed to the newly created board of directors of the Cook County Health System, a position he held until 2012. He continues his service to the medically underserved in his volunteer activities at the Community Health Clinic, a free clinic in Chicago, and with his medical-relief work in the Dominican Republic and Haiti.

Ansell has consistently supported issues related to access to health care and health-disparity reduction. In 2006, he and colleagues helped expose the egregious breast-cancer mortality gap that causes black women in Chicago to die of breast cancer at twice the rate of white women. They also joined with others to found the Metropolitan Chicago Breast Cancer Taskforce a group dedicated to the elimination of this disparity in the Chicago area.

Positions[edit]

  • Division Chief, Division of General Medicine/Primary Care, Cook County Hospital, Chicago, IL, 1993-1995
  • Chairperson, Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, 1995-2005
  • Chief Medical Officer at Rush University Medical Center, Chicago, IL, 2005–present
  • Member of the board of directors of the Cook County Health System, Chicago, IL, 2008–2012
  • Chairperson of the Quality and Patient Safety Committee of the Cook County Health System, Chicago, IL, 2008–2012
  • President of the Board of the Metropolitan Chicago Breast Cancer Task Force, Chicago, IL, 2007–present

Published works[edit]

County

Ansell holds a Masters in Public Health from the University of Illinois School of Public Health and has written extensively about health disparities. Most recently, he wrote County: Life, Death and Politics at Chicago’s Public Hospital, a memoir about his years at Cook County Hospital.

Leonard Lopate, introducing Ansell on WNYC, remembers Ansell calling Cook County Hospital “doctors within borders... his way of emphasizing the kind of third-world conditions that persist within a major US city that is also home to some of the best hospitals in the country." County documents these conditions and the difficulties faced by doctors, nurses, and patients of which most are low-income individuals and members of a minority. County gives context to a frightening statistic: a black man living on the south side of Chicago will die eight years earlier than the average white man living in the United States.

The memoir and social history was released on July 1, 2011 to critical acclaim. Julia Keller of the Chicago Tribune calls County “a landmark book, brave and angry and indispensable, not least because Ansell dares to declare that the health-reform legislation passed in 2010 — dubbed "Obamacare" — was no breakthrough."[1] The New York Times ran a book review titled “Their Zeal Changed Lives, if Not the System”, praising Ansell’s dedication and how it shines through in his writing: “when it comes to the stories of his patients, many of whom he cared for over decades... Dr. Ansell soars... We cannot have too many of these stories in circulation, to bear witness, to inform and to inspire."[6] Publishers Weekly highlights the book’s relevance to the national health care debate, citing "Ansell's exposé will shock and motivate readers to take a stand on the issue."[7]

References[edit]

  1. ^ a b c Julia Keller (2011-07-22). "County: Life, Death and Politics at Chicago's Public Hospital by David A. Ansell". Chicago Tribune. Retrieved 2012-09-29. 
  2. ^ a b Scott Simon, Weekend Edition, National Public Radio, 1994
  3. ^ "Dr. David Ansell — 'Life, Death And Politics' Treating Chicago's Uninsured". NPR. 2011-06-15. Retrieved 2012-09-29. 
  4. ^ "The Leonard Lopate Show: Life, Death, and Politics at Chicago’s Public Hospital". WNYC. 2011-07-13. Retrieved 2012-09-29. 
  5. ^ Schiff, R. L.; Ansell, D. A.; Schlosser, J. E.; Idris, A. H.; Morrison, A.; Whitman, S. (1986). "Transfers to a Public Hospital". New England Journal of Medicine 314 (9): 552–557. doi:10.1056/NEJM198602273140905. PMID 3945293.  edit
  6. ^ Abigail Zuger, M.D. “Their Zeal Changed Lives, if Not the System.” New York Times. The New York Times Company, 25 Jul 2011. Web. 27 Jul 2011. http://www.nytimes.com/2011/07/26/health/views/26zuger.html?_r=2&emc=eta1 Date of Access 27 Jul 2011.
  7. ^ "Nonfiction Review: County: Life, Death and Politics at Chicago's Public Hospital by David Ansell. Academy Chicago, $29.95 (256p) ISBN 978-0-89733-620-8". Publishersweekly.com. Retrieved 2012-09-29.