David C. Colby Interview

     David Colby:   Are we rolling?

     Male Voice:    [Inaudible]

     David Colby:   David C. Colby.   D-A-V-I-D C. C-0-L-B-Y.      I'm

the vice president for research and evaluation at the Robert

Wood Johnson Foundation.

     Jennifer Muldoon:     So Doctor Colby, why did you choose to

work in the field of health services research?

     David Colby:   I started as a political scientist and I was

very interested in public policy issues.    And then I had a

Robert Wood Johnson Fellowship from a program called Health

Finance Fellows, and that is the point where I really turned

into thinking about the questions of health services research,

especially around the health policy questions.

     Jennifer Muldoon:     In your opinion, what are some of the

most significant contributions of health services research?

     David Colby:   The most significant contributions around, I

think, around the medical care system and improvement of the

medical care system, both in quality of care - we first learned

how to measure quality of care - and then we learned how to use

those measures to try to move quality of care.    And then the

same kind of thing happened in access to care where we learned

how to measure access to care, and we're learning how to use

that to improve the access to care for Americans.
     Jennifer Muldoon:   How about opportunities for the field's

future?

     David Colby:   I think the future really lies in much more

of an intersection between sciences and health services

research; that we need to move the field to think about

genomics; understanding of the natural science so that health

services research can really study the use of natural sciences

and genomics in provision of healthcare.

     Jennifer Muldoon:   Do you have any advice for someone

considering a career in health services research?

     David Colby:   I think since it's a two trillion dollar part

of our economy and it's growing, it's a great field to get into

and will continue to be a great field.

     Jennifer Muldoon:   Back in the early days back when the

annual meeting was just getting underway, what were some of the

important health policy and research issues?

     David Colby:   The issues were really around, I think,

mainly around access to care, health insurance coverage, and

Medicare and Medicaid issues in those early years, and mainly on

the sort of medical care system.   They weren't on the health

system - or lack of system.

     Jennifer Muldoon:   And where do you think - what do you

think will be the important issues of tomorrow, say, ten years

from now?
     David Colby:    I think the important issues are really going

to be around spreading a more public health system across the

country that is more viable and delivers more care; that we sort

of think about population health and not just medical care

system.

     Jennifer Muldoon:    And what are the challenges we face to

address those issues?

     David Colby:    I think the challenges are - there's a huge

data challenge in addressing those issues.    We don't have a lot

of information we can use to address them at least on an

intervention side.    We have sort of national surveys, but we

can't tell what's happening in local areas, and so I think there

are huge data problems.    There are also conceptual problems.   We

have a public health system that is largely politically

invisible in healthcare and we don't realize the benefits it is

providing.

     Jennifer Muldoon:    How can Academy Health help achieve the

future vision?

     David Colby:    Well, I think Academy Health can help achieve

a future vision by really taking, I think, the students that are

coming through the pipeline, at this point, and getting them

oriented much more towards population health and much more

towards the natural science aspects of health.

     Jennifer Muldoon:    Is there anything you would like to add?
     David Colby:    Like to ask?

     Jennifer Muldoon:       No, add, anything you would like to add?

     David Colby:    Oh [laughter].     Okay.   Well, the 1988 meeting

and the earthquake were fine in San Francisco.        They're going to

take that one out.    [Laughter]

     Jennifer Muldoon:       Yes, we'll edit that out.   No, thanks -

that's it for all the questions.

     David Colby:    Okay.

     Jennifer Muldoon:       I told you I wouldn't ask you about your

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