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Healthy Choices 

by Kevin Taylor & r & & r & & lt;span class= & quot;dropcap & quot; & S & lt;/span & ince the flap over the firing of Health Officer Dr. Kim Thorburn in December, the Spokane County Board of Health has been considering its options. Last Thursday, the Board's Ad Hoc Committee held a public meeting on possible changes to the leadership of the health district. At the meeting, Washington Department Of Health administrator Joan Brewster reviewed the different structures for local health jurisdictions.

The Board is considering three leadership structures. Option 1: Same as it was with Dr. Thorburn. The Health Officer is in charge and reports directly to the Board of Health. Option 2: The Administrator, who would supervise the Health Officer, is in charge and reports to the board. Option 3: The Health Officer and Administrator each have responsibility; both report to the board.

Citing its reputation for leadership and effectiveness, former Health Officer Dr. Kim Thorburn said to the committee: "I urge the Board to maintain physician leadership of this department." Pointing out that it has always been led by a physician, a scientist whose training informed policy, Thorburn insisted: "Science should lead the way." And larger counties around the state do tend to hire physicians to lead their public health efforts.

After the meeting, Dr. Brian Seppi, president of the Spokane County Medical Society, said he agrees with Thorburn: "We feel that the chief executive should be a medical officer, so communication is very clear and [that person] leads the organization." To have both the Administrator and Health Officer on an equal footing, with each reporting directly to the Board, would create "a disorganized and difficult situation," Seppi says.

Seppi argues that the Health Officer, not the Administrator, should be in control of the budget, particularly when resources are scarce. If a physician does not control the budget, he says, it would be hard to fund programs deemed most important. "Physicians would feel more confident that health issues would be addressed in a scientific way rather than in a political way."

And a physician would be a better advocate, he says: "Those segments of the community that don't have a strong political voice might not get the attention they deserve or be left behind -- children, for example."

Seppi urges the Board of Health not to jettison the existing structure: "We don't want to change the whole system just because of the communication issues with the previous Health Officer. The system's not broken."

No one advocated for the administrator model at the meeting, but Ad Hoc Committee chair Brad Stark announced that three physician health officers and two health district administrators from around the state will give presentations on their systems at a meeting on April 12 at 5:30 pm, in the Health District Building, to which the public is invited.
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