Health commitee chairman, wife, share outlook on prevention

Bill Monning is the new chairman of the state Assembly’s Health Committee.

His wife, Dr. Dana Kent, is a doctor in Monterey County who has spent her life serving the poor.

Dr. Kent is careful to point out that she does not advise Monning on health policy. But as Monning ponders the federal health reform that will roll out soon with a major assist from the state and his committee, the lawmaker says he will naturally call upon all he has learned through their 32-year partnership.

“I’ve lived vicariously through my wife’s involvement in the health care system,” he said in an interview.

Dr. Kent, a former nurse, has been a physician and medical director at hospitals and clinics in Monterey County. She is currently teaching a course in community medicine at the county hospital in Salinas.

Monning said his wife’s work has shown him that the health care system is fragmented and reactive, focused too much on the back end and not enough on prevention. Family medicine doctors who can keep people healthy are not as valued as the specialists who fix things after they are broken.

“One of our big issues is to meet the challenge of recruiting and retaining primary care physicians,” he said.

The federal expansion of access to health insurance means that 4 million to 5 million of California’s 8.2 million uninsured will be covered. Yet there are not enough doctors now to treat everyone who needs care in California.

“We have a system that does not reward people going into primary care,” Monning said. “They are among the lowest paid and hardest working health care professionals. People who go into medical school with the best of intentions look at those big loan repayments, the cost of living, and they pursue a specialty that will pay them better.”

Monning would also like to see more emphasis on prevention. And that is something that Dr. Kent is also working on. In an interview, she said she is a big believer in physicians getting out of their offices whenever possible and into the community to help resolve problems that can eventually make their patients sick.

“Instead of looking at the individual patient as the patient, you are looking at the community as the patient,” she said of her approach to community medicine. “In most traditional medical training, residents are in the hospital and in their clinic for all of it. They don’t interact, they don’t go outside the walls of the hospital too much. This is an effort to have the residents understand more of the community context of what they are seeing, the social effects, the environmental effects, the psycho-social effects that are formative in their patient’s disease process.”

In Salinas, doctors treat victims of gang shootings in the emergency room. But now they also think about what is going on in the homes of young children, as early as the second and third grade, and public health nurses go into those homes to help ensure that the children do not drift toward gangs or drugs.

“We are teaching these residents, when you become a practicing physician, in private practice or a public clinic, you do become involved by necessity with those issues in the community,” she said.

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