Innovating in the Public Health Sector: Republica

Abstract

Dr. Albert Viau has developed a national physician’s assistant program to help solve the problem of rural health service delivery in Republica, a mountainous Central American country. This program would provide high level preventative and primary care in the rural and underserved areas of the country. His proposed solution faces major opposition from his medical colleagues and the health establishment. Dr. Viau knew the proven policy would help alleviate the problem, but he could not find any support. He ran for Dean of the Medical School to begin the reform and did not succeed. The political right opposed him for threatening the medical establishment and diluting quality, and the political left for proposing second-class care for the rural areas. Dr. Viau could not find a way to frame the policy to gain support within the country. After an election the incoming party favored his idea, and Dr. Viau supported by the new minister convened a conference to seed the policy proposal. The case ends with Dr. Viau needing to propose a strategy to advance and implement the idea in the new political environment.

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