Gary Passama

Gary Passama retired as president and CEO of NorthBay Healthcare on March 31, 2017. An active blogger since 2010, here’s a collection of his work.

The Ends And The Means

November 03, 2015

Two weeks ago I returned home from a vacation as mellow as could be — until I opened my accumulated mail. There it was, amid all my junk mail, another plea for a donation from the University of California, Berkeley, the place where I earned two degrees and endured years of frustration with its football team.

This plea was from the School of Public Health which bestowed on me the degree of Master of Public Health, something of which I am very proud. They wanted me to contribute to their building fund. They lost me in the very first paragraph of the letter from the Dean, Stefano M. Bertozzi, MD, PhD:

"Dear Gary,

Have you ever been called a radical? As a graduate of the UC Berkeley School of Public Health, you're part of something that is inherently disruptive - a diverse community unafraid to challenge the status quo when seeking solutions to complex health threats. Like you, these researchers, educators and practitioners are committed to achieving maximum population health impact by any means necessary."

By any means necessary? We now have Public Health School Nazis? I got mad because this is the kind of hubris which you often find in health care, particularly among the academics and consultants. We know what is good for you and we will shove it down your mouth regardless of what you think.

My reply to the Dean was as follows:

"Dean Bertozzi:
As a proud double degree holder from Cal (B.S.-Business Administration 1970 and M.P.H. 1972) and former President of the Health Care Services Management Program Alumni Association, I am used to receiving many solicitations for donations from the University. I am currently the CEO of a Bay Area integrated healthcare delivery system. I do make donations on a regular basis to those programs which I believe merit my support.

"Your October 16 letter seeking financial support for the School of Public Health did nothing to make me want to support the building program for the School of Public Health. The last sentence in the first paragraph was amazing in its implications and surprising even for the frequently tone-deaf faculty and administration at Berkeley. This statement was arrogant in the extreme: 'Like you, these researchers, educators and practitioners are committed to achieving maximum population health impacts by any means necessary.'

"For the record, that is not how this Berkeley M.P.H. graduate views the world. The end does not justify the means and it is discouraging and troubling that the Dean of the Berkeley School of Public Health apparently believes so. I was a student at Berkeley during the most turbulent and radical time in its existence (1966-1972) and only the most anarchist elements on the faculty espoused that 'radical' notion.

"I hope that letter was written on your behalf by some half-wit trying to be hip who does not reflect your world view. I cannot support an institution which shares the beliefs contained in your letter.

"Signed, Gary Passama."

Health care delivered by any means necessary is not good health care. The problem with true believers is that blind adherence to a belief gets in the way of truth. The ends do not justify the means.

In this era of political correctness and a hesitancy, particularly in academia, to confront coercion, I really did not expect a response. I was wrong.

This weekend I received a gracious reply from Dean Bertozzi. It is worth repeating in full:

"Dear Gary,

"Thank you for writing to me about the School's October 16 letter. Alumni feedback - positive or negative - is always very helpful to me and my colleagues. We really appreciate the insight into how our communications are coming across.

"I also want to apologize for the unfortunate wording of the Oct 16th letter. It came for my approval when I was out of the office and I only listened to it and gave a verbal OK. This episode makes me realize that communications that go out to such a wide audience need more careful review from me and I have built that time in for next year.

"At the same time, I want to assure you that none of us believes 'the ends justify the means.' The intent of my colleagues who drafted that sentence was to convey the passion that our community has for public health and the health of our communities - but that clearly did not come across, and for that I apologize. To some degree it may also be generational - the phrase probably is far more laden for someone of my generation than for people 20 years younger. My team and I will endeavor to be more careful about word and phrase choices in the future.

"I hope you can put this unfortunate letter out of your mind, because I would not want it to negate your goodwill toward the School and the hard work our faculty, staff and students are doing. We have many productive partnerships with Bay Area healthcare delivery systems and community groups. I also invite you to read our 2015-2020 Strategy [], which I stand behind as the framework for our School moving forward.

"If you'd like to talk further about the School's vision or connect with any of our HPM or MBA/MPH faculty or students, please don't hesitate to ask me. Thank you again for taking the time to reach out.

"Best regards, Stef."

That is the Berkeley I remember where the ends do not justify the means, in health care or anywhere else. So I'll be making a contribution to the School of Public Health - and to the football team.

Go Bears! Beat Oregon!

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