Department of Medicine

Department of Medicine

  Division of General Internal Medicine

Division of General Internal Medicine Newsletter

  • GIM News
  • Donna L. Bishop, Editor
  • Next issue:
    May 25, 2018
  • Submission deadline:
    April 20th, 2018
  • E-mail: Donna Bishop

Rishi Manchanda, MD, MPH, Physician and Activist, Inspires Students and Faculty During Visiting Professorship in September

The Center for Behavioral Health & Smart Technology also co-sponsored the recent visit to the University of Pittsburgh by Rishi Manchanda, MD, MPH, president and founder of HealthBegins, a non-profit “think-and-do tank” based in California. As a visiting professor from September 25 to 26, he met with faculty, students, and staff, and delivered the Department of Medicine Grand Rounds presentation, “Moving Upstream: Addressing Social Determinants to Advance the Quadruple Aim and Health Equity.” Dr. Manchanda, who combines roles as a physician, author, community health activist, and "upstreamist"—more on this later—is motivated by a determination to improve population health by addressing social determinants of health. The company he founded, HealthBegins, shares a similar goal: to create a smarter health care system that improves health where it begins.

During his visit to Pittsburgh Dr. Manchanda met with our health care and educational leaders and was very impressed with UPMC Health Plan’s commitment and efforts to improve the health of dual eligible beneficiaries. At the same time, he inspired our residents and students to think outside the box, creatively and astutely, to solve the biggest challenges in health care today: cost and inequities.

Dr. Manchanda also had a lively discussion with Thuy Bui, MD, associate professor of medicine, on how we could incentivize hospitals, clinics and health care-related organizations to develop quality improvement activities that address root causes of diseases and population health issues. Dr. Bui encourages readers of this newsletter to share their opinions on the subject (email:, on which there are multiple viewpoints as to how best to tackle health-related social needs like inadequate housing, employment, income, healthy food, social support, health literacy and neighborhood safety. One approach is exemplified by a recent initiative from Geisinger to offer a fresh food pharmacy program. Another option is to try to infuse aspects of social determinants of health into each and every quality improvement project at UPMC. For example, a QI project on improving discharge instruction could go “upstream” and address the needs of patients with limited English proficiency in the discharge process. Which approach do you favor—tailored projects or the drip method? (And no, “trickle down,” is not a third option.)

“If there is enough of us going upstream,” Bui said, “we can change the direction of health care in this country.” Dr. Manchanda also shared with Julia Holber, Associate Director of the CBHST and one of its research associates, that “going upstream requires not just financing and resources but vision, commitment, executive sponsorship, and teamwork.” UPMC seems primed to take on this challenge.

Kudos to Bruce Rollman, MD, MPH, CBHST Director, for planting the seeds to get Dr. Manchanda to come to Pittsburgh and for cheerleading the Program for Healthcare to Underserved Populations.