Nirav Shah to head NY's health department

Mrs Calderon, an elderly patient who came to see Dr Nirav R Shah during his residency, did not speak any English. So she would bring her daughter to translate. When she ended up taking twice the dose of a medicine Shah had prescribed for her, Shah says he learned his first big lesson.

'I had a new appreciation for how critical a patient's understanding is and how you can not take it for granted,' he confessed to a medical journal recalling the encounter that had happened about 10 years ago.

Shah, 38, was recently selected  by New York Governor-elect Mario Cuomo as the commissioner for the State Department of Health that has a budget of $4.6 billion (excluding Medicaid).

'The other thing I noticed was how happy and healthy she was, despite her overall economic and living situation, which was poor,' Shah continued about Mrs Calderon. 'She described her quality of life as good because she had a strong network of close family and friends who kept her in good spirits. She never appeared or acted sick. This is a great example of why the new models of care involving community and family are so effective.'

Shah, a specialist in internal medicine, has taken special interest in studying the means of offering better health care despite the reduction in state budget for low-income patients. An attending physician at Bellevue Hospital Center and as assistant professor at New York University's Langone Medical Center, Buffalo, New York-raised Shah is an alumnus of Harvard College, Yale School of Medicine, and the University of California Los Angeles. He will hold one of the top positions in the state government. His nomination is not expected to face hurdles when it comes for confirmation before the state senate.

According to CityHall.com, Shah was vetted by Cuomo's health-care transition team, who say they were looking for someone who understood  upstate and downstate health needs, as well as bring fresh ideas to the state health agency.

'He's a pretty dynamic guy with a background in disease management and ways to predict future health-care costs,' Stephen Acquario, executive director of the New York State Association of Counties and a member of Cuomo's health-care transition team said. 'He comes in at a really opportune time, when federal health-care reform allows us to make these changes.'

The Department of Health oversees state hospitals, health care facilities, and public health prevention initiatives, including efforts to encourage breastfeeding, and reduce  sodium use. Children's safety, anti-smoking advocacy and cleaner water are among the many tasks for the department.

'As an internist with deep experience in community health and an expert in comparative effectiveness, Dr Shah is ideally suited to lead the Department of Health in today's challenging health-care environment,' said Robert Grossman, dean and chief executive officer, NYU Langone Medical Center.

A powerful gay and lesbian organisation said unlike previous commissioners who were much older than Shah, the new commissioner could be more effective in helping the community.

'With Dr Shah's history working with marginalized populations and his roots in upstate New York, we are hopeful that he will continue this strong legacy and make New York a beacon of health care in the 21st Century throughout the nation,' said Brittany R Allen, executive director, New York AIDS Coalition.

Daniel Sisto, president, Health Association of New York State, said, 'Dr Shah's understanding of vulnerable populations, his expertise in designing efficient models of care delivery, and his background in clinical quality research and health information technology should help New York State work with stakeholders to redesign Medicaid and improve health-care delivery. We need a new approach that avoids yet another round of across-the-board Medicaid cuts.' Shah believes health-care providers including hospitals and doctors must find out the most appropriate care and  ways to treat patients. 'We are really transforming how we think of the doctor-patient relationship to include things like patient-centered care, electronic health records, and utilizing other health-care team members such as a specialized nurse practitioner,' he said.

Shah, who lives in New York with wife Nidhi and two children, is a great believer in family involvement in promoting better health.

Image:  Dr Nirav Shah