I have held high-profile, leadership positions in clinical practice, scientific research, teaching, project design and management, and policy development. As a result, I have worked closely with virtually every major sector that affects health systems and health outcomes: clinical practice, managed care organizations, medical groups, hospitals and pharmaceutical firms. I have led successful projects for health plans, major businesses groups that purchase health,for their employees, and also with government agencies that define high-quality care. My research and managerial projects have focused on both health and economic outcomes. Because I have worked across all those sectors that influence health care practices and outcomes, I have been highly successful in identifying ways to improve efficiency and outcomes. I have developed, managed, and evaluated innovative programs designed to improve clinical outcomes and avoid unnecessary and costly practices. Because I have extensive experience working with the major national regulators, quality-improvement groups,government programs at all levels, I can therefore see the "big picture" and can design and implement solutions that work -- solutions that solve health care problems.Special skills include Internal medicine, infectious diseases, managed care, public health polic and organization, clinical research, epidemiologic research, health economics, health policy, and, education and advocacy, and ethics. I have documented management skills that build effective and efficient programs. Special relationships include Federal agencies such as AHRQ, NIH, and CDC.; businesses that purchase health care for employees and their families; private-sector organizations that set performance standards for health care, such as the Joint Commission, the National Quality Forum, NCQA, and the American Hospital Association.