The Freeman Spogli Institute for International Studies has welcomed five new senior military fellows, including three active duty lieutenant colonels from the U.S. Air Force and two from the U.S. Army, who will spend the next academic year at Stanford pursuing self-directed study of important national issues.

Former U.S. Secretary of Defense and CISAC faculty member Bill Perry created the program to give military officers the opportunity to take a deep dive into an area of strategic interest.

The fellows will be considering a diverse range of topics, from how to adapt Silicon Valley’s innovative work culture to the Army, to China’s actions in the South China Sea, and the effectiveness of U.S. economic sanctions against North Korea.

You can learn more about our fellows’ military backgrounds and the intended focus of their studies from the brief bios below.

John Cogbill and Scott Maytan will be assigned to the Center for International Security and Cooperation.

John Chu, Ryan Blake and Jose Sumangil will be based at the Walter H. Shorenstein Asia-Pacific Research Center.

LTC John Cogbill

LTC John Cogbill was commissioned as an Infantry officer from the United States Military Academy in 1994 and has held a variety of positions in both conventional and special operations units. John’s first assignment was as a Platoon Leader and Executive Officer in the 82nd Airborne Division. John then served two years in the 1st Battalion, 75th Ranger Regiment as a Platoon Leader and Civil-Military Affairs Officer. Next, John served three years in Alaska as an Airborne Rifle Company Commander and the Aide-de-Camp to the Commanding General. After earning his MPA from the Harvard Kennedy School, John taught Economics in the Social Sciences Department at West Point. Following the Command and General Staff College, he spent two years as a Combined Arms Battalion Executive Officer in the 1st Cavalry Division. He then served as the Strategic Plans and Requirements Officer for the 75th Ranger Regiment. Most recently, John commanded the Reconnaissance and Surveillance Squadron for the U.S. Army Third Corps. John has deployed on three combat and two peacekeeping missions, including two tours in Iraq, one tour in Afghanistan, one tour in Haiti, and a recent tour in Kosovo. He will be exploring how the Army can encourage innovation and use emerging technologies to achieve and maintain a competitive advantage on the battlefield.

Lt Col Scott Maytan, U.S. Air Force

Lt Col Scott Maytan was the commander of a B-52H operational bomb squadron, responsible for ensuring combat mission readiness for any worldwide nuclear or conventional tasking. Lt Col Maytan is a navigator with over 2500 flying hours, primarily in the B-52H, and is a graduate of both the Command and General Staff College (U.S. Army) and the U.S. Air Force Weapons School. He has served four operational assignments, as an advanced tactics instructor, and also a tour at the Pentagon where he developed Air Force positions concerning long-range strike and aircraft nuclear requirements. Lt Col Maytan has served three combat deployments for Operations Desert Fox (Southern Watch), Allied Force and Iraqi Freedom and has also deployed four times supporting USPACOM’s Continuous Bomber Presence mission. Maytan will be studying the “red-lines” that shape Western deterrence posture, and how strategic action and deterrence posture in one region affects others.

LTC John Chu, U.S. Army

LTC John Chu is an active duty officer in the United States Army. Chu has held a variety of leadership and staff positions in his 20 year career. Most recently, he served as the Chief of Intelligence Training at the Department of the Army. Chu has twice been deployed to Iraq and once to Bosnia, with multiple assignments to South Korea, Germany and Turkey. Born in Seoul, he grew up in California and graduated from West Point in 1995. At Stanford, Chu is researching the Korean armistice agreement and the United Nations mission to South Korea. He will also examine U.S. policy toward North Korea, particularly analyzing the “brink of war” tension and developing strategic deterrence measures to reduce risk of unwanted military escalation on the Korean Peninsula. For both research streams, Chu aims to produce analyses and recommendations that could inform a policy audience.

Lt Col Ryan Blake, U.S. Air Force

Lt Col Ryan Blake is an active duty officer in the United States Air Force. Blake was the commander of a flight test squadron where he was responsible for the flight test of new Air Force programs. He has over 2,400 flying hours in over 40 types of aircraft, and has held two operational F-15E assignments, including combat deployments in support of Operations Southern Watch, Iraqi Freedom and Enduring Freedom. He had also been positioned at the Pentagon in defense acquisition and the Office of Security Cooperation in Baghdad. At Stanford, Blake is researching the U.S. policy toward China and its relation to Northeast Asia. He aims to discover areas of cooperation between the U.S. and Chinese militaries.

Lt Col Jose “Ed” Sumangil, U.S. Air Force

Lt Col Jose “Ed” Sumangil is an active duty officer in the United States Air Force. During his career, Sumangil has served in a range of operational assignments, including joint staff officer at U.S. Strategic Command where he was a lead planner of the command’s space campaign. Before coming to Stanford, he was the commander of a B-1 squadron and led airmen through combat deployments in support of Operations Enduring Freedom, Inherent Resolve and Freedom’s Sentinel. At Stanford, Sumangil is examining China’s actions in the South China Sea and the Philippines arbitration case regarding Chinese actions there. He seeks to offer perspectives and policy and strategy options to maintain peace and stability in the South China Sea.

Rodney Ewing, senior CISAC fellow and Frank Stanton professor in nuclear security, has been honored with three prestigious awards in the geological and mineralogical sciences.

Ewing will receive two medals at the Geological Society of America’s next annual meeting in Baltimore at the end of this month: the Ian Campbell Medal for Superlative Service to the Geosciences from the American Institute of Geosciences, and the Roebling Medal of the Mineralogical Society of America for scientific eminence.

He is being recognized for his groundbreaking research on nuclear materials and his contributions to nuclear waste management.

“Rod Ewing is a modern mineral scientist at the top of his field who has excelled in both science and service,” according to the citation for the Campbell Medal.

“Dr. Ewing has made seminal contributions to our knowledge of radiation damage in minerals and the design of waste forms for high-level nuclear waste. And he continues to have a major impact on the policies underlying nuclear waste management in the United States.”

The international impact of professor Ewing’s research into nuclear waste storage is also being recognized with the IMA Medal of Excellence in Mineralogical Sciences from the International Mineralogical Association, which will be awarded at a meeting in Rimini, Italy next September.

U.S. Senator John McCain told a select group of Stanford undergraduate students that technological innovation had created both unparalleled opportunities for the United States as well as new national security risks, during a visit to Silicon Valley this week.

“This has changed the world,” Senator McCain told the students as he held up his smart phone.

“This is the biggest change in our ability to inform and educate than any invention since the printing press.”

However, McCain told students that he believed the United States needed to develop a clearer policy for responding to cyber attacks from foreign nations.

Image

“The people who are doing these cyber attacks have to realize that the costs will be higher than the benefits of the attack. Everybody has to know that there will be a price to pay for it.”

McCain called on the students, who included several computer science majors, to step up and defend the United States in cyber space.

“I would call on the people here to help us develop defensive capabilities, and frankly, offensive capabilities,” McCain said.

In the wide-ranging conversation, McCain fielded questions from students and shared his views on the conflict in Syria, the Iran nuclear deal, Russia’s imperial ambitions and the pullout of U.S. troops from Afghanistan.

“I study international security, and I feel that his dedication to national security and to veterans have been fundamental, and it was an honor to meet him and hear him talk about these issues,” said Chelsea Green.

The forty students who met with McCain were selected for their special interest in international affairs and politics, and included representatives from the Center for International Security and Cooperation’s honors program, Hoover Institution National Security Mentees and Stanford in Government student group.

International relations major Kayla Bonstrom said she was excited to meet the Senator from her home state of Arizona.

“He was very easy to talk to,” she said.

Bonstrom said McCain’s casual style, which included the occasional joke, helped put the students at ease.

“It was nice to see him in a different setting.”

Mathematical and computation science major Varun Gupta said he was touched by the empathy McCain showed when he shared his experiences visiting refugee camps in war zones.

[[{"fid":"220696","view_mode":"crop_870xauto","fields":{"format":"crop_870xauto","field_file_image_description[und][0][value]":"","field_file_image_alt_text[und][0][value]":"","field_file_image_title_text[und][0][value]":"U.S. Senator John McCain gives an impassioned presentation to students about American foreign policy, as CISAC faculty member Coit Blacker looks on.","field_credit[und][0][value]":"Rod Searcey","field_caption[und][0][value]":"","field_related_image_aspect[und][0][value]":"","thumbnails":"crop_870xauto"},"type":"media","attributes":{"title":"U.S. Senator John McCain gives an impassioned presentation to students about American foreign policy, as CISAC faculty member Coit Blacker looks on.","width":"870","style":"width: 400px; height: 267px; float: left; margin-right: 15px","class":"media-element file-crop-870xauto"}}]]“It was good to see his concern, his actual visceral concern for these issues,” Gupta said.

“It was really great to see the more human side.”

Other students were also impressed by McCain’s sincerity.

“He seems to sincerely believe in all of his views,” said Alexa Andaya, a political science major.

“You can tell when he says something he’s genuine about it.”

Matt Nussbaum, another political science major, said that while he disagreed with many of McCain’s hawkish positions on national security, he welcomed the opportunity to hear the opinions of such a seasoned veteran of foreign policy.

“A lot of times, we’re looking at the academic side of things, and I think that’s very interesting, but Senator McCain and other policy makers use the theory to create policy, so it’s useful to see what they think, how they think and why they think that way,” Nussbaum said.

McCain ended his talk by urging the students to get more involved in politics, whether they were “Democrat or Republican, libertarian or vegetarian.”

He told them that he believed the next presidential election was going to be the most important decision point for the country since 1980, when Republican Ronald Regan defeated Democratic incumbent Jimmy Carter.

“Pick the cause that you want to support, pick the candidate you want to support, and be engaged,” he said.

“It’s your future. You’re the ones that are going to live with the person that you choose to be president of the United States.”

As more physicians move from solo and small practices, a dozen common medical procedures are becoming more expensive in areas where physicians are clustered into large medical practices, according to a new study.

The October study in Health Affairs assessed the relationships between physician competition and prices paid by private organizations in 2010 for 15 common, high-cost procedures to determine whether high concentrations of physician practices and accompanying increased market power were associated with higher prices for services.

They found that prices were indeed 8 to 26 percent higher in the thousands of counties analyzed, with the highest average physician concentration compared to counties with the lowest. This was for 12 of the 15 procedures they examined, including colonoscopy with lesion removal, vasectomy, laparoscopic appendectomy and knee replacement surgery.

“Our findings are consistent with the hypothesis that greater market power allows physicians to bargain for higher prices from insurers,” wrote Dan Austin, a graduate of the Stanford University School of Medicine and a resident physician at the University of California, San Francisco, and Laurence C. Baker, chair of Health Research and Policy at Stanford and a core faculty member at CHP/PCOR.

“We concluded that physician competition is frequently associated with prices,” they said. “Policies that would influence physician practice organization should take this into consideration.”

The authors studied 15 high-cost, high-volume procedures that generated 7,000 total bills in 2010 and had a mean price of at least $500. They identified nine surgical and medical specialties: dermatology, cardiology, radiation oncology, gastroenterology, otolaryngology, urology, ophthalmology, orthopedics, and general surgery.

Average prices for the procedures studied varied. Total knee replacement surgery and insertion of intracoronary stent were the two most expensive, at  $2,301 and $1,282, respectively. Vasectomy and colonoscopy were the least expensive, at  $576 and $586.

The authors found there was also considerable variation across counties within each specialty. The mean price in the 90th-percentile county was 1.8 to 2.7 times higher than in the 10th-percentile county. The 75th-percentile county was commonly $200 to $300 more expensive than the 25th-percentile county, and in some cases more.

This study adds to the growing body of research that demonstrates wide variation in medical prices for the same procedure or test based on a number of factors, including where a procedure is performed and who performs it.

“We know from some good examples that larger, well-run practices can provide high- quality care," Baker said in an interview. “And many of our current policies are built around the notion that we should encourage the formation of larger organizations in the hope of improving the quality of care and fostering improvements in value."

But, adds Baker: “It is also important that we factor in these kinds of effects on prices and the downstream impacts this can have on our health-care costs.”

Health economics expert Laurence C. Baker has been appointed chair of the Department of Health Research and Policy (HRP) in the Stanford School of Medicine. He said he intends to encourage students and faculty within the department to expand the use of emerging data and analytic tools in their health-care research and policy recommendations.

Baker, a professor of health research and policy and a core faculty member at the Center for Health Policy/Center for Primary Care and Outcomes Research, succeeds Philip W. Lavori, who becomes vice chair of the newly established Department of Biomedical Data Science.

“Laurence is a natural and excellent choice for the HRP chair position,” said Stanford Dean of Medicine Lloyd Minor. “Well-respected, trusted, and admired by his peers, Laurence has been chief of Health Services Research within HRP since 2001, during which time the division has grown in strength and reputation.”

Minor called Baker one of the top health economic experts in the world with a strong policy focus, saying he would “bring the unique perspective, energy, and thoughtful guidance needed during this time of change for the department.”

The Health Research and Policy department houses the divisions of Health Services Research and Epidemiology, and provides the analytical foundation for research conducted at the Stanford School of Medicine, offering expertise, research and training on collecting and interpreting the scientific evidence essential to improving human health.

“It’s an exciting time for health policy and the Division of Health Services Research,” Baker said. “The country is facing important challenges in our health-care system, and countries around the globe are looking for insights and new ideas that can improve health care. So  there are real opportunities for Stanford to be a leader and make a difference.”

Baker, who is also a research associate at the National Bureau of Economic Research, said that in his new role he intends to strengthen the epidemiology and the health services research groups at HRP. He will build on Lavori’s efforts to recruit diverse junior and senior faculty, train and retain graduate students and post-MD physician scientists, and make significant contributions to the Stanford Cancer Institute and Population Health Sciences.

“I’ve learned a lot from Phil and have really appreciated his steady and thoughtful leadership of HRP, as well as his insightful approaches to seeking excellence at a time of great change,"  Baker said. “We already have a strong history of making important contributions, and I think we are in an excellent position to make the most of new opportunities — like bigger and better emerging data and analytic tools and new settings for research — to do outstanding work.”

Image

Baker said that the department successes have also included growing its faculty, establishing  new PhD programs and working on interdisciplinary research projects at the School of Medicine and in collaborations with CHP/PCOR.

“I want to continue looking for opportunities to grow and strengthen the research and education that we offer, in the hope that we can strengthen the overall contribution to national and international health policy that Stanford can make,” he said.

Baker’s research examines the impact of financial incentives, regulations and organizational structures in health care. He also looks at the impact of managed care and related insurance arrangements on health care costs, the pricing of physician services, prices for health insurance and the availability and utilization of medical technologies.

Baker completed his doctoral degree in Economics at Princeton in 1994, and joined the faculty at Stanford in HRP soon after. His research focuses on the way that changes in health-care delivery systems influence the cost and quality of care, with a particular interest in the growth of large, multi-specialty, and hospital-affiliated medical practices.

In addition to his position in HRP, Baker is a professor of economics (by courtesy) at Stanford, a fellow of the Center for Health Policy, and a senior fellow of the Stanford Institute for Economic Policy Research.

He also leads the School of Medicine’s Scholarly Concentration and Medical Scholars programs. Baker has received multiple honors and awards, including the ASHE medal from the American Society of Health Economists, and has helped lead key professional groups, serving on the boards of directors of the International Health Economics Association, AcademyHealth, and the American Society of Health Economists.

“There is growing recognition of the need for well-crafted health policies that can help us deliver quality care and real value,” Baker said. “More and more people are on the lookout for ways to improve population health in the United States and around the world, so I think we’re going to see more interest in the kind of work we do.”

Most Americans will get at least one faulty diagnosis in their lifetime, sometimes with devastating consequences. “Urgent change is warranted to address this challenge,” according to a recent landmark report from the Institute of Medicine.

The September report, by a committee of medical experts, found that despite dramatic improvements in patient safety over the last 15 years, diagnostic errors have been the critical blind spot of health-care providers.

Kathryn McDonald, executive director of Stanford’s Center for Health Policy/Center for Primary Care and Outcomes Research, is a member of the committee that wrote the report, “Improving Diagnosis in Health Care.”

We ask McDonald Five Questions about the report’s findings and also got her suggestions for limiting one of the most overlooked health-care dilemmas today. You can read her responses here on the Stanford Medicine news center website.

Read more here about the report when it came out last month.

B

Basic science aims to advance knowledge, not only develop new drugs or cure disease. Yet today's biomedical innovations are only possible because of fundamental research conducted decades ago. As national funding priorities shift toward applied research, young basic scientists face the most challenging funding landscape in 50 years, diverting many of them to new careers altogether. Though impossible to divine where the experiments of Stanford investigators and researchers will lead them, investing in their work — and in basic science in general — is crucial to keeping the next great discovery alive.

In this multimedia photo essay, Magnum photographer Peter van Agtmael and FSI digital media associate Kylie Gordon, shine light on the interdisciplinary medical and scientific research being conducted at Stanford — which could lead to the #NextGreatDiscovery.