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Charting a Course for Better Health Care

Hanover, NH—As a U.S. Navy navigator in the 1950s, Richard "Dick" Fleming (D'53) calculated routes that would take ships to their destinations as quickly as possible without compromising safety. The job was a natural for Fleming, who went on to complete an MBA at the Tuck School of Business at Dartmouth and build a career as a consultant focused on gathering and analyzing data—often health care data. That's how he came to know and appreciate the work of the Dartmouth Atlas at the Geisel School of Medicine. Fleming recently established a substantial bequest for the Atlas in his estate plans.

"Gifts such as Dick's allow us to respond quickly to emerging issues and avoid the lags inherent in the granting process," notes David Goodman, M.D., M.S., the Atlas program's co-principal investigator. "That kind of flexibility enables us to get information quickly into the public domain and lead the national discourse about the quality and efficiency of health care."

For more than 20 years, the Dartmouth Atlas Project has been documenting the often glaring geographic variations in how medical resources are distributed and used in the United States, independent of the medical needs of a region or health outcomes. The Atlas is a program of The Dartmouth Institute for Health Policy and Clinical Practice, a part of the Geisel School. For health-care providers, policymakers, and analysts—like Dick Fleming—the Atlas is a valuable resource for reducing unnecessary spending, improving quality, and achieving the best possible outcomes for people.

Among Fleming's projects as a consultant was calculating the determination of need for new health-care facilities in his home state of Massachusetts.

"If you want to build or add to a hospital or nursing home," he explains, "in most states you first have to be able to answer the question, 'Is this service necessary or are we overbuilding?'"

End-of-life care is another common area of interest for the Dartmouth Atlas and Fleming. Inspired by his mother's courageous decision to forego aggressive treatment near the end of her life, Fleming established his planned gift as a memorial to his parents.

"The Dartmouth Atlas is very focused," he says. Like a navigator charting a ship's course, Fleming gets that. "Delivering the right amount of service at a reasonable cost—that's the essence of the Dartmouth Atlas and what attracted me to learn more about it and to support it. I appreciate knowing that my gift will make a tangible contribution to that effort."