Iver Juster

Iver A. Juster, MD

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Iver A. Juster, MD

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With a background and several years in Family Medicine, I moved into managed care at a large staff model HMO and became frustrated with trying to make (or help the doctors make) evidence-informed clinical and services (also known as "utilization") decisions about new technologies, medicines and procedures. And we were tasked with improving outcomes cost-effectively (in other words, increasing 'value' as measured by dollars spent per health outcome achieved). I had access to a lot of data and analytic tools - but getting to "What's important...of value from whose perspective?" not so easy.

I learned more about measuring value (and the world it 'lives in') during 16 years  as outcomes specialist and health economist at a clinical decision support company, later subsumed into a national health insurer from which I recently retired (

The light switched on at a 2015 international conference about a condition I have a special interest in. The conference billed as convening the range of stakeholders in this very disabling condition, and it really was a wonderful meeting, yet at the end I yearned for an authentic sense of a community of stakeholders, who could together design, prioritize, communicate and monitor the progress of a research agenda.

I wrote: "Imagine patients, those who are in their lives, academics, researchers, clinicians and policy-makers seated around a table. The conversation starts out with each stakeholder saying "What I wish you understood about me is…" and asking the others "What do you wish I understood about you?" With skillful moderating we could from these mutual understandings develop and prioritize a research (and education) agenda that everyone could stand behind." (

So grateful to discover SPM and looking forward to learning and contributing!