Kurt C. Stange, MD, PhD

headshot of kurt stange

Home Institution: Case Western Reserve University

Field: Family Medicine and Community Health 

Current Positions:

My Driving Question

How can the core values of family medicine and community health can be re-invented in a new era of information and technology?

Scholar Project 

RELATIONSHIP-CENTERED CARE AT THE
COMMUNITY INTERFACE

Dr. Stange is examining the integration of relationship-centered care at the crossroads between person and population. His work fosters a dialogue between numbers and narrative, between quantitative and qualitative, between statistic and story.

By iterating between on-the-ground research and development projects, and narrative and scientific writing, Dr. Stange is working to discover how the fundamental primary health care tenets can be carried forward and re-invented by a new generation in the information age.

The research and development work encompasses diverse initiatives at the health care-community/public health interface. The writing involves scientific articles, theory development, policy analysis, narrative non-fiction, and a novel. This work includes mentoring a new generation that is trying to balance individual responsibility with evenhanded opportunity to advance the collective good over individual and group avarice.

Biography 

Kurt C. Stange, MD, PhD, is a family and public health physician, practicing at Neighborhood Family Practice, a federally-qualified community health center in Cleveland, Ohio. 

At Case Western Reserve University he is a Distinguished University Professor, and is the Gertrude Donnelly Hess, MD Professor of Oncology Research, and Professor of Family Medicine and Community Health, Epidemiology & Biostatistics, Oncology and Sociology.

He is an American Cancer Society Clinical Research Professor, and serves as editor for the Annals of Family Medicine (www.AnnFamMed.org). He is working on Promoting Health Across Boundaries (www.PHAB.us). He is a member of the Institute of Medicine of the US National Academy of Sciences.

Dr. Stange serves and has served in numerous leadership and educational roles. His research uses participatory, multimethod, systems science-informed approaches that aim to understand and improve primary health care and community health. This includes basic science investigation to reveal how health care can be integrated, personalized, prioritized and linked with public health, to foster healthy individuals, families and communities. His highly collaborative lines of investigation are advancing understanding of cancer prevention and control, how care can be improved for people with multiple chronic conditions, how patient strengths can be effectively brought into health care, and how multiple sectors can work together to improve the health of their community.

Education and Training
  • Certificate, Physician Executive Institute, Health Systems Management Center, Weatherhead School of  Management, Case Western Reserve University
  • PhD, University of North Carolina School of Public Health
  • MD, Albany Medical College
  • AB, Dartmouth College
Selected Honors
  • Distinguished University Professor, Case Western Reserve University, 2014 
  • Max Cheplove Award, New York State Academy of Family Physicians, 2013
  • Family Medicine Mentorship Award, CWRU School of Medicine, 2013
  • Family Medicine Education Consortium’s Champion of Family Medicine Award, 2012
  • Curtis G. Hames Research Award, Society of Teachers of Family Medicine, 2012
  • American Cancer Society Clinical Research Professorship, 2007-2017
  • Society of Teachers of Family Medicine Award for best peer-reviewed research paper, 2011
  • American Cancer Society Cuyahoga County Unit Cancer Hall of Fame Award in Research, 2006
  • Maurice Saltzman Award, Mount Sinai Health Care Foundation, 2005
  • Charles Kent Smith Faculty Award, 2004
  • Elected to the Institute of Medicine of the National Academy of Sciences, 1999
  • Robert Wood Johnson Foundation Generalist Physician Faculty Scholar, 1994-1998
  • Fellow, American College of Preventive Medicine, 1991
  • Kenneth G. Reeb, MD Award for Excellence in Teaching, CWRU/University Hospitals Family Practice Residency Program, 1990
  • Commendation from the Medical Assistants at the University Hospital Family Practice Center, 1989
  • Certificate of Merit from the (US) Secretary of Health & Human Services “For a Proposal for an Innovative Approach to Health Promotion and Disease Prevention,” 1988
  • William J. “Terry” Kane, MD Award for Excellence in Clinical Family Medicine, Duke-Watts Family Medicine Program, 1986
  • Chief Resident, Duke-Watts Family Medicine Program, 1985-1986
  • The Anna Perkins Award in Family Medicine, Albany Medical College, 1983
  • Alpha Omega Alpha, Albany Medical College, 1982
  • Highest Distinction in Biology, Dartmouth College, 1979
Selected Publications

Healing is facilitated through safety, persistence, and trust.

  • Persistence: “People did not simply progress through this sequence and experience healing. The healing journey was a recursive, back and forth process. They found helpers, used the skills/resources that those helpers provided, found other helpers that provided more resources and used those skills and resources. As this process continued, people experienced a gradual amelioration of their suffering. Although many despaired at times, all demonstrated the quality of persistence—they refused to give up.”
  • Safety & Trust: “To connect to helpers, it was essential for people to feel safe in those relationships and able to trust that the person would be a helper and not a barrier to healing. Persons whose wounds included a violation of trust were especially careful about testing the safety of new relationships.”

Resources support us as we heal. They include reframing, responsibility, and positivity. “Making connections enabled participants to acquire and refine resources and skills that were essential in their healing journey. People also brought their own personal strengths to the journey.”

  • Reframing: “A particularly important skill was the ability to reframe—that is to look at suffering through a different lens.” This does NOT mean minimizing trauma or pain, but rather it often means the opposite: understanding what happened was wrong, unfair, or uncontrollable and that we are not to blame for it.
  • Responsibility: While we don’t have control over what happened to us, we are the only ones who can help ourselves heal. “A third essential resource that people acquired or refined was the ability to take an appropriate amount of responsibility for their healing journeys. They participated actively in the process of healing. Once again, some participants already had developed this skill, and some acquired or refined it from their helpers.”
  • Positivity: “Another resource that people acquired or refined during their healing journey was choose to be positive—that is to have some optimism about their situation.” People have varying predispositions to positivity. In the study, positivity was important in helping people heal. This doesn’t mean a toxic positivity, but rather simply finding some good in life and feeling hopeful about our situations.

“Connection to others was an essential part of all the healing journeys.” Humans are social creatures, and even the most introverted of us need close relationships. Friends and family add meaning and value to life and help support us, in good times and bad. 

When we experience relational trauma, relationships can feel scary, but reestablishing safety and trust in relationships is where the healing happens. (To be clear, we do not mean reestablishing safety and trust with abusers, but rather finding other healing relationships.) 

“When safety and trust had been established, people were able to connect with helpers. The nature of the behaviours of helpers that fostered healing ranged from small acts of kindness to unconditional love.”

  • “Moving from being wounded, through suffering to healing, is possible. It is facilitated by developing safe, trusting relationships and by positive reframing that moves through the weight of responsibility to the ability to respond.”
  • “Relationships with health professionals were among these but were not necessarily any more important to the healing journey than other kinds of helpers, which included family members, friends, spirituality and their God, pets, support groups, administrators, case workers and supervisors.”

Healing probably means different things to different people, but one definition that emerged from the study is: “The re-establishment of a sense of integrity and wholeness.” 

Healing was an emergent property that resulted from each individuals’ complex healing journey, a result of bridged connections between resources and relationships. “…they gradually found relief from suffering and began to exhibit emergent characteristics: a sense of hope, self-acceptance, and a desire to help others—the immediate precursors to healing.”

 In varying degrees, “they were able to transcend their suffering and in some sense to flourish.” 

  • Helping Others: We find meaning in helping others. “Understanding that suffering gives the strength and experience to help others in similar situations.”
  • Hope: We begin to have hope that we will not always feel this bad. A Crohn’s patient said, “I think gradually I realized that I was going to feel better. I did have days when I actually didn’t vomit, when I did feel better. And I think gradually I came to believe that maybe I could have a normal life again.”
  • Self-Acceptance: We see our inherent value and understand that we are not to blame for our suffering. A participant living with HIV said, “I’m really proud of myself. I think that now I still want to live. I don’t want to die, and I really love myself a lot. I have a lot of comfort in myself.”

Suffering is the ongoing pain from wounding. 

There is debate about whether or not one actually needs to experience suffering on the path to healing.

Wounding happens when we experience physical or emotional harm. It can stem from chronic illness or by physical or psychological trauma for which we do not have the tools to cope, or a combination of those factors. 

“The degree and quality of suffering experienced by each individual is framed by contextual factors that include personal characteristics, timing of their initial or ongoing wounding in the developmental life cycle and prior and current relationships.”

Characteristics: How predisposed someone may be to wounding/how many tools and resources someone may have to deal with trauma/illness.

Lifestages: Developmental timing plays an important role in the impact of trauma — young children often do not have the same resources as older adults.

Relationships: Relationships can provide solace and support for those suffering, while lack of healthy relationships can prolong suffering.