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John Lumpkin, MD, MPH, senior vice president and director of the Health Care Group of the Robert Wood Johnson Foundation, delivered the keynote at the 136th Meharry Medical College Convocation on October 3, 2011. In his remarks Lumpkin discusses the importance of "going upstream" to work to prevent health problems before they become bigger issues, an instinct without which medical skills, even of the highest order, fail to become a healing art.