healthcare horrors & hope tom peters/10.26.2004. 1. premise

Healthcare Horrors &

HopeTom Peters/10.26.2004

1. Premise.

“If one didn’t know better, one might think that hospitals set

out to design systems that provide the most sophisticated technical care but deliver the worst possible experience to sick people.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel

Golden American Age of Patient-centric, Genetics-driven Healthcare Looms!

Current status: $1.3T+. 30M-70M uninsured. 100K killed and 2M injured p.a. in hospitals. 85% treatments

unproven. Cure depends on locale in which treated. 50% prescriptions do not work. 2X docs. 2X hospitals.

IS primitive. Accountability & measurement nil.

And … EVERYBODY’S MAD-AS-HELL AND FEELS POWERLESS: DOCS, PATIENTS, NURSES, INSURERS,

EMPLOYERS, PHARMA & DEVICE COS, HOSPITAL ADMINISTRATORS AND STAFF.

2. Consumerism (Patient-centric Healthcare Arrives)

Anne Busquet/ American Express

Not: “Age of the Internet”

Is: “Age of Customer Control”

Amen!

“The Age of the

Never Satisfied Customer”

Regis McKenna

“We expect consumers to move into a position of dominance in the early

years of the new century.”

Dean Coddington, Elizabeth Fischer, Keith Moore & Richard Clarke, Beyond Managed Care

“Parents, doctors, stockbrokers, even military leaders are starting to lose the authority they once had. There are all

these roles premised on access to

privileged information. … What we are witnessing is a collapse of that

advantage, prestige and authority.”

Michael Lewis, next

Today’s Healthcare “Consumer”:

“skeptical and demanding”

Source: Ian Morrison, Health Care in the New Millennium

“He shook me up. He put his hand on my shoulder, and simply said,

‘Old friend, you have got to take charge of your own medical care.’ ”

Hamilton Jordan, No Such Thing as a Bad Day (on a conversation with a doctor pal, following Jordan’s cancer diagnosis)

“A seismic shift is underway in healthcare. The Internet is

delivering vast knowledge and new choices to consumers—raising their

expectations and, in many cases, handing them the controls.

[Healthcare] consumers are driving radical, fundamental change.”

Deloitte Research, “Winning the Loyalty of the eHealth Consumer”

“It may be the most far-reaching evolution of them all: the metamorphosis of passive patient into consumer – and well-informed,

assertive consumer at that. The defining axiom of traditional medicine – ‘doctor’s

orders’ is being turned on its head. These days it’s the patients who are armed, the

doctors who must get wired to keep nimble.” “E-health is the new house call.”

Richard Firstman, “Heal Thyself,” On Magazine

“Savior for the Sick”

vs.

“Partner for Good Health”

Source: NPR

Consumer Imperatives

ChoiceControl (Self-care, Self-management)

Shared Medical Decision-makingCustomer Service

InformationBranding

Source: Institute for the Future

“The ‘curative model’ narrowly focuses on the goal of cure. …

From many quarters comes evidence that the view of health

should be expanded to encompass mental, social and

spiritual well-being.” Institute for the Future

Determinants of Health

Access to care: 10%Genetics: 20%

Environment: 20%

Health Behaviors: 50%Source: Institute for the Future

“Consumerism”: HMO backlash (e.g., plans with more choice). Alternative Medicine, Wellness & Prevention bias. Info availability (disease, health,

docs, support groups, outcomes). Boomers (“I’m in charge!” Discretionary $$$$ to spend:

cosmetic surgery, vision improvement, fertility,

etc.). Self-care (chronic disease). High expectations (genetics, etc.) …

3. Demographics: The BOOMERS Reach 60 in ’05!

“NOT ACTING THEIR AGE: As Baby Boomers

Zoom into Retirement, Will America Ever Be the

Same?”USN&WR Cover

Boomer World

“From jogging to plastic surgery, from vegetarian diets

to Viagra, they are fighting to preserve their youth and

defy the effects of gravity.”M.W.C. Howgill, “Healthcare Consumerism, the Information

Revolution and Branding”

“Pick up any copy of Glamour or Men’s Health, and you’ll see pages of advertisements encouraging readers

to enlarge their breasts, retard baldness, correct their vision,

improve their smile, or relieve stress through herbs, massage therapy,

acupuncture—you name it.”Coddington, Fischer, Moore & Clarke, Beyond Managed Care

“Sixty Is the New Thirty”

—Cover/AARP/11.03

4. “Quality”: COULD IT TRULY BE

THIS AWFUL?

“Quality of care is the problem, not

managed care.”Institute of Medicine

“Without being disrespectful, I consider the U.S. healthcare delivery system the largest cottage industry in

the world. There are virtually no performance measurements

and no standards. Trying to measure performance … is the next

revolution in healthcare.”Richard Huber, former CEO, Aetna

“A healthcare delivery system characterized by idiosyncratic

and often ill-informed judgments must be restructured

according to evidence-based medical practice.”Demanding Medical Excellence: Doctors and Accountability in

the Information Age, Michael Millenson

“As unsettling as the prevalence of inappropriate care is the enormous amount of what can only be called

ignorant care. A surprising 85% of everyday medical treatments have never been scientifically

validated. … For instance, when family practitioners in Washington were queried about

treating a simple urinary tract infection, 82 physicians came up with an extraordinary 137 strategies.”

Demanding Medical Excellence: Doctors and Accountability in the Information Age, Michael Millenson

CDC 1998: 90,000 killed

and 2,000,000 injured from nosocomial

[hospital-caused] drug errors & infections

1,000,000 “serious

medication errors per year” … “illegible handwriting, misplaced decimal points, and missed drug

interactions and allergies.”

Source: Wall Street Journal / Institute of Medicine

Various studies: 1 in 3, 1 in 5, 1 in 7, 1 in 20 patients “harmed by

treatment”

Demanding Medical Excellence: Doctors and Accountability in the Information Age, Michael Millenson

HealthGrades/Denver: 195,000 hospital deaths per year in the U.S., 2000-2002 =

390 full jumbos/747s in the drink per year. Comments: “This should give you pause when you go to the hospital.” —Dr. Kenneth Kizer, National Quality

Forum. “There is little evidence that patient safety has improved in the

last five years.” —Dr. Samantha Collier

Source: Boston Globe/07.27.04

“This should give you pause when you go to the

hospital.”

“There is little evidence that patient safety

has improved in the last five years.”

RAND (1998): 50%, appropriate preventive care. 60%,

recommended treatment, per medical studies, for chronic

conditions. 20%, chronic care treatment that is wrong.

30% acute care treatment that is wrong.

“Established state-of-the-art cancer care—about

which there is no longer any debate—is erratically applied.”

Source: Institute of Medicine’s National Cancer Policy Board

“In a disturbing 1991 study, 110 nurses of varying experience levels took a written test of their ability to

calculate medication doses. Eight out of 10 made calculation mistakes at

least 10% of the time, while four out of 10 made mistakes 30 % of the

time.”Demanding Medical Excellence: Doctors and Accountability

in the Information Age, Michael Millenson

YE GADS! New England Journal of Medicine/ Harvard Medical Practice Study: 4% error rate (1 of 4 negligence). “Subsequent investigations around the

country have confirmed the ubiquity of error.” “In one small study of how clinicians perform when patients

have a sudden cardiac arrest, 27 of 30 clinicians made an error in using the defibrillator.” Mistakes in

administering drugs (1995 study) “average once every hospital admission.” “Lucian Leape, medicine’s

leading expert on error, points out that many other industries—whether the task is manufacturing

semiconductors or serving customers at the Ritz Carlton—simply wouldn’t countenance error rates like

those in hospitals.”—Complications, Atul Gawande

“In health care,

geography is destiny.”

Source: Dartmouth Medical School 1996 report

Geography Is Destiny

“Often all one must do to acquire a disease is to enter a country where a disease is recognized—leaving the

country will either cure the malady or turn it into something else. … Blood pressure

considered treatably high in the United States might be considered normal in England; and the low blood

pressure treated with 85 drugs as well as hydrotherapy and spa treatments in Germany would entitle its sufferer to lower life insurance rates in the

United States.” – Lynn Payer, Medicine & Culture

Geography Is Destiny

E.g.: Ft. Myers 4X Manhattan—back surgery. Newark 2X New Haven—

prostatectomy. Rapid City SD 34X Elyria OH—breast-conserving surgery. VT, ME, IA: 3X differences in hysterectomy by age 70; 8X tonsillectomy; 4X prostatectomy

(10X Baton Rouge vs. Binghampton). Breast cancer screening: 4X NE, FL, MI

vs. SE, SW. (Source: various)

PARADOX: Many, many formal case reviews …

failure to systematically/ systemically/ statistically

look at and act on evidence.C.f., Complications, Atul Gawande

“Most physicians believe that diagnosis can’t be reduced to a set of generalizations—to a ‘cookbook.’ … How often does my intuition lead me astray? The radical implication of

the Swedish study is that the individualized, intuitive approach that lies at the center of modern medicine is flawed—it causes more mistakes

than it prevents.” —Atul Gawande, Complications

Deep Blue Redux*: 2,240 EKGs … 1,120 heart attacks.

Hans Ohlin (50 yr old chief of coronary care, Univ of

Lund/SW) : 620. Lars Edenbrandt’s

software: 738.

*Only this time it matters!

“Practice variation is not caused by ‘bad’ or ‘ignorant’ doctors. Rather, it is a natural

consequence of a system that systematically tracks neither its processes nor its outcomes,

preferring to presume that good facilities, good intentions and good training lead automatically

to good results. Providers remain more comfortable with the habits of a guild, where

each craftsman trusts his fellows, than with the demands of the information age.”

Michael Millenson, Demanding Medical Excellence

Genius Required?

Leapfrog Group:

CPOE/Computerized Physician Order Entry*ICU staffing by trained intensivists**EHR/Evidence-based Hospital Referral***

*Duh I: Welcome to the computer age.**Duh II: How about using experts?***Duh III: If you do stuff a lotta times, you tend to get/be better. Source: HealthLeaders

The Benefits of … FOCUSED EXCELLENCE

Shouldice/Hernia Repair: 30-45 min, 1% recurrence.

Avg: 90 min, 10%-15% recurrence.

Source: Complications, Atul Gawande

5. The IS/Web REVOLUTION

“Some grocery stores have better

technology than our hospitals and

clinics.” —Tommy Thompson, HHS

Secretary

Source: Special Report on technology in healthcare, U.S. News & World Report (07.04)

“We’re in the Internet age, and the average

patient can’t email their doctor.”

Donald Berwick, Harvard Med School

Computerized Physician Order

Entry/CPOE: 5% of U.S.

hospitals

source: HealthLeaders/06.02

Want email consultation: 90% patients, 15% docs.

Evidence: Patients do not pester docs. Time is saved. No one has sued (shows “care & connection”—

the absence of which is the major cause of suits).

Source: New York Times

Telemedicine …

Reduces days/1000 patients and physician visits for the chronically ill

Decreases costs of managing chronic disease

Expands service areas for providers

Reduces travel costs to and from medical ed seminars

Douglas Goldstein, e-Healthcare

“Our entire facility is digital. No paper, no film, no medical records. Nothing. And it’s all integrated—from the lab to X-ray to records to physician order entry. Patients don’t have to wait for anything. The information from the physician’s office is

in registration and vice versa. The referring physician is immediately sent an email telling him his patient has shown up. … It’s wireless in-house. We have 800 notebook computers that are wireless. Physicians can walk around with a computer that’s

pre-programmed. If the physician wants, we’ll go out and wire their house so they can sit on the couch and connect to the

network. They can review a chart from 100 miles away.” —David Veillette, CEO, Indiana Heart Hospital (HealthLeaders/12.2002)

Detroit Med Center: $100M IS Makeover

Experiment: Surgical residents equipped with Palm IIIxe. Med Director: “It’s not unusual to have

a team of 5 or 6 residents responsible for the patients of 25 doctors. For each resident, that

could mean seeing 40 patients spread across 10 floors and 5 buildings.” Records work was

manual; but “Now you export the list of patients to your Palm, with the room number for each

patient and with lab results from the last

72 hours.”

The VHA gets it! E.g.: Laptop at bedside calls up patient e-records from one of 1,300 hospitals. Bar-coded wristband confirms meds. National Center for Patient Safety in Ann Arbor. Docs and researchers

discuss optimal treatment regimens—research center in Durham NC. Doc measures & guidelines; e.g.,

pneumonia vaccinations from 50% to 84%. Blame-free system, modeled after airlines. “What’s needed in the U.S. is nothing short of a medical revolution and

the VHA has gone further than most any other organization to revamp its culture and systems.”—

Rand/Source:WSJ 12.10.2001

“Patient by patient, problem by problem—drug reactions, hospital

caused infections—Salt Lake City’s LDS Hospital has attacked treatment-

caused injuries and deaths. One of the secrets of LDS’s success is a custom-

built clinical computer system that may serve as a national model for how

to save patient lives.”Demanding Medical Excellence: Doctors and Accountability

in the Information Age, Michael Millenson

Info Revolution

Consumerism (research, consultation, B2C, etc.)

Clinical Info Systems (guidelines and outcome measurement, etc.)

100% Web-based (internal) SystemsElectronic Medical Records

Patient-physician email-consultationTelehealth-Remote Monitoring

(biosensors, home testing, etc.)

Telemedicine (consultation, invasive treatment, “global medical village,” etc.)

6. Conclusion.

Golden American Age of Patient-centric, Genetics-driven Healthcare Looms!

Current status: $1.3T+. 30M-70M uninsured. 100K killed and 2M injured p.a. in hospitals. 85% treatments

unproven. Cure depends on locale in which treated. 50% prescriptions do not work. 2X docs. 2X hospitals.

IS primitive. Accountability & measurement nil.

And … EVERYBODY’S MAD-AS-HELL AND FEELS POWERLESS: DOCS, PATIENTS, NURSES, INSURERS,

EMPLOYERS, PHARMA & DEVICE COS, HOSPITAL ADMINISTRATORS AND STAFF.

7. HealthCare21

HealthCare21: 21 Ideas for Century211. Hospitals kill people. (And many of those they don’t kill, they wound.) (And they deny it.) (ERRORS RULE!) And: Hustling ambulances kill pedestrians—and don’t save patients.2. Doctors are spoiled brats—who don’t like measurements. Or any form of “interference.” Docs are also cover-up artists. The REAL Hippocritic [sic?] Oath: “DON’T RAT ON A FELLOW DOC”. 3. Most prescription drugs don’t work—for a PARTICULAR patient. Current drugs = Blunderbusses.4. Think … WELLNESS. Think … PREVENTION.5. THERE IS LITTLE “SCIENCE” IN “MEDICINE.” (See state to state variations … country to country variations … the general lack of agreed-upon treatments.)6. You could save thousands of lives (think Schindler)—if you just outlawed handwritten prescriptions.7. “Detailers” will disappear … when GenX docs arrive.

HealthCare21 (Cont.)8. IS/IT in hospitals is primitive (despite smart people and enormous expenditures—think Sears).9. Systemic IS/IT is worse—links between docs, insurers, providers, patients.10. ELECTRONIC MEDICAL RECORDS …TO UNIFORM STANDARDS. (NOW.) (PLEASE.) 11. THE WEB WILL LIBERATE. (Info = Power.) 12. 80M BOOMERS RULE. ($$$$$. Desire for c-o-m-p-l-e-t-e CONTROL. NOW. “LEADERSHIP” OF AGING PROCESS.)13. “Drug Discovery” processes at Big Pharma are … hopelessly over-complicated. (???: Bye Bye … Big Pharma.)14. 90% of the “healthcare fix”: HARVEST THE LOW-HANGING FRUIT. “They” are … NOT … the Enemy. “I have seen the enemy … and it am me.” Damn it.

HealthCare21 (Cont.)15. The number of U.S. un-insured is the nation’s #1 disgrace. That said, insured “consumers” are spoiled brats. They/we/me act as if healthcare were a free good … and believe that an incipient hangnail calls for at least a CAT scan … or two. ANSWER: MAKE US FEEL THE PAIN.16. Genetic engineering & biotech change … EVERYTHING. (Within 15 years.)17. New Medical Devices change … EVERYTHING. (Within 15 years.)18. IS/IT changes … EVERYTHING. (Within 10 years.)19. New Docs change … EVERYTHING. (Within 10 years.)20. New Patients change … EVERYTHING. (Within 5 years.)

* *

HealthCare21 (Cont.)

21. ALL THIS = ENORMOUS OPPORTUNITY. The

Opportunity of Several Lifetimes. (For the Bold & Brave.) H’Care WILL be … TOTALLY … re-invented in the next two decades. (And, hey, it is our largest “industry.”)

8. Doing It RightPlanetree: A Radical

Model for New Healthcare/Healing/Wellness Excellence

“It was the goal of the Planetree Unit to help

patients not only get well faster but also to stay well longer.” —Putting Patients First, Susan Frampton,

Laura Gilpin, Patrick Charmel

“Much of our current healthcare is about curing.

Curing is good. But healing is spiritual, and healing is

better, because we can heal many people we cannot

cure.” —Leland Kaiser, “Holistic Hospitals”

Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Determinants of Health

Access to care: 10%Genetics: 20%

Environment: 20%

Health Behaviors: 50%Source: Institute for the Future

The 9 Planetree Practices

1. The Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information3. Healing Partnerships: The importance of Including Friends and Family4. Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing6. Human Touch: The Essentials of Communicating Caring Through Massage7. Healing Arts: Nutrition for the Soul8. Integrating Complementary and Alternative Practices into Conventional Care9. Healing Environments: Architecture and Design Conducive to Health


1. The Importance of Human Interaction

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly.

Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget.

Kindness is free. Listening to

patients or answering their questions costs nothing. It can be argued that negative interactions—alienating patients, being

non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring

far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First, Susan


Press Ganey Assoc/1999: 139,380 former patients from 225 hospitals

0 of top 15 factors determining Patient Satisfaction referred to patient’s health outcome

PS directly related to Staff Interaction

PS directly correlated with ES (Employee Satisfaction)


Mgrs re staff: wages, security, promotion opportunities

Staff re staff: interesting work (M:5 of 10), appreciation (5 of 10), sense of being “in” about

what’s going on (10 of 10)


The Customer Comes Second: Put your People First and Watch ’Em Kick Butt, Hal Rosenbluth (and

Diane McFerrin Peters)

“100 Best Places to Work”/RLevering/2001

Get straight answers

Appreciation

Collaboration

Interest in me as a person

Camaraderie (“Fun place to work”)

“Perhaps the simplest and most profound of all human interactions is kindness. … But if it is so simple, it is surprising how

frequently it is absent from our healthcare environments. … Many staff members report verbal ‘abuse’ by physicians,

managers and coworkers.” —Putting Patients First, Susan


“Planetree is about human beings caring

for other human beings.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel (“Ladies and gentlemen serving ladies and gentlemen”—4S credo)

2. Informing and Empowering Diverse

Populations: Consumer Health Libraries and

Patient Information

Planetree Health Resources Center/1981Planetree Classification System

Consumer Health LibrariansVolunteers

Classes, lectures (CR)Health Fairs

Griffin’s Mobile Health Resource CenterOpen Chart Policy

Patient Progress NotesCare Coordination Conferences (Est goals, timetable,

etc.)


3. Healing Partnerships: The

importance of Including Friends

and Family

“When hospital staff members are asked to list the attributes of the ‘perfect patient and family,’ their

response is usually a passive patient with no family.” —Putting Patients First,

Susan Frampton, Laura Gilpin, Patrick Charmel

The Patient-Family Experience

“Patients are stripped of control, their clothes are taken away, they have little say over their schedule, and they are deliberately separated

from their family and friends. Healthcare professionals control all of the information

about their patients’ bodies and access to the people who can answer questions and connect

them with helpful resources. Families are treated more as intruders than loved ones.”

—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

“Family members, close friends and ‘significant others’ can have a far

greater impact on patients’ experience of illness, and on their

long-term health and happiness, than any healthcare professional.” —Through

the Patient’s Eyes


“A 7-year follow-up of women diagnosed with breast cancer

showed that those who confided in at least one person in the 3

months after surgery had a 7-year

survival rate of 72.4%, as compared to 56.3% for those who

didn’t have a confidant.”Institute for the Future

Institute of Medicine/ “Crossing the Quality Chasm”

Respect for preferencesInvolvement in Decision Making

Access to careCoordination of care

Information and educationPhysical comfort

Emotional supportInvolvement of Friends and Family

Continuity of care


Care Partner Programs (IDs, discount meals, etc.)

Unrestricted visits (“Most Planetree hospitals have eliminated visiting restrictions altogether.”) (ER at one hospital “has a policy of never

separating the patient from the family, and there is no limitation on how many family members may be present.”)

Collaborative Care ConferencesClinical Guidelines Discussions

Family SpacesPet Visits (POP: Patients’ Own Pets)


4. Nutrition: The Nurturing Aspect

of Food

Meals are central events

vs

“There, you’re fed.”*

*Irony: Focus on “nutrition” has reduced focus on “food” and “service”


KitchenBeautiful cutlery, plates, etc

Chef rep


Aroma therapy (eg “smell of baking cookies”)


5. Spirituality: Inner Resources for Healing

Spirituality: Meaning and Connectedness in Life

1. Connected to supportive and caring group2. Sense of mastery and control3. Make meaning out of disease/find meaning in suffering


Griffin: redesign chapel (waterfall, quiet music, open prayer book)

Other: music, flowers, portable labyrinth


6. Human Touch: The Essentials of Communicating

Caring Through Massage

“Massage is a powerful way to communicate caring.” —Putting Patients

First, Susan Frampton, Laura Gilpin, Patrick Charmel

Mid-Columbia Medical Center/Center for Mind and Body

Massage for every patient scheduled for ambulatory surgery (“Go into surgery with a good attitude”)

Infant massageStaff massage (“caring for the caregivers”)

Healing environments: chemo!


7. Healing Arts: Nutrition for the Soul

Planetree: “Environment conducive to healing”

Color!Light!

Brilliance!Form!Art!

Music!


Florence Nightingale/Notes on Nursing/patient’s need for beauty, windows, flowers: “People say the

effect is only on the mind. It is no such thing. The effect is on the body, too”


Griffin: Music in the parking lot; professional musicians in the lobby

(7/week, 3-4hrs/day) ; 5 pianos; volunteers (120-140 hrs arts & entertainment

per month).


8. Integrating Complementary and

Alternative Practices into Conventional Care

CAM (Complementary & Alternative Medicine):

83M in US (42%)CAM visits 243M greater than to PCP (Primary Care

Physician) (With min insurance coverage)W-F-Educated-Hi incDon’t tell PCP (40%)

OTA: <30% procedures used in conv med have undergone RCTs (randomized clinical trials)


Griffin IMC/Integrative Medicine Center

MassageAcupuncture

MeditationChiropractic

Nutritional supplementsAroma therapy


9. Healing Environments: Architecture and

Design Conducive to Health

“Planetree Look”

Woods and natural materialsIndirect lighting

Homelike settings

Goals: Welcome patients, friends and family … Value humans over technology .. Enable patients to participate in their care … Provide flexibility to

personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a

connection to nature and beauty


SoundTextureLighting

ColorSmellTaste

Sacred space


Access to nurses station:

“Happen to”vs

“Happen with”Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Eden Alternative

The Ten Principals of the Eden Alternative

1. The three plagues of loneliness, helplessness, and boredom account for the bulk of suffering among Elders.2. Life in an Elder-centered community revolves around close and continuing contact with children, plants, and animals. These ancient relationships provide young and old alike with a pathway to a life worth living.3. Companionship is the antidote to loneliness. In an Elder-centered community we must provide easy access to human and animal companionship.4. A healthy Elder-centered community seeks to balance the care that is being given with the care that is being received. Elders need opportunities to give care and caregivers need opportunities to receive care.


“The Eden paradigm allows elders to care for animals,

birds, and children as well as each other.” —Susan Eaton, Harvard/JFK school



5. Variety and Spontaneity are the antidotes to boredom. The Elder-centered community is rich in opportunities to sample these ancient pleasures.6. An Elder-centered community understands that passive entertainment cannot fill a human life.7. The Elder-centered community takes medical treatment down from its pedestal and and places it into the service of genuine human caring.



8. In an Elder-centered community, decisions should be made by the Elders or those as close to the Elders as possible.9. An Elder-centered community understands human growth cannot be separated from human life.10. Wise leadership is the lifeblood of any struggle against the Three Plagues. For it, there can be no substitute.


“The most basic question we need to

pose in caring for others is this: Is this a loving act?” —Leland Kaiser, “Holistic

Hospitals”


Conclusion: Caring/Growth “Experience”

Care!Control!Connect! Engage!Grow!

De-stress!

“An estimated 60 to 90 percent of doctor

visits involve stress-related

complaints.” —Newsweek/

“Health for Life”/09.27.2004

Learn more about Planetree/

The Planetree Alliance:

www.planetree.org

9. Tom’s

HealthCare2

Healthcare’s 1-2 Punch

1. Hospital “quality control,” at least in the U.S.A., is a bad, bad joke. Depending on whose stats you believe, hospitals kill 100,000 or so of us a year—and wound many times that number. Finally, “they” are “getting around to” dealing with the issue. Well, thanks. And what is it we’ve been buying for our Trillion or so bucks a year? The fix is eminently do-able … which makes the condition even more intolerable. (“Disgrace” is far too kind a label for the “condition.” Who’s to blame? Just about everybody, starting with the docs who consider oversight from anyone other than fellow clan members to be unacceptable.)

2. The “system”—training, docs, insurance incentives, “culture,” “patients” themselves—is hopelessly-mindlessly-insanely (as I see it) skewed toward fixing things (e.g. Me) that are broken—not preventing the problem in the first place and providing the Maintenance Tools necessary for a healthy lifestyle. Sure, bio-medicine will soon allow us to understand and deal with individual genetic pre-dispositions. (And hooray!) But take it from this 61-year old, decades of physical and psychological self-abuse can literally be reversed in relatively short order by an encompassing approach to life that can only be described as a “Passion for Wellness (and Well-being).” Patients—like me—are catching on in record numbers; but “the system” is highly resistant. (Again, the doctors are among the biggest sinners—no surprise, following years of acculturation as the “man-with-the-white-coat-who-will-now-miraculously-dispense-fix it-pills-for-you-the-unwashed.” (Come to think of it, maybe I’ll start wearing a White Coat to my doctor’s office—after all, I am the Professional-in-Charge when it comes to my Body & Soul. Right?)

CR

07.03: 60/264/180/145-85/14010.04: 61/195/092/097-60/058

Off …

Univasc (<1/2)BextraLipitorToprol

Propranolol

healthcare horrors & hope tom peters/10.26.2004. 1. premise

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