Last year one of my patients was on the phone, lamenting about how long he had been in the emergency room. He had already waited several hours to get a CT scan. Medications he was supposed to be given were repeatedly delayed. I heard his voice rise and fall, with each swell more expansive than the one before. When I turned to look at him, he yelled a racial epithet before hurling a desktop computer into the area where doctors and nurses sit. A seasoned nurse ducked. As I pushed an intern and medical student out of the way, he charged at us with a steel tray. Thankfully, no one was injured.

According to the article, a 2022 survey of Emergency Medicine Physicians found that “55 percent said they had been physically assaulted, almost all by patients, with a third of those resulting in injuries. Eighty-five percent had been seriously threatened by patients.” For ER nurses, it is worse: 70% reported physical assaults at work.

This is unconscionable.

The article was written by Emergency Medicine physician and Columbia University professor Dr. Helen Ouyang. She wrote this:

In the E.R., there’s a certain level of resignation that violence is just part of the job, like getting bloodstains on our shoes. We have come to endure racist, sexist and homophobic slurs, choosing silence over confrontation, to fulfill our duty to care for human life. After all, we pledge to hold our patients’ well-being above all else.

Violence should never, ever, ever, ever, ever be “just part of the job.” This is unacceptable. Those of us who have answered the call of healthcare – whether physician, or nurse, or respiratory therapist, or physical therapist, or patient care technician – have sacrificed a great deal to be here. We have given so much of our time, our blood, our sweat, and our tears to care for those who are ill.

No part of this job should include violence directed toward the healthcare team. None.

I understand that sometimes, if not many times, patients are not in their right minds. They may be sick with infection, or organ failure, or substance abuse. That does not excuse violence against us. I always say that patient safety is “number one a.” Staff safety is “one b”: it is co-equal with patient safety.

We can’t easily fix the societal maladies that lead to violence against healthcare workers. At the same time, every healthcare institution must ensure that their staff is safe at work. It is an absolute necessity.

Please make sure you read the article and watch the opinion video accompanying it. It is heart-wrenching.

And I say again: violence should never, ever, ever, ever be “just part of the job.” It is absolutely unacceptable.

The post Violence in Healthcare Should Never Be “Just Part of the Job” appeared first on Medika Life.

In order to make that money, however, it takes literally decades of schooling and many years of training, racking up hundreds of thousands of dollars in debt. In order to become a specialist, it can take more than half a decade of training to get there. It is not an easy path.

And, it is also true that primary care physicians are among the least paid of the profession. Primary care physicians are the bulwark of the healthcare system, the load bearing walls of our field, and it is truly unfortunate that, sometimes, they can make less than many other professionals.

Having said all of that, it is also true that the latest rounds of physician pay cuts announced by the Centers for Medicare and Medicaid Services (CMS) are quite distressing and truly unsustainable.

They state that these cuts are mandated by federal law:

By factors specified in law, overall payment rates under the PFS are proposed to be reduced by 1.25% in CY 2024 compared to CY 2023. CMS is also proposing significant increases in payment for primary care and other kinds of direct patient care.

The proposed CY 2024 PFS conversion factor is $32.75, a decrease of $1.14 (or 3.34%) from the current CY 2023 conversion factor of $33.89.

The conversion factor is multiplied by relative value units, which quantify how much “work” something a physician does, to arrive at a payment from CMS. And, CMS only pays 80% of that rate, the rest being paid by supplemental insurance (if a patient has it).

Immediately, physician groups decried the cuts:

“While the ACR [American College of Rheumatology] appreciates CMS’ continued recognition of the value of complex care provided by rheumatologists and other cognitive care specialists … we are gravely concerned that the proposed rule’s physician payment cuts contained in CMS’ conversion factor would add to physicians’ uncertainty about their continued ability to provide the highest quality of care to Medicare patients,” ACR president Douglas White, MD, PhD, said in a statement.

The President of the American Medical Association also weighed in with a statement, saying:

When adjusted for inflation, Medicare physician payment already has effectively declined 26% from 2001 to 2023 before additional inflation and these cuts are factored in. Physicians are one of the only providers without an automatic inflationary increase … Physicians need relief from this unsustainable journey.

Anders Gilberg, MGA, senior vice president for government affairs at the Medical Group Management Association chimed in as well:

The proposed 2024 Medicare Physician Fee Schedule (PFS) raises significant concerns for medical groups related to its 3.4% reduction to the conversion factor, which further increases the gap between physician practice expenses and Medicare reimbursement rates. Medicare already largely fails to cover the cost of furnishing care to beneficiaries, and the proposed cut to the 2024 conversion factor compounds the problem.

This is the key to understanding why physicians are upset about these cuts. It is not about greedy physicians. It’s not about a doctor previously earning $400,000 and now earning $388,000.

It is about the costs of running a practice. When adjusted for inflation, physician reimbursement has declined significantly, as the AMA correctly pointed out. But, the costs of running a physician practice has not decreased by the same amount. They have, in fact, dramatically increased: there has been 7% inflation in healthcare labor costs, and now CMS answers this increase in costs with another 3% payment cut. This math is not sustainable.

I used to be a partner in a small private practice. Yes, I earned a comfortable living. But, it costed a lot of money to keep the practice open: the salary of the office staff; the rent of the office space; the utilities; office supplies; among many other costs. Those costs didn’t go down. Ever.

Yet, our reimbursement from CMS and other payers did. Eventually, if the costs of running a practice exceed its income, the practice closes. Or, they stop taking Medicare because the reimbursement was not enough to cover the costs.

In very large practices, there are other costs – such as interest on loans to cover payroll – have increased dramatically in the past few years. With every cut in reimbursement, it makes staying in business that much more difficult.

This is what physician groups mean when they say these payment cuts by CMS threaten access to care for seniors. If practices close their doors because the math is not sustainable, then that means less doctors are available to care for seniors. There is already a shortage of physicians, especially in rural areas, and these payment cuts could make it worse by making it impossible to run a practice.

Now, it is great that CMS is paying primary care physicians more. It is high time they get the proper reimbursement they deserve. What I don’t understand is why the law forces CMS to pay PCPs more by taking the money from other physicians, most notably specialists. This makes no sense to me.

“Well,” some may say, “specialists make too much money anyway.” That’s a non-argument. The whole formula under federal law needs to be changed for something much more sustainable for everyone.

Physicians can’t just keep working harder for less reimbursement. That is part of what is driving physicians to burn out and leave the profession. How does this help our patients? And, no one tells a plumber, after he or she fixed your leaky shower or faucet, “Well, your bill is $200, but I’m only going to pay you $120.”

Yet, that’s what happens to physicians all the time, and the math is not sustainable. CMS spends only 1 out of every 5 dollars on physician and clinical services. It is not right to keep cutting physician reimbursement to reduce healthcare spending. There has to be a better way.

The post The Unsustainable Math of Medicare Physician Reimbursement Cuts appeared first on Medika Life.

But what happens when goods and services are priced beyond the reach of the average person? Pandemic-fueled unemployment and inflation, and looming electricity, food and water shortages caused by climate emergencies, have provided an unsettling reminder that the basic things many people depend on to live can become unaffordable.

For most Americans and their employers, however, one of the single greatest threats to prosperity – even survival – is the uncontrolled cost of healthcare. In the past 20 years, the cost of the average family insurance premium has increased twice as fast each year as the annual rate of wage growth. In real terms, the average American family in 2002 paid $7,954 for health insurance but saw that figure skyrocket to $22,463 last year. Within a couple of decades, the cost to insure a family could be three to four times higher if nothing changes.

To put perspective to that calculation, assuming wage growth remains the same, it will require one parent to work full time just to cover the cost of protecting their family’s health. For many American households, this already is the case. Left unchecked, healthcare costs will significantly constrain economic growth as employers pass on costs to consumers and curtail investments, while governments at every level see a decrease in tax revenues that would fund a range of essential programs.

This bleak outlook should force a reckoning for the global pharmaceutical industry. While health companies must remain profitable to continue to fuel innovation, maintaining business as usual cannot come at the expense of the very customers who depend on functional healthcare to prosper. Such a conundrum poses a unique opportunity for pharma companies to live up to the credo of truly putting patients first by redefining how they lead on areas that are fundamental to strengthening health access and affordability for the long term. Among the many ways to achieve this outcome, some areas stand out:

Fostering greater cross-industry collaboration

Contrary to the views of some policymakers, the solution to averting the worst-case scenario of pricing most Americans out of affordable healthcare is not to increase competition. A better path may be to create greater incentives for collaboration between industry peers and government agencies through all stages of the value chain, from early discovery through manufacturing to patient administration.

The Covid-19 pandemic illustrated how collaboration can deliver speed and scale during an emergency. But despite the active involvement of the National Institutes of Health (NIH) in sponsoring early research for the most successful vaccine candidates and heavy government intervention to waive or reduce the costs of vaccination in many countries, the success of intra-industry collaboration has been muted by headlines of windfall profits from vaccine sales.

While many pharmaceutical and biotechnology companies already participate in the NIH’s Accelerating Medicines Partnership (AMP), more can be done to use this program as a launch pad for cooperation among industry leaders. With greater funding for the AMP and a commitment by participating companies to leverage the partnership to deliver cost-effective therapeutics, we could see a groundswell of pioneering products that provide lifesaving benefits without bankrupting patients. Such a push would support specific companies in their efforts to strengthen reputation among a variety of audiences.

Using digital tools to deliver increased transparency

From the rapid growth of electronic health records to the increase in clinical trial management solutions, information technology has been fully integrated into nearly every aspect of the pharmaceutical industry. But how can the array of digital tools be used to benefit patients?

As the health industry faces ever greater scrutiny over soaring costs, leading companies could forge a different approach by leveraging the power of their IT and storytelling capabilities to provide patients, advocacy groups and policymakers with important details on the drug delivery process. By bringing R&D to life and engaging patients in the various facets of drug development, companies may be able to spark a new dialog with informed audiences about realistic ways to lower the costs of care and focus on therapeutics with the greatest potential for public benefit without sacrificing the profits that are necessary to support medical breakthroughs.

Achieving health access equity by innovating for all

More than two decades ago, Merck’s CEO at the time, Dr. Roy Vagelos, took the bold step of restricting the company’s drug prices to match inflation. Under his leadership, Merck made efforts to price its drugs according to the economic benefits to patients. Years later, Allergan CEO Brent Saunders announced a social contract to adhere to single-digit percentage increases no more than once a year.

Few would argue that Merck or Allergan set themselves up for failure by staking patient-first positions on cost management and drug pricing. In fact, Merck’s stock price rose 22% annually during the Vagelos years. The moves likely strengthened employee morale and public perception, while serving as reputational insurance for each company against future issues.

These examples – and others – show that there is a middle path to developing innovative products with patient access and affordability at the center. This is the foundation to supporting a level field in healthcare, where patients enjoy equitable care and the health ecosystem becomes more accessible and sustainable.

It’s easy for health leaders to look at the growing crisis and kick the can down the road. That’s the playbook oil companies employed when confronted with clear evidence that their actions were causing global warming and fueling a public health crisis. Alternatively, they can recognize the moral imperative to move quickly and stake out bold pipeline, communications and pricing strategies that put cost sustainability and equitable access to care squarely in the center of everything they do. It’s worked before; it can work again.

The post Reckoning or Opportunity? appeared first on Medika Life.

President Biden, in his State of the Union address, also spoke about noncompete clauses to a great amount of applause: “For example – and I should’ve known this, but I didn’t until two years ago: 30 million workers had to sign non-compete agreements for the jobs they took. 30 million. So a cashier at a burger place can’t walk across town and take the same job at another burger place and make a few bucks more. That was part of the deal, guys. But not anymore. We’re banning those agreements so companies have to compete for workers and pay them what they’re worth.”

This proposed ban on noncompete clauses would include healthcare professionals such as physicians, and some colleagues hailed the new rule: “Although I am professionally and personally fulfilled with my current practice and the community I serve, there are physicians and providers who do not enjoy the same luxuries as me. Noncompete clauses ultimately infringe on physician well-being, which then cascades opens in a new tab or window into suboptimal patient care,” wrote Dr. Jeremy Peterson, a family physician practicing in Minnesota.

He further illustrates the conundrum faced by physicians who are subject to these noncompetes: “If a circumstance arises where I no longer wish to carry on my employment status with my current healthcare organization, I will be faced with a terrible choice. I will have to choose between either: uprooting my family and severing the community bonds I have built within my personal and professional roles; commuting further than the 3.5 miles I currently drive to a clinic outside of my noncompete agreement in a community I have no personal engagement within; or roll the dice and set up a practice in my community and beg for my noncompete clause to not be enforced. I cannot imagine how a fully vested and seasoned family physician could navigate this choice.”

I totally understand this conundrum. In fact, I knew a colleague who was forced to stay in a terrible job because her employer (a private medical practice) had a noncompete clause that would force her to practice hundreds of miles away. These types are noncompetes are truly obnoxious, and those deserve to be banned. Incidentally, when her kids finally finished school, she did in fact leave and practice hundreds of miles away for two years. Once her noncompete clause expired, she came back to that very same hospital and directly and successfully competed with her former employer. So, these sort of egregious noncompetes tend to be counterproductive anyway.

At the same time, as someone who recruits and hires physicians and APPs, I see why a noncompete clause would be beneficial. For a business associate, companies can take back stock or prevent their stock from vesting if they leave for a competitor. For a clinician, however, a considerable amount of resources is expended in hiring and onboarding that individual. There is the cost to recruit them (including substantial signing bonuses sometimes), train them, and fund their working capital before any revenue comes in from their work. If they then leave and go work for a competitor down the street (or in the same hospital), it places a substantial strain on the medical practice.

Another scenario is spending a tremendous amount of resources purchasing a practice from a physician or physician group, and then that physician or group turns around and sets up shop across the street, directly competing with us. That is not to mention any trade secrets that this physician or APP would come to learn and potentially take to the competition. Theoretically, the noncompete clause protects the employer from this risk.

I asked a healthcare executive, who asked to remain anonymous for this article, about the issue of noncompetes: “I think it is a complex topic. We never prohibit people from making a living, [it] just can’t be at the detriment of [our company].” This executive also told me, “I think the bigger issue is how do we prevent competitors from just taking a big group of our docs to sell the same services to an existing client. That is the one I have always struggled with. Clearly, trade secrets, etc. are hard to legally protect in the real world. The noncompete is a more concrete way to protect trade secrets at least for a period of time.”

Steve Lowenthal, MD – Senior Vice President and Chief Medical Officer of Rush Copley Medical Center – also made a reasonable point: “It takes a lot of investment to bring a physician into a practice. Once this investment is recouped by the health system, I think it is reasonable to no longer have a noncompete clause. How long would this take? 5 years? 10 years? That is still unclear.”

Throughout my entire career, I have always been subject to noncompete clauses. I understood them to be part of the business of healthcare, especially in the era of private practice. Yet, they have always been reasonable, and I would never have agreed to a noncompete clause that would force me to leave an entire metropolitan area if I had to leave a job for whatever reason. In fact, I would actively avoid those practices which were known to include such egregious noncompete clauses (and counsel my colleagues to do the same).  

I think there should be a balance. A reasonable noncompete clause, such as not practicing in the same specialty in the same hospital or hospital system for two years, should be allowed. Perhaps the distance requirements, such as not practicing within 10 or 15 miles of every facility in the hospital system, should be banned, as these can force someone to uproot their entire families for a job change. I also like Dr. Lowenthal’s suggestion that noncompetes should “sunset” after a certain number of years. And if an employer is at fault and the reason why someone is leaving, then the employee should not be subject to the noncompete clause.

Furthermore, it is not like these clauses are Scripture in an employment contract; they are clearly negotiable. I have had hires negotiate these noncompete clauses with us, and I myself have also negotiated these clauses for my own employment contracts. It also must be said that employers cannot hide behind noncompete clauses to avoid dealing with toxic work environments or poor working conditions. This persistent problem needs to be addressed. At the same time, it is clear that the issue of noncompetes are more complicated than the catch phrases of “economic liberty” and “freedom of choice” that grab headlines. It is my hope that the final rule issued by the FTC can strike a proper balance. 

The post In Defense Of The Noncompete Clause In Healthcare appeared first on Medika Life.

It was a great conversation. During the conversation, a fellow physician remarked to me about a common clinical scenario: An elderly patient will present to the hospital emergency department looking quite sick. He has a urinary infection, acute kidney injury, altered mental status, and a low blood pressure. We evaluate said patient and aggressively intervene with IV fluids, antibiotics, and close monitoring. The patient greatly improves by the following day, and he is discharged from the hospital. It is a great patient care win.

The insurance company – weeks to months after the fact – will then send a denial notice to the hospital, refusing to pay for the care that was delivered because the “patient was not that sick” and did not warrant the inpatient level of care. And then the fight ensues, frequently enlisting Physician Advisors like me to argue the case for proper reimbursement.

There’s the rub, it seems. If that same patient had gotten sicker, developed acute renal failure and shock, needed invasive mechanical ventilation, and was admitted to the intensive care unit, there would be no question (one would hope) that the hospital would receive the proper reimbursement for all the care that was delivered. It is a strange and frustrating paradox, and it highlights an important point:

We do not get credit for being good clinicians.

There is no diagnostic code for “could have become septic if we didn’t intervene.” There is no DRG that says, “this patient is sick, and I can’t wait for her to get sicker.” There is NO WAY that I would EVER wait for a patient to develop organ failure so that I can definitively diagnose her with sepsis according to the Sepsis-3 definition. And yet, if I even smell sepsis on a patient, if I have the slightest suspicion that a patient is septic, I will aggressively intervene so I can prevent that patient from developing multiorgan failure and death.

And if I don’t get credit for that, then so what. Who cares. It is why I became a doctor in the first place.

At the same time, there is something we can do as clinicians to better tell the story about that sick patient upon whom we aggressively intervened. We can document our thinking process much, much better.

For example, for that patient scenario mentioned above, if we write in the medical record:

Assessment and Plan:

1. UTI

• Admit for IVF and IV antibiotics

This doesn’t really capture “how sick” the patient really was. It does not capture our clinical concern, our “gut feeling” that – if we do not aggressively intervene – the patient will get worse and develop “full blown” sepsis.

Contrast that with this documentation on the same patient:

“This is an elderly man with multiple comorbid conditions that place him at very high risk for adverse outcome and acute deterioration. He presents with a urinary tract infection, acute metabolic encephalopathy, acute kidney injury, and hypotension. All of these complications are likely related to the urinary tract infection itself. He looks quite ill on examination. If we do not aggressively intervene, he is at great risk for sepsis, organ failure, and death. As a result, he will be admitted to the hospital for close monitoring, IV antibiotic therapy, IV fluid resuscitation, serial laboratory assessment to monitor renal function, and serial reassessments.”

Now, if this patient gets better by the following day, the commercial insurance company may still deny the care for “lack of medical necessity” for inpatient admission. Yet, it is so much easier to defend the care of the clinician who wrote the second paragraph. This second paragraph better encapsulates how the patient appeared to the clinician and why the clinician decided to admit the patient as an inpatient in the first place.

It all comes down to documentation. It is the only thing upon which everyone – other clinicians, regulators, payers, third parties, and auditors (like myself) – relies: the clinicians’ documentation in the record. If it is poor, everything becomes that much harder.

Poor documentation makes it much easier for a commercial insurance company to deny medically necessary care. Poor documentation makes it much easier for an auditor to go back and deny this diagnosis or that. Poor documentation adversely affects so much in today’s healthcare world. In the era of EMRs, dictation, and technology, there is really no excuse for poor documentation.

Yes, it is true that we do not get credit for being good clinicians. We do not get more reimbursement if we do the right thing and aggressively treat a patient and prevent organ failure and death. If anything, commercial insurance payers may penalize us by refusing to pay for the care at the appropriate level deserved. It is annoying. It is infuriating. It is patently unfair.

We push back against this by properly documenting in the record what we are doing and why. And, at the end of the day, if we do right by that patient and prevent him from dying from sepsis, then that is a wonderful thing. It is why we went into healthcare in the first place.

The post We Get No Credit For Being Good Clinicians appeared first on Medika Life.

• Inspire and influence leaders (leadership does not equate to a title) to prioritize the practical build of pathways and platforms that measurably move us from our current sick care model to a future model of actual healthcare.
• Invite an increasing engagement of talents, resources, technology, ideas, and influential networks to shift our focus from perpetuating our sick care model to stepping into a concrete vision of true healthcare.
• To spark conversation and amplify the message: we can do better.

Step into the following words – lift them from the page. Debate, share, and put them into action. Discuss them in a board meeting, during a podcast, as a class assignment, in a team meeting, or while sharing a meal with friends. Lift them from the page and bring them to life.

Many will resonate with these concepts. Others will not understand them or perhaps choose to disagree. There will also be those with no interest, being too stressed by waves of daily disruptive change. Some walk that tricky line of being rewarded financially yet are experiencing burnout from the sick care system they serve. I respect each position and each individual.

As you can, I ask that you participate in envisioning a better way. Today, that’s the invitation offered by our children and our future.

Singularity

The term singularity is defined as the state, fact, quality, or condition of being singular. Similar terms are “unique”, “distinctive”, and “particular”. In physics or mathematics, the term singularity reflects a point at which a function takes an infinite value. In the study of unstable systems, James Clerk Maxwell in 1873 was the first to use the term singularity in its most general sense: it refers to contexts where arbitrarily small changes, commonly unpredictably, may lead to arbitrarily large effects.

It refers to contexts where arbitrarily small changes, commonly unpredictably, may lead to arbitrarily large effects.

The term singularity offers a glimpse into an unfolding journey of true healthcare transformation. I believe it will not be what most envision or expect. It will start small (quite possibly already underway in corners of the world) and capture the vision and passion of the greatest minds and hearts. Those excelling in technology, design, social theory, behavioral science, cognitive computing, ethics, and economics will be drawn into the vision and will eventually steward a future of infinite value and exponentially large effects. Before we go there, however, we must first visit the ground on which we currently stand.

Our Present Reality

According to Silicon Valley Bank, for the full year 2021, a record $86B of venture funding was invested in health sector companies in the U.S. and Europe. In just Q1 of 2022, that number was $19.6B. That’s $105,600,000,000 in fifteen months. These investments in venture-funded health sector startups are happening while many large health systems are hemorrhaging. For example, according to Beckers Hospital Review, nationally recognized Cleveland Clinic reported a net loss of $786.9M for the second quarter of 2022 and a $1.07B loss for the year’s first half. They are not alone. In an article published one week ago, Beckers highlighted the need for health systems to shrink executive teams as costs rise.  

In a recent briefing, Fitch Ratings warned it could take years for provider margins to recover to pre-pandemic levels. Those moves include steeper rate increases (read rapidly rising prices) and “relentless, ongoing cost-cutting and productivity improvements” over the medium term. Further out, “improvement in operating margins from reduced levels will require hospitals to make transformational changes to the business model,” Fitch emphasized.

Our sick-care system is killing us and killing our economy. Transformational changes are required. In the recent blog post titled “Prime Health,” Professor Scott Galloway stated it this way.

“The U.S. Healthcare industry is a wounded 7-ton seal, drifting aimlessly, bleeding into the sea. Predators are circling. The blood in the water is an unearned margin: price increases, relative to inflation, without a concomitant improvement in quality. Amazon is the lurking megalodon, its 11-foot jaws and 7-inch teeth the largest in history. With the acquisition of One Medical, Amazon is no longer circling…but attacking.”

Professor Galloway allows facts to speak for themselves (I strongly suggest you read his full blog here):  

• Per capita, U.S. healthcare spending went from $2,968 in 1980 to $12,531 in 2020 (both in 2020 dollars), resulting in an industry with 13% of the nation’s workers and total spending accounting for a fifth of U.S. GDP.  
• Two-thirds of personal bankruptcies in the U.S. result from sick-care issues (medical expenses and time off work).  
• Forty percent of adults in the U.S. have delayed or gone without needed sick care because it’s too expensive.  
• The U.S. has one of the highest infant mortality rates among developed nations.  

Professor Galloway provides an additional summary opinion; “No industry has better demonstrated the dis-economies of scale. If we received the same return on our healthcare spending as other countries, we’d all live to 100 without getting sick … U.S. healthcare is the worst value in modern history.”

U.S. healthcare is the worst value in modern history precisely because it is not healthcare – it is overburdened sick care.

A Growing Discontent

Improving the future in no way diminishes the past or disparages the present. For the last few decades of my career, I have served within the same industry reflected in the data above. Most recently, as market COO in a national health system with a portfolio of provider services exceeding $1.2B in gross revenue, facilitated and supported by a team of thousands. I’ve worked with exceptional physicians, extended care team members, non-clinical leaders, and a host of others that are passionate about their mission, skilled in their craft, and seeking a better tomorrow.

Over a decade of consulting nationally, I’ve also been privileged to support founders in startups, early-stage launches into healthcare, middle market provider organizations, physician-owned national practices, and the household names of multi-billion dollar health systems. All these experiences have taught me this truth: serving the sick with grace and compassion is a worthy calling. It is a vital necessity in our nation’s infrastructure and required for a flourishing society.

It has also taught me another essential truth.  Though our current sick care industry is necessary, it is not sufficient. I’m thankful for access to world-class sick care, but we can do better. We must do better. Physicians and nurses are burnt out and quitting in mass. Executives and leaders at all levels are also under extreme pressure and joining the “great resignation.” Our talented and caring front office team members are quitting and going to work at Costco or Chick-Fil-A for “better pay and less stress.” There is an ongoing flurry of mergers, acquisitions, bankruptcies, restructuring, and closures. 

There is no easy answer to transforming what we are now experiencing. No vested “unicorn” will pull us out of our current challenges. No siloed approach in chronic disease management, remote patient monitoring, hospital at home, or digital innovation will bring us where we need to go. Yes, Amazon buying One Medical is bold. CVS buying Signify Health is bold. Walmart and UnitedHealthcare signing a 10-year collaborative is bold. We all sense it and see it; accelerated and purposeful movement. Things “as is” are changing and must continue to change.

In observing these bold movements, I (and many others) are left with growing discontent. These moves are necessary, but they are not sufficient. Data trends still reflect an unraveling and unsustainable system. These trends we observe both in the headlines and in our bank accounts. Most poignantly, in our and our loved one’s health journeys, we know it. I suggest we need a longer view. We need the courage to amplify the growing voice of “we can and must do better.” We need to move radically and decisively upstream from sick care. We must continue building and making changes of different sorts and in different directions. We must dramatically reduce the need for sick care. Our vision must be bold. Very bold. Fortunately, there are models we can use to inform our approach.

The Model of Megaprojects & Cathedrals  

According to The Prepared, in an article titled Building a Cathedral by Nicolas Kemper, “across 217 church and abbey projects in England, construction took an average of 250–300 years.” Cathedrals were megaprojects rooted in community and spanning generations. The emphasis here is not on the cathedral but on the representation of a megaproject model rooted in community, spanning generations, and having an expansive scope. In this fascinating study of building cathedrals, Kemper goes on to highlight the practical work of Virginia Greiman and her survey of megaprojects.

“In her book on the Boston Big Dig, Megaproject Management, Virginia Greiman offers a list of 25 different characteristics, including long duration, multiple stakeholders, ethical dilemmas and challenges, and discontinuous management (the Big Dig, for instance, spanned the terms of five governors). Yet the single most salient feature of what makes a megaproject a megaproject is the scope.”

Unlike other megaprojects, an essential and unique (singular) component of building cathedrals is the realization that all effort is accretive. Cathedrals are distinct from typical megaprojects in a significant way: an unfinished cathedral, even if over decades or centuries, is by no means a failure. Most large megaprojects are binary; they are done or not. For example, a 90% complete bridge is practically useless.

“Cathedrals, on the other hand, are not binary. The aspiration may be much larger, but in essence, a single room could act as a cathedral. Salisbury cathedral took a full century to build, but services commenced almost immediately in a temporary wooden chapel. Cathedrals, Ansar posits, are accretive – they gain value as built, “like a beehive.”

This posture of evolving accretive value (expanding as ongoing components come to life) is one of purpose and patience. It is a model of a broader arc pointing to a future state and more significant benefit. Applied to themes within healthcare, the supposition behind population health is radically different than pursuing short-term profit by launching a digital tool to manage a specific disease state. Seeking accretive value by offering and impacting healthcare is a different journey than harvesting outsized economic return by building the next sick care unicorn.  

The resourcing of today’s sick care system is necessary. It is up for debate how it is resourced, at what levels, and to produce what benefits and outcomes. However, what is not up for debate is the importance of one of the most critical and clarifying questions in healthcare: what is the definition of winning, and how do we do it? I believe, quite simply, that we win when individuals are flourishing, and we do it by keeping them healthy. If we’re not lowering cost, improving quality, enhancing access, and measurably moving from “sick care” to improved health of populations, we’re all still losing.

If we’re not lowering cost, improving quality, enhancing access, and measurably moving from “sick care” to improved health of populations, we’re all still losing.

This perspective presents a different view and an expansive definition of success. A model of megaprojects can inform the effort of building a healthcare singularity. Like building a cathedral, the actions and efforts produce accretive value as they develop. Even if judged unfinished five, ten, or twenty years from now, it should not keep us from starting and is by no means a failure.

Even in the most minor initial and incremental steps to keeping people healthy, there is value and worth.  The process of building is accretive; the effort will gain value as it develops and evolves, “like a beehive.” Over the coming years and decades, more individuals will become and stay healthy. As a generation learns and then passes on, choices in health flourishing, the future beneficial impact will be incalculable.

The Beehive – Endless Accretive Value

The following components of building this healthcare singularity are worthy of further study, debate, and economic investment. In decades ahead, a few degrees of change beginning today will create an entirely different trajectory and outcome for future populations (resulting in planned and arbitrarily large effects). As the “beehive” evolves, it will also produce lasting accretive economic value. As we step toward building a true healthcare singularity, let’s remind ourselves that all the raw materials we need exist today. All the talent is currently present. We lack nothing to get started. With the hopes of creating a meaningful nudge in turn of our collective health flywheel, these proposed components reflect an aspirational, high-level, and directional view. Over time they can (and will) be proofed, adjusted, and implemented in a foundational and tangible way. Here is what I see coming to life:

• Successive generations begin to learn improved health literacy, improved health behavior, and increased transparency (at scale) in how their personal choices impact the economics of individual and societal health rewards and sick-care expense burden.
• Creation of a meaningful and personal indicator of health (personal health score) that is clinically accurate, always current, accessible in real-time, insightful, and actionable.
• Building of a 24/7 “opt-in” A.I. enabled, digitally designed, and personally influenced healthcare ecosystem (spanning and reconfiguring typical industry boundaries). The health ecosystem will offer an integrated and elegant service bundle to influence and guide individuals on a journey to sustained health, overall wellbeing, and improved health scores. For example, see the recent article Prevention-as-a-Service by Dr. Ramin Rafiei and Dr. Jacob LaPorte.
• An evolving “beehive” of cross-industry and local community connections on the one hand and access to health products, goods, and services on the other, with the intended purpose of reinforcing health literacy and healthy choices at decision points related to food, fashion, exercise/sport, finance, mental wellness, art, entertainment, and connection. As compelling examples, review how Iceland reduced alcohol and tobacco consumption among youth here and how a West Virginia town uses a similar model.
• An offering of an “opt-in” community (locally in-person, virtually connected, and globally networked) that allows community members to encourage, support, and invest in the health scores of one another.
• This “opt-in” community brings a heightened invitation to purposely connect with causes and efforts that preferentially pursue the marginalized, underserved, and those who will most value from deeper connection, practical resources, and new possibilities on their journey to health and wellbeing. As encouraging evolving models, see ChenMed and CityBlock.
• Curated gateways developed within the “beehive” ecosystem that allows for seamless access to growing national and global platforms of health-focused providers and health prevention services (primary care, optical care, dental care, dermatology/skin care, mental health/behavioral health, labs/testing, and discretionary health spend)
• A radically increased investment in developing a strong sense of individual and personal health “agency” at scale (to the strongest degree, I am the one who impacts my health)
• A radically increased investment in building an expanded base of primary care physicians who are digitally enabled and upskilled, health-coach supported, team connected, and fully resourced and rewarded to keep individuals healthy.
• The launch, soon, of a megaproject that will shift, over longer rhythms of time, a legacy sick care system to an integrated and aggregated healthcare ecosystem producing a sustained quality of life (and substantial economic value) for future generations.  
• Joining this megaproject will be an increasing number of proven and influential leaders inviting us into a journey of actually walking away from sick-care-centric national models to a healthcare-centric future. Healthcare singularity.

The Long View

While improving how we care for the sick today, we must also strive to make the need for ongoing sick care obsolete. 

While improving how we care for the sick today, we must also strive to make the need for ongoing sick care obsolete. 

In a parallel path to enhancing current models, we must gather meaningful investment and exceptional talent to create a future foundation of sustained healthcare. This dual process is possible and yet will not be easy. Increasing numbers of individuals and organizations are willing to see and join the long game. It is also a reality that there are constructs of power, control, and profitability deeply rooted in ensuring sick care’s expansion and economic engine continues. To a few, sick care has become the bullseye of profitable investments. There is a better way. For our benefit and the benefit of future generations, we must cast a vision beyond unicorns fueled by individual and societal ills.  

I am proposing the long view; a meaningful megaproject per se to move us away from a burdened and unsustainable sick-care model to actual healthcare.  

Characteristic of a megaproject, the effort will take a long duration, have multiple stakeholders, present ethical dilemmas and challenges, be stewarded with discontinuous management, and require a massive scope. The building will not be easy. We most likely will not see it complete in our generation. It is for those who possess vision and hope.

Characteristic of a megaproject, the effort will take a long duration, have multiple stakeholders, present ethical dilemmas and challenges, be stewarded with discontinuous management, and require a massive scope. The building will not be easy. We most likely will not see it complete in our generation. It is for those who possess vision and hope.

In casting a vision worthy of both personal and collective investment, an image of increasing health and flourishing for successive future generations, that sounds about just right.

Coda

Each of us can lift the concepts presented from the page. Find others who resonate with this journey. Discuss and debate the bullet points offered and influence how we might bring them to life. Ponder the long view and begin to take small steps. Build prototypes and launch experiments. Co-create with grade school and high school students. If Roblox can be built and grow to engage 202 million monthly active users spanning 180 countries, we can create a healthcare singularity for this (and a future) generation.

Talk with college students about the future they desire regarding health and wellbeing. Think through and discuss the unique profiles and needs of those in their 30’s, 40′, and 50’s. Find a few sages, share the vision, and listen. Really listen. Take the learning and begin to build. Yes, there will be questions we (today) cannot answer. There will be ethical dilemmas and challenges. As we collaborate and move forward, however, we will eventually find answers to all of today’s unanswered questions. The accretive value will bear fruit.

I still support many efforts related to sick care. It is worthy of passion and resources to improve the necessary sick care systems we all need. It is not sufficient. Let’s also spend as much (or more) time, intellect, and resources ensuring coming generations inherit a better future. A future where the vast majority of sick care needed today, with associated economic and societal pain, can be significantly reduced.  True healthcare singularity.

The post Toward a Healthcare Singularity appeared first on Medika Life.

All the usual suspects

To identify the root causes, and there are many, we need to examine the engines that power the industry, the healthcare behemoths. The corporate giants that have clawed their way to dominance, many amassing levels of wealth and influence on that journey that place them beyond the reach of even governments. They have become a law unto themselves, and they are without a doubt, what ails healthcare at its heart.

The extent of the wealth acquired by these corporations, their reach, and their influence has been brought home by the pandemic. What has become even more apparent is that the harmonious balance required for an effective relationship between the patient (the customer) and the company (in whatever form) has all but vanished. That relationship, so key to both the health of the industry and the patient, relies on two key elements to function — trust and ethics.

Both of which are absent in modern healthcare in 2022. The blame for the erosion of these elements can be laid squarely at the door of the behemoths. Patients are, for the most part, now viewed by industry as cash cows, rounded up for fattening and subsequent slow exsanguination over the course of their lives. Any loud complaints from the herd and the ranchers simply move the ranch house further from the pens. 

It’s a terrible picture to paint, isn’t it, and one many healthcare experts would deride as being a ridiculous representation of the industry. Nothing could be further from the truth.

In an article by NPR which hit the headlines in the last week, a baby powder produced by one of these companies contained carcinogenic asbestos, which, had unfortunately found its way into their powder during the production process. Sadly, by the time the product has been removed from shelves, consumers had been diagnosed with cancers. A class-action was brought against the company by the affected customers, seeking some form of redress or compensation. Faced with a choice of paying settlements, the company elected to pursue a legal loophole.

In a shuffle, known in legal circles as the Texas Two-Step, they registered a new company in Texas, shifted all onus for the product claims to the new division, and then filed for its bankruptcy, effectively killing off the hopes of any potential payments to their affected customers and ending the class action. As appalling as this is, it is an acceptable legal loophole which many companies use, in itself an indictment of the American legal system. The existence of the loophole, however, does not excuse the ethics of the companies prepared to engage it.

Profits are protected at any expense, with trust and ethics forgotten, and therein lies the problem. These companies aren’t selling us cars or cellphones. They are, in many instances selling us products that can cure our ills, extend our lives or potentially kill us, and in medicine, where that product ends up on that scale can often be a fine line.

So trust matters, hugely so. Breach it and you better have a damn good reason, supported by an ethical and transparent response to any harm you’ve caused. The fact that lawyers make a living off class actions aimed at these companies speaks volumes to the behemoth’s disregard for the customer and their wellbeing. Engage in legal shenanigans to avoid that responsibility and then offer me your Covid vaccine with the assurance it’s safe. 

The Power of the People 

If we then assume that much of what ails healthcare can be resolved by addressing and regulating the business practices of these corporate giants, that leads us to the title of this piece. Can these companies be “saved” or are they too far gone, despotic dictators obsessed with their own self-inflated worth who’ve lost the ear of their people? I tend to believe the latter.

The public is rediscovering their voice in terms of their health, determining outcomes, and engaging in the processes that surround their treatment. I use the term public and patient interchangeably, as any member of the public is, was, or will be a patient at some stage in their lives. We all require healthcare, no matter our status, race, or sex.

This patient-centric movement sweeping through healthcare is long overdue and has been birthed as a direct response to much of what I have described above. Taking that as a given, logic dictates that a popular movement that arises in response to a dictatorship will not endeavor to change the minds and hearts of its despotic rulers. Complete regime change is called for, and almost always results. You cannot fix something that is fundamentally broken and no longer fit for purpose. The behemoths have served their purpose and must be retired. For the sake of the patient and healthcare globally, we need to start afresh.

If we look to oust the current regime, how do we then harness this new force sweeping through the industry? How best do we use the momentum of the patient voice to engage lasting solutions?

At the risk of buying into trending catch phrases, decentralization of the industry is key. Redistributing the power amassed by the few among the many. Smaller, more focused companies that address specific needs, specialists in their chosen fields, offering tailored solutions to the real issues affecting the development and delivery of equitable and accessible health care. In short, a new model of care and delivery, built from the ground up with patients actively engaged as masons. And yes, ethical businesses that place their customers’ interests first and foremost can be profitable.

It isn’t simply the patients that stand to benefit from this change. Make no mistake, the egregious travesties visited on healthcare by these large corporations extend beyond the patient and has ensnared providers, who are in many ways, products and prisoners of the environment they are forced to function within. Patients looking around their lifeboat will find themselves surrounded by white coats.

I’d like to end this with a few probing questions, directed to the industry in its entirety. What happens when the next pandemic strikes, an event that is inescapable? How, at that point do we convince the global population that any potential treatment we’ve developed is in fact fit for purpose? How, when we currently engage in deceitful and dishonorable practices and place the acquisition of wealth before the interests of the very population we’re sworn to protect, do we reclaim our credibility? How do we rebuild and regain trust?

Now is the time to build afresh from the ground up, as many promising new start-ups are doing. We have the technology, the intellectual capital, and the desire. Time will show if we possess the will.

The post Are Healthcare’s Behemoths Destroying Healthcare? appeared first on Medika Life.

Covid has highlighted these systemic craters in the US medical landscape, showing them up for what we have always known them to be. A major impediment to the delivery of effective healthcare across America. We can now contemplate a manned mission to Mars in the next decade but can’t match data between two hospitals separated by less than a mile.

As Covid developed and spread across the US, it became glaringly obvious there were massive constraints in terms of the free sharing of data based on any industry standards. There are none. No standardization exists. An excellent example provided by a colleague highlights this.

A pre-term birth in Texas, at 20 weeks, results in the death of the infant. Our lungs only develop at 23 weeks. The death certificate issued in Texas will list asphyxiation as the cause of death. Arguably, the baby was doing perfectly well until the mother unexpectedly went into labor. So shouldn’t the real cause of death be exactly that, premature labor? Other states think so and may use that as the cause of death.

Researchers delving into preterm deliveries and mortalities associated with it have to manually sift through data from 50 states, account for variances in the way the data is collected and interpreted, and then reformat the data into a system that accounts for all these variables. It is an impossible task. The end result is that the benefits of the actual data collected are lost, permanently.

Identifying disease trends and prevalence, treatment outcomes, drug efficacy, spikes in notifiable diseases and any other use you care to attach to the data become all but impossible. This results in two very distinct outcomes. Poor response times and poor delivery of care based on evidence, the cornerstone of effective medicine. We are drowning our patients and caregivers in a worthless sea of uninterpretable data. It is unsustainable and patently stupid.

Again, in Texas, a doctor friend’s office has one electronic health record. He works with various hospitals in the area. One hospital uses its own proprietary system. The other two hospitals both use Epic. None of them can communicate Covid results to each other without someone manually inputting the result from one system to the other. The duplication, the loss of man-hours, and the lack of transparency simply beggar belief.

When you are forced to resort to Facebook and Twitter to share information about potentially beneficial results in treating your pandemic patients, we know the system is broken. When you cannot medically assess your population at glance, you lose the ability to respond in a timely fashion to threats. You lose the ability to assess the efficacy of treatments across a population. All of which boils down to one simple thing. Poorly managed and mismatched data aggregation resulting from fragmented systems. No standardization.

Towards Standards

Medicine understands and obeys protocols. The practical implementation of treatments functions more effectively within a predetermined set of parameters, created by the industry, for the industry and that evolve along with the industry. The same needs to hold true of the software that endeavors to understand, collect and sort the data the industry produces. Its primary purpose must be to serve the industry.

America’s IT health issues stem directly from its political system and the autonomy enjoyed by states over their own healthcare and health software. It simply promotes fragmented solutions. Add insurance companies, federal systems, and pharma to the mix and the complexity of a “one system for all” solution becomes apparent.

Hospitals who wish to protect their financial models, income streams and other data are loathe to share. Financial motives outweigh the overriding need for open transparency. These are issues that occur within the confines of the same city, and when distances move these treasure troves of data into different states, any hope of meaningful data sharing is all but lost.

To formalize or standardize this turbulent sea of data, the industry must develop a clear and medically relevant set of healthcare data standards. Guidelines that allow national and state-wide access to data for caregivers, patients, stakeholders, and regulatory authorities. It is an insanely simple task, complicated to impossibility by the interference of influences from outside the sphere of healthcare.

Politics, law, legislation, profits, and privacy issues notwithstanding, the ever-increasing fragmentation needs to be addressed now. Not by outside parties, but by those who intimately understand the inner workings of the industry. We may be divided geographically and politically, but our physiology and susceptibility to illness remain a global shared constant.

This is the foundation we need to build from, never losing sight of the end goal. The effective and timely delivery of meaningful care for patients. They are, after all, the reason the industry exists.

Past Failures and Present Day Winners

Remember Google Health and Microsoft’s brave version. They were going to conquer health and change the world. It’s been a decade. Neither has achieved much, not even a perceptible dent or scratch on the surface of healthcare in the US, and this failure is telling.

Change cannot be driven by agents outside of the industry. Patients can also not impact this eco-system in a meaningful way. It is the caregivers that matter most, the individuals who use the systems, day in and day out, in the pursuit of their noble cause. These are the individuals who can and must demand standardization, who must enforce conformity for the data they produce to enable the amazing benefits we currently blithely ignore.

Oklahoma has done things right. Their medical system functions incredibly efficiently. Built by doctors for doctors, it has served the state well and this system, along with others can provide hugely valuable insights into a real-world working model for efficient medical data sharing.

In much the same way Android and Apple can both access the internet and the data it contains, despite their glaringly different operating systems, healthcare needs to set about creating its own intranet. Call it Mednet or Healthnet, it really doesn’t matter. Just build it. It is medicines “Field of Dreams” moment. Build it and they will come.

Tomorrow

Ask me what I see for medicine, ten years from now and you better have a chair handy. Essentially it is this.

Medicine is a trailblazer when it comes to embracing new technologies, often an early adopter and equally often, an innovator. In ten years and possibly far sooner, your smartwatch will save your life. Data it collects will be fed back via a secure network to your healthcare provider. Automated triggers will be enacted allowing your doctor to schedule medical interventions, adjust medication dosages and monitor your overall health.

This streamlining of services will only become possible once the healthcare industry develops those standards we were discussing. That way Apple and Android will know exactly how to connect to healthcare’s internet. Standardized protocols matter. They enable the rapid development of supporting software, products, and services.

Imagine in 2020, if we’d been able to pick up by location, spikes in body temperature for covid infected Americans. Arguably, millions of infectious people could have been isolated or quarantined within hours. Time matters, responses matter. Both require standardized data. We need to use the impetus covid has provided to make work of this.

Trust

That elusive commodity we have come to take for granted. Any system is only as good as the data it can collect and without widescale adoption, the system fails. Trust plays an integral part in the delivery of effective healthcare. Compromise the ability of the public to trust and you are lost, Again, covid has provided a rude wake-up call, vaccines being the casualty in this instance.

Wide-scale abuse of patient data is prevalent in the industry, accompanied by unethical practices, including the illegal harvesting of patient DNA. These practices need to be vigorously outlawed and policed to restore public faith. To restore trust.

Take Facebook and Apple as an excellent analogy. Facebook enjoys almost no trust in the public mind relating to its data collection and use. It’s one of the reasons I don’t use the Facebook platform, but I happily let Apple intrude on my life. The difference. Trust.

[This article was written by Founding Medika Editor Robert Tuner, PhD., one year ago. It’s an insightful piece and as we look toward HIMSS 2022, consider what – if anything – has changed.]

The post How Fragmentation in U.S. Health Care Disrupts Standardized Medical Data appeared first on Medika Life.

As John Nosta pointed out, if a conference charges attendees/sponsors/exhibitors, then there is money available to compensate speakers.  Often, I speak on panels with executives who represent their employers as part of their paid, already full-time jobs. Many patients are self-employed, on disability, or both. This is compounded by the financial toxicity of what qualifies us to, unfortunately, identify as “patients” in the first place:  a chronic illness that in some cases disallows full-time employment. Therefore, the expectation needs to be that payment is always provided, whether for virtual or in-person opportunities, to value proficiency, time, preparation, travel, and expenses.  If a patient is working in a research setting, compensation should be an additional line item written into a grant. 

A patient perspective can generate leads as well as increase social media and content engagement for your organization.  Also as Alicia Staley notes, “it can change the way an organization thinks from the inside out.”  Patients should be classified as consultants and advisers when we contribute in a professional capacity to industry or health systems.  Our training through combined lived experience and individually sought expert knowledge is the equivalent of anyone working intensively in the field.  And that is worth a whole lot. 

When not extending our services in a ‘work’ capacity, patients are fulfilling the ‘mission’ part of our identity: as advocates.  In this role, we serve our peers to publicly support or recommend a particular cause or policy.  Some of us are paid as advocates, but most of us are not.  Ultimately, an advocate represents an underserved individual or community in the spirit of collecting information to disseminate back to them for improved outcomes.  The advocate serves as that person/community’s voice for positive change.  The goal is that we advance learning and do better. Many of us as advocates feel a certain calling to “pay it forward” for those who come after us – that they have an easier time of whatever plight befalls them than we did. It’s a desire to contribute to the greater good. 

In this quest for knowledge, patient advocates seek to attend conferences and webinars when/where we can carry key takeaways back to our constituents. Since social media during COVID leveled the playing field for a variety of stakeholders in the healthcare ecosystem, all healthcare-related conferences and webinars should have a patient advocate category for registration.

Matthew Herper of STAT news stepped up to resolve my tweet ask, and now there is a patient advocate category. Kudos to Matt for his leadership in making a change for patients that others will follow. Michael Gaspar was instrumental in helping #HIMSS20 and #HIMSS 21 embrace patients. I’m also working with Victoria Tiase to include patient advocates at AMIA.  Back to my above point regarding our position of being financially compromised, the registration fee for patients should be discounted or ideally free.

I am hopeful for durable change this year in these two areas for those of us who identify as patients: pay for performance and inclusion, not only as attendees at conferences but as valued speakers and panelists.  I will continue to call out conferences that have areas of improvement for patients – not in a snarky way as Dr. Matt Keener thoughtfully pointed out, but with love and empathy. 

Every time I share examples from the ‘journey as a patient’ time in my life with a client, I ultimately receive numerous direct private messages from employees who reach out to tell me what they maybe don’t what anyone at their company to know:  that they felt seen and represented because of an illness they are dealing with or a loved one they are caring for. 

COVID unfortunately created more “patients” than ever before and exposed a level of vulnerability never before felt.  If you’re of a certain age like me, you’ll recognize that the title of my blog is a song reference.  Even though there are mountains in our way, we climb a step for patients every day. 

Stacy Hurt, MHA, MBA works as a Patient Engagement Consultant to represent the consumer perspective in clinical decision making, health IT user experience, and pharma/biotech drug development.  She was the patient keynote speaker at DPHARM 2021 and is a HIMSS Digital Health Influencer.  Stacy regularly advises on how COVID innovations such as telehealth need to remain as permanent options to enhance patient care.  Connect with her at https://stacyhurt.net/

The post Patients: Up Where We Belong appeared first on Medika Life.

In every sector of science that mankind excels in, peers recognize exceptional individuals and achievements. These acknowledgments strengthen the sector and express appreciation for the talented individuals who so often change our lives.

Even before the pandemic ravaged the nation, pharmacists across the United States were experiencing significant burnout and mental fatigue based on the metrics & expectations of their employers in the retail pharmacy chain sector of the industry. The pandemic compounded the issue of pharmacist burnout and has caused hundreds of pharmacists to question their choice of careers based on the stress they experience daily.

In a recent article from Crain’s Chicago Business, Dr. Maurice Shaw PharmD was quoted saying that he struggled to keep pace with surging demand for flu shots, answer constantly ringing phones, fill prescriptions and fetch front-end items such as milk and hair dye for drive-thru customers who were afraid to enter the store. By October, he could take no more.  

‘There’s no way I can keep working here because this is just too much.’ And that was without COVID vaccines.”

Shaw now works at the University of Illinois at Chicago College of Pharmacy. Dr. Elizabeth H. Padgett, PharmD participated in research published in the May 2020 edition of U.S. Pharmacist titled “Pharmacist Burnout and Stress” where she outlines data collected regarding the impact the pandemic has had on retail chain pharmacists.  

While burnout in traditional occupations focuses on the well-being of the individual worker, burnout in the healthcare setting must also consider the potential negative effects on patients’ healthcare outcomes. Pharmacy technicians are under similar stresses within the retail pharmacy space & experience burnout and mental breakdowns from the high volume of work expected with a shortage of staff during flu season.

It’s been a rough 18 months in pharmacy. Pharmacists in consultant roles focusing on geriatric care, pharmacists in the specialty sector, and hospital pharmacy technicians and the pharmacists they help are not spared from the incredible amount of pressure the pandemic has placed on their roles. 

In a recent interview with Pharmacy Times®, Melissa Santibañez, PharmD, BCCCP, critical care clinical pharmacist at Memorial Regional Hospital, said understanding the impact of burnout is essential.  Santibañez said there is a lack of data on this subject, especially among subsets of pharmacists such as hematology and oncology pharmacists.

She believes the high prevalence of burnout is largely because of 3 components: high emotional exhaustion, high levels of disconnect from colleagues, and a lower sense of personal accomplishment or satisfaction. According to Santibañez,

“Pharmacists, just like any other health care provider and professional, have direct patient care at the core of everything that we do on a daily basis, no matter what setting we work in. That high responsibility comes with very severe implications if we are not managing all of the aspects of our jobs in a healthy manner.”

Since 2009, the Pharmacy Podcast Network (PPN) has advocated for the pharmacist and pharmacy professional. Founder and CEO Todd Eury who began his pharmacy career in 2004 recognized a need for an audio publication that catered specifically to the pharmacy profession.

In the last 12 years, the Pharmacy Podcast Network has blossomed into the leading audio publication within healthcare focused on pharmacy and the publication now has more than 40 participating podcast hosts focused on a multitude of themes and topics regarding the clinical, business, and continuing education for the pharmacy professional. 

Eury, an avid podcaster & audio learner, created an awards program to honor his profession, the ’50 Most Influential Leaders in Pharmacy’. It sets out to inspire and advocate for the pharmacy profession. According to Eury;

“It’s taken a long time to build this network and today it’s a mission to build high-quality audio to supplement the written word, continuing education, and subject matter experts in the form of podcasting. Pharmacists and the pharmacy profession get overlooked a lot in national news and the majority of the general public doesn’t realize how complex the pharmacy industry is nor what pharmacists and technicians go through every day to ensure their communities are taken care of and are kept safe”

The PPN began collecting nominations in September and will be accepting names through an online form which will be closed on November 8th, 2021 at 5:00 PM EST. After a selected panel of judges thoroughly evaluate the nominees, the organization will announce the honorees on November 15, at 12 PM ET on a Live podcast episode.

Nominations can be submitted here: https://surrvey.app/f/5fkep 

The post Advocating for Leaders in Pharmacy. Drawing Attention to Unsung Heroes appeared first on Medika Life.