Posts filed under ‘Health care provider’
A Softer Side of Health Care
By John D. Clague, Christian Science Committee on Publication for Oregon
Not long ago I had an email exchange with Dr. Pamela Wible, a physician in Eugene, about the recent documentary Escape Fire. The movie examines the problems with health care in the United States, and possible solutions.
Unhappy with the “conveyor belt” system of medicine that she had found herself in since medical school, “pushing pills into patients as they flew past me,” Dr. Wible got off the racetrack and stopped to consider what kind of health care system she wanted to work in.
The first step towards building her new medical practice was holding town hall meetings to see what patients wanted in a community health clinic. She describes her experience in building her practice around patient values for health in her recent book, Pet Goats and Pap Smears.
Because Escape Fire points out systemic issues that confronted Dr. Wible, I thought it would be instructive to discuss these with a physician in the trenches.
John: Several prominent physicians were interviewed in the film: Andrew Weil, Don Berwick, Dean Ornish, and Steven Nissen. They are pretty critical of our current health care system. Do you agree with their assessment?
Pamela: Yes. We have a disease billing system, not a health care system.
John: It was said in the movie that “conventional medicine suppresses symptoms which just keeps disease going. Do you agree with this view of conventional medicine?
Pamela: Yes, but conventional medicine is fabulous with trauma and tertiary care. We fail at chronic disease and certainly we lack the training to deal with the most prevalent health problem in America: Despair. Despair is at the root of self-destructive behaviors such as overeating, smoking, alcohol and drug abuse.
John: How do you measure health outcomes?
Pamela: By helping patients become self-actualized and fulfilled human beings. I don’t spend my time forcing them into algorithms that conflict with their values. I invite patients to define their own health goals. I align my care with their goals, not mine, and certainly not the system’s goals. We have an innate ability to heal ourselves.
John: It was also said that the interventions we depend on in our health care system depend on expensive technology (imaging etc.), and that includes pharmaceuticals. Do you agree with this?
Pamela: Yes. We have a high-tech, low-touch model. When I ask citizens in town halls to describe ideal health care, they describe the reverse. They prefer high-touch, low-tech care when possible. We breed dependency on a high-tech, complex system. The basic message to patients is that the answer to their problems is outside of themselves (in pills, doctors, machines). This is disempowering and dangerous. When I listen long enough, patients will reveal their real core issues. Unfortunately, we do not take the time to get to the root of their problems in ten-minute visits.
Dr. Pamela Wible
Photo used with permission
John: Seems to me that primary care physicians as the hub around which specialty care is provided would be the ideal model.
Pamela: YES!! YES!! YES!! We spend far too much time caring for the system, caring for profits, caring for insurance companies and third parties. Caring for patients and doctors is no longer the priority. 1) We need a simplified model. 2) We need ethical human beings at the helm. WITHOUT these elements, all models will fail. We need a spiritual awakening in health care. We are holistic human beings, not reductionist robots. Escape Fire, reveals the failure of our patriarchal, reductionist medical model. Though holistic therapies are suggested as the solution, the film primarily interviews male physicians and fails to showcase female physicians or innovative health care solutions developed by women in medicine.
The film was heavily focused on the “problems” we face in health care, yet did not offer a balanced perspective on solutions. We know the problems.
Dr. Wible makes quite a few important points about health care. I found her perspective on what female qualities can bring to health care interesting, especially since my own health care system was discovered by a woman, Mary Baker Eddy.
Even though Dr. Wible associates the qualities of nurturing, love, and compassion with women, I’m wondering if perhaps this is a way of highlighting these qualities. In her book she mentions men whom she respects, and who embrace a balance of male and female qualities.
It appears to me that problems in life arise when complementary elements such as male and female are divorced. Perhaps the whole nature of health care in this country could be readjusted and aligned by the recognition and reintegration of this balance. Caring, nurturing qualities are important to health care delivery, but not confined to one gender or the other.
In my reading of the Bible I’ve found it intriguing that the ‘great physician’, Christ Jesus, seemed to possess tough qualities, and yet expressed compassion and love in his healing ministry.
Pamela Wible is a doctor exploring these important issues and taking them seriously, introducing them into her practice with very positive results.
WHO HEALS THE HEALERS?
By John D. Clague, Christian Science Committee on Publication for Oregon
I’ve imagined that doctors are good at taking care of themselves, and that they’re a healthy lot. After all, they’re smart people. Their discipline and training are more rigorous than most professions. They are dedicated to helping people get well and stay well, and I assumed that included them.
It appears that I’m not alone in this point of view. Merry N. Miller writes in Medscape News about what we think doctors should be.
Physicians are expected to be healers, available to others whenever a crisis occurs or a medical need arises. They are expected to have unfailing expertise and competence, to be compassionate and concerned, and to provide universally successful care in a cost-effective manner.
Many doctors do fulfill this image, and most doctors have a healthy diet, don’t smoke, and they exercise. But in spite of, or perhaps because of what we expect physicians to be, those in the healing arts suffer high rates of mental distress. And paying so much attention to the bottom line can sometimes turn health care into a stress-filled industry for the care giver.
iStockphoto/WillSelarep
Dr. Pamela Wible in Eugene was part of that rat race in the early years of her career. Here’s how she describes it in her new book Pet Goats and Pap Smears:
“I felt like a factory worker pushing pills into patients as they flew past me on a conveyor belt. I tried other jobs, but they were all the same—assembly-line medicine. Doctoring was dumbed down to a numbers game with cookbook care if they had no insurance or if they took too long to express themselves.
After ten years on the treadmill, I was tired of being rude to people and neglecting myself—all in the name of health care.”
Spending so much time trying to help others can come at the expense of a doctor’s own health needs. The consequences of this contradiction are sometimes tragic.
The father of one of my best friends in college was a specialist physician. His family lived in a nice neighborhood and from what I could tell, they were happy. At one point I learned that his father went through “the cure” for alcoholism. Tragically, he later took his own life.
At the time I thought this was unusual. Unfortunately, I was wrong. Research shows that physicians have high rates of failed marriages, severe depression, substance abuse, and suicide — one of the highest rates of all professions.
The few who have taken a close look at this problem posit that, while alcohol and drug abuse is sometimes a problem, harsh self-criticism and a perfectionist personality can make some doctors neglect to get help for themselves when it’s needed.
But, do doctors have to be healthy to properly care for their patients?
As Wible so aptly puts it:
“If doctors are victims, patients learn to be victims. If doctors are discouraged, patients learn to be discouraged.”
Wible’s story doesn’t end in tragedy, though. There was a mental shift that occurred.
It was her sense of compassion for patients that allowed her to break out of her own despair and the rut that can be destructive to the wellbeing of our caregivers.
What she did was revolutionary. She set up town hall meetings for would-be patients to give them a chance to tell her what their ideal community clinic would look like. From their 100 pages of input, she built a community clinic embracing many of the ideas she heard.
She built her practice around a compassionate, caring relationship with her patients that started with the town hall meetings and listening to their needs.
Research is now finding that “relationships” are at the core of a more complex dynamic that has a significant impact on health. These are called “therapeutic relationships” and they directly affect patient response to physician prescriptions.
Some of Wible’s favorite prescriptions, described in her book, are: “take a vacation to the coast; go on a seven-day silent retreat in the woods; stop worrying; go on a media fast for a week; fall in love with yourself; speak your truth; see an energy healer”… and so on.
She’s helping patients get healthy by addressing their thought. It appears that her practice of spending time with patients, listening to them deeply, and caring about them allows her to get at their real health issues.
Getting back to her core values for patients, listening to them deeply and compassionately, and not just being a pharmaceutical dispensary nor quickly processing patients through her clinic, she is now happy and fulfilled in her medical practice.
Could it be that by meeting deeper patient needs, Wible has found a way to fulfill the ancient biblical admonition, “Physician, heal thyself?” (Luke 4:23)
By putting the patient at the center of compassionate health care, might it help other practitioners to be more healthy, too?
As author Monica Dougherty puts it: “Compassion is really about loving yourself first and then others. Loving means wanting the best for everyone.”
Essentials for better physical & financial health
How does an insurance company keep a positive bottom line and still provide real customer service? That’s an important question.
I suppose It’s a delicate balance, deciding what benefits to provide at what cost, and still be competitive in the market. After all, everyone needs to make ends meet.
Here’s an interesting piece showing how one managed care plan found that including spiritual care actually benefitted them financially.
My colleague in Texas recently talked with its chief medical officer. Very interesting discussion.
By Keith Wommack, Corpus Christi, Texas
How often do you better your health and save money at the same time? I know. Never.
Yet, through some health care plans, it seems possible. Some plans include unique programs that will reward you for taking meaningful actions toward enhancing health.
Within good-health-behavior reward plans, an individual can earn up to $300 a year for participating in a coaching program or for meeting recommended health guidelines.
Eat healthy foods, get regular physical activity, abstain from tobacco use, — these are some of the suggested steps often recommended to stay healthy. However, there may be pieces of the puzzle missing from health care plans and healthy lifestyle choices that you could benefit from.
©iStockphoto/Igor Dimovski
Last September, Robert P. Faraci, MD, a principal with Medical Care Consultants, gave public testimony about health care before a Health System Reform Task Force of the Utah legislature. Faraci suggested that he may have stumbled upon a missing puzzle piece to the health care delivery equation. His testimony centers on his discovery that when it comes to health care, an important element is spiritual care.
Faraci practiced general surgery for 20 years. Later he became the Chief Medical Officer for a managed care plan in Denver, Colorado. Faraci was one of the executives of the plan who began investigating the mind-body aspects of disease and health care. His investigation directly led this plan to becoming the first HMO in the United States to offer spiritual care as a benefit.
Faraci stated before the Utah legislature, “In the course of my research, I discovered that spiritual beliefs have profound effects on patient outcomes. Furthermore, my own anecdotal experiences as a surgeon supported this conclusion.”
“Our research indicated that people with strong spiritual beliefs often had better medical outcomes than those who did not have such beliefs. Subsequent studies at Duke and Harvard Medical Schools and a comprehensive review by the Mayo clinic have reinforced these findings.”
Faraci continued, “We also discovered that people wanted this benefit. A John Templeton study revealed that 55% of Americans said they would choose a health plan that included spirituality and religious healing practices over a plan that did not. Finally, we felt that the addition of spirituality to our members’ care might lead to better clinical outcomes and, as a result, lower utilization of other resources.”
When other resources were utilized less, the company would save money. Therefore, they were able to offer the plan at a reasonable price, enabling members to keep their dollars in their wallets.
If you learned that there was a beneficial plan that acknowledged your spiritual beliefs and practice, wouldn’t you want to sign up for it?
Dr. Faraci quickly found that there was a huge demand for this spiritual benefit plan and the demand exceeded anything this managed care group could have imagined. It resulted in a doubling of their plan membership in the first year and doubling again in the second.
Faraci closed his testimony by sharing with the Utah legislature the likely results if a spirituality benefit were to be included in health plans of state Health Exchanges:
It could be added to the health plans at little to no increase in premium
It could potentially improve clinical outcomes
It will give members a stronger sense of well-being
It will make members happier with their health plans because mind, body and spirit have been addressed.
Perhaps, recognition of the bonuses spirituality brings to the health care table will bring an even greater interest in how spirituality heals minds and bodies. The care of each individual is of the utmost importance. And spiritual treatment has been shown not only to improve health but also to give relief from the tremendous financial burden imposed by other forms of care.
When examining the essentials needed to better health and to do it in a financially prudent way, don’t forget to consider spirituality. Many feel that it can provide you with the best rewards.
Keith Wommack is a Syndicated Columnist, Christian Science practitioner and teacher, husband, and step-dad. He has been described as a spiritual spur (since every horse needs a little nudge now and then).
Keith’s columns originate at: KeithWommack.com
(reprinted with permission)
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John Clague is a retired sheriff’s office captain, father of two grown sons, and husband. He now works with the media to ensure accurate representation of Christian Science.
Health Insurance–Everyone pays but is Everyone covered?
I heard someone recently talking about an acupuncture treatment that had helped him. He joked, “It may have been a jab well done, but I sure wish it was covered by my insurance!”
©iStockPhoto/courtneyk
All over the country, the question of health insurance is being pondered by governments, uninsured individuals, and employers, as they try to sort out what the new laws will require of them. And the insurance companies are looking at what coverage they can provide and at what cost.
The US spends more per patient on health care than any other developed country in the world. We now spend more than $2.5 trillion annually on medical care–a little less than 20% of the GDP. According to a Fox news report, in 1950, Americans spent about $70 billion in today’s dollars on health care. “After adjusting for inflation, we now spend as much on health care every ten days as we did in the entire year of 1950.”
Yet, In 2010, the World Health Organization assessed the overall health outcomes of each nation. The United States came in 37th.
And in a 2005 Johns Hopkins University analysis, “On most health indicators, the US relative performance declined since 1960; on none did it improve.”
In Oregon, as we move towards full implementation of our own health care reform and the federal Affordable Care Act, let’s not lose sight of our goal. Health insurance is certainly a means to the end, but it’s not the end itself.
Good health is the outcome people are looking for.
We need to be sure that all options for achieving and maintaining health are provided for in this reform, not just the use of conventional medicine. An expanded area of coverage that could be good business for everyone is some form of spiritual care. This kind of care can embrace many options, including complementary and integrative medicine.
While conventional health care costs are skyrocketing, many of these treatments are more modestly priced, less invasive, and with fewer side effects. And research shows that where responsibly used, they are safe and effective.
Americans are willing to spend $34 billion each year out of their own pocket on these alternative treatments, and in their experience there is good reason for this. They feel healthier than with conventional medicine alone. And some feel they get better overall care. Among the alternative treatments noted in the longest running survey on the trends in patient choice of alternative medical care, the number one top choice is prayer or spiritual care.
According to economist Robert Samuelson escalating health care costs will be especially hard on our children. “To aid the young, we could tighten Social Security, and Medicare, raising eligibility ages, and reducing payouts for wealthier retirees.” But, he says, this is politically unlikely.
Corporations and governments are rightly concerned about the proportion of income that now goes to cover health care, both for current and retired employees. Warren Buffet called General Motors “a health and benefits company with an auto company attached.” The price of every new car includes more than $1,500 for employee health care costs. And Starbucks spends more money on insurance for its employees than it spends on coffee.
Insurance companies operating in Oregon could take the first step of providing coverage for less costly treatments. At least one insurance company that tried this in another state found it to be good for its bottom line.
Right now insurance companies are making decisions on what will be included in their coverage at or above the “essential benefits” mandated by the federal government. If you have insurance and a special treatment option that could fall under the category of spiritual care, why not let your insurance company know of your interest in having it covered?
Or, you could hope to come across a doctor like comedian Joey Bishop’s, who said, “My doctor is wonderful. Once, when I couldn’t afford an operation, he touched up the x-rays.”
Previously published in the Oregonian
John Clague is a retired sheriff’s office captain, father of two grown sons, and husband. He now works with the media to ensure accurate representation of Christian Science.
Does more medical treatment mean better health?
Keith Wommack is my friend. He’s also the Committee on Publication for Texas. He wrote this excellent blog on a topic I’ve been thinking about. Keith presents the issue so well that I wanted to share it. John D. Clague, Christian Science Committee on Publication for Oregon
By Keith Wommack, Christian Science Committee on Publication for Texas
I respect the great heart, the motive, of every physician and healer. For, I believe, they yearn to improve their patients’ quality of life and care. Yet, is this what’s taking place? Perhaps not — because when it comes to health care, we are learning more is not always better. Sometimes more means that quality of life suffers.
For example, many American primary care physicians believe that their own patients are receiving too much medical care. This was the take-away from a survey of primary-care doctors conducted in 2009.
The most important factors physicians identified as leading them to practice more aggressively were malpractice concerns (76%), clinical performance measures (52%), and inadequate time to spend with patients (40%). Physicians also believe that financial incentives encourage aggressive practice: 62% said diagnostic testing would be reduced if it did not generate revenue for medical subspecialists (39% for primary care physicians). – Archives of Internal Medicine
My heart goes out to the physicians facing this dilemma. I know they want to help and heal.
Where does the patient stand in all this? According to over one hundred new articles recently released, excessive medical testing is a problem. Excessive testing can lead to diagnosing conditions that never would have caused problems. This leads to more treatment with its own special side effects and complications. The cycle continues with even more tests and drugs prescribed. No wonder quality of life is declining and health care expenses are ballooning.
However, there is a method of care that has no side effects, and its costs are minimal. This care is spiritual in nature. This responsible, spiritual care may be viewed as just another short-lived alternative method; yet, it was successfully practiced 2,000 years ago.
I believe Jesus knew what he was doing. He knew how to supply others with real quality of life. He knew how to heal. He didn’t over-treat. And he taught others to heal.
Many are beginning to recognize that Jesus utilized specific, spiritual laws in order to heal. This is why he could teach others. His healing ministry was not a one-shot divine wonder. He told everyone who would listen, “Follow me. Heal the sick.”
I have found, in my own practice, that this type of spiritual care physically restores without undermining quality of life. For example: Glen collapsed in his home. After a friend found him, he was rushed to a hospital, where he lay in a coma for two weeks. Doctors believed he would never revive. Yet, Glen’s family and I prayed.
To the surprise of the medical staff, Glen awoke. He was told that he had a serious kidney problem and would require regular dialysis and medication for the rest of his life.
Doctors wanted to begin treatment immediately, but Glen was used to using prayer as an effective treatment. So, he called me and wanted my continued spiritual care. I assured him that God was in complete control and nothing could impede his progress. I knew God would inspire Glen spiritually and restore him physically.
The next day there were already signs of improvement, and the doctors were willing to give him three days to gain even more significant progress. He, his family, and I continued to pray for his health. Glen told me that he had never prayed so diligently and sincerely. The doctors commented on the remarkable recovery taking place.
On the third day, the healing was complete. The kidney was fine. There was no need for dialysis or medication. Glen was released from the hospital.
Again, the motive of every healer, I believe, is to improve his patients’ quality of life and care. Quality of life and care are essential. Is this what you are experiencing?
While many people face over-the-top testing and costs, I have found that there is a method that can be practiced where more is always better.
