Out of Africa

I just got back from the trip of a lifetime: an African safari. I had the good fortune to visit South Africa (both Cape Town/Cape of Good Hope and Krueger National Park) as well as the Zimbabwe side of Victoria Falls. Wow. If you have done it, you know what I mean. If you haven’t, it’s so worth it. No tigers or bears, but lions galore. And elephants and rhinos and hippos (my favorite) and monkeys and I could go on and on. Even ostriches and penguins! It’s something to behold. Of course it’s hard to go the entire trip without making Lion King references or Book of Mormon jokes.

Penguins from near Cape of Good Hope

Penguins from near Cape of Good Hope

The trip wasn’t 100% perfect in that I had a particularly fun bout of whatever the African equivalent of Montezuma’s revenge might be called (Mugabe’s revenge?). But, while inconvenient and generally nasty, it did afford me a field trip around the Zimbabwe health system. Wow, that was another sight to behold. Basically Zimbabwe has no health system. The government doesn’t fund one that meets any standard you might assume should apply (average per capita spend by the government on healthcare is about $20/per person according to those with whom I spoke – yes, you read that right). The average American probably spends as much at Starbucks every month as the Zimbabwean government spends on public health. (more…)

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Mental Health and Substance Use Disorder Parity Task Force Holds Listening Session with Key Stakeholders

DesperateThis post by Kathryn Martin originally appeared in the HHS’s blog on June 22, 2016.

On June 10th, Secretary Burwell and Office of National Drug Control Policy Director, Michael Botticelli, hosted a listening session to engage stakeholders in a discussion about mental health and substance use disorder parity implementation. Fifteen leaders of organizations representing consumer and provider groups from the mental health and addiction fields shared their perspective and offered recommendations for how to improve awareness of and compliance with the law.

More than 170 million people have better insurance coverage for mental health and substance use disorder care thanks to new coverage and parity protections in the Affordable Care Act, the Mental Health Parity and Addiction Equity Act and Medicaid/CHIP.

The President established the Task Force on Mental Health and Substance Use Disorder Parity (www.hhs.gov/parity) to build on that progress and to focus federal agencies on realizing these improvements. (more…)

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Johnie’s Story

This post first appeared in The Odyssey Online on June 14, 2016. 

Children in foster care often remain voiceless so I decided we need to start listening.


Trigger Warning: Child and/or sexual abuse. The following story is from the point of view of a fictional five-year-old boy named Johnie. His voice represents the voice of thousands of children in foster care and thousands of children with no agency as they are victims of child abuse, sexual abuse, and neglect.

My teacher Ms. Jackson is so pretty. She wears dresses every day when she teaches us. I like learning about math and counting. I think I’m pretty good at counting. I used to help mommy count little bags filled with white dust. I asked her if I could play with it one day and she said no. I played with it anyways and started coughing so she had to punish me bad. That was a long long time ago. I don’t know what day, maybe a Tuesday. But today is a Thursday and Mr. Sun is shining so bright. I love that song in music class, “Mr. Sun. Sun. Mr. Golden Sun. Please shine down on me!”

Last night was a scary night. I had a nightmare but I think I was awake. I was on the mattress next to Mommy’s bed I sleep on and she had friends come over. I think they were having a brown bubbly drink and eating chips. I’m a bit sad because Mommy said she had no food for dinner but then she had food for the friends. One man came in and kept saying scary things to me. His name is Jones and he is really tall. I was sleeping with Peanuts. That is my stuffed elephant. I love Peanuts. He is so soft and a very good friend. He never yells at me and will always play with me. But Jones came into the bed with me and started asking me to play some weird game. I just wanted to sleep and he was scary. I said no and he hit me hard. I got a mark from it. (more…)

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The Perfect Father’s Day Gift: A Prostate Screening

Men’s Health Month: Focus on Prostate Screening

By Dr. Jon Elion, MD, FACC and Founder/President of ChartWise Medical Systems. This post first appeared in ChartWise2.0 on Jun 16, 2016 in honor of Men’s Health Month.

runners-635906_1280June is Men’s Health Month, when we focus on prevention, detection, and treatment of disease in men and boys. As a cardiologist, it is tempting for me to use this platform to talk about heart disease. Instead I have decided to push myself beyond that, connecting to my cardiology roots while shooting for some extra bonus points by mentioning coding and Clinical Documentation Improvement.

I saw a patient in the office for follow-up two weeks after an acute inferior MI caused by a right coronary artery occlusion (that would be ICD-10 code I2.11). Remember that the meaning of “initial” and “subsequent” for MIs has changed since ICD-9, where it referred to the episode of care. But under ICD-10, this office visit for the single MI within the previous 4 weeks did not get any special code modifier. As he was leaving, the patient asked me to check his PSA (the Prostate-Specific Antigen which is used to help detect and screen for prostate cancer). Apparently his family doctor normally did this, but it hadn’t been checked in a while. He called a few weeks later to tell me that his insurance company refused to pay for the PSA check, as the test is not indicated in the context of a follow up visit after a heart attack. It would have been covered if I had documented our discussion and coded for an encounter for screening for prostate cancer (Z12.5). [See how I snuck in a mention of coding and Clinical Documentation Improvement?] (more…)

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8 Notable Washington, D.C. Dads on Fatherhood 

We have been seeing many stories of violence and intolerance in the past few weeks. As we approach Father’s Day, Disruptive Women in Health Care has been taking time to focus on the unsung good men out there.  FEEL FREE TO SHARE STORIES ABOUT THE GOOD GUYS/DADS IN YOUR LIFE. We know that not all of our dads are with us anymore as we approach Father’s Day. We continue to honor and cherish their memories as well. **This article was written by Jessica McFadden and originally appeared in Mommy Nearest on June 11, 2015. 

lead image for 8 Notable Washington, D.C. Dads on Fatherhood 

Father’s Day in the Washington, D.C. area is always a great holiday—the weather is usually gorgeous (fingers crossed!), schools are out and work is paused as we honor the dads in our lives. We asked eight D.C. fathers to share with us their recommendations for celebrating their big day and their insights on parenting in the nation’s capital. These cool dads include a District Councilman, the key spokesperson for the MPAA, a rocking children’s musician, an education start-up founder, a kids’ party planner and some financial wizards with hearts of gold.

Read on for some inspiration on what to do for your own Father’s Day! (more…)

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“20 Minutes of Action”: A Father’s Response To Dan Turner’s Statement

In light of recent events that have brought issues of violence and intolerance to the fore, Disruptive Women will use the next few days leading up to Father’s Day to highlight the good guys. There are many more of them. **This article was written by Kyle Suhan and originally appeared on Christine Suhan’s blog on June 6, 2016.  


Sex is always intentional, and [my sons] are going to understand that even consensual sex needs to be cared for with the utmost delicacy.

“That is a steep price to pay for 20 minutes of action out of his 20 plus years of life. The fact that he now has to register as a sexual offender for the rest of his life forever alters where he can live, visit, work and how he will be able to interact with people and organizations. What I know as his father is that incarceration is not the appropriate punishment for Brock.” —Dan Turner

Steep? Mount Everest is steep. The peak of the emotional roller coaster Brock Allen Turner’s rape victim has only begun to descend is steep. Six months in jail is a joke; a speed bump, if you will. The “20 minutes of action” that Brock’s father minimizes in his above statement will haunt his victim for the rest of her life. It may have been a measly twenty minutes for him but for her, the impact of those twenty minutes will weave into every fiber of her being, every facet of her life, for its entirety.  In her letter, the rape victim states that she, “does not remember” the night Brock penetrated, groped, and left her behind a dumpster. But what she will soon find out is that her body will not let her forget. I know this because I married a victim of a college rape.

Steep will be the amount of time, energy, and financial resources that will go into undoing what Brock has done. Undoing is the wrong word here, what he did can never be undone. It can only be rewired, reworked, processed, and worked through again. When she is but a distant bad decision in your life, you will be a permanent fixture of her subconscious. (more…)

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Focusing on the Good Guys

Between the Stanford rapist, his father and judge; the awful murders in Orlando, we have all been rocked. In the midst of all the frustration and grief and absolute anger, Disruptive Women will use the next few days leading up to Father’s Day to highlight the good guys. There are many more of them.

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Silicon Valley Joins the Drug and Device Discovery Party

Sean Parker

Sean Parker


Kobe Bryant

Every year the Milken Global Conference pulls together an amazing cadre of people for discussions of a myriad of topics, from politics to energy to healthcare to technology and entertainment. There are few places where one can simultaneously sit in the green room with Vicente FoxSean Parker and Kobe Bryant, but this was the place to be if you like to be the least famous person in a room. FYI, of the four of us, I am the only one without my own Wikipedia page.

And I was in that room because I was fortunate enough to be asked to participate in a panel at the program called: The Search for Cures Leads to Silicon Valley. I was paired with a really interesting group for the panel, including Lindy Fishburne, executive director of, Breakout Labs and senior vice president of investments at the Thiel Foundation;, , Linda Avey, Co-Founder, Curious, Inc.and Co-Founder, 23andMe; Noah Craft, Co-Founder and CEO, Science 37; Lloyd Minor, Dean, Stanford University School of Medicine and Asha Nayak, Chief Medical Officer, Intel Corp. I know, no sports figures, international presidents or Facebook founders, but wow – a pretty august group where I got to stand out for my considerable lack of initials after my name. (more…)

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America’s Newest Pioneers: Elder Orphans

Glenna Crooks

Elder Orphans. Have you heard the term?  Not many people have.

Elder Orphans are people who age alone. How many elder orphans would you guess are in the US today? Can you imagine 14 million? There are. If they were U.S. State, they’d be the 5th largest, smaller only than California, Texas, New York and Florida and if they were a city, they’d be larger than the combined population of New York, Los Angeles and Chicago.

In some cases, people age solo because they never had children; no next generation is there to help them. In many cases people cared for family and others – their children, spouses, parents, grandparents, in-laws and friends – out-lived them and are now left with no help for themselves. In a few rare cases, they (mostly men) are orphan because they are estranged from family members. (more…)

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June Man of the Month: Marc Sommers, PhD

Robin Strongin

As a child, Marc loved looking at National Geographic magazines, especially at his Uncle’s home on New Year’s Day. That’s where young Marc went with his family to celebrate.  Not much for the adult conversation upstairs, Marc would slip away to the basement and lose himself in exotic photos of far-away places.  At 12, he decided he was going to go to the Serengeti.

marc sommers-head shot (2)Not only did he get there, but he has dedicated much of his adult life to working with young people, primarily in Africa—19 countries and counting.  Marc Sommers, who is fluent in Swahili, is an internationally recognized youth, conflict, education, gender, and development expert, an experienced evaluator, and an award-winning author. He has provided technical advice and policy analysis, and conducted research, assessments and evaluations in 21 war-affected countries.

Marc’s first position in Africa was as Headmaster of a girls’ high school in Kenya, at the ripe old age of 23. That experience was his initiation into gender issues—he had to, as he explained to me, “Defend my students.” (more…)

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MusiCorps: Helping Wounded Warriors Play Music and Recover Their Lives

Ibloomn 2007 Arthur Bloom was invited to visit a soldier recovering at Walter Reed Army Medical Center. The soldier, a drummer who had lost his leg to a roadside bomb, was concerned about whether he would ever be able to play the drums again.

Bloom, a Juilliard- and Yale-trained composer and pianist, didn’t have any previous experience with wounded service members. However, during this initial visit to Walter Reed Bloom promised to do whatever it took to help the soldier play again.

Stepping back from the situation, Bloom recognized that the need was great, with Walter Reed overflowing with injured service members. He also saw that the injured had very little to do at Walter Reed outside of their medical appointments during recoveries that could last for years. Bloom quickly realized how he might assist with the growing crisis of thousands of severely wounded service members returning from Iraq and Afghanistan. (more…)

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Dear Provider – Your Image Matters!

Jane O. Smith

It’s been almost eight years since my mastectomy – since then I’ve dealt with an array of side issues and preventative health procedures.  As someone who helped launch one of the nation’s first case management models 25 years ago – the “ROSE” program – my sensitivities to the communication, behavior and appearance of my physicians and allied healthcare professionals have become more acute – especially through my journey with cancer.

ROSE taught us that in order for patients to comply and to flourish, they needed to trust whomever they worked with – and the keys were civility and self care.  It’s still somewhat of a secret, it seems.

Prior to ROSE, in 1984, I served as the first director of marketing for a rehabilitation hospital during the advent of HMOs.  I was tasked to grow referrals from insurers, reinsurers and employers.  My heart usually skipped a beat when I toured them through our facility, as one of our more vocal physiatrists was overweight and gruff, and her staff was in disarray.  It felt a bit disingenuous to talk to our payers, patients and families about healthy habits and our commitment to “guest relations” at events and board meetings. (more…)

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Cinderblocks 2016: Bring on the Patients!


Regina Holliday

The irrepressible Regina Holliday is doing it again. This week will be the third time the mighty patient advocate, author and founder of the Walking Gallery of Healthcare is holding the “Cinderblocks” conference, a patient-led art and medical forum which has become sort of a revival meeting for patient advocates. Among headliner presenters is our friend and colleague, patient engagement advocate and kidney cancer survivor e-Patient Dave deBronkart. But the force behind the conference is Regina. (Read a recent USA Today profile of her work here.)

I remember attending the very first Cinderblocks conference in Kansas City, Missouri, and finally getting a chance to know Regina, whom I’d spotted during a previous conference in her customary venue – bellied up to her easel, clad in a smock, paints splayed in front of her. Labeled “Little Miss Type-A personality” by one of the doctors who treated her late husband, she proudly sports a big letter “A” she painted on the back of her own signature red jacket, as a key reminder of her own health care journey. For the uninitiated among us, Regina leverages her passion for storytelling and artistic talents to paint wildly expressive paintings on the back of business jackets.

walking-gallery-300x219The coveted jackets are worn at medical conferences and other events, where they’re guaranteed to prompt conversations. 44 artists have since participated, but most of the jackets (about 350 out of more than 400) were painted by Regina herself. She continues to churn out jackets, in between delivering keynote speeches, volunteering in her community, raising funds to buy and build a home for the Walking Gallery in her hometown, and raising two boys on her own.

Launched into patient advocacy by the death of her beloved husband Frederick from kidney cancer, and struggling to get him good care as he was moved from facility to facility, Regina fought to get his medical records. She was told it would take 21 days and she would have to pay 73 cents per page (there were 162 pages).  “73 Cents” became the name of the mural she painted on the side of a garage in Washington, DC, depicting the full array of both shameless and heroic acts by the medical team that surrounded her husband in his final days. The Walking Gallery became an extension of this work.

The Cinderblocks conference will always be extra special to me and Diane Stollenwerk. It’s there we met, in 2012, cabbing together with e-Patient Dave from the airport to the hotel. We reveled in the energy, enthusiasm and brainstorming at this aptly named “unconference”. And it was on the very last day, departing for home, that  Diane and I first sketched out the idea for what would become PVI on the back of a cocktail napkin.

This year’s Cinderblocks is in Grantsville, MD. Here’s how to get tickets, and here’s the full agenda. Through the miracle of technology, PVI will be able to visit with our friends virtually.

We’re looking forward to checking in. Patient advocacy is often lonely work; these regular infusions of energy, optimism, community and creativity help keep us going. You can be sure Cinderblocks, and the community built by Regina Holliday, will bring it, in spades.

By . This post originally appeared in Patient Voice Institute.

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#SpacesOfHealth: Aging in Place [Recap]

Can a city help improve your health outcomes? Can a hospital make you sick? The #SpacesOfHealth campaign, brought to you by the Milken Institute School of Public Health at the George Washington University, seeks to answer these and similar questions in a series of live webinars around the relationship between environment and health.

call outGone are the days when the thought of aging meant slowing down, a sure retirement and eventual disability. This thinking is being rewritten by baby boomers who want to enjoy their homes, embrace their communities, maintain an active lifestyle and “age in place” — that is, remain in their home of choice for as long as possible. According to the AARP, 87 percent of adults age 65 and older want to age in place. By renovating their homes, engaging in the “village” model, and using innovative solutions, it is now possible for aging adults to safely stay in their homes longer. But more needs to be done on both the community and government levels to make this a reality for more people in all economic brackets.

To explore the issues surrounding the aging in place movement, the Milken Institute School of Public Health at the George Washington University hosted a webinar as part of the #SpacesOfHealth series. Aging in place advocates and experts in the field of home care, long-term care and aging policy discussed the intersection of the nation’s aging population, and the innovations and opportunities that exist that will allow older adults to age on their terms. Below are the panelists who participated in the webinar and the key takeaways from the discussion.


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Improving Maternal Health in the U.S. and Around the World

Sophia Headshot_Sep15Since 1990, the United States is the only World Health Organization (WHO) region that has actually had an increase in maternal deaths. Although many think that maternal health problems are isolated to the developing world, challenges persist in our country. This is despite spending the most in the world on hospitalization for pregnancy and childbirth. In contrast, the countries that have been most successful in reducing maternal deaths have often achieved these results by using a midwifery model of care—an example that the U.S. may benefit from. Midwifery programs provide advanced education and training to support this model, and studies highlight the positive outcomes that result. Here, we’ll examine why maternal health may be getting worse in the U.S. and solutions that may offer better results. (more…)

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