Beyond Repeal and Replace

Robin Strongin

While most of the attention in the health zone is being sucked up by the latest attempt to repeal ACA and replace it with God knows what, there exists a disturbingly high number of health related issues that never seem to get the attention they deserve.

So I thought I would remind us about a few of them — (would love to hear from others–what else should be on this list?):

  • Hunger: do you have any idea how many children go to school hungry? How many older people do not get enough nutrition? How many homeless people and people living in poverty go to bed hungry?
  • Hospitals’ tax-exempt status: what are hospitals giving back to their communities?  If they aren’t, why do they still maintain non-profit status?
  • When we talk about Quality in/of health care–what does that really mean? Are we delivering quality health care and if not, what can be done?
  • Patient’s rights/wishes–do people really understand what they should/can be asking/demanding? Are individual’s wishes being honored, especially at the end of life?
  • Workforce–are we training and maintaining adequate health teams–if not, what can we do differently?  What/who should the health workforce of the future include?
  • Young adults with chronic diseases–we don’t often “see” or know about 14.5 million young adults who struggle everyday–to stay in school, to work, to attain/maintain independence?
  • Mental health services–where are the beds? the services desperately needed?
  • Increasing women in real health care leadership positions (C-suite; boards; equity partners) and related to this, Increasing access to capital for women innovators
  • Violence against women (and girls); sexual assault (civilians and military)–we are so far from where we need to be on this one
  • Bias: how best to conquer unconscious bias in delivering health care to individuals who may be “different” from the health care practitioner–gender sensitivity/language challenges/socioeconomic status/race/mental health status

None of this is easy.   We have to keep pushing forward.

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Fighting the injustice of health disparities: Honoring the legacies of Dr. Martin Luther King Jr. & Dr. John M. Eisenberg

Robin Strongin

For the past several years I have run this post and just as it was those years, it is this year a very important message.

Dr. Martin Luther King, Jr.John EisenbergWe, as a nation, have made progress and I believe Dr. King would be proud. But our work is far from complete – particularly where health care is concerned. Another doctor, Dr. John M. Eisenberg, a physician of tremendous stature whose life was also tragically cut short (not by an assassin’s bullet but by brain cancer) was equally passionate about the dignity of life and justice for all Americans. Dr. Eisenberg, who among other things, served as the Director of the Agency for Health Care Policy and Research (as AHRQ was known back in the day), cared deeply about access to and the integrity of health care for all Americans – regardless of skin color.

Seventeen years ago, on January 14, 2000, Dr. Eisenberg gave what is, in my opinion, a brilliant speech to the employees of the Department of Health and Human Services. As with the past years I want to share his words with all of you today — as a reminder of how far we’ve come, and how far we still have to go. (more…)

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“Excuse me, I have requested a download” of health records (watch)

Our August 2010 Man of the Month, “E-Patient” Dave eBronkart speaks. This post was originally published on MedCity News.

“E-Patient” Dave eBronkart speaks at MedCity ENGAGE 2016.

Back in June, Beth Israel Deaconess Medical Center CIO Dr. John Halamka wrote about a certain perceived shortfall in the Meaningful Use “view/download/transmit” requirement for patient engagement in electronic health records.

In a blog post that MedCity News reposted as a MedCitizens contribution, Halamka said:

Meaningful Use Stage 2 has a requirement that I’ve always considered to be the “cart before the horse” — patients must be able to View/Download/Transmit their data. Viewing is great — we’ve done that at Beth Israel Deaconess Medical Center since 1999 for all patients and all data. Download makes little sense since at the moment there is nothing a patient can do with a download. Of the 2 million patients at Beth Israel Deaconess Medical Center, not one has ever requested a download. Transmit makes even less sense since there is no place to transmit the data to.


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Lessons Learned: Graduation Day Reflections

Robin Strongin

In honor of this past weekend, which for me included celebrating my daughter’s college graduation and Mother’s Day, I wanted to take this opportunity to share what I have learned along the way. Here is what Elise and I talk about:

  • Never let anyone else define you. No professor, no employer, no elected official, nobody. Sure it’s important to be open-minded and respectful. But remember, a grading system, an employer’s evaluation, a demographic, and a bank’s metrics tell only part of your story. While you need to operate, to some extent within existing systems, never ever stop questioning, refining, redefining definitions, metrics and systems that don’t capture your full contributions and awesomeness.
  • Learn to read a financial statement. Regardless of your major, do not leave college without a class or two that can help you negotiate a salary, fight for a budget, and demand your fair share of equity.  If you can’t read the financials, you cannot advocate for yourself and your team.
  • Don’t stress if you decide the degree you start with no longer seems to be your life long career choice.  Life is funny that way. We grow, we change, experiences and reality come crashing in to utterly upend our best laid plans.  Sometimes they are welcomed, and other times we wish they never happened. But you are young and just getting started. If nothing else, a girl needs to learn to stay flexible,  to adapt, and to see each challenge as an opportunity. Easier said than done but at the end of the day, survival takes chutzpah, a sense of adventure, and a sense of humor.  Don’t just take the road less traveled, design and map that road (allowing for all kinds of twists and turns) and then go roaring down it. (Please remember to buckle up–the ride will be bumpy.)
  • Life is not fair.  No matter where you are in life, there will be assholes.  Always do your best to avoid them, move away from them, and yes, not let them define you.  Remember, they are assholes.
  • Understand the value of compound interest.  Even an intern in a non profit can begin her financial planning.  Setting up a savings account, contributing regularly, learning about retirement planning.  I know, I know, getting a job is hard, earning a decent salary is harder, and the very idea that one day you will be old enough to retire is hardest of all to fathom. I am here to tell you: it pays to start now.
  • Relish this moment.  GRAD 2016

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  • May 2nd, 2016 Playing the Disruptive Woman Card
    By Glenna Crooks
  • What it means to meet Mikey

    Ellie_Dehoney_HeadshotYou know those really good people, the ones who are determined to make the world a better place?  I’m not one of those.  I live in the Nation’s Capital – a beehive for the cause-oriented – so I know a really good person when I see one.  I have colleagues who tithed their babysitting money.  Who spent their college downtime standing up global nonprofits. Who mentor and tutor and build habitats for humanity.

    I spent my babysitting money on ill-considered teenage clothing.  I spent my college downtime playing quarters.  And until recently, my adulthood has been, for all intents and purposes, volunteerism-free.  I had my reasons for studiously ignoring any need that wasn’t my own: too busy, too tired, too poor.  The usual.

    Then I met Mikey. (more…)

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    Women and Pay in the UK

    Long gone are the days of the suffragettes fighting for basic women’s rights and Emmeline Pankhurst would no doubt be delighted to see just how far women have come. But perhaps she would be a little disappointed to discover women still lag behind men when it comes to equal pay.

    According to the Level Pay Field Report from Randstad, fewer women have asked for a pay rise than men in the last three years, and they are less likely to ask for a pay rise than men.

    A survey of 2,000 working adults across a wide range of sectors, found around a fifth of women had asked for an increase in earnings in the last five years compared to a third of men.

    On average women had had two pay rises in three years while men had secured three, and nearly half of all women asked thought men had a better chance of securing a pay increase. Another 28% of respondents felt men got more respect when promoted. (more…)

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    The Role of Nurse Practitioners in Health Care Reform

    This article was originally published by Georgetown University’s family nurse practitioner programs.

    The Affordable Care Act created new health care delivery and payment models that emphasize teamwork, care coordination, value, and prevention: models in which nurses can contribute a great deal of knowledge and skill. Indeed, the nursing profession is making a wide-reaching impact by providing quality, patient-centered, accessible, and affordable care.

    - Institute of Medicine 1

    An estimated 27 million Americans have gained health insurance coverage during the past five years thanks to the Affordable Care Act (ACA).2 But that, coupled with an aging population and an expansion of preventive care benefits, is putting significant strain on the country’s primary care provider workforce. (more…)

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  • April 4th, 2016 Health Policy Grief
    By Glenna Crooks
  • The Gender Pay Gap in Nursing

    Sophia Headshot_Sep15With women dominating nursing, it could be assumed that a gender pay gap doesn’t exist. However, according to a recent study published in the Journal of the American Medical Association (JAMA), nothing could be farther from the truth. Although women make up the vast majority of the nursing workforce, they are paid significantly less than their male counterparts—to the tune of $5,100 less per year on average. If you’re a nurse anesthetist, it’s even worse. Annually, male nurse anesthetists make an average of $17,290 more than women in the specialty. In a recent publication, Nursing@Simmons explored the factors which feed the gender pay gap—as well as what can be done to combat them. Here, we’ll explore what they are and how women in health care can take action to prevent wage disparity.

    Riding the Glass Escalator

    There is actually a term for the fact that men have typically received higher wages and faster promotions in female-dominated professions like nursing: the “glass escalator” effect. (more…)

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    Women, Children and Water

    Pat Ford Roegner

    Kaiser Health Tracking Poll: February 2016 reports that 64% of Americans have closely followed the news about the lead contamination of Flint, Michigan’s water supply, its likely effects on public health in that city, and the long road ahead as Flint struggles to restore a safe water supply. The same survey found nearly eight in 10 Americans are concerned about the safety of the water in low-income communities across the U.S.

    But even the challenges facing one mid-sized American city pale when we see World Health Organization (WHO) estimates that 1.2 billion people worldwide lack access to clean drinking water, with an additional 2.6 billion lacking adequate sanitation services.

    The United Nations estimates that by 2025, 2.8 billion people will face water scarcity in 48 countries worldwide. Closer to home, is Flint just the beginning of a water supply nightmare for low-income communities across North America?

    As the news from Flint unfolded in recent weeks, I was reading a paper – of which my daughter Amber is a co-author – about the potential for natural grasses to filter the waters on Lake Victoria near Kisumu, Kenya. (more…)

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    Take Your Own Advice! U.S. Should Pay More Attention to STD Prevention Programs Abroad

    Julie-PotyrajMost sexually transmitted diseases are preventable. That’s one reason it’s so upsetting that one in four sexually active girls in the United States has one. Out of the 19 million new STD cases annually in the U.S., almost half are among people ages 15 to 24. And those statistics only represent the number of reported cases; many more infections go undocumented. Despite the clear need for STD prevention strategies among young people, current efforts are scattered and inconsistent across the U.S. While 23 states require sex education, only 13 states require that the information be “medically accurate.” Even when sex education is taught in schools, many states require an emphasis on abstinence. But are these abstinence-only programs really helping to reduce STDs in younger generations? Simply put, no.

    Comprehensive sex education, using the example of Zambia

    For elementary and middle school students at Chadiza Basic School in the Eastern Province of Zambia, every day begins with a prayer. (more…)

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  • March 7th, 2016 We Could All Use a Dose of Eleanor Roosevelt’s Genius
    By Glenna Crooks
  • Sisters Are Doing It For Themselves

    DW Vegas HIMSS v2-01

    Lisa-Suennen-photoYou don’t have to look far in the business of health to find rampant sexism.

    If you were at JP Morgan, you couldn’t miss the story about LifeSci Advisors’ party, where they hired a cadre of beautiful female models to keep the predominantly male partygoers company, ostensibly because they couldn’t find enough professional women to invite to make the room feel equal. Such a ruckus ensued afterwards that the LifeSci Advisors team issued an apology to party attendees (see their somewhat desperate-sounding apology letter below), after first firmly insisting that the ruckus wasn’t merited.   My friend Nancy had a hilarious comment on this, fantasizing about this situation from Emily Litella’s perspective (if you are too young to remember Gilda Radner’s Emily Litella character, curse you and click HERE for clarity). (more…)

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    Symposium on Disability and the Sustainable Development Goals

    DW-UKThe speech below was first posted here on Medium. It was given by Liz Ditchburn, Director of Policy Division for the Department for International Development (DFID) during the first day of the 2016 International Symposium Disability in the Sustainable Development Goals. The theme for this symposium was: Forming Alliances and Building Evidence for the 2030 Agenda.

    Speech as delivered:

    “Much of what Catalina said I would like to give my own take on. I was very privileged to be in the UN General Assembly when the gavel came down on the Global Goals. This is going to be something which I hold in my heart for the rest of my life.

    There are a few things about this set of Global Goals that really set them apart from their predecessors. They genuinely integrate all of the issues that we think are important for development. We finally have this integrated set of Global Goals which include everyone. (more…)

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