Mind-Body (in my case Mind-Butt) Connection

Archelle Georgiou, MD

Colonoscopy…no way, no how, don’t want it, don’t need it. I’d rather have colon cancer. I don’t have any risk factors anyway. Can’t I have a root canal instead?

These are the thoughts that swirled through my head starting at age 49 as I anticipated turning 50 and hitting the magic moment for this right of passage.

But, several months ago, the resistance disappeared. I made the appointment in March and didn’t think about it again until I had to start the prep at 4 pm on the day before my procedure. Drinking 64 oz of Crystal Light with Miralax and 10 ounces of magnesium citrate made me feel like a bloatedwhale. I was stuck in a bathroom, chilled from the cold liquid, and could only tolerate wearing grey flannel sweats. (more…)


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The Quiet Revolution: The Power of Storytelling in Health Care

Beth Toner

In 1981, my 61-year-old father died of lung and liver cancer. I was just 14 years old. This, during the “Cancer Dark Ages” – a time when there was no ondansetron to offset the devastating nausea and vomiting that so often accompanied chemotherapy, and dying at home was as alien a thought as, well, an alien. Watching his nine-month decline was, without a doubt, the most difficult experience of my childhood, and perhaps my life.

It would be years before I could set foot in a hospital without being overwhelmed by crippling sadness. Despite the fact that I’m enthusiastically extroverted with a penchant for sharing too much information, for many years I spoke rarely of that time – and then, only in generalities. (more…)

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Making Policy Personal

Shortly after I moved to Washington, D.C. to begin a fellowship with HHS, my aunt was diagnosed with stage four ovarian cancer. I took a trip back to Michigan three months later to celebrate Thanksgiving at my parents’ home where she lived. The chemotherapy she had received during that intervening time had rendered her nearly unrecognizable.  I was at home when she asked me to take her to the emergency room; she died later that day in the ICU.

I have kept the program from her memorial service pinned to the bulletin board in my office ever since. If you read the dates underneath her name, you will notice that she died the day before her 50th birthday. And even if you read the attached pages of scribbled notes that were my feeble attempt at eulogizing her life, you may not really understand why I keep this type of reminder by my desk rather than a memento of a happier time. (more…)

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Man of the Month Revisited: Dr. William Cohn

Photo Courtesy of Houstonian Magazine

Last week, we honored medical heart technologist, surgeon, and  innovator Dr. William Cohn as our man of the month. This week, he sat down with us to chat a bit  more about what he has been up to and new advances in the field of medical innovation.

How did you become interested in the intersection of technology and health care?

I’ve always been attracted to the vibe of heart surgery. It seems like the ultimate gig: it combines my passion for innovation and working in health. Growing up in Houston, I had an older brother who was very brilliant and into science. In our garage, we had a lab set up, where we made explosives, lasers, (more…)

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A Disruptive Conversation with the Co-founders of Personal Medicine Plus

HODGE_PHONE_SCREENSHOT8_white (3)

We love stories about women that are truly changing the face of health care, particularly through innovation. Today is no exception. We recently sat down with Co-founders Natalie Hodge, MD and Brandi Harless, MPH of Personal Medicine Plus, an app that allows individuals to self-manage health through behavior tracking and health data metrics. Both Hodge and Harless shared their experience in developing their tool, being a woman innovation leader, and a few words of wisdom and inspiration to other women interested in following their goals. Check it out below.

What drew you to health innovation technology?

NH: My first passion was in medicine. I always had a deep interest in people and solving problems, so naturally that fits well with a career in medicine.  The interesting thing is that the problems of my early career have largely been solved by vaccines.  And in the 15 years we spent diagnosing disease, the obesity epidemic floated to the top. That’s when the opportunity for me to marry medicine and innovation arose.

BH: After studying global health at Boston University and working on health issues in Kenya, Haiti and Sierra Leone, I accidentally moved back to my hometown in rural Kentucky.  Not knowing if I would stay around, I started working with HIV patients and getting involved in the health of the local community.  After leading a local health clinic for a while, I realized the extreme need to help rural patients turn back their lifestyle illnesses.  When Natalie approached me to work on this startup that would do exactly that, I WAS IN!  (more…)

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Pam Cipriano: Woman to Watch 2014

Pam Cipriano

Pam Cipriano

“I am always inspired by seeing the resilience of the human spirit. Being a nursing and health care professional affords me the great honor to appreciate stories of real people surviving challenging experiences every day.” – Pam Cipriano

Encouraged to achieve limitless dreams by her parents, Pam Cipriano, PhD, RN, FAAN, represents a perfect mix of imagination, grit, and determination. She currently serves as Editor-in-Chief of American Nurse Today and works as the University of Virginia Health System’s Special Advisor to the Chief Nursing Officer, and also serves as clinical associate professor at the UVA School of Nursing. She has received numerous honors throughout her career, including being named a distinguished member of the ANA and a Sigma Theta Tau International Distinguished scholar. An accomplished nurse and mentor, Pam is the Senior Director at Galloway Consulting where she is focused on the art of clinical transformation.  (more…)

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Kenda West: Woman to Watch 2014

Kenda West

Kenda West

“Show you’re willing to get in there and start shoveling. Make smart choices, be generous, and be diplomatic – but speak your mind…If you can apply common sense to problems and solve them calmly, you’ll get noticed. I promise.” – Kenda West

Driven by the passion and success of her high school field hockey coach, Kenda West was molded at an early age to have discipline and always dig deep in the pursuit of her goals. Landing in the health care IT space just three days after her last exam in college, Kenda first entered health care in 1983. This year, Kenda joined Voalte, a company specializing in mobile smartphone applications that caregivers use, as its Chief Operating Officer. (more…)

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Rebecca Mitchell Coelius: Woman to Watch 2014

Rebecca Mitchell Coelius

Rebecca Mitchell Coelius

“Read, travel, and speak to people with a diversity of opinions as often as possible, and, most importantly, never get too invested in seeing a problem from only one angle.” – Rebecca Mitchell Coelius

Treasuring the history of health science and continuously pursuing the next opinion, idea, or discussion, Rebecca Mitchell Coelius first became a physician with the goal of becoming part of the health care industry. Rebecca’s career has taken her through that system, to entrepreneurship, to her current role at the Office of the National Coordinator where now works with entrepreneurs, investors, and innovation centers every day. (more…)

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Disruptor Profile: M. Bridget Duffy, M.D.

Dr. Bridget DuffyRecently, DW interviewed  Dr. Duffy, e Chief Medical Officer of Vocera Communications, Inc. Dr. Duffy is working to provide breakthrough mobile communication technologies and solutions that address critical communication challenges facing health care today. Prior to her appointment as CMO at Vocera, Dr. Duffy co-founded and served as CEO of ExperiaHealth, that assists organizations rapidly improve staff and patient loyalty through innovative solutions that restore the human connection to health care. Dr. Duffy was an early pioneer in the creation of hospitalist medicine and launched programs to accelerate clinical discovery in the field of Integrative and Heart-Brain medicine, helping to establish the Earl and Doris Bakken Heart Brain Institute. She previously served as Chief Experience Officer (CXO) of the Cleveland Clinic, the first senior position of its kind in the nation—leading the institution in improving patient experience as its top strategic priority. She is a frequent speaker on the subject of why patient experience matters and how it impacts clinical outcomes. Her work has earned her the Quantum Leap Award for taking the risk to spur internal change in her field and has led her to be featured in HealthLeaders magazine as one of “20 People Who Make Healthcare Better.” (more…)

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Opportunities Abound for Women in the Armed Forces Medical Field

Dr. Jacqueline ThompsonPrior to WWI, women’s roles in the Armed Forces were limited to helping on the home front. WWI marked the first time in U.S. history that regular nurses in the Army and Navy were allowed overseas, and women were permitted to enlist in the Navy and Marine Corps as civilian volunteers.

Now, women are an integral part of the Armed Forces, standing toe-to-toe on the frontlines and in hospitals with their male counterparts, treating and serving their country as equals. The opportunities available to women in the military medical field have never been more promising, and the flexibility for serving in conjunction with a civilian career — and even while raising a family — makes military medicine the perfect platform for launching a successful career. (more…)

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Develop a Coaching Culture

“I know I blow up and get angry. I am protective about my patients and the physicians in my department and I can’t help myself.”

Dr. Leonard was one of my coaching clients, a surgeon who had left a trail of destruction by his combative style everywhere – the operating room, staff meetings and medical executive meetings.

“I’m a leader in my surgical specialty. People expect me to be forceful.”

I asked, “What do you look for in a good leader?”

“I want someone who listens to me, who looks at all options without stuffing his solution down my throat. I want someone who is calm, thoughtful and . . .”

After a long pause I heard “Oh.” (more…)

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What’s the Best Way to Retain a Health Worker? Just Ask Her!

Dr. Kate Tulenko

By Kate Tulenko. The world currently has a shortage of some 4 million health workers. This shortage is amplified by a complete mismatch between where health workers are stationed and where they are most needed.  The healthier and wealthier a community is, the more health workers it has. The poorer and sicker a community, the fewer health workers it has. The situation is worsening as every year hundreds of thousands of health workers move from poor, rural, and underserved communities to wealthier, metropolitan communities with a surfeit of health workers. This occurs both within countries (a nurse moving from a rural area to the capital city) and between countries (a doctor moving from a developing country to a wealthy country).

Governments and their development partners have struggled to address this problem. Many have tried mandating new graduates to provide a few years of service in underserved areas. These programs have met with variable success depending on the governments’ commitment and ability to enforce the plan. Since the publication of the World Health Organization’s well-thought out and evidence-based guidelines on increasing access to health workers in rural areas, some health systems are implementing mid- and long-term solutions such as recruiting and training health workers in underserved communities.

But governments are under intense pressure to solve the problem now. Some have tried rural retention schemes but many of these have been too expensive to maintain long term or scale up to the entire country. For example, Zambia has a rural retention program for physicians, but the program is funded by an external donor (not sustainable) and the salaries are significantly out of proportion with the salaries of other health workers as well as per capita income in the country. These programs also tend to be more expensive than necessary because ministries of health tend to design them without involving the workers in the rural areas that they want to retain or even workers in metropolitan areas that they want to post to underserved areas. The plans have no foundation in evidence. (more…)

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The Key to mHealth Tools

Kate Otto

By Kate Otto. What do you think is the key to a great mHealth tool?  Is it efficiency?  Scalability?  Interoperability with similar systems?

I would argue none of the above.

I would say that the key to a great mHealth tool is a great health worker at the helm.

My name is Kate Otto and I work with the World Bank and other partners to develop and test the effectiveness of mHealth tools on health outcomes.  Based on two recent mHealth experiences – one with health extension workers (HEWs) in rural Ethiopia and another with midwives in urban Indonesia – I have noted a recurring lesson in this emerging field: that technology is not the solution itself but simply a means to arriving at a solution.  The people behind the tools are what make the difference between success and failure.

Too often, the sleek and impressive nature of new technologies makes the headlines: how they solve all the problems that human beings tend to mess up so sorely, how they avoid any mishaps in the first place with a fool-proof design.

Yet the truth is, the success of mHealth tools and applications are based largely on the intrinstic motivation of the end user – and how tools can be designed to leverage, not stamp out, that motivation.

Our product in Ethiopia allows HEWs to register expecting mothers and newborns so that they receive back appointment reminders, creating a patient schedule for the HEW and increasing the likelihood that she’ll deliver the proper care at the proper time, ideally decreasing maternal mortality, increasing vaccinations, and decreasing infant and child mortality.  But if a HEW does not deeply care about saving lives, if the tool does not work smoothly with her rugged lifestyle, if she cannot see the immediate benefit of using it over the status quo system, then will she take the effort to use it properly or consistently? (more…)

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AHRQ’s Questions are the Answer Campaign

When patients become more actively involved in their own health, there’s a much stronger likelihood their health outcomes will be better.

That’s why “Questions are the Answer,” a new public education initiative from the U.S. Agency for Healthcare Research and Quality (AHRQ), encourages patients to have more effective two-way communication with their doctors and other clinicians.

“Questions are the Answer” features a website — where you will find these free educational tools to use with your patients:

  • A 7-minute video featuring real-life patients and clinicians who give firsthand accounts on the importance of asking questions and sharing information – this tool is ideal for a patient waiting room area and can be set to run on a continuous loop.
  • A brochure, titled “Be More Involved in Your Health Care: Tips for Patients,” that offers helpful suggestions to follow before, during and after a medical visit.
  • Notepads to help patients prioritize the top three questions they wish to ask during their medical appointment.

Clinicians can request a free supply of these materials by calling AHRQ at 1-800-358-9295 or sending an email to AHRQpubs@ahrq.hhs.gov.

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Obstructed Hearing

Diana Mason

By Diana Mason. Two weeks ago, I got my hearing checked by a doctoral student in audiology at a faculty practice clinic at a university. The student was quite thorough. She advised me that she was not a physician and could not diagnose and treat hearing problems. Later on during the visit, her faculty supervisor repeated this mantra.  I said each time, “Yeah, yeah…I know the spiel.”

I know it because for decades nurses were not allowed to say a patient was dead or bleeding or in congestive heart failure despite the obvious signs. Physicians were the only ones who could do these things. About 100 years ago, nurses didn’t even take blood pressures–or temperatures! As new technology was introduced into medicine and health care, the physicians claimed it as their purview–until they were bored with it. Then, they decided that nurses could be taught to do these things. Of course, in many states, including New York until last year, nurse practitioners still can’t pronounce a dead patient to be thus.

When she was the Associate Dean at the Yale Law School, Barbara Safriet (now at Lewis and Clark School of Law) wrote a classic article on the laws regulating medicine and other health care professions. She pointed out that state medical practice acts that govern the practice of medicine were written so broadly that they precluded other health professionals from doing most anything without the authorization and supervision of physicians. As such, podiatrists have fought endless battles to move from working independent of physicians on foot problems; optometrists, to do more advanced assessments of eye problems; chiropractors, to practice at all; audiologists, to use an otoscope to look in patients’ ears; and advanced practice registered nurses (APRNs), to be able to diagnose and treat common health problems.

The battle between APRNs–nurse practitioners, certified nurse midwives, nurse anesthetists, and clinical nurse specialists–and organized medicine is heating up because of the Institute of Medicine’s recommendation that all health professionals be able to practice to the full extent of their education and training and that the barriers to them doing so be removed. A very large body of evidence supports that APRNs provide high quality, safe care and produce the same or better outcomes as physicians. While some states already permit nurse practitioners and nurse midwives to practice without physician supervision or mandated collaboration, the majority of states continue to have restrictive laws and regulations that get in the way of APRNs being able to improve people’s access to affordable, quality, efficient care. (more…)

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