Category Archives: Healthcare

Dear dear Dr. Ruth

Here’s my confession: I’m such a Dr. Ruth fan. A couple of decades ago, when I was scheduling an interview with her, she left a message on my phone mail that I kept for weeks, delighting in that throaty signature voice.

Here is Dr. Ruth Westheimer’s prescription for Covid positivity, published in the AARP newsletter. Memo to freelancers: she pitched her own story. It wasn’t the editors’ idea but they bought it. Memo to photographers and stylists: This is how to make an elder look good!

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Helping One Helps All

Best Buy’s landmark employee handbook

Reading this post I watched an interview with a nationally known HR guru on how taking care of caregivers can help everyone – including the employer.

Charles Montreuil, SVP of Human Resources at Best Buy, was interviewed by Alexandra Drane, co-founder and CEO of Rebel Health and ARCHANGELS, a national movement that recognizes and honors caregivers.

Montreuil broke new ground in ways for a corporation to care for its workers who are caregivers, and as both a recipient of care and a caregiver myself, his ‘corporatized empathy’ has special meaning for me.

Charles Montreuil and Alexandra Drane

At minute 23 came my AHA moment about why my church’s new arrangements for “taking care” are so meaningful. Montreuil says that having a caregiving system in place will reduce stress — not only for the employee caregiver — but also for everyone who works with or who knows that person. Stress for one person affects those around her. When the employee’s friends – her team – know that she can get help if she needs it — they can relax too.

I tend to carry a lot of that kind of stress. As an empath and a diagnosed worrywart, I am prone to worrying about who isn’t being taken care of. Ten years ago I helped manage an informal team to look after a beloved church member who lived alone but had dementia and other health problems. Refusing to move from her fourth floor walk-up Palmer Square apartment, she charmed everyone in sight, inspiring them to help her. But it took 10 of us to manage all aspects of her care.

What org”>Princeton United Methodist Church lacked then was an organized system of tracking who else needed care. We did have had other formal systems in place. In addition to the pastors, they included:

Stephen Ministry, which I knew pretty well since my late husband worked, as the lay leader, with then -pastors Rev. Jana Purkis-Brash and Rev. Catherine Williams and the lay team of Stephen Ministers — caring Christians trained to walk alongside those in need for as long as necessary to provide emotional and spiritual care.

From Stephen Ministry grew a caring group for widows and widowers, called Love Lives On.

The Prayer Chain, for as long as I can remember, offers solace to many. To be able to say “our prayer warriors will pray for your loved one” seems to help even those (perhaps especially those) without a firm faith.

Until Covid, several 12-step groups had, for decades, found a warm and welcoming meeting home in the church’s building on the town’s main drag. (After Covid, they will return).

Then. last year, Pastor Ginny Cetuk and an experienced lay member, Laverna Albury, put together a program, Circle of Care, to try to ensure that no one in our flock would “fall through the cracks.” This 12-member team “provides services and support to individuals or families who find themselves in acute distress due to illness, injury or family stress. ” When Covid came along, Circle of Care was in place and ramped up its efforts.

My AHA moment: When Best Buy’s HR guy, Montreuil, acknowledged that help for a stressed out caregiver could reduce the stress among that worker’s associates. “When you take care of one employee you are influencing the rest of the store. ‘Look at how this store takes care of us.'” Just knowing that respite care is available for the co-worker makes everyone breathe easier.

Yes! I realized. With the Circle of Care in place I can put that particular worry, that particular reason to be anxious, on a shelf. Other folks are in charge!

Full disclosure: I found this video on the website of my daughter, Susannah Fox. She bills herself as an “internet geologist” who helps people navigate healthcare and technology. At the end of her post she gave a link to Best Buy’s caregiver handbook.

The photograph below shows the elder in the fourth floor walkup, barely able to walk herself, charming a 10-yea-old stilt walker.

Guilty Pleasures Needed

loneliness
by Tracy Lee for NPR

“Guilty pleasures” are good for our health says psychologist Dan Gottlieb on WHYY today. He says there is a good study suggesting these guilty pleasures do help loneliness. So, to combat loneliness, grief, and the fear of tomorrow, do something you enjoy at least every day. This will nurture social capital.

Another tip from NPR, this from a May 10 segment on Quarantine Blues:  Don’t miss the opportunity for small touch points throughout the day. Even sharing a joke over text can make you feel less alone, says  Judith Moskowitz, of Northwestern University.

Got questions? Dr. Barile has answers

logoKnowledge is power. Information reduces stress.
Join Dr. David Barile on a weekday to get your questions answered. He sends this invitation: 
Here in NJ we are facing the very real possibility of a shortage of respirators, PPE and ICU beds. Just today we had additional positive tests reported bringing our state’s total cases to 8,825 with 108 deaths. We are working with several of our Coalition partners to address some of the unmet needs.
Toward that end, from Monday 3/30 to Friday 4/24, Goals of Care Coalition of New Jersey (GOCCNJ) will be launching a daily webinar M-F at 1:00pm to help educate people and address their questions regarding POLST and advance directives for the populations at high-risk for complications of COVID-19 (nursing home populations, frail elders, people with underlying medical concerns, etc.) and/or their family decision makers/healthcare proxies. Visit the GOCCNJ website, www.goalsofcare.org, to register for the webinar.

Please share the attached flyer with your networks and let people know this resource is available. We have more information and resources online at our website www.goalsofcare.org. We would be so grateful if you help spread the word!

Many thanks and please stay healthy and safe!

Best,

David R. Barile

Founder & Chief Medical Officer
Goals of Care Coalition of New Jersey
webinar flyer

Clarity of purpose trumps knowledge: Clayton Christensen

christensenDisclosure: I had never heard of this man, Clayton Christensen, until my daughter noted his obituary and said that he had had a big influence on her life.

When I read this excerpt of his words in the Weekend Reader* — the fact that Christensen  is so devoted to God’s purpose for him, and that he has managed to impart this to the secular business community, ‘blew my mind.”

For me, having a clear purpose in my life has been essential. But it was something I had to think long and hard about before I understood it  … Clarity about (a business person’s)  purpose will trump knowledge of activity-based costing, balanced scorecards, core competence, disruptive innovation, the four Ps, and the five forces…

If you study the root causes of business disasters, over and over you’ll find this predisposition toward endeavors that offer immediate gratification. If you look at personal lives through that lens, you’ll see the same stunning and sobering pattern: people allocating fewer and fewer resources to the things they would have once said mattered most…

If you want your kids to have strong self-esteem and confidence that they can solve hard problems, those qualities won’t magically materialize in high school. You have to design them into your family’s culture—and you have to think about this very early on. Like employees, children build self-esteem by doing things that are hard and learning what works. 

I also really liked this principle, one that I learned from Rev. Paul Couch when he pastored Redeember Moravian Church:

The lesson I learned from this is that it’s easier to hold to your principles 100% of the time than it is to hold to them 98% of the time. If you give in to “just this once,” based on a marginal cost analysis, as some of my former classmates have done, you’ll regret where you end up. You’ve got to define for yourself what you stand for and draw the line in a safe place. 

Rev. Couch said over and over again — if you slip once, it will be easier to do it again.

My daughter, Susannah Fox, posted about listening to Christensen in 2014. 

Then, his remarks targeted health care.  Her comment: “Great thinkers can … take you on “a helicopter ride and point out new patterns in a familiar landscape.”

Perhaps that is because he was, by definition, humble. (May I point out that great spiritual leaders, from Paul Couch to Fred Rogers are, by definition, humble?

Said Christensen:

 And if your attitude is that only smarter people have something to teach you, your learning opportunities will be very limited. But if you have a humble eagerness to learn something from everybody, your learning opportunities will be unlimited.

My interpretation of how teach humble is to offer good preschool care. Self esteem matters.

Generally, you can be humble only if you feel really good about yourself—and you want to help those around you feel really good about themselves, too. When we see people acting in an abusive, arrogant, or demeaning manner toward others, their behavior almost always is a symptom of their lack of self-esteem. They need to put someone else down to feel good about themselves. 

Here’s the takehome, for both business leaders and the rest of us.

Think about the metric by which your life will be judged, and make a resolution to live every day so that in the end, your life will be judged a success.   

 *Note: Maxwell Anderson, who blogs as The Weekend Reader, is a Princeton seminary graduate and can be counted on to take a God-centered view of every issue. If curious, subscribe here.  I borrowed the image from his blog post.

‘Don’t let the failure of your imagination limit your ability to serve your customers’

close-up-person-cutting-cheese-with-knife-round-chopping-board_23-2148166558

My friend Hugo Campos, writes Susannah Fox, is originally from Brazil and taught me a lovely phrase in Portuguese about someone who holds all the cards, who seems to have all that they need to create change: “Está com a faca e o queijo na mão.” It means: He holds the cheese and the knife. This person has what they need to execute their vision. You want to be that person.

Details here. 

Image credit:
<a href=”https://www.freepik.com/free-photos-vectors/food”>Food photo created by freepik – http://www.freepik.com</a&gt;

 

The care they need – the care they want

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If any part of health care in New Jersey needs reform, it’s end-of-life healthcare. Patients here are likely to undergo more intensive medical care, in their final days, than in any other state. All this treatment rarely helps the patients; likely it just makes them uncomfortable.

David Barile MD, palliative care specialist, founded NJ GoalsofCare,  a non-profit, to help everyone — lay people and medical people — achieve their goals for this stage of life that is often feared and ignored.  “We’re working to set a new standard by helping healthcare providers, patients, and families make medical decisions that genuinely reflect a person’s wishes,” says Barile. He created educational materials and documents to ensure that patients would receive the care they need and no less, and the care they want and no more.

In our family, we have had examples of too much care, too little care, and just the right amount of care. The “just the right amount,” no coincidence, was supervised by Dr. Barile. 

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Now his small organization has coalesced into The Goals of Care Coalition of New Jersey. Its partners are healthcare providers, government agencies, and community organizations.  Founding members are an impressive list:  NJ Hospital Association, the Medical Society of NJ, the NJ Association of Health Plans, the Health Care Association of NJ, HQSI, the Home Care & Hospice Association of NJ, LeadingAge NJ, the NJ Health Care Quality Institute, the NJ Palliative Care APN Consortium, the VNA Health Group, Samaritan Healthcare & Hospice, the NJ Association of Health Care Social Workers and the NJ Association of Mental Health and Addiction Agencies.

From Robert Wood Johnson Foundation it has a one-year grant, $195,000, to address disparities in access to palliative care for minority populations living in New Jersey. It also landed a $75,000 matching grant, and here’s where I — and maybe you — come in. I’m donating, and I invite you to contribute. You can do it through a Facebook fundraising page or directly through GoalsofCareNJ website. 

Talking about the end-of-life does not come easily! That’s why I believe both the medical people and lay people need the GoalsofCare materials.

Bottom line: When it’s time to say goodbye to someone you love, it’s such a comfort to know that the caregivers are following the patient’s wishes.

 

 

 

 

Entertaining Engineer: Prud’homme

 

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Gathered to hear Bob Prud’homme speak at the Princeton Chamber breakfast was a contingent from Princeton United Methodist Church. In this quickie snap, from left: Bruce Henry, Barbara Fox, Prudhomme in back, Jamileh Gerber in front, Dana Dreibelbis in back, Daniel Shungu in front. Also attending from Princeton UMC: Ed Sproles and Doug Fullman.

Scientific “war stories” were on the agenda today, as Bob Prud’homme entertained members of the Princeton Regional Chamber at the Nassau Club. Some of the twists and turns of his 40-year career at Princeton University revealed good news, some not so good.

In the disheartening category was the realization that, since virtually no drugs are manufactured in the United States, the U.S. stands to lose significant intellectual capital re drug development.

Why? A therapy doesn’t leap from lab to assembly line. It undergoes translation from research to retail in a “pilot” manufacturing plant, where veteran managers and supervisors can keep close tabs on quality control. Until recently the major pharmas built those pilot plants in the U.S., supervised by U.S. managers. If all the pilot plants move overseas, technical managers in the other countries will acquire that extremely valuable expertise.

On the heartening side, Prud’homme says he often finds himself working with research scientists in Asia whom he knows – because they were his students and collaborators at Princeton. Surely this answers any chauvinistic assertions that U.S. schools should limit the number of students from abroad.

IMG_4615In the good news category, Prud’homme and his collaborators get money from the Bill and Melinda Gates Foundation to develop drugs for global health. (UFAR founder Daniel Shungu, seen chatting with Prud’homme before the breakfast, is also the recipient of Gates funds.) What can sell in a blister pack at CVS won’t work for a third world country, which needs drugs to be packaged in jars that will last for six months in a hot damp climate. Princeton’s engineering quad leads the industry in meeting the need for these opportunities in drug delivery.

Only inexpensive drugs can be brought to poor countries. In contrast, cancer therapies are so costly that they can’t be used in the Third World. Prud’homme worries that cancer therapies will even be too expensive for OUR country’s insurance capacity, and that our healthcare business plans are in danger. Either our healthcare insurance will topple, or it will be outrageously unequally distributed, or the people will make decisions about what gets covered and who doesn’t.

One fix would be to deny $60,000 immunotherapy if it won’t prolong life by at last a year. Another way is to adopt the single-payer system used in Australia and make the hard decisions. “I worry about the future of our healthcare system,” says Prud’homme, “and that we will have an unjust society. What problems are we willing to live with?”

Prud’homme memorably described the ins and outs of nanotechnology in clear terms. The challenge for using nano in injectable drugs is that the drug might disperse too quickly, before it reaches the target site. The difficulty with using nano molecules in oral therapies is that many molecules are hydrophobic. They do not live comfortably in water.

His lab, successful in conquering both challenges, has been selected as the “academic lab of choice” by the major pharmas. The story behind that reinforces MY conviction that our town is ever so fortunate to have this university and these research labs at our doorstep.

Many complain that because the university has “deep pockets” it should pay more in lieu of taxes. Exactly because Princeton University has those deep pockets, it can afford to offer generous terms to potential partners. Someone asked how scientists can get molecules through the patent process without revealing secrets to competitors. The answer, says Prud’homme, lies in the university’s motto “Princeton in the Nation’s Service.”

Nobody has approved this metaphor, but here’s how I would explain it. You have five pirates at your door for Trick or Treat, almost identically costumed. One has a face mask, Pirate X. When a big pharma (BASF, GSK, Pfizer, Merck – all Princeton collaborators) wants to secretly develop a molecule, Princeton sends all five to the patent office, revealing the identity of four, leaving one unidentified. This gives the big pharma lead time to develop Molecule X. (Somebody please comment if this comparison doesn’t work.)

Princeton University came late to the entrepreneurial market becauase. as Prud’homme acknowledged, research suitable for the commercial market used to be scorned by the academics. Princeton was one of the most hoity-toity of universities in condemning research that results in a salable product.  He credits the philosophy of John Ritter  (in charge of technology licensing) and the success of two researchers – Steve Forrest and Edward C. Taylor – with changing the university’s attitudes about the inviolable sanctity of basic research. Forrest (now at the University of Michigan) channeled his research on organic light -emitting diodes (OLEDs) into a start-up, Universal Display Corporation that leads the market for displays for smart phones and has revenues of more than $300 million. Taylor developed the cancer-fighting drug, Alimta, and the proceeds from that virtually paid for the university’s new chemistry building.

With its generous endowment, the university does not have to nickel-and-dime its collaborators, and its scientists and engineers can be “in the nation’s service.”

Labs inside the Ivory Tower

Robert_Prudhomme-orig-300x300Find out what’s going on at Princeton University’s e-quad. What research projects will spawn the next billion dollar company? What, exactly, can we expect from nano technology? Hear Professor Robert Prud’homme’s entertaining stories on Wednesday, November 14, 8 a.m. at the Nassau Club. Plus, it’s a yummy breakfast! See you there — Click here for details.