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.
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.
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.
In 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.”
Find 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.
I was lucky enough to be able to take Eileen Sinett’s 4 Points of Connection earlier this year. In this workshop I was able to put together a talk about social justice — not an easy task but she skillfully guided me through it. Her next presentation of this workshop is on October 18, details here.
Sinett knows how to connect with her students, whether a student is frightened to just open her mouth, or is an experienced speechmaker seeking to hone her skills. Everybody comes away more confident, more ready to step up to the podium.
All speaking is not the same! Speaking has many nuances, structures and applications, says Eileen N. Sinett of Speaking that Connects.
“It is the communication vehicle most of us have for conveying ideas, developing relationships, sharing feelings, debating points of view and negotiating terms,” says Sinett. She offers two free webinars to support professional development and speaking success. One is on networking introduction and the next, on storytelling.
“Networking that Connects” is on August 16, and I have a conflict for that date.
But I am looking forward to taking advantage of her free offer to tune in to the webinar on Wednesday, September 6 on the subject of “Facts Tell, Stories Sell.” That’s a subject dear to my heart as a newspaper reporter who must “sell” my story to the reader, to make it worth her/his/their time.
Garbage is certainly the hero at the Terracycle headquarters, says Diccon Hyatt, who tells of Tom Szaky’s latest iteration, a new business model for his throwaway manufacturing business. It’s Diccon Hyatt’s cover story in the issue dated July 4 but being distributed a day early, click here,
It’s a long way from when the headquarters for Szaky’s four-person start-up was a basement room, with a futon cot, on the corner of Nassau and Chamber Street. U.S. 1 has charted his progress. His success story – leaving Princeton University to start a business – is no comfort to hand-wringing parents of students aiming to quit school to follow their dreams.
An article from the Harvard Business Review courtesy of Niki (Veronica) Fielding’s new newsletter Owlthena, validated one of my favorite approaches to reporting: Keep prepared questions to a minimum and just ‘follow the trail’ of where the conversation leads.
It works only when there is no time limit, and when you have the freedom to circle back to the subject again, but it’s pretty exciting to start at square one as if you know almost nothing. When you let one question lead to another, both you and your subject may be surprised at the discoveries.
HBR says: Follow-up questions seem to have special power. They signal to your conversation partner that you are listening, care, and want to know more. People interacting with a partner who asks lots of follow-up questions tend to feel respected and heard.
It also works for me to say, at the beginning, anything can be off the record:
HBR: People also tend to be more forthcoming when given an escape hatch or “out” in a conversation. For example, if they are told that they can change their answers at any point, they tend to open up more—even though they rarely end up making changes.
The article came to me in Niki’s new Owlthena newsletter, “What’s Hot Wednesday,” an assembly of business studies that I would not have seen. The one from HBR was by Alison Wood Brooks and Leslie K. John. (Feminist thought: is it a coincidence that this intensive study on listening was done by women?)
One caution about this approach: Many busy people don’t want to give you the time to meander down uncharted lanes. Keep the prepared questions in your pocket.
Here is a guest post by Greg Wong, co-founder with his brother Kevin of Princeton Tutoring and PrepMaven. Engineering majors at Princeton, they began their careers as strategy consultants and hedge fund operators. Now, as they apply their data and research-backed problem solving skills to the college preparation process, they emphasize personal development, character, and service as key components of college admissions success.
The Wongs are on the right track. Having interviewed high school seniors for my alma mater for more than 30 years,I see too much angst over ‘resumes’ and not enough attention to what really matters. Here are some good thoughts to start the school year, no matter what age the student is.
Admissions rates for highly selective colleges continue to fall. For example, Princeton University has had record low admission rates for each of the past EIGHT years.
Unsurprisingly, many of the families that we advise are increasingly stressed about college. These students are increasingly pressured to overload on AP classes and pack on the extracurriculars in order to compete. Many of their schedules are so over-prescribed that they don’t have any time to think about why they’re doing their activities in the first place.
Is this what colleges really want? NO.
Whether they like it or not, colleges and universities have a huge impact on millions of high school students based on their college admissions requirements. Unfortunately, there are a lot of misconceptions around these requirements.
In direct response to the ever-increasing arms race that we’re all seeing and feeling, the Harvard Graduate School of Education released a report in 2016 called “Turning the Tide” that I encourage every parent to read.
The report shares a vision of college admissions that emphasizes not just individual achievement but also concern for others and the common good. It is endorsed by over 80 college admissions officers and other key stakeholders.
Additionally, a group of 90+ institutions including all the Ivies and Stanford have developed a new alternative to the Common Application called the Coalition Application that “encourages reflection and self-discovery” through an online portfolio that students can start populating as early as ninth grade.
Pamela T. Horne, vice provost for enrollment management at Purdue University, explained in an interview with Inside Higher Ed that “the idea isn’t about how you should pad your resume, but about how you should have significant experiences as part of your education.”
Whether you think that the ability to start populating components of your college application and sharing information with admissions officers as early as ninth grade is a good idea or not, the intentions behind these new tools seem to be well meaning.
The “new” thinking behind the “Turning the Tide” report and the Coalition Application gels with the way my brother Kevin and I have been thinking about things for years. We’ve done quite a bit of research on what top colleges really want, and we’ve identified 3 major characteristics of the most successful college applicants:
Character and Personal Qualities
Many students and families focus way too much on #1 and #2.
Our personal philosophy is that students should also emphasize the things that will make them successful in LIFE – character, personal development, and concern for others.
By doing these things, students will automatically set themselves up for college admissions success (if they choose to go to college of course), which should be the happy byproduct, not their life’s end goal.
And when you see a Kushner name on a commercial real estate property in Princeton, you now know for sure what THAT Kushner has to do with THE Kushner, Jared. As here:
“The founder of Kushner Real Estate Group is Murray Kushner, and his son, Jonathan Kushner, serves as president. Murray is the estranged brother of the developer Charles Kushner whose son, Jared Kushner, is the son-in-law of President Trump.”
To meet the folks who put out this paper every week, come to the Summer Fiction reception, Wednesday, August 16, from 5 to 8 p.m. at Tre Piani restaurant in Princeton Forrestal Village. The free event begins with informal networking, accompanied by a cash bar and free hors d’oeuvres, with introductions of the poets and authors beginning at around 6 p.m.