Lessons from LeadingAge
With the caliber of sessions and the opportunity to network with
leaders of non-profit senior living facilities from across the country, the LeadingAge annual convention in Denver was the place to
be this week. I’ve selected a few highlights from one of the general session
speakers to share here. (Impressively Archbishop Desmond Tutu was one of the speakers;
unfortunately I did not arrive in time to hear his presentation.)
Atul Gawande, MD, is a practicing surgeon and staff writer
for The New Yorker. He focused on the
need to bridge the worlds of healthcare and aging care, noting that the story
of care of the sick and frail has been centered primarily on hospital-based
care with home- and community-based care coming later. As a society and
economically we are feeling the distance that is between good care and great
care, and what we (the healthcare industry) does every day.
The challenge, Gawande said, is that medicine has gotten
complex. There are 6,000 medical procedures, 4,000 surgical procedures and
13,600 ways the body can fail. A typical Medicare patient has 10 different
doctors. Yet, 40% of coronary artery patients receive incomplete care; 60% of
stroke patients; and 80% of patients with mental health/addiction issues
receive incomplete care.
He emphasized this is not an issue of not spending enough
money. The most expensive care is not always the best care. To Gawande, that
means there is hope that we can afford to get the results we need. He gave many
examples of this in action, citing the success of Jeff Brenner, MD, who changed
healthcare in Camden, NJ, reducing costs by 56% and improving
quality of health and life. For more, read about the Camden Coalition of Healthcare Providers.
Gawnade also sang the praises of hospice care and gained a
new understanding of its purpose when he went on rounds with a hospice nurse. From
this experience he concluded that in medicine you sacrifice people’s time now
for better time later. In hospice, you give people their best possible day
today – based on their goals, not the goals of medicine.
This should change, he said. “You shouldn’t have to wait for
hospice to plan for your best day.”