I'm reflecting today on the power of mercy on our health, wellness and wholeness (HW2). Not just any mercy, however, rather that which is characterized by an empowered and unexpected outreach that fundamentally changes the life of another. The basis for these thoughts is the story of the "Good Samaritan" from the Gospel of Luke, Chapter 10, verses 30-37.
Mercy has as one definition, according to Merriam-Webster's Dictionary, as "a blessing that is an act of divine favor or compassion". Thus, there is a component of the ability of one to "suffer with" (the meaning of the word compassion) another that conveys a blessing on both. The Samaritan came along following a beating and treated a man who was not of his faith. All this happened after both a priest and a Levite (of the beaten man's faith) had passed him by. The Samaritan not only treated the beaten man, but left enough money to care for him for the duration of his recovery. Surely, this reflects divine favor as well as earthly means.
Mercy appears to be in short supply within our current worldview. How often do we pass by those of our faith because of some perceived issue with being in relationship with that person? Maybe they suffer with mental illness, maybe they are infected, maybe they are dirty, maybe they are begging, maybe they are all of the above. Mercy is daily in short supply. Mercy certainly has been relegated to a minority opinion in the debate over healthcare reform and the need for access to quality healthcare for all persons. Even though many hospitals have the name of mercy on their buildings and letterhead, mercy is relegated to a secondary position behind profit. The same can be said for many faith communities which purport to follow an unconditionally loving creator, yet who ignore social injustices in their neighborhoods, communities, country and world, and minister only to those of the same faith narrative.
A return to biblical mercy would radically change our ability to care for those less fortunate. It would free us from our dependence on cash flow and reconnect us with spiritual flow. We would once again see ourselves operating out of the mandate to "love neighbor as self" and to not allow those without means and access to struggle for their basic life needs. A return to mercy is what Possibilities Journey, Inc, is all about (see: www.possjrny.org). We seek to re-integrate the narrative of compassion and mercy into the daily practice of healthcare, by reuniting all faith communities in the delivery of healthcare.
So this holiday weekend, as we once again celebrate the founding of this nation, consider how we measure up against the Declaration of Independence and the Bill of Rights. Also consider how we might use this next year to reconnect faith and health into a sustaining whole.
May you all have a safe and blessed 4th of July celebration!
Dan
Thursday, June 30, 2011
Monday, June 27, 2011
The Power of Agency
Today's post comes from a muse on the book, "Leading Causes of Life" (LCL) by Gary Gunderson and Larry Pray. "Agency" is the third leading cause of life (after connection and coherence and before blessing and hope). Agency is the energy that allows (compels?) us to do something. The authors of LCL also say that agency is all caught up with the idea of call. Agency is just so much more energy if it is not focused by a sense of purpose - a call.
Having two young men in my house with ADD/ADHD, I know all about unfocused energy. ;-) Often, especially in the morning and at night, there is a huge amount of energy in my house - most of it being used in distracted actions that lead to limited outcomes. My children are a metaphor for how much of our activity as humans is done as well. Many well-meaning people (WMP) "do" many things each day, but they do them without a purpose or a sense of a call. Much of our healthcare is delivered in this same episodic or random manner. In fact, if one reads the healthcare literature and the critiques of healthcare with this bias, it becomes quite apparent that we have lost the focus for what we need to be doing.
Agency and call have been lost in healthcare - some believe that they were never there. However, it is important to realize that not very long ago, spiritual matters and health matters were one and the same. Health was interpreted in the face of communal norms and values. What values are we interpreting our healthcare by in 2011? How does the ever increasing cost of providing "sick" care lead to ever increasing social injustice and division? Where's the agency and call?
Possibilities Journey, Inc (www.possjrny.org) is working to try to uncover the sense of call and to return healthcare to a communal perspective. Our sense of agency comes from our vision that the next iteration of healthcare is integrated with all the communal people and programs that lead to life. Come and join us on that journey and rediscover your sense of agency and call.
Peace,
Dan
Having two young men in my house with ADD/ADHD, I know all about unfocused energy. ;-) Often, especially in the morning and at night, there is a huge amount of energy in my house - most of it being used in distracted actions that lead to limited outcomes. My children are a metaphor for how much of our activity as humans is done as well. Many well-meaning people (WMP) "do" many things each day, but they do them without a purpose or a sense of a call. Much of our healthcare is delivered in this same episodic or random manner. In fact, if one reads the healthcare literature and the critiques of healthcare with this bias, it becomes quite apparent that we have lost the focus for what we need to be doing.
Agency and call have been lost in healthcare - some believe that they were never there. However, it is important to realize that not very long ago, spiritual matters and health matters were one and the same. Health was interpreted in the face of communal norms and values. What values are we interpreting our healthcare by in 2011? How does the ever increasing cost of providing "sick" care lead to ever increasing social injustice and division? Where's the agency and call?
Possibilities Journey, Inc (www.possjrny.org) is working to try to uncover the sense of call and to return healthcare to a communal perspective. Our sense of agency comes from our vision that the next iteration of healthcare is integrated with all the communal people and programs that lead to life. Come and join us on that journey and rediscover your sense of agency and call.
Peace,
Dan
Thursday, June 23, 2011
Health Scores and HW2...
Followed a Tweet by Jessie Gruman from CFAH to a blog post from the NY Times (see: http://well.blogs.nytimes.com/2011/06/20/keeping-score-on-how-you-take-your-medicine/?ref=health). This blog describes a new scoring system for medication adherence (how well someone takes their medication). A score less than 200 is a person at "high risk" for medication non-adherence, while a score of more than 400 (out of 500) is good adherence. It got me wondering - especially in light of the incredible amount of research on medication adherence, compliance, persistence, patient engagement in their health, and other sociologic parameters of people's health behaviors - how does a score here "predict" what someone is going to do in a given situation?!
The folks behind the scoring system are the same folks that bring you credit scores (FICO). Credit scores, as we all know, are based on transactions and how each of us manages our debt. The better we are at paying our bills on time and in full, the higher the credit score - the more "credit worthy" we are. I'm not sure that the same rationale can be applied to a multi-factorial process like whether or not I fill or refill my prescription(s). This process is all about trust and belief - that is, do I believe my prescriber got it "right" with the diagnosis and am I therefore inclined to follow the advice and fill the prescription? Obviously not as straight forward as whether I bought a trinket and never paid for it.
Health, wellness and wholeness (HW2) are integrated and multivariate. We continue to try to take a complex system of action and reaction and simplify it to component parts. The blog details a situation of a man on 12 medications who was having problems managing them. No doubt, it is well documented in healthcare literature (especially Pharmacy) that the greater the number of medicines and the greater number of doses per day drammatically decreases the likelihood that a person will take them appropriately. This person would benefit from a high quality, face-to-face medication therapy management consult from a pharmacist - rather than a FICO score that suggests a phone call from a managed care company.
There are great data from pharmacist projects across America (Asheville and others) over the last 15 years that show how face-to-face counseling with pharmacists improves not only medication adherence, persistence and compliance, but improves health measures such as HbA1c, ED visits for out of control asthma, blood pressure and cholesterol. Now, if FICO scores were sent to Pharmacys that these "at risk" individuals use, then the pharmacist could use this information to tailor medication counseling and relationship building which would (I predict) improve scores. Just like a credit counselor does.
After all, as discussed in prior blog posts here, HW2 improvements come with improved relationships across our lives. Having people we trust, who we are in close relationship with, makes it much more likely that we will make healthier choices. See what we're doing about this at Possibilities Journey, Inc (www.possjrny.org).
This week, get to know your friendly neighborhood pharmacist. A great and underutilized resource in our journey towards HW2.
Peace,
Dan
The folks behind the scoring system are the same folks that bring you credit scores (FICO). Credit scores, as we all know, are based on transactions and how each of us manages our debt. The better we are at paying our bills on time and in full, the higher the credit score - the more "credit worthy" we are. I'm not sure that the same rationale can be applied to a multi-factorial process like whether or not I fill or refill my prescription(s). This process is all about trust and belief - that is, do I believe my prescriber got it "right" with the diagnosis and am I therefore inclined to follow the advice and fill the prescription? Obviously not as straight forward as whether I bought a trinket and never paid for it.
Health, wellness and wholeness (HW2) are integrated and multivariate. We continue to try to take a complex system of action and reaction and simplify it to component parts. The blog details a situation of a man on 12 medications who was having problems managing them. No doubt, it is well documented in healthcare literature (especially Pharmacy) that the greater the number of medicines and the greater number of doses per day drammatically decreases the likelihood that a person will take them appropriately. This person would benefit from a high quality, face-to-face medication therapy management consult from a pharmacist - rather than a FICO score that suggests a phone call from a managed care company.
There are great data from pharmacist projects across America (Asheville and others) over the last 15 years that show how face-to-face counseling with pharmacists improves not only medication adherence, persistence and compliance, but improves health measures such as HbA1c, ED visits for out of control asthma, blood pressure and cholesterol. Now, if FICO scores were sent to Pharmacys that these "at risk" individuals use, then the pharmacist could use this information to tailor medication counseling and relationship building which would (I predict) improve scores. Just like a credit counselor does.
After all, as discussed in prior blog posts here, HW2 improvements come with improved relationships across our lives. Having people we trust, who we are in close relationship with, makes it much more likely that we will make healthier choices. See what we're doing about this at Possibilities Journey, Inc (www.possjrny.org).
This week, get to know your friendly neighborhood pharmacist. A great and underutilized resource in our journey towards HW2.
Peace,
Dan
Monday, June 20, 2011
Perspective and HW2
I had an interesting encounter last week with a person who has a much more conservative and literal interpretation of Christianity than I. The interaction was formed out of a discussion within a support group that I facilitate and centered around the topic of sexuality within and outside marriage. The group that I facilitate is about 1/2 "churched" and the other half not. The discussant is a member of a large non-denominational church near where I live.
I've mused about the conversation ever since it ended. This musing has blessed me with its challenge to continue to be in dialogue with persons who not only hold to different doctrine than I do, but who are very assertive in their defense of their views. While the theme of human sexuality and morality are good ones, the dialogue has broadened in my mind to one of perspective and its effect on our health, wellness and wholeness (HW2).
Perspectives change as we go on in life. New experiences test "old" or "usual" modes of being and reacting. New knowledge, and hopefully a bit of wisdom, creep in and alter the way we interpret situations. Informed dialogue and study create a crucible where new data can be "vetted" and either accepted or rejected. Our spiritual beliefs inform our secular beliefs and create a new way of seeing - a new way of being. Now, there are approximately 38,000 versions of Christianity to choose from (at last count). All have (purportedly) the same Bible (with the exception of the Book of Mormon) but the perspective and interpretation of the doctrine varies widely (and often wildly).
It is no different with our health information. Schools of thought on how to live life fully and in a good state of health are legion. In fact, I fully expect that there are many more than 38,000 different "doctrines" to choose from when one is evaluating health and wellness. We all choose those views that reflect our worldview and our interpretation of what it means for our HW2. It's no wonder that folks will follow fads and schemes that promise great things - especially if those great things come without great change in behavior. We really don't want to have to alter the way we are living in order to achieve HW2.
Perspective and wisdom bring us to HW2 through the knowledge that we can never be "sure" of the path that we're on. We never have all the answers, we just try to do the best we can each day with what we're given. In my role as facilitator, I'm called to hold open the space for others to find their way. I can give perspective and information, but I have to "soft pedal" my own beliefs. I need to keep in perspective my own journey and how difficult it has been both spiritually and physically. HW2 is not gained without significant effort both physically and spiritually. Wholesome doctrines in all areas of life are likely going to bear the most fruit - and allowing space for "unknowing" seems logical and practical to me.
So this week, examine your perspective on health, wellness and wholeness. What narratives are operating that determine how you evaluate these aspects of living? What might you need to do to alter those perspectives and routines to improve your HW2? What do you not know that is important to your pursuit of HW2?
May your discernment be blessed,
Dan
I've mused about the conversation ever since it ended. This musing has blessed me with its challenge to continue to be in dialogue with persons who not only hold to different doctrine than I do, but who are very assertive in their defense of their views. While the theme of human sexuality and morality are good ones, the dialogue has broadened in my mind to one of perspective and its effect on our health, wellness and wholeness (HW2).
Perspectives change as we go on in life. New experiences test "old" or "usual" modes of being and reacting. New knowledge, and hopefully a bit of wisdom, creep in and alter the way we interpret situations. Informed dialogue and study create a crucible where new data can be "vetted" and either accepted or rejected. Our spiritual beliefs inform our secular beliefs and create a new way of seeing - a new way of being. Now, there are approximately 38,000 versions of Christianity to choose from (at last count). All have (purportedly) the same Bible (with the exception of the Book of Mormon) but the perspective and interpretation of the doctrine varies widely (and often wildly).
It is no different with our health information. Schools of thought on how to live life fully and in a good state of health are legion. In fact, I fully expect that there are many more than 38,000 different "doctrines" to choose from when one is evaluating health and wellness. We all choose those views that reflect our worldview and our interpretation of what it means for our HW2. It's no wonder that folks will follow fads and schemes that promise great things - especially if those great things come without great change in behavior. We really don't want to have to alter the way we are living in order to achieve HW2.
Perspective and wisdom bring us to HW2 through the knowledge that we can never be "sure" of the path that we're on. We never have all the answers, we just try to do the best we can each day with what we're given. In my role as facilitator, I'm called to hold open the space for others to find their way. I can give perspective and information, but I have to "soft pedal" my own beliefs. I need to keep in perspective my own journey and how difficult it has been both spiritually and physically. HW2 is not gained without significant effort both physically and spiritually. Wholesome doctrines in all areas of life are likely going to bear the most fruit - and allowing space for "unknowing" seems logical and practical to me.
So this week, examine your perspective on health, wellness and wholeness. What narratives are operating that determine how you evaluate these aspects of living? What might you need to do to alter those perspectives and routines to improve your HW2? What do you not know that is important to your pursuit of HW2?
May your discernment be blessed,
Dan
Thursday, June 16, 2011
Discipline and Health...
Today's post is a musing on the need to be disciplined as we approach all aspects of our life. Most importantly, the discipline to do the things we need to do and avoid those unhealthy behaviors that lead to our disease (individual and communal). Self discipline is uppermost on my mind as I am in dialogue with a certain 14 year old male in my house. He embodies a culture of instant gratification and ego-centrism that is somewhat appropriate for his level of development, but in other ways is descriptive of much of what is currently wrong with our world and world view.
We live in a time where everything is packaged for us and we need to do nothing but plug-in and tune-out. Easy to prepare meals, microwave and convection ovens, fast food restaurants, sound bite "news" programs, "30 minutes to a better you". The world narrative continues to get faster, more banal and superficial, less useful and helpful, more destructive and isolating. In healthcare, we wonder why people are not more committed to healthy behaviors - yet we live in cities and countries rife with social injustice and lack of accountability. When we look at ourselves, do we see paragons of virtue and discipline, or do we reflect the culture just as much as anyone else?
Is there a way out of this place? The answer is a definitive "yes". It is not an easy way, it is not a way filled with quick and easy solutions. It is a narrow way, a challenging way, a long way, a way that leads to dying to the ways of the world so that we can discover heaven on earth. It is a way of discipline - through prayer and discernment, we find a path to mindfulness (ala Thich Nat Hanh) and to serenity. We find a place that is not in a hurry, that savors each day as if it were the last; that spends time getting to know people as neighbor.
Spiritual disciplines lead us to a different world view and life narrative. To a healthier and more full life lived in the here and now, not in a hoped for nirvana. Discipline and the resulting improvements in our health will lead us into a new place where we can all discover what we are meant to be. This week, take on a new discipline. Turn off the T.V. and other electronic devices; leave work a little early or start your day a bit earlier with some walking; eat an extra piece of fruit or an extra serving of fresh vegetables; drink more water and less alcohol. Each small step can lead to bigger and better things. Each act of self dicipline makes life better.
Peace for your week,
Dan
We live in a time where everything is packaged for us and we need to do nothing but plug-in and tune-out. Easy to prepare meals, microwave and convection ovens, fast food restaurants, sound bite "news" programs, "30 minutes to a better you". The world narrative continues to get faster, more banal and superficial, less useful and helpful, more destructive and isolating. In healthcare, we wonder why people are not more committed to healthy behaviors - yet we live in cities and countries rife with social injustice and lack of accountability. When we look at ourselves, do we see paragons of virtue and discipline, or do we reflect the culture just as much as anyone else?
Is there a way out of this place? The answer is a definitive "yes". It is not an easy way, it is not a way filled with quick and easy solutions. It is a narrow way, a challenging way, a long way, a way that leads to dying to the ways of the world so that we can discover heaven on earth. It is a way of discipline - through prayer and discernment, we find a path to mindfulness (ala Thich Nat Hanh) and to serenity. We find a place that is not in a hurry, that savors each day as if it were the last; that spends time getting to know people as neighbor.
Spiritual disciplines lead us to a different world view and life narrative. To a healthier and more full life lived in the here and now, not in a hoped for nirvana. Discipline and the resulting improvements in our health will lead us into a new place where we can all discover what we are meant to be. This week, take on a new discipline. Turn off the T.V. and other electronic devices; leave work a little early or start your day a bit earlier with some walking; eat an extra piece of fruit or an extra serving of fresh vegetables; drink more water and less alcohol. Each small step can lead to bigger and better things. Each act of self dicipline makes life better.
Peace for your week,
Dan
Monday, June 13, 2011
Culture of Fear...
Today's post is a reflection on a quote from theologian Scott Bader-Saye that states, "Following Jesus will mean surrendering the power that masquerades as security in order to love the neighbor and welcome the stranger. It will mean avoiding the safe path in order to pursue the good. But in a culture of fear, we find such risks all the more difficult since our natural inclinations lead us to close in on ourselves when we face danger. How can we maintain the posture of the open hand toward a world that scares us?" Hmmm, "culture of fear", that really describes our world right now, doesn't it?!
The news media preys on that fear of the "other" and the "stranger"; as my teenaged children are often lead to say, "stranger danger". While this is to some degree true, one has to be aware of the dangers of the world - Bader-Saye's words are also true in that fear makes our world close in on us. Fear makes us want to close and lock our doors, to go to our "safe rooms", to limit our interactions to those persons who most resemble us. Fear makes us not want to give anything that we might need later in some dark and scary future that has us pitted against each other.
Spiritual wisdom puts forth a different narrative, however. A story that isn't scary or dark, but one that does challenge our world view. We are called by this spiritual wisdom to welcome the stanger as a neighbor and to love that person as we love ourselves. You can't love someone that you fear - the two emotions are diametrically opposed. Therefore, the call is to put away our fear, to trust in a loving and forgiving God, and to create an open space for the stranger to become a friend. This is very counter-cultural and thus very difficult to do. I believe that this is a reason that we are called to be in a faith community with one another. A safe environment where we can experiment with what it looks and feels like to be neighbors and not strangers. to take two steps forward and three steps back, but to continue to try to be in loving relationship.
This week, look to put away the culture of fear. Look to expand your world view to be more inclusive. This will feel very uncomfortable at first, so be easy with yourself. It will take a while, and not every relationship that you try to form will work out. Pray for strength and wisdom, and I bet that you will ultimately be successful and be able to hold out an open hand.
Peace and grace,
Dan
The news media preys on that fear of the "other" and the "stranger"; as my teenaged children are often lead to say, "stranger danger". While this is to some degree true, one has to be aware of the dangers of the world - Bader-Saye's words are also true in that fear makes our world close in on us. Fear makes us want to close and lock our doors, to go to our "safe rooms", to limit our interactions to those persons who most resemble us. Fear makes us not want to give anything that we might need later in some dark and scary future that has us pitted against each other.
Spiritual wisdom puts forth a different narrative, however. A story that isn't scary or dark, but one that does challenge our world view. We are called by this spiritual wisdom to welcome the stanger as a neighbor and to love that person as we love ourselves. You can't love someone that you fear - the two emotions are diametrically opposed. Therefore, the call is to put away our fear, to trust in a loving and forgiving God, and to create an open space for the stranger to become a friend. This is very counter-cultural and thus very difficult to do. I believe that this is a reason that we are called to be in a faith community with one another. A safe environment where we can experiment with what it looks and feels like to be neighbors and not strangers. to take two steps forward and three steps back, but to continue to try to be in loving relationship.
This week, look to put away the culture of fear. Look to expand your world view to be more inclusive. This will feel very uncomfortable at first, so be easy with yourself. It will take a while, and not every relationship that you try to form will work out. Pray for strength and wisdom, and I bet that you will ultimately be successful and be able to hold out an open hand.
Peace and grace,
Dan
Thursday, June 9, 2011
Life Transitions...
Musing today about life transitions. These can take many forms: empty nesting, transitions with retirement or job change, changes in health, loss of spouse, changing locations for jobs. One of the things about transitions is that they always affect our health. This is uppermost on my mind as about a third of United Methodist clergy get ready to assume new positions on July 1st.
Clergy are now one of the least healthy professionals in the U.S. This is across all denominations and through all sizes of congregations. One aspect of this dis-ease, at least in The United Methodist Church, is the need to itinerate. Moving routinely, especially with a family and children, is a very stressful endeavor. The Church Systems Task force of the UMC, just reported that the average tenure for UMC clergy was 3.1 years. This means that the average clergy person would have to move up to 10 times in their work life. No wonder they are stressed!
There is a somewhat hidden health detractor in that statistic. Each time the clergy person and the family move, they not only have to re-create friendships, they have to find new healthcare professionals. With the state of failing health, most clergy have chronic illnesses that either they or their family members are dealing with. Interruptions in care along with differences in treatment patterns, may lead to worse health outcomes. It is one of the things that clergy health researchers are investigating.
How do we as members of congregations and friends of clergy help this process? We can do it be recognizing that transitions take a toll on our clergy and their families. We can help clergy build healthy boundaries and help them enforce these. We can work with our larger church bodies to design clergy expectations to be healthier and more reasonable (who would knowingly sign on to a job that is "on" 24/7/365 for 40 years?). We can, as we are called as laity to do, share the load and take on our portion of caring for our fellow travelers. God does not intend for those "set aside" to do all the work of running the church.
So this week, be kind to yor clergy and their families. Engage in conversation witht eh leadership of your faith community on how you all can improve the life transitions for all persons. How can you address stresses in your clergy person's life that are leading to burnout and disease? Powerful questions that will lead to healthier congregations.
Peace and health,
Dan
Clergy are now one of the least healthy professionals in the U.S. This is across all denominations and through all sizes of congregations. One aspect of this dis-ease, at least in The United Methodist Church, is the need to itinerate. Moving routinely, especially with a family and children, is a very stressful endeavor. The Church Systems Task force of the UMC, just reported that the average tenure for UMC clergy was 3.1 years. This means that the average clergy person would have to move up to 10 times in their work life. No wonder they are stressed!
There is a somewhat hidden health detractor in that statistic. Each time the clergy person and the family move, they not only have to re-create friendships, they have to find new healthcare professionals. With the state of failing health, most clergy have chronic illnesses that either they or their family members are dealing with. Interruptions in care along with differences in treatment patterns, may lead to worse health outcomes. It is one of the things that clergy health researchers are investigating.
How do we as members of congregations and friends of clergy help this process? We can do it be recognizing that transitions take a toll on our clergy and their families. We can help clergy build healthy boundaries and help them enforce these. We can work with our larger church bodies to design clergy expectations to be healthier and more reasonable (who would knowingly sign on to a job that is "on" 24/7/365 for 40 years?). We can, as we are called as laity to do, share the load and take on our portion of caring for our fellow travelers. God does not intend for those "set aside" to do all the work of running the church.
So this week, be kind to yor clergy and their families. Engage in conversation witht eh leadership of your faith community on how you all can improve the life transitions for all persons. How can you address stresses in your clergy person's life that are leading to burnout and disease? Powerful questions that will lead to healthier congregations.
Peace and health,
Dan
Monday, June 6, 2011
Blended Intelligence...
One of the terms that I came away from my visit to Memphis, TN, and my interaction with the Congregational Health Network (CHN) leadership is "blended intelligence". They define this as the intersection between those that understand pathophysiology and pathology (healthcare professionals) with those that understand life (pastors and congregants). Fascinating! It implies that those of us who have trained as health care clinicians have somehow lost our ability to recognize life - at least life as it is lived by those we claim to serve.
I have thought deeply about this blended intelligence and the implication on my own loss of recognition of life in the persons that I have served over most of the last 25 years. I find that there is more than a grain of truth in the words. I marvel at how my clinical training as a Doctor of Pharmacy student quickly focused me on solving problems and coming up with recommendations, rather than on listening and valuing the person I was treating. Seeing with "new vision" I'm surprised that I was so naive to think that just because I recommended the "right" medicine to someone, that they would value that recommendation and follow the prescription.
Not understanding that there are many decisions that go into why someone does or does not follow any direction, I blithely went through my days. I knew that physicians and other prescribers would take most of my recommendations, and that the better my relationship with them, the better my acceptance rate. I never paused to consider this from the perspective of my "patients" - or those I didn't work closely with on a daily basis. I never sought to blend my intelligence with those who my intelligence was acting upon. Egotism, hubris and blindness - guilty on all counts.
That's the beauty of the CHN system. It brings into relationship parts of the system that have been discounted and denied. It links through relationship building those parts of communities that are health assets - that are working to improve the health and well-being of the community. These may be faith communities, hair salons, grocery stores, soccer teams, and other social gathering spots - places where lives are valued and shared. Places where persons learn from one another.
Blended intelligence leads to wisdom. May we all this week seek to blend our intelligence with others and in so doing, become wiser.
Peace and grace,
Dan
I have thought deeply about this blended intelligence and the implication on my own loss of recognition of life in the persons that I have served over most of the last 25 years. I find that there is more than a grain of truth in the words. I marvel at how my clinical training as a Doctor of Pharmacy student quickly focused me on solving problems and coming up with recommendations, rather than on listening and valuing the person I was treating. Seeing with "new vision" I'm surprised that I was so naive to think that just because I recommended the "right" medicine to someone, that they would value that recommendation and follow the prescription.
Not understanding that there are many decisions that go into why someone does or does not follow any direction, I blithely went through my days. I knew that physicians and other prescribers would take most of my recommendations, and that the better my relationship with them, the better my acceptance rate. I never paused to consider this from the perspective of my "patients" - or those I didn't work closely with on a daily basis. I never sought to blend my intelligence with those who my intelligence was acting upon. Egotism, hubris and blindness - guilty on all counts.
That's the beauty of the CHN system. It brings into relationship parts of the system that have been discounted and denied. It links through relationship building those parts of communities that are health assets - that are working to improve the health and well-being of the community. These may be faith communities, hair salons, grocery stores, soccer teams, and other social gathering spots - places where lives are valued and shared. Places where persons learn from one another.
Blended intelligence leads to wisdom. May we all this week seek to blend our intelligence with others and in so doing, become wiser.
Peace and grace,
Dan
Thursday, June 2, 2011
Engagement in Health
I mentioned in my post on Monday that I was in Memphis, TN, last week visiting and learning from the terrific folks at the Congregational Health Network (CHN). This dedicated team is attempting to re-create the healthcare system in that town of 1.2 million, and address some of the most distressing health disparities in the nation. What is most fascinating to me, is the engagement of faith communities in the process to aid the engagement of their congregations in health and healthy behaviors. This is echoed by a recent address given by Dr. Jessie Gruman of the Center for Advancing Health. (see: http://e-patients.net/archives/2011/06/jessie-gruman-at-icsi.html) This sould be required reading for all providers of healthcare services as it crystallizes the issues that we all face.
As a pharmacist, I've spent much of the last 25 years attempting to figure out the best ways to "ensure" compliance and persistence with medications. Still today, however, about 50% of the prescriptions written in America go unfilled. Those that are filled, especially for chronic conditions (e.g., high blood pressure, diabetes) are taken more or less appropriately by the population. Medications can be life prolonging and in some cases life saving - but only if they are ingested (they are 100% ineffective if they remain in the bottle)!
I've come to see persistence and compliance as an engagement issue thanks to Dr. Gruman's work - and my own spiritual journey. The white papaer on patient engagement that is available on the CFAH website is terrific. Engagement for me comes down to a belief model, which puts it squarely in the spiritual arena. If I don't believe that I'm 25 pounds overweight (which I am), and I don't believe that if I continue the same trajectory that I will soon develop all the associated problems of overweight (which I will) - then I will not do anything about it. Just this week, however, I have awoke from my "slumber of denial" and begun to walk every morning. My ability to engage in my own health-promoting behavior is directly tied to my ability to name my demons (my love for food and eating when I'm stressed) and exorcise them. I can not be successful alone, however - I need support and affirmation.
Now, the spiritual language may be anathema for some, but it has helped me to adopt a more positive life narrative. Belief that I've been placed on earth for some reason, that there is something larger than myself that I'm connected to, and the witness of countless people in my life who need me to be healthy, are all working together to support me as I move forward. Engagement of faith communities in a revised and revitalized health care system is for me foundational to address the deep seated societal issues that we have created. The CHN is doing some wonderful work on these matters, and is beginning to be recognized for it. Developing support systems for folks who are coming out of our hospitals sicker and more debilitated is key to having a system that is more efficient and effective. Fully engaged people are the key to a healthier world. Faith communities can and should engage in the provision of this integrated model of healthy living. It only makes sense - what we've been doing is not working.
Gandhi told us all that in order to change the world, we have to become the change we want to see. This is engagement, this is belief, this is necessary, this is do-able.
Peace,
Dan
As a pharmacist, I've spent much of the last 25 years attempting to figure out the best ways to "ensure" compliance and persistence with medications. Still today, however, about 50% of the prescriptions written in America go unfilled. Those that are filled, especially for chronic conditions (e.g., high blood pressure, diabetes) are taken more or less appropriately by the population. Medications can be life prolonging and in some cases life saving - but only if they are ingested (they are 100% ineffective if they remain in the bottle)!
I've come to see persistence and compliance as an engagement issue thanks to Dr. Gruman's work - and my own spiritual journey. The white papaer on patient engagement that is available on the CFAH website is terrific. Engagement for me comes down to a belief model, which puts it squarely in the spiritual arena. If I don't believe that I'm 25 pounds overweight (which I am), and I don't believe that if I continue the same trajectory that I will soon develop all the associated problems of overweight (which I will) - then I will not do anything about it. Just this week, however, I have awoke from my "slumber of denial" and begun to walk every morning. My ability to engage in my own health-promoting behavior is directly tied to my ability to name my demons (my love for food and eating when I'm stressed) and exorcise them. I can not be successful alone, however - I need support and affirmation.
Now, the spiritual language may be anathema for some, but it has helped me to adopt a more positive life narrative. Belief that I've been placed on earth for some reason, that there is something larger than myself that I'm connected to, and the witness of countless people in my life who need me to be healthy, are all working together to support me as I move forward. Engagement of faith communities in a revised and revitalized health care system is for me foundational to address the deep seated societal issues that we have created. The CHN is doing some wonderful work on these matters, and is beginning to be recognized for it. Developing support systems for folks who are coming out of our hospitals sicker and more debilitated is key to having a system that is more efficient and effective. Fully engaged people are the key to a healthier world. Faith communities can and should engage in the provision of this integrated model of healthy living. It only makes sense - what we've been doing is not working.
Gandhi told us all that in order to change the world, we have to become the change we want to see. This is engagement, this is belief, this is necessary, this is do-able.
Peace,
Dan
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