Make A Difference

Thailand: Making a Difference – one small action at a time

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I should first open up and say….wow, it has been a long time since I have blogged. June of 2021! That may be the longest break that I have ever taken. Needless to say, it has been an eventful 17 months but more on that later.

I wanted to write again this week for a special reason. I have the honor of hosting with my work friend, Julie, our CHG Healthcare Difference Makers on a Medical Mission trip with International Medical Relief (IMR) to Chiang Mai Thailand this week. Not only that, I got to bring my mom with me! For both of us, a trip of a lifetime. We are about half way through the trip and I though I would share my perspective on our time here.

Me and Mom on the way to clinic

First things first, let me tell you about our CHG Difference Makers. For 6 years , we have recognized at CHG people who live our core value of Putting People First by serving each other and in their local communities. Four winners are chosen each year, and the award is going on a company-paid humanitarian trip. COVID put a stall in our trip plans, but we are excited this year to be back at it traveling again this year in Thailand. Congrats to Amanda, Nick, Mariska and Randy for bring a CHG difference maker this year, and thank you so much for the impact all of you make in your lives for others!

Our partner IMR helps us by leading these trips. They bring together our Difference Makers, a few of us hosts and clinicians from around the world to help local communities. Our team here in Chiang Mai is about 20 people on mission and a local support team of dozens helping. We are all working on bring our talents together as a team to help make a sustaining difference for the people of Thailand – one small thing at a time. Karla and PJ are amazing! Their knowledge, giving spirit and willingness to help all of us and the people who need it in the world is an inspiring example for all of us

It has been an amazing start to the trip. We started on Saturday night with meeting the team, and organized and trained Sunday and just completed our first two days in clinic. For me, the best part of the trip so far has been meeting the Thai people. In our clinics the last two days, we have seen over 250 people. The first day we were about an hour southwest of Chiang Mai, helped by the Thai ministry of health and yesterday we were 2 hours away from the city, in the hills northwest of Chiang Mai serving the Karen people.

Day 1 in Clinic: Eva our fantastic NP helping at the clinic outside of Chiang Mai with Primary Care. Translators in action again.
Amanda (one of our CHG Difference Makers) with Craig her fiancé and Maddie another volunteer (and 16 years old!) working the pharmacy as pill counters
Mom and I after we wrapped up Clinic Day 1 outside of Chiang Mai. 150+ patients served in partnership with the Thai Ministry of Health
Day 2 in Clinic: Eyeglasses for the first time for a woman from the hills outside of Chiang Mai from the Karen tribe. Two translators in action. English to Thai, Thai to tribal language

There are so many lessons to learn from these days, but the one that sticks out to me the most after these 3 days, and one that is embodied by our Difference Makers, is how much of a difference you can make with the little things you do. We did stretching classes, sang songs, taught oral hygiene, taught hand washing and of course provided medical care. But most of all we were here, helping and working with as a team.

Thank you CHG and IMR for leading the way, and bringing our mission back to Thailand – a beautiful country with beautiful people.

Reflections on COVID-19: Humanity, not Politics

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I sit here tonight, after watching some of the the One World: Together At Home broadcast (which was an awesome representation of good people), and after reading a few Facebook posts (which makes me sad), and I feel perplexed.  I want to be able to stand on the top of a mountain and yell to everyone that this is a crisis about humanity, not politics.

11707DA2-29C7-4D7E-991C-54AFD86D3D4APhoto by Nagesh Badu on Unsplash

This COVID-19 crisis is a struggle to do what is right around the world.  It is about making the best choices possible to help the most people knowing that every choice made will hurt someone.  It isn’t, and shouldn’t be about political positioning, or making a name for yourself.

In these times we see the best and the worst of people.  And, unfortunately social media is an amplifier of those characteristics.  I even found myself commenting back today on someone’s Facebook post that wasn’t worth it.  This is a humanitarian crisis.  Every decision has a downside, but we all have to do the best we can to help our country and the world get through this.

A few stats that will make you cringe:

  • As of today over 150,000 people have died in the world from COVID-19.  In the United States this number is nearing 39,000. The first US death occurred on 2/29, a mere seven weeks ago.
  • To help put this in perspective, let’s compare to three tragedies that most all of us can all agree were horrible events in the world:
    • Over 400,000 American lives were lost in WW2 over a long six year, world changing tragedy.  The US lives lost were dwarfed by the 75 million estimated dead around the world.
    • Almost 60,000 American lives were lost in Vietnam.  The global death count was again much more severe, but losing almost 60,000 American lives remains one of the largest tragedies in our history.
    • 9/11/2001 had over 3,500 lives lost in the day.  We also put brave soldiers in harm’s way as follow up to this terrorist attack.  We all remember where we were the day of this horrific tragedy.
  • Currently, estimates of American deaths by the end of August 2020 (just six months after the first death) range from 60 – 100K.  This will make the COVID-19 crisis surpass Vietnam in its impact on our people.  Not to mention all of those around the world.

Everyone is sacrificing right now in order to help to minimize the global impact of this crisis.  There are people out of work, without food, with “elective” healthcare procedures that they can’t get completed even though tumor removal doesn’t sound elective when the tumor is growing in your body.  There are situations where families are housebound with an abusive adult in the home, there are mental health challenges developing.  And, it sucks.  It is bullshit.  But, so is 60,000+ projected American lives lost from a Coronavirus.

My call to action for all of us is to do is to do our best every day, to be human, to not politicize this crisis, and to support each other however we can by offering help to those in need.  And to STAY HOME and socially distanced as long as the CDC recommends.  Trust scientists and help the crisis be as short as possible for humanity.

The Future of Healthcare

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I had the privilege of attending Fortune Brainstorm Health last week, an innovation conference working to bring together the best minds in Healthcare, Technology and Business to make a difference in healthcare.  The theme of this years conference was “Accelerating the Health Revolution.”  The topics were broad and thought provoking.  I found myself at the event wondering how I could do more on a day to day business to help.  Since the conference the question has only gotten louder in my mind.   In reflection, I think that the starting point is to write down my top observations after review of my notes.  Maybe this exercise will lead my somewhere…

  • There are amazing people who work in healthcare:  scientists, physicians, innovators and investors.  I met people brave enough to tackle life or death situations with a gusto every day that most of us don’t muster at our best moments.  People with an insatiable quest for learning.  These people provide me a great deal of hope for the future despite the rhetoric of politics.  
  • This conference reinforced my belief that healthcare is a fundamental human right.  You can often get lost in the public debate over healthcare finance, which is what most of the political conversations center around.  The media doesn’t help, covering the politics of healthcare, and grabbing on to often non-core issues.  This conference allowed me time to simplify it for myself.  All people deserve access to care.  In order to afford this as a country, investment must shift from treatment to prevention.  This will ultimately bend the cost curve.  That said, the reason to have health care for all isn’t economic, it is ethical.  
  • Despite what I said above, costs are a major problem.  As a nation, we over invest in late stage healthcare and under invest in prevention.  Dr. Sandro Galea, physician and currently Professor and Dean, School of Public Health at Boston University, made a compelling case for the investment in creating health versus treatment illness as our priority.  When ranked versus 17 peer countries, the US mortality rates are ranked #15 – 17 for all age groups under age 60 and we quickly rise to the lowest mortality rates in the world for over age 80.  We invest a large portion of our healthcare dollars into this treatment and it is what is incentivized by our healthcare payment system.  The alarming thing is that it doesn’t increase longevity.  
  • Healthcare is about so much more than clinical care.  We were joined at the conference by Mark Bertolini, CEO of Aetna.  He shared that  “Only 10% of life expectancy is driven by clinical care – 30% by genetic code, 20% by the social determinants of health, and 40% by lifestyle choices.”  Dr. Galea, who I mentioned above, spoke of this as well.  In follow up to his talk, I read a great piece he wrote last fall.  Within this article, you can also find the chart to support the mortality rate information I shared above.  Improving the health of our nation is as much about investments in our social infrastructure (e.g. education, clean water, public transportation, a living wage) as it is investment in medical advancements.  I feel incredibly lucky for the good fortune that my family has had.  
  • One of the best comments from the audience at the event was about hospitals and their role at the center of healthcare improvement. The quote was something like…”Isn’t it ironic that our healthcare system is hospital-centric? Particularly given that a trip to the hospital is the failure of care.” Prevention, prevention, prevention. Our role must be to influence behavior so that people do not reach the point of needing the hospital.  
  • Corporations have a critical role in improving healthcare.  It is the right thing to do to focus on employee health and wellness.  If moral responsibility doesn’t convince you, employees that are well – getting enough sleep, eating well, exercising regularly – are more productive. The power of top-down leadership to drive a culture of wellbeing for our employees will be the pressure our healthcare system needs to evolve. On a side note, I crossed paths again with a former leader of mine, Chip Bergh, who is now the CEO of Levi Strauss. I remember his dedication to well being 20 years ago, and it was amazing to see his continued commitment to wellness as a driver of employee engagement and productivity. 
  • Fertility issues are a health crisis. The awareness of the breadth of fertility issues is low, and there is still a stigma to discussing these challenges.  A world-renowned fertility physician, Dr. John Zhang spoke about a controversial procedure (the three-parent baby) that he led last year.  It was a fascinating discussion, which prompted me to talk with him on a break.  We had a great conversation about this awareness issue.  His point…there is a Breast Cancer Awareness month, an MS walk, a Lymphoma/Leukemia organization all of which are doing great work to raise awareness of their disease, and funds to help reach a cure.  Yet, fertility issues are still taboo, unfunded, and impact over 6 million women in the US alone.  Fertility issues are reported to be as stressful as dealing with cancer for a family. Solutions are expensive, and the path to the solution is complex. Long-term this is decreasing wellbeing, and increasing costs within our healthcare system.  
  • Our company (CHG Healthcare) has a critical role in helping physicians to perform at their best.  With all of the challenges in healthcare, physicians are working harder, showing signs of stress and burnout and more focused on administrative tasks than ever (less time on patient care).  I sat next to a surgeon who said that given all of the electronic charting that she has to do, she sees about 40% less patients per day now than she used to.  Helping physicians to be successful and delivering to their maximum contributions well help save lives. 
  • Technology and data will be a propelling force for change.  Amazing people are investing in amazing things.  We got two live demonstrations that were particularly impressive.  The first, a matchstick size device that slides under the skin currently in development from Intarcia.  This device, combined with chemical innovation that allows medicine to stay good at 104 degrees for up to three years, enables medicine to be dispensed into the body automatically for up to a year post implementation.  Imagine chronic disease treatment improvements via increased drug compliance if this could be installed once a year in a less than a one minute procedure.  The second was a partnership between Tricog Health and GE Healthcare to provide EKG support to rural Indian clinics via a connection to the cloud for immediate diagnosis.  Both of these were amazing innovations, but just the tip of the iceberg in terms of what could be.  
  • Genomics.  All I can say is wow.  This field is moving through years of progress in weeks and months.  To envision its role in the future is for people smarter than me.  Refer to the first point above. 
  • Finally, there are people in this world who are way braver than me. Two physicians, Dr. Nahid Bhadelia and Dr. Raj Panjabi discussed the Ebola breakout in 2014. They were both on the front lines of the disease in Africa.  Dr. Bhadelia spoke of the impact of global security decisions on their work on the ground. As a country, we were began acting with an “abundance of caution” and airlines stopping flying into this part of the world.  Although well intentioned, this created immediate supply issues for healthcare workers on the ground. At one point, she and her team were out of personal protective equipment and had to make the decision to either use tarps to cover themselves and go back to work, or to let more people die.  They went in with tarps.  The bravery that this requires is something that I cannot fathom. I leave this week with an even further appreciation of the difference healthcare providers make for patients every day.  

An amazing, thought-provoking event to say the least.  What do I do with it?  I don’t know.  What I do know is that we all have a role in the Future of Healthcare.  Whether as a consumer of care, the owner of our own personal health or as an activist for a cause, we are all leaders in this challenge.  That said, senior corporate executives have a unique role given their influence.  I will paraphrase (and adjust) a quote from Mark Bertolini:

“The role of a CEO (substitute any senior executive leader in my point of view) is the power to convene, and the power to set the agenda.”   – Mark Bertolini, Aetna