ten days after graduating medical school
I was diagnosed with leukemia
I received a bone-marrow transplant that
saved my life and I found myself in awe
of how great our healthcare system was
it taking care of me when I was sick but
I soon realized that the excellent care
I received was only part of the care I
needed you see after I went home and
because of things that transplant did to
my body I became chronically unwell and
had to start caring for myself in a way
I never had I had meds I needed to take
and exercises I needed to do I had najd
and pain and fatigue I needed to manage
and tests and appointments I had to
organize and even when I wasn’t feeling
well and all this work seemed to be
keeping me from doing the things I
really wanted to do I knew I couldn’t
get stressed or anxious or sad because
if I did it would only make things worse
to be honest there were times when there
felt overwhelming and my wife and I
would get frustrated because it seemed
like too much of my health was dependent
on us it felt like the health care
system didn’t want to support my efforts
to be well now I realized that it simply
couldn’t see the truth is we designed
our health care system Adhan for a
different time we started building it in
the early 1900s when people were sick
and injured and it seemed like the only
work that needed to be done was the work
that doctors and nurses did after all
the top causes of death were things like
pneumonia and the flu and since we just
started developing things like vaccines
and antibiotics which were essentially
cures all we really needed as far as
anyone knew was just a system that could
deliver treatments effectively all we
really needed was sick care we live in a
different world today and we know better
for example today seven of every ten
deaths and 80% of all healthcare costs
are the result of chronic ongoing
conditions things like diabetes heart
disease and depression or in my case
something called graft-versus-host
disease these are of course the sorts of
diseases that don’t even have a cure to
deliver but they’re also the sorts of
conditions that are mostly managed and
prevented not by the work that doctors
our nurses do
by the work that we do every day of our
lives it’s the choices we make and the
lifestyles we pursue coupled with our
ability to cope with and overcome
whatever life throws at us this is the
work of being well it actually has a far
greater impact on our health than the
sick care we receive and yet our
healthcare system is not designed to
support it but there is a way that it
can see over the last several decades
physicians and scientists have worked
closely with patients to develop
interventions that can support our
efforts to be well the effective ones
are called evidence-based programs and
what they show us is that in order for
us to be well we need a few basic things
first we need to know and understand the
parts of our health that really are
under our control and what we can do
about it actually works secondly we need
support at time and space in which to
practice what we learn and lastly and
perhaps most importantly is we need to
know we’re not alone we need to know
that our struggles and our fears are
normal consequently most of these
interventions involve getting groups of
people together that have some common
health concern to go through a specially
designed curriculum that’s often
delivered by trained facilitators that
actually have a personal connection to
the same concern and what we find in
trial after trial of these programs is
that when you support people in doing
the work sick care can’t do you get
results sick care can’t give for example
when people with chronic physical or
mental illness participated in a program
designed to help them self manage their
health we find that they feel better and
that their quality of life improves
similarly when older adults participate
in a program designed to help them avoid
a fall we find that they fall half as
frequently as they otherwise would
allowing them to maintain their
independence there are programs that
help people cut the risk of developing
diabetes in half and programs that help
people with chronic pain hurt less and
get more satisfaction from their lives
and those are just a few examples
actually there are hundreds of proven
ways for people to support one another
and doing the work sick care can’t do
the National Cancer Institute even has a
registry of these sorts of interventions
if you want to look them up same with
the National Council on Aging I mean
it’s not a secret we know how to help
people be well we even know that helping
people be well saves money about five
dollars save to every dollar invested no
the problem is not that we don’t know
what WellCare is or whether WellCare
works the problem is that well care does
not fit in a sick care system and this
is why over the last few years my team
and I have focused on doing the
proof-of-concept work to show how a well
care system could function a system
based in communities but integrated with
and supported by the existing sick care
system we’ve trained individuals from
the community to deliver evidence-based
programs in churches and schools and
libraries and workplaces and in
partnership with a Rochester based
software company developed a scalable
technology that allows them to work
closely with one another and with
clinicians in the sick care system and
as a result patients like juan after
being diagnosed with diabetes no longer
have to feel alone and abandoned by a
system not designed for them rather
they’re being referred directly to
people from their community people like
Alma and Magda who’ve been trained to
deliver a highly effective diabetes
self-management program in Juan’s native
Spanish a program that will of course
improve one’s clinical outcomes but that
will also give him hope for the future
and help to save his struggling marriage
you see the point I’m trying to make is
that the situation we are in as a
society is not unlike the one in the
early 1900’s we know what improves
health but will we commit now to
building a system for well care like we
did then to building a system for sick
care will we allow people like Alma and
Magda to be part of the health care
system
well we allow communities to be more
than passive recipients of sick care
well we enable them to be active
partners in the provision of health care
I’ve searched high and low for a good
reason why we shouldn’t and I can’t find
one ten days after I graduated in
medical school I was diagnosed with
leukemia
I received incredible sick care that
saved my life and yet I felt like
something was missing six years later I
stand before you with a dream and a plan
for making health care more than sick
care let’s build a system for well care
and let’s make that system available to
everyone everywhere thank you
you
I was diagnosed with leukemia
I received a bone-marrow transplant that
saved my life and I found myself in awe
of how great our healthcare system was
it taking care of me when I was sick but
I soon realized that the excellent care
I received was only part of the care I
needed you see after I went home and
because of things that transplant did to
my body I became chronically unwell and
had to start caring for myself in a way
I never had I had meds I needed to take
and exercises I needed to do I had najd
and pain and fatigue I needed to manage
and tests and appointments I had to
organize and even when I wasn’t feeling
well and all this work seemed to be
keeping me from doing the things I
really wanted to do I knew I couldn’t
get stressed or anxious or sad because
if I did it would only make things worse
to be honest there were times when there
felt overwhelming and my wife and I
would get frustrated because it seemed
like too much of my health was dependent
on us it felt like the health care
system didn’t want to support my efforts
to be well now I realized that it simply
couldn’t see the truth is we designed
our health care system Adhan for a
different time we started building it in
the early 1900s when people were sick
and injured and it seemed like the only
work that needed to be done was the work
that doctors and nurses did after all
the top causes of death were things like
pneumonia and the flu and since we just
started developing things like vaccines
and antibiotics which were essentially
cures all we really needed as far as
anyone knew was just a system that could
deliver treatments effectively all we
really needed was sick care we live in a
different world today and we know better
for example today seven of every ten
deaths and 80% of all healthcare costs
are the result of chronic ongoing
conditions things like diabetes heart
disease and depression or in my case
something called graft-versus-host
disease these are of course the sorts of
diseases that don’t even have a cure to
deliver but they’re also the sorts of
conditions that are mostly managed and
prevented not by the work that doctors
our nurses do
by the work that we do every day of our
lives it’s the choices we make and the
lifestyles we pursue coupled with our
ability to cope with and overcome
whatever life throws at us this is the
work of being well it actually has a far
greater impact on our health than the
sick care we receive and yet our
healthcare system is not designed to
support it but there is a way that it
can see over the last several decades
physicians and scientists have worked
closely with patients to develop
interventions that can support our
efforts to be well the effective ones
are called evidence-based programs and
what they show us is that in order for
us to be well we need a few basic things
first we need to know and understand the
parts of our health that really are
under our control and what we can do
about it actually works secondly we need
support at time and space in which to
practice what we learn and lastly and
perhaps most importantly is we need to
know we’re not alone we need to know
that our struggles and our fears are
normal consequently most of these
interventions involve getting groups of
people together that have some common
health concern to go through a specially
designed curriculum that’s often
delivered by trained facilitators that
actually have a personal connection to
the same concern and what we find in
trial after trial of these programs is
that when you support people in doing
the work sick care can’t do you get
results sick care can’t give for example
when people with chronic physical or
mental illness participated in a program
designed to help them self manage their
health we find that they feel better and
that their quality of life improves
similarly when older adults participate
in a program designed to help them avoid
a fall we find that they fall half as
frequently as they otherwise would
allowing them to maintain their
independence there are programs that
help people cut the risk of developing
diabetes in half and programs that help
people with chronic pain hurt less and
get more satisfaction from their lives
and those are just a few examples
actually there are hundreds of proven
ways for people to support one another
and doing the work sick care can’t do
the National Cancer Institute even has a
registry of these sorts of interventions
if you want to look them up same with
the National Council on Aging I mean
it’s not a secret we know how to help
people be well we even know that helping
people be well saves money about five
dollars save to every dollar invested no
the problem is not that we don’t know
what WellCare is or whether WellCare
works the problem is that well care does
not fit in a sick care system and this
is why over the last few years my team
and I have focused on doing the
proof-of-concept work to show how a well
care system could function a system
based in communities but integrated with
and supported by the existing sick care
system we’ve trained individuals from
the community to deliver evidence-based
programs in churches and schools and
libraries and workplaces and in
partnership with a Rochester based
software company developed a scalable
technology that allows them to work
closely with one another and with
clinicians in the sick care system and
as a result patients like juan after
being diagnosed with diabetes no longer
have to feel alone and abandoned by a
system not designed for them rather
they’re being referred directly to
people from their community people like
Alma and Magda who’ve been trained to
deliver a highly effective diabetes
self-management program in Juan’s native
Spanish a program that will of course
improve one’s clinical outcomes but that
will also give him hope for the future
and help to save his struggling marriage
you see the point I’m trying to make is
that the situation we are in as a
society is not unlike the one in the
early 1900’s we know what improves
health but will we commit now to
building a system for well care like we
did then to building a system for sick
care will we allow people like Alma and
Magda to be part of the health care
system
well we allow communities to be more
than passive recipients of sick care
well we enable them to be active
partners in the provision of health care
I’ve searched high and low for a good
reason why we shouldn’t and I can’t find
one ten days after I graduated in
medical school I was diagnosed with
leukemia
I received incredible sick care that
saved my life and yet I felt like
something was missing six years later I
stand before you with a dream and a plan
for making health care more than sick
care let’s build a system for well care
and let’s make that system available to
everyone everywhere thank you
you
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