the health care system in America is an
inefficient ineffective technology
driven machine with the soulless purpose
of generating profit at times to our
detriment of our physical and collective
health so this is health care and three
questions which one three questions do
you think dominates the landscape yep
money what I would like to present to
you today is that we as a Qin spend more
money on health care both publicly and
privately and yet lag all other wealthy
nations in the world in terms of outcome
and quality I’d like to make the case
today that rediscovering relationships
in health care is the primary solution
to our healthcare problem that
connection can actually save our souls
from the healthcare machine for the last
150 years in America health care
providers have been paid for just a
sheer number of things that they do to a
patient so if you order more MRIs if you
do more surgeries the more money you
make health insurance companies tally
record profits while simultaneously
cutting payments to providers and
shifting more of the cost of care to the
patient in the form of higher co-pays
and higher deductibles health care
providers are forced to see more
patients in order to meet the bottom
line and inevitably
the quality of that interaction it
suffers with productivity expectations
looming and that with incentives to
control certain comorbid diseases like
hypertension diabetes and asthma the
healthcare provider arrives at the
primary care visit with their own agenda
a study of doctors at the Mayo Clinic
indicated that within 11 seconds of
speaking the doctor had early
interrupted the patient and 2/3 of the
time never even bothered to ask what the
purpose of the visit was so the longer
you work for the healthcare machine a
bit of your soul dies each year with
expectations looming to produce more
revenue happy patient treatment success
they ratchet up more and more each year
you take home hours of paperwork just to
keep up in my profession exactly none of
us went to seven years of college to end
up stuck in this machine we all
universally said in our grad school
interview that we just wanted to help
people a few years ago I did some
in-depth training in the UK that
produced a seismic shift in my practice
it’s a shift that fuels a joy that the
machine cannot steal and I’m very happy
to share it with you today I was taught
how to connect with human beings
specifically those patients that were
the most complex and suffer from chronic
pain let’s just say I know a gal she was
an elite ballerina
she had a scholarship to a New York
dance school she loved rock climbing
both indoor and out she was young and
life was full of potential like many
chronic pain patients her pain started
after a time of unprecedented loss and
stress in her life during her high
school and college years she fought and
survived breast cancer but only after
losing both breasts to mastectomy
while she was searching for answers to
her chronic fatigue fibromyalgia
irritable bowel syndrome she was
misdiagnosed with Lyme disease the
doctor started her on an extended course
of strong antibiotics they’d left her
body both ravaged and weak so severe
were her symptoms that she spent many
days bed bound traveling only by
wheelchair and spent ten years of her
life undisciplined effective treatments
to a chronic pain she’s seen numerous
doctors had multiple treatments and has
yet to reclaim her former life while
interacting with a health care machine
she’s wasted countless visits countless
dollars and she’s avoided some disasters
but she’s also suffered a great deal
needlessly a severe neck pain brought
her to see me in physical therapy about
eight months ago during that time she
has made a remarkable transformation I
would want to share with you today
the significant difference is that she
felt were meaningful in her care I
listened to her and I did not interrupt
I heard her past strength as a ballerina
and as a rock climber and I also heard
the negative interactions that she’s had
with health care providers I stuffed my
agenda to meet my patient where they’re
at instead of her feeling aggression
from me she felt safe safe to have a bad
day safe to come in with her homework
not done safe to share the true barriers
to her progress
I gave her practical ways that she could
calm down her nervous system and care
for her own body for once I helped focus
the treatment on simple tasks that would
give benefit to her life all she wanted
to do was simply sit on the floor and
play with her kids comfortably to be
able to put on her shoes with a little
less difficulty I created a safe place
where she could cry and grieve the
Lear’s
that she lost and her lost potential but
more importantly I connected her to her
joy la we just had her simply modify it
temporarily until her next symptoms calm
down I too would have repeated all the
other health care providers mistakes and
done her yet another disservice if I was
in a production mode the answers to the
first three questions that we started
with research tells us is in the
building of a therapeutic alliance with
our patients therapeutic alliance
indicates the level of agreement between
the provider and the patient in regard
to the goals of treatment specifically
what each person will do to achieve
those goals and the extent to which
there is trust and connection between
provider and patient it is the
single-most predictor of treatment
success for both physical and mental
health problems and all is also an
excellent predictor of adherence to
exercise fostering a therapeutic
alliance with your patients is the
antithesis of the behaviors that the
machine produces for example we have
in-depth and extended conversations as
to the nature of chronic pain its
triggers and why it persists
we have a flexible format every view at
every visit we collaboratively set an
agenda based on her current needs and
greatest barriers sometimes we break the
rules evidence says that we should
minimize the amount of passive
treatments that we do for patients in
pain however I know that a little bit of
TLC goes a long way on a given day to
engender trust with my patient and it
actually helps her rebound quicker we
engage in root cause analysis we
carefully weigh the relative
contributions of the biological
psychological and social factors that
affect her pain so that brings us to
today now I can’t tell you that
she has 0 out of 10 pain I can’t tell
you that every day is perfect and she
has no more problems but what I can tell
you after 20 years of being frequently
bed bound traveling by wheelchair she’s
back playing with her kids she just ran
2 miles with her son she’s dancing twice
a week she rock climbs once a week and
now she’s strong enough to do this on a
paddleboard there’s still times the
stress and pain get too much so she runs
the stairs to get a natural dose of
endorphins to deal with that pain so
I’ve got to think what would life look
like for her if she had access to this
type of care much earlier in her chronic
pain cycle at the point of postpartum
care post cancer care post surgical care
at any of those points
she could have reclaimed function pain
control and life how much money could be
saved an ineffective treatments and
scans and procedure
if we were all trained to deliver care
in this manner how much more of our own
joy and purpose could we recapture as
healthcare providers if we didn’t work
for the Machine chronic disease and
chronic pain in America are the most
expensive problems that we face as a
nation but they can be remedied by
effective training in the therapeutic
alliance
so pursuing greater connection with our
patients it actually does a few things
for both provider and patient we we were
able to find success where many other
providers failed my patient is happy
with the care that she received and she
will advocate for many other people to
seek it out and yes I got paid but more
importantly I get to keep my soul thank
you [Applause]
inefficient ineffective technology
driven machine with the soulless purpose
of generating profit at times to our
detriment of our physical and collective
health so this is health care and three
questions which one three questions do
you think dominates the landscape yep
money what I would like to present to
you today is that we as a Qin spend more
money on health care both publicly and
privately and yet lag all other wealthy
nations in the world in terms of outcome
and quality I’d like to make the case
today that rediscovering relationships
in health care is the primary solution
to our healthcare problem that
connection can actually save our souls
from the healthcare machine for the last
150 years in America health care
providers have been paid for just a
sheer number of things that they do to a
patient so if you order more MRIs if you
do more surgeries the more money you
make health insurance companies tally
record profits while simultaneously
cutting payments to providers and
shifting more of the cost of care to the
patient in the form of higher co-pays
and higher deductibles health care
providers are forced to see more
patients in order to meet the bottom
line and inevitably
the quality of that interaction it
suffers with productivity expectations
looming and that with incentives to
control certain comorbid diseases like
hypertension diabetes and asthma the
healthcare provider arrives at the
primary care visit with their own agenda
a study of doctors at the Mayo Clinic
indicated that within 11 seconds of
speaking the doctor had early
interrupted the patient and 2/3 of the
time never even bothered to ask what the
purpose of the visit was so the longer
you work for the healthcare machine a
bit of your soul dies each year with
expectations looming to produce more
revenue happy patient treatment success
they ratchet up more and more each year
you take home hours of paperwork just to
keep up in my profession exactly none of
us went to seven years of college to end
up stuck in this machine we all
universally said in our grad school
interview that we just wanted to help
people a few years ago I did some
in-depth training in the UK that
produced a seismic shift in my practice
it’s a shift that fuels a joy that the
machine cannot steal and I’m very happy
to share it with you today I was taught
how to connect with human beings
specifically those patients that were
the most complex and suffer from chronic
pain let’s just say I know a gal she was
an elite ballerina
she had a scholarship to a New York
dance school she loved rock climbing
both indoor and out she was young and
life was full of potential like many
chronic pain patients her pain started
after a time of unprecedented loss and
stress in her life during her high
school and college years she fought and
survived breast cancer but only after
losing both breasts to mastectomy
while she was searching for answers to
her chronic fatigue fibromyalgia
irritable bowel syndrome she was
misdiagnosed with Lyme disease the
doctor started her on an extended course
of strong antibiotics they’d left her
body both ravaged and weak so severe
were her symptoms that she spent many
days bed bound traveling only by
wheelchair and spent ten years of her
life undisciplined effective treatments
to a chronic pain she’s seen numerous
doctors had multiple treatments and has
yet to reclaim her former life while
interacting with a health care machine
she’s wasted countless visits countless
dollars and she’s avoided some disasters
but she’s also suffered a great deal
needlessly a severe neck pain brought
her to see me in physical therapy about
eight months ago during that time she
has made a remarkable transformation I
would want to share with you today
the significant difference is that she
felt were meaningful in her care I
listened to her and I did not interrupt
I heard her past strength as a ballerina
and as a rock climber and I also heard
the negative interactions that she’s had
with health care providers I stuffed my
agenda to meet my patient where they’re
at instead of her feeling aggression
from me she felt safe safe to have a bad
day safe to come in with her homework
not done safe to share the true barriers
to her progress
I gave her practical ways that she could
calm down her nervous system and care
for her own body for once I helped focus
the treatment on simple tasks that would
give benefit to her life all she wanted
to do was simply sit on the floor and
play with her kids comfortably to be
able to put on her shoes with a little
less difficulty I created a safe place
where she could cry and grieve the
Lear’s
that she lost and her lost potential but
more importantly I connected her to her
joy la we just had her simply modify it
temporarily until her next symptoms calm
down I too would have repeated all the
other health care providers mistakes and
done her yet another disservice if I was
in a production mode the answers to the
first three questions that we started
with research tells us is in the
building of a therapeutic alliance with
our patients therapeutic alliance
indicates the level of agreement between
the provider and the patient in regard
to the goals of treatment specifically
what each person will do to achieve
those goals and the extent to which
there is trust and connection between
provider and patient it is the
single-most predictor of treatment
success for both physical and mental
health problems and all is also an
excellent predictor of adherence to
exercise fostering a therapeutic
alliance with your patients is the
antithesis of the behaviors that the
machine produces for example we have
in-depth and extended conversations as
to the nature of chronic pain its
triggers and why it persists
we have a flexible format every view at
every visit we collaboratively set an
agenda based on her current needs and
greatest barriers sometimes we break the
rules evidence says that we should
minimize the amount of passive
treatments that we do for patients in
pain however I know that a little bit of
TLC goes a long way on a given day to
engender trust with my patient and it
actually helps her rebound quicker we
engage in root cause analysis we
carefully weigh the relative
contributions of the biological
psychological and social factors that
affect her pain so that brings us to
today now I can’t tell you that
she has 0 out of 10 pain I can’t tell
you that every day is perfect and she
has no more problems but what I can tell
you after 20 years of being frequently
bed bound traveling by wheelchair she’s
back playing with her kids she just ran
2 miles with her son she’s dancing twice
a week she rock climbs once a week and
now she’s strong enough to do this on a
paddleboard there’s still times the
stress and pain get too much so she runs
the stairs to get a natural dose of
endorphins to deal with that pain so
I’ve got to think what would life look
like for her if she had access to this
type of care much earlier in her chronic
pain cycle at the point of postpartum
care post cancer care post surgical care
at any of those points
she could have reclaimed function pain
control and life how much money could be
saved an ineffective treatments and
scans and procedure
if we were all trained to deliver care
in this manner how much more of our own
joy and purpose could we recapture as
healthcare providers if we didn’t work
for the Machine chronic disease and
chronic pain in America are the most
expensive problems that we face as a
nation but they can be remedied by
effective training in the therapeutic
alliance
so pursuing greater connection with our
patients it actually does a few things
for both provider and patient we we were
able to find success where many other
providers failed my patient is happy
with the care that she received and she
will advocate for many other people to
seek it out and yes I got paid but more
importantly I get to keep my soul thank
you [Applause]
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