Thanks for publishing my photo, in 12 Most Eye-Catching Public Works of Art in NYC – NewYork.com

Gay Liberation Monument Christopher Park 19069
Gay Liberation Monument Christopher Park 19069 (View on Flickr.com)

Of the many things New York City has to be proud of, its art collection may be at the top. But, it’s not all inside the Met, MoMA, Guggenheim or Whitney. Many of its best works are out among the public — in parks, street corners, subway stations, plazas and even the water — starting with the 305-foot Statue …

Source: 12 Most Eye-Catching Public Works of Art in NYC – April 15, 2016 – NewYork.com

George Segal: Gay Liberation / West Village
In the early hours of June 28, 1969, police raided the Stonewall Inn in Greenwich Village for serving gay people alcohol and allowing them to dance with one another, both illegal at the time. What the police didn’t expect was that the bar’s patrons, and neighborhood in general, decided to fight back, overturning the police wagon and pelting officers with bottles and bricks. The now-famous “Stonewall riots” continued for days afterward, igniting the gay rights movement. In tribute, artist George Segal cast four bronze figures — two standing males and two seated females — depicting the love shared between them rather than sexuality. Completed in 1980, it took 12 more years to overcome public opposition and be installed in Christopher Park, opposite the Stonewall Inn. Despite repeated vandalism over the years, the couples remain ever tender. 51-53 Christopher St., Stonewall Inn

I wrote about the history behind this photo when it was taken, in 2013:

via @NewYorkcom

Photo Friday: It’s important for a health system to score 100% on the HRC Corporate Equality Index, too

2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03832
With representatives from the other 406 best places to work in the United States for LGBTQ humans – 2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03832 (View on Flickr.com)

My generation of physicians came to medicine to be our 100% selves in support of 100% of our patients.

In addition, healthcare organizations with 500+ employees may well want to participate in HRC’s Corporate Equality Index, which offers a wealth of suggestions for workplace equality. – Human Rights Campaign, Health Equality Index : Employment Non-Discrimination

Except that no health systems, hospitals, or academic medical centers have achieved 100% on this index. Except for Kaiser Permanente.

The Corporate Equality Index measures, on a scale of 0-100, an employers’ commitment to treat their LGBTQ employees equally, across all industries.

For an LGBTQ employee, it’s important that the rating be 100%. Any less to us is a failing grade – this is a lot different than many of the quality ratings in health care where 90, 80, or even 70 % is considered “industry leading” (and what does that say about our expectations).

The Healthcare Equality Index, currently not on a numerical scale, but going to one next year, measures inclusiveness in policies for LGBTQ patients. In 2017, it will have a criteria for “employee benefits and policies.” Perhaps there will be reconciliation of the two indices for health systems and hospitals.

In the meantime, when a health system is a leader on one and not on the other, the potential for LGBTQ discrimination is much greater. Kaiser Permanenente is the only health system in the United States that has both (Kaiser Permanente Recognized as a ‘Leader in LGBT Healthcare Equality’ by the Human Rights Campaign Foundation – Kaiser Permanente Share).

The two are tightly connected. When you’re receiving medical care, you want your nurses and doctors to bring all of themselves to your health. When you’re providing medical care, you want to be able to help your patients bring all of themselves to their lives.

2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03870
Healthcare: Such a short list. Why? 2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03870 (View on Flickr.com)

My colleague Bianca Rey (@BiancaRey) and I, went to New York City this week, to collect Kaiser Permanente’s 100% Corporate Equality Index Award. KP has achieved 100% for every year the index has been in place, except for one, and that year prompted changes that brought us back to 100%.

If you look at the list of health care organizations that scored 100% this year, you’ll notice it’s short. Really short. There are no hospitals or health systems present (except for Kaiser Permanente, as stated). There are 5,627 hospitals in the United States.

As Chad Griffin, President of Human Rights Campaign (@HRC) so eloquently stated on this evening, working for an employer that embraces your identity is not just better business, it can be life saving. Extend that to the 16 million people who work in health care in the United States, 11% of the workforce, and it can be lifesaving for the 318 million people they serve.

2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03841
Being a part of the 407 best. Not just employees that are embraced, lives that are saved. 2016.03.30 Human Rights Campaign Corporate Equality Index Best Places to Work Reception 03841 (View on Flickr.com)

I asked a colleague from another 100% company outside of health care why they thought that there weren’t more (any) hospitals on the list. He theorized that many of them may not have the time to certify 100% on this index.

My answer to that is that humans always make time for what’s important. At Kaiser Permanente, the organization has taken the time. And not because of me, because of KP.

I wouldn’t want to work at a place that’s less than 100% committed to every employee bringing all of themselves to what they do. Same with the lawyers, engineers, architects, human resource professionals, powerline workers, and every employee represented in the room of 406 other best places to work.

A health system can exist for all who want to participate in it and for all who want produce their own health in collaboration with it. Join us.

I AM excited to be part of XXinHealth’s sixth annual women’s retreat

And I'm the man (barely) 😀 this is fantastic XXinHealth #ally
And I’m the man (barely) 😀 this is fantastic @XXinHealth #ally (View on Flickr.com)

The title of the post says it all. I will be present this year, where I have the honor of facilitating a discussion with Vivienne Ming, Entrepreneur and Scientist (@neuraltheory).

We’ll be addressing the concept of a “Post-Gender Business World” which is totally cool, because of my passion around the subject (which is slightly palpable), mostly and significantly because of Vivienne and the other people in the room. As a famous pop star once said, our generation has the power to change everything.

They are taking over the boys club, The Harvard Club of New York, and I am delighted excited to be there with this group, not just as an honorary woman, as an ally and with allies.

Thank you Halle Tecco (@HalleTecco) Robin Strongin (@DisruptiveWomen) and the XX in Health (@XXinHealth) team for creating the vision. A lot of us came to health to ensure that all people have equal access to it. And why shouldn’t they. The human species depends on it. Our communities and society is more enjoyable because of it. And…. love always wins 🙂 .

See you on March 31, feel free to nominate yourself or a colleague to attend.

A Walk Through New York – Designed to Move – is this our 1968 moment in creating active cities?

The 1968 moment refers to the peak of tobacco use in the United States, which really happened around 1963, but after 1968 started the gradual decline that has resulted today in the social norm of not smoking. 

I am in New York City on behalf of Kaiser Permanente at the Nike Designed to Move Active Cities Work Session. If you haven’t seen Designed to Move, it’s an an initiative supported by Nike’s Access to Sport team that’s described as a physical activity action agenda, easy to absorb, easy to understand. Take a look.

After day 1, I had the awesome opportunity to walk (which is always awesome regardless), which I did with Jeff Olson, who’s one of the Principles with Alta Planning (@altaplanning), the company that has produced the bike share systems in the city I love, Washington, DC, (Capital Bikeshare @bikeshare) and more recently, New York’s Citibike (@citibikenyc). Citibike only launched in May, 2013, and Jeff told me it has already documented 3,000,000 rides, fast encroaching on Washington, DC’s 4,000,000 to date.

It’s a cultural phenomenon. Fashion Week has designated Citibike Blue as its official color. If you walk anywhere in New York City, Citibike after Citibike will pass you by (hence the blurry photos). We interviewed one rider who said non-chalantly, “it changed my life.”

What I was wondering aloud as we walked, was if this was our 1968 moment. Do we recognize that our cities are changing to support more activity, and that this is the turning point? 

I happened to mention this in this recent blog post, see: I love how our cities are changing to support health for all : Adams Morgan Day, Washington, DC USA | Ted Eytan, MD. My walk on this evening makes me wonder even more. I related to Jeff a few things about my own bikesharing experience that I had forgotten about:

  • My first Capital Bikeshare trip was my first time riding a bicycle in Washington, DC – I had only walked the city for the previous years I lived there. Totally changed my perspective.
  • I was hesitant to take my first few trips alone because I thought I looked silly, that’s how new this “norm” was

Now, of course, I ride all the time (but not as much as I walk). 

I don’t know the answer to the question about whether it is or isn’t our 1968 moment – one other perspective on this is that this is really the “re-integration” of technology back into our lives in a healthy way.

Either way, it looks like something is happening. See, and Google for yourself. Great job, Jeff and Alta Planning (@altaplanning), you quietly or not so quietly transformed us with a brightly colored cultural token that expresses our freedom (to move) – kind of like tobacco, but in a healthy way.

Photo Friday: Love wins (again) – end of marriage discrimination in New York State

Marriage Equality Celebration by The Stonewall

This series of posts on this blog started with this article: Love wins: Gay marriage in Washington DC / The Christian Science Monitor – CSMonitor.com. I’ve always thought this is a great theme to organize not just health care but all of society.

It’s worth noting that on this specific issue, the Millenial generation is the first in the history of the United States whose majority supports marriage equality. As they should, because love always wins.

Congratulations, New York State, for joining the District of Columbia and 5 other states in ending marriage discrimination.

  • Civil Rights Protesters, Washington DC
  • Let Freedom and Love Ring
  • Please!
  • Chris and Hampton
  • Prop 8 ruling outside Federal court in San Francisco 4
  • Washington DC Demonstration for Equality November 15 2008 15664
  • reason to celebrate
  • The Death of DADT - 352/365
  • Standing on the Side of Love with LGBT People Everywhere!
  • Marriage Equality Celebration by The Stonewall
  • CA Day of Decision
  • Civil Marriage Protection Act 2012 Signing Ceremony
  • SCOTUS - DOMA  20991
  • Boy Scout Memorial 19242
  • 2013 Rally for Transgender Equality 21169
  • SCOTUS  26251
  • March on Washington 2013 29383

Now Reading: Transforming The Role Of Medical Assistants In Chronic Disease Management

The excellent issue of Health Affairs issue on reinventing primary care is out and I wanted to point people to this article about medical assistants, yes medical assistants.

First, a disclosure – I have been a fan of the UNITE Health Center ever since I visited it in Feburary, 2008 (photos and blog post are here), because it is one of several practices that is innovating as much as any of the well known large practices in the United States. Actually, there are many many more innovations happening in practices like this than people think, and as I have mentioned on here tons of times, they are all willing to teach, all we have to do is ask.

The article discusses the inclusion and involvement of medical assistants in the improvement of primary care. One key component of this groups thinking caught my eye:

UNITE Health Center decided to transfer most of the responsibility for patient teaching to its patient care assistants, who are hired with medi- cal assistant credentials. The hope was that these assistants, who typically share the patients’ cultural backgrounds, would foster a level of comfort and trust that would enable them to teach patients how to manage their chronic diseases, at a much lower cost than using registered nurses or certified diabetes educators.

It immediately triggered the memory of me sitting in the same room photographed in the article, with the primary care team, and one of the team members describing to me her own family’s experience with UNITE Health Care Center before it became what it is today. She talked about how her family would block off an entire day from their calendars to see a doctor, and contrasted it to the work of UNITE in it’s new incarnation, where patients and families were afforded the same access (and dignity, really) as patients in the most well-funded health care systems. That’s experience that’s worth bringing to the improvement of primary care – it’s really foolish not to.

As the article describes, the physicians who work here are trained to involve all members of the team caring for patients, and in turn, all members of the team receive the investment of comprehensive training so they can perform well for their patients. I learned here that medical assistants are as interested as physicians in performing well for patients.

In the era of social media, where we understand more than ever that people trust people “just like me,” look at one of the impacts of the investment:

The need for a substantial presence of patient care assistant staff has also allowed the health center to hire from its communities. The center has thus been able to institutionalize the strong relationships and shared backgrounds between patients and caregivers that are so important to the success of this model.

And…the clinical outcomes and costs favorably follow from this approach. It’s worth noting that the patients in this practice are among the least advantaged in society, and yet, their time is as valued as if they are the most advantaged, with great results. Virtuous circle.

If I were to generalize the findings here with my own experience, I would say that the most productive, enjoyable, and health-promoting primary care practices I have seen are the ones that make the investment in the entire team. An investment in the patient as part of the team typically is not far behind.

Thanks again to the medical assistants. And to Karen Nelson, MD, Jonathan Arend, MD, and the UNITE Health Care staff and patients for demonstrating that primary care is not meant to be going to be a row of blinking lights in a clinic hallway.


Recognition for The original "share everything with my patients" physician – Sal Volpe, MD – eClinicalWorks.com

Recognition for The original "share everything with my patients" physician – Sal Volpe, MD – eClinicalWorks.com – " Several eClinicalWorks' customers, including Dr. Salvatore Volpe, the Aquidneck Medical Associates and Ninth Street Medical Associates, have been recognized for achieving the highest level.

"The PCMH concept has great potential to improve the quality of care delivered in a primary care setting, while improving efficiencies," said Dr. Salvatore Volpe. "My practice immediately saw the benefits of this and became involved early on, allowing us to become the first solo physician practice in New York State to receive Level 3 PCMH recognition. We have always viewed our patients in the context of their family and community. PCMH helped solidify our role as the team leader across the full spectrum of care. With information technology, a solo practitioner can now be part of a virtual health care system."

When physicians are ready to promote patient empowerment / engagement, what do we want them to do?

This question was posed to me by Ann Barber, MD, who I just spoke with. Ann reached out to me because she has been following the work of the group at e-patients.net, and specifically their call to recruit physicians to support the patient empowerment movement. Ann is an internist who specializes in hospital medicine, and has recently relocated to New York.

Ann asked me the question in the title of this post, and in talking with her, I decided to ask it here as well, because I’m unsure of the answer.

I wondered if this is because I/we have assumed that the majority of physicians are not interested in empowering patients, and therefore we don’t know how to support those that are?

I did a mini-check in with myself on this, and although I have alluded to some physician groups still feeling challenged by the idea of patient empowerment on this blog, the majority of my writing here points to the idea that physicians are very interested in empowering patients, because they want to perform well for them. The overwhelming majority of my posts here point to that idea, and here’s just one example.

Back to the question – where should a physician start when they have the energy and drive to make a difference in this area? When they interview for positions, what vocabulary should they use to describe what they are looking to do? How do they find the institutions in their communities that are already forging ahead in this area? If there are no institutions identified, how do they find the ones that are open to new ideas/thinking in this area?

My suggestion was to walk the hallways of any potential medical center employer and observe and ask questions – how are patients and families involved in their care? Do nurses and doctors round at the bedside (like they do at Medical College of Georgia, and hospitals in the Kaiser Permanente system [article in Harvard Business Review describes this] )? Are there visiting hours? How does the institution keep families and informed throughout a hospital stay?

I recommended a few resources, including the Wachter’s World Blog, written by hospitalist expert Bob Wachter, MD, the Institute for Family Centered Care, to find institutions in a community that are practicing patient and family centered care in New York, and of course, HelloHealth in Wlliamsburg.

I think the inpatient setting is the next frontier of patient and family involvement in their care, enabled by technology, and welcome the creativity of Ann and other hospital medicine specialists who want to make a difference for patients and famlies everywhere, which is why I wanted to think about this more.

Are there other ideas for Ann and the physicians in our profession who are among the “already recruited?”, in New York (and beyond)? Post them in the comments, please!

And thanks to e-patients and all the patients who have made it easy to remember who I am accountable to.

Patient Online Access in the Safety Net: Adam Szerencsy, MD and Neil Calman, MD’s slides

These are Adam Szerencsy, MD and Neil Calman’s slides from the recent discussion in Oakland, “Patient Online Access in the Safety Net,” hosted by the California Healthcare Foundation.

Adam and Neil are from the Institute for Family Health, and as you can tell, have learned a lot in providing online access to their patients in New York City.

This presentation had special meaning for me for several reasons. The first is that Neil’s organization was the first to host me outside of my integrated health system environment, to learn about applying PHRs to the care of all patients. The second is that I got to watch Adam lead the rollout of IFH’s patient portal from the initial thinking through to watching him prepare his patients for its eventual rollout, when I got to watch him practice in Bronx, New York. You can read the story (and see the pictures at this link) about what that day was like. I still remember it as strong affirmation that there are really exceptional physician leaders among us, who with the right tools can be freed to do great things for their patients and their communities.