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My 2 Hour Talk at Apollo College of Nursing

(The following is cross-posted at my blog with the Archimedes Movement)
Since the community presenters training last spring I’ve been lucky enough to give a few presentations. The most recent was last Tuesday the 4th (election day!) for a class of nursing students at Apollo College of Nursing. I gave an hour long presentation to a different class at the same school in late August, but I had technical problems and scheduling difficulties, so I didn’t fee terribly successful. I was invited to come back though, this time for a 2 hour lecture on Health Policy, The Archimedes Movement, and Leadership in the health professions.

My powerpoint slides are based on the draft generic presentation that Liz gave us at the speakers training, but pretty extensively modified. Here are a few major differences.

1. I re-arranged the order of the slides so that it all fits into three questions. At the bottom of every slide I indicate which question the slide is addressing, to help them keep track of the overall scheme of the presentation

How did we get here (the broken system)?
What do we really want (our needs, what would a new system look like)?
How do we get there (agree on vision, political tension)?

2. To start, I ask them to give me a list (I wrote it on the white board) of why they want to be nurses. Throughout the presentation I continually refer to these motivators, how they are affected by each issue I talk about (e.g. cost-shifting). A major theme is that EVERYONE has their own unique list of motivators, and we have to understand that whatever solution we come up with WILL be the best compromise of everyone’s motivators, otherwise it won’t be a solution at all. I think this is more personal, and easier for them to apply in their lives than the “I commit to be a citizen first and stake holder second” idea.

3. I use funny pictures of Dr. Quinn medicine woman (from an old TV show), and an old french TB poster to introduce the infectious disease model of care.

4. Dr. Kitzhaber uses an analogy where the delivery system is like a car, it’s top speed is a product of the car, not how you “finance” the car. I’ve switched to a hover craft analogy. I say:

I just finish talking about the American frontier in which the infectious disease model of care was established

I transition by saying imagine an American frontier without roads. Without roads, a hover craft would be great - you can go 30 miles per hour over all kinds of terrain.

Now imagine an America with roads - on the highway your stupid hover craft only goes 30 miles per hour, it doesn’t have a sharp enough turning radius, stop time, or covering/protection on the top to even be safe when all the traffic is concentrated on these roads.

What we really need is cars that can go fast, stop quickly, turn quickly, and have protection and padding in the case of these new kinds of accidents (like colliding with other vehicles) that only happen in a world with roads.

Here’s why I like it better:

It’s comical - everyone laughs but I think the hilarity of saying politicians are calling for “universal hover crafts” when they should call for electric cars is instructive.

It emphasizes that the reason our health system has become inefficient is that the context of care has changed - we now can and do treat chronic diseases etc.

It emphasizes that the infectious disease model (hover crafts) is qualitatively different than a chronic disease model (cars). The hover crafts (infectious disease) are so different from what we need today that they aren’t even safe anymore.

It makes a solution seem more tangible. Switch from hover crafts to cars jives better with switching from infectious disease model to a triple aim-centric chronic disease model better than thinking about a car that just needs to go faster.

5. I included slides on Barack Obama’s and John McCain’s health care plans, emphasizing that both are talking mainly about financing rather than changing delivery models (I base it on Dr. K’s October 16th video). I also include a quote by John McCain saying that the solution to lowering costs is to deregulate health care like we did with banking (because it turns out banking isn’t doing very well with extreme/radical deregulation in the long term).

6. Finally, this lecture introduced these nursing students to a whole semester on the topic of leadership, so we discussed specifically how health care providers can be leaders. I was pleased that someone had said a motivator was “scrubs = respect.” I argued that the reason people respect professionals who wear scrubs is that they expect them to take responsibility in difficult situations. I even encouraged them to show up to a town hall or the capital in Salem wearing scrubs; it’s harder for legislators to ignore advice about our health system if it comes from someone wearing scrubs.

Some of the slides won’t make very much sense without me explaining them individually, and my notes are certainly incomplete, but I would be happy to answer an email if you have any questions.

I’m getting to the busiest part of my semester now, so I don’t know if I’ll be doing any more presentations until late December. I’ve really enjoyed them though, and I’m excited to have two more talks schedules for January. Let me know if you find any more opportunities!

cheers
Isaac

Blog Action Day: Where there is health there is hope

(image from www.villagehealthworks.org)

Today, just in time for midnight, I’d like shout out to blog action day. What’s blog action day? From the blog action day website:

Today thousands of bloggers will unite to discuss a single issue - poverty. We aim to raise awareness, initiate action and to shake the web!

For my part, I’d like to let you know about an organization called Village Health Works. They do amazing work in Burundi, a small country in east Africa. They work in a small village called Kigutu. VHW and the people of Kigutu definitely have their work cut out for them; the 2006 World Bank statistics peg Burundi as the poorest country in the world and most Burundians are not able to access effective medical care.

Village Health Works is partnering with Partners in Health, bringing the PIH model to Burundi. Some of the key characteristics of the PIH model are
a committment to rights based medicine - no one is refused care for any reason
a hollistic approach to engaging and empowering communities to address problems like poverty and poor education
engagement of community members as respected and paid members of the organization.

Oh, and a large and growing body of evidence indicates that the PIH model is very effective at promoting health in areas with the highest disease burden and minimal resources. That’s a pretty important characteristic.

Where there is health, there is hope, is the VHW motto. It pretty well sums up my opinion of medicine, and captures why I want to be a physician. It’s about using medical science, collegiality, empathy and entrepreneurship to offer health and hope to people who would otherwise go without. That’s why I hope to join my good friend Joey in Burundi, and work with VHW sometime after I graduate.

If the VHW cause speaks to you, please check out the powerful slide show they recently put on their website, and consider pitching them a few bucks to help with the wonderful work they do.

And if you are interested in more Blog action Day stuff, check out their website, or my friend Daniel’s blog action day post.

cheers
Isaac

Conservatives Warn Voters that Obama is a Mudblood!

In recent weeks, several prominent conservatives have challenged Illinoise Senator Barack Obama’s “Full-Blooded” Americanism. Their apparent argument: only an American who was raised in America by 100% American parents is able to fully understand what it means to be American. Peggy Noonan writes in the Wall Street Journal,

Hillary Clinton is not Barack Obama’s problem. America is Mr. Obama’s problem…[H]as he ever gotten misty-eyed over… the Wright Brothers and what kind of country allowed them to go off on their own and change everything? How about D-Day, or George Washington, or Henry Ford, or the losers and brigands who flocked to Sutter’s Mill, who pushed their way west because there was gold in them thar hills?…

Lucius Malfoy John McCain carries it in his bones. Mr. Malfoy McCain learned it in school, in the Naval Academy, and, literally, at grandpa’s knee….

Mr. Potter Obama? What does he think about all that history? Which is another way of saying: What does he think of America?

In an election characterized by unusual activity among youth, such sentiments are occasionally expressed more bluntly by young voters. Student Draco Malfoy recently was recorded as saying “No one asked your opinion, you filthy little Mudblood” to Hermione Granger, a fellow student whose parents were born outside of the wizarding world America.

The Harry Potter Super Serious Politics wiki provides an explanation of this term:

“Mudblood” is a derogatory term for a Muggleforeign-bornwizard or witch citizen; that is, individuals with no wizarding American parents or grandparents. There does not appear to be any difference in the magical power judgement or character of Muggleforeign-borns compared to those who are pure-blood or half-blood, but those prejudiced against Muggle foreign-borns consider them to be of “lower breeding” or worth, and undeserving of magic citizenship. The term implies that the individual has ‘dirty blood’.
Many older wizarding , elitist political families place great emphasis on “blood purity” and reject association with Muggles foreigners andMuggle foreign-borns. The notion is foremost in the minds of Dark Wizards, Death Eaters, and other followers of Lord VoldemortKarl Rove. It is possible that some well-meaning pureblood families espouse this prejudice as well, but to a less virulent degree.

The plight of these so called “mudbloods” in the wizarding world United States may in fact be worsening. Two resolute Democratic analysts describe the situation:

Remus Lupin: “Muggleforeign-borns are being rounded up as we speak.”
Ron Weasley: “But how are they supposed to have ‘stolen’ magiccitizenship? It’s mental, if you could steal magicAmericanism, there wouldn’t be any Squibs people who want American citizenship but can’t get it, would there?”
Remus Lupin: “I know. Nevertheless, unless you can prove that you have at least one close wizarding non-elitist American relative, you are now deemed to have obtained your magical power citizenship illegally and must suffer the punishment.”

Fortunately, Presidential hopeful Barack Obama is in fact near relative to several patriotic and well respected Americans. He has two white grandparents from Kansas; his grandfather fought in WWII, and his grandmother worked on a bomber assembly line. Obama was later born to a white teenage mother, and his father left while Barack was just two years old. He can also trace his family tree back to a more distant relationship with Vice President Dick Cheney, and even as far back in America’s history as George Washington. Indeed, under serious scrutiny, it seems Barack’s biography may in fact be one of the most poignantly and thoroughly American stories of any Presidential hopeful since Harry Truman.

Nonetheless, critics still choose to highlight Obama’s ties to family outside of the wizarding world America. Being a decendant of some patriotic Americans, or “half-blood” is apparently not enough, as conservatives are increasingly calling for “pure-blood”. Columnist Kathleen Parker writes:

Full-bloodedness is an old coin that’s gaining currency in the new American realm. Meaning: Politics may no longer be so much about race and gender as about heritage, core values, and made-in-America. Just as we once and still have a cultural divide in this country, we now have a patriot divide.

Who ‘gets’ America? And who doesn’t?…It’s about blood equity, heritage and commitment to hard-won American values. And roots.
Some run deeper than others and therein lies the truth of Josh Fry’s political sense. In a country that is rapidly changing demographically — and where new neighbors may have arrived last year, not last century — there is a very real sense that once-upon-a-time America is getting lost in the dash to diversity.
We love to boast that we are a nation of immigrants — and we are. But there’s a different sense of America among those who trace their bloodlines back through generations of sacrifice.

While these remarks may seem politically motivated to some (they must be referring to the father who didn’t raise him, or to the 4 years he spent in Indonesia, or implying that Hawaii is another country), they are certainly rooted in sentiments held deeply by many Americans. Bridging the gaps between Muggle foreign-borns, half-bloods, and pure-bloods may even be the challenge that defines the next great chapter in the American Story.

lol cats more focused on the issues than network news

originally uploaded by Isaac on I Can Has Cheesburger.

I just made my first lol cat. Check it out…
vote it up so it will get more views on the i can has cheesburger site

Update: My friend Liz just told me about www.yeswecanhas.com. Awesome!

Archimedes Movement: “What do we actually do?”

The interim steering committee of the Archimedes Movement has been hard at work defining an operating structure for our Movement. For the last few days they have been busy gathering feedback from chapter leaders and other Archimedes members, and discussing the merits of many comments and concerns. Several times I have heard people express concern that our mission statement is not clear enough to really engage people. The mission statement really shouldn’t be part of the operating structure document, but it is so important and so up in the air right now that I think people are craving to find direction even in unlikely places.

I think we have a brilliant mission statement:

The mission of the Archimedes Movement is to create a new space for civic engagement outside our traditional legislative and governance structures to advance solutions to the common problems we face – starting with the crisis in the U.S. health care system.

But it doesn’t say what we actually do. It is the kind of visionary, 30,000 foot high mission statement that always makes people ask “so what are you doing to achieve that mission, what is it that you guys actually do?” This doesn’t mean it is a bad mission statement, it means we need a mission execution statement to explain exactly how we will execute our visionary mission statement. Last June our mission execution statement was as simple and persuasive as our mission statement:

In an extensive grass-roots process that has engaged thousands of Oregonians, we created Senate Bill 27, the Oregon Better Health Act. This bill contains a blue print for national health care reform, starting here in Oregon. We are currently working with legislators and special interest groups to rally the votes we need in the Oregon legislature to pass this awesome bill.

When SB 27 didn’t pass during the summer legislative session, our mission execution statement deflated in a big way, and we haven’t developed a very good one to replace it.

We have a speaker training soon, and a member meeting scheduled for May. We have set the goal of having a concrete mission execution statement ready for speakers before the upcoming speaker training. I would like to help speed that effort along, so I offer a few potential mission execution statements that we can all discuss.

When people get sick and die because they don’t have health care, they are the victims of a moral crisis in our nation. What most people don’t realize is that these sick people are only a fraction of the victims; we are also victimizing our children and their children because our health care system has such an inefficient structure that it is bankrupting our entire nation.

Right now our members are meeting up with local chapters, speaking in their communities, canvassing, tabling at public events, writing and engaging their legislators, and knocking on doors to educate people about these future victims. We are not doomed to ignorance or shortsightedness, we can do better. We can fix the sad structure of our health care system if we work together.

Or this mission execution statement:

When people get sick and die because they don’t have health care, they are the victims of a moral crisis in our nation. What most people don’t realize is that these sick people are only a fraction of the victims, we are also victimizing our children and their children because our health care system has such an inefficient structure that it is bankrupting our entire nation.

We are currently lobbying Oregon State Representative Mitch Greenlick, asking him to make modest changes in his proposed Hope Initiative so that we as an organization can support it. If we are successful, we will engage Representative Greenlick, other legislators, and thousands of Oregonians to pass this initiative in Oregon, and lay the foundation for health care reform in Oregon and the nation.

I think the first part is true to the Archimedes Movement, and to Dr. Kitzhabers most recent video “The Unfinished Business of the Baby Boom Generation.” I also think it is necessary to highlight the plight of future generations, because if we only care about offering our current broken system to more people, then it be more logical to just campaign for Senators Barack Obama or Hillary Clinton, both of whom intend to institute universal access to some kind of health care in the US. This frame of caring for future Americans, this perspective is what makes AM very important and very, very unique as a health care reform effort.

The second part is way more up in the air, and will change more as we go along.

Please discuss. Tell us all what you think.