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3. Poll: The Next President’s Top Priority

When I set up The Developing Families Center in Washington DC’s Ward 5, it was with the goal of addressing this very issue, particularly from the point of view of infant mortality.

At a rate of 12.22 per thousand live births, the District has the highest infant mortality of any of the states, with only Mississippi, at 10.74 also experiencing a double digit rate.

Related posts:

1. This International Women’s Day Let’s Aim to End Maternal Deaths
2. The Need for Innovation: Our Health Care Crisis Cannot Be Solved by Insurance Alone
3. On International Women’s Day: Ask Yourself What It Means To Be Healthy

Officials have created an innovative partnership with a number of organizations and celebrities to distribute female condoms in HIV hotspots — and if you want to try them yourself, they’re now on sale at all the CVS’s in the District.

Disruptive Women’s Wendy Grossman spoke for a few minutes with Mary Ann Leeper, senior strategic advisor for the Female Health Company — about the D.C. initiative that started this week.

Q: Tell me about the DC initiative.
A: The initiative is just the coming together of the five different
groups: The MAC Foundation, the CDC, the Department of Health, the Female Health Company and CVS — coming together to bring the female condom to women in the D.C. area.

DC has the highest rate of HIV and STI’s in the country. The Department of Health has initiated a strong prevention outreach program. They’re also tying in the some of the key, community based organizations into the programs.

Q: The FDA approved the female condom almost 20 years ago, right?
A: Yes. The FDA approved the first female condom in 1993. The second
FC2 female condom — this is what it’s all about. It’s the reintroduction of the female condom into the U.S. It was approved about a year ago. Late last summer, we brought it into the US. To the cities that have the highest rates of STI’s and HIV — to work with them and reintroduce the female condom.

Q: What’s different about the new condom?
A: It’s a new material. We switched from a polyurethane material to a synthetic latex material called Nitrile that allowed us to move from a welding process — very intensive, expensive process — to a dipping process that’s very similar to what’s used for male condoms.
So it allows us to reduce the cost of the product to make it. It increases the donors and these NGOs they can better afford it.

Q: They’re crazy expensive, right?
A: They’re at least 30 percent less. The higher the order, the lower the cost.

Q: What about over the counter?
A: It’s only available right now in CVS in the District of Columbia.

Q: Isn’t the argument against condoms for dudes partly because it ruins the spontaneity? How long would it take to put that in? Just looking at it makes me think it could take me an hour?

A: One of the articles that was posted they did a — I forget what city. It was either Chicago or D.C. — Chicago also introduced it this week. And they did a race on how fast it was to insert the female condom versus the male condom. And the female condom won.
Granted, realistically it takes two to three tries to be comfortable.
It’s just as fast as putting in a tampon. It’s basically the same process.

Q: Can you wear all day, just in case?
A: Yes. You could. Realistically, you won’t. You should insert it about 20 min before becoming intimate.

Q: They seem to be crazy expensive. A box on Amazon is $20.
A: That’s the first female condom. Ultimately they will be available on pharmacy websites.

Q: I read that in 2005 they were distributed in Africa to try to combat AIDS. Any stats on how that’s actually worked out?
A: Well, it’s highly acceptable. FC2 is now in over 100 countries.
And the demand continues to grow 35 percent, per year.

Q: I also read that it has a higher failure rate at preventing pregnancy than, say birth control pills.
A: Birth control pills? Oh sure. The failure rate is comparable to male condoms which is somewhere around 93 to 95 percent. But whereas oral contraceptives or injectables, or the IUD. Those hormonal methods are 99 percent effective.

Q: Anything else you think is really important to know?
A: By reducing the cost, we’re really increasing the accessibility to women who need it and want it. Women are the fastest growing group of persons becoming HIV and STI positive in the U.S. This effort that was initiated in Washington D.C. and Chicago — the coming together, the partnership of the company with the CVS retailer with the department of health is a unique way of helping women stay healthy.

Everybody’s working together to make it happen.

Related posts:

1. Condoms, Condoms, Condoms
2. Preparing for the Fourth Decade of AIDS
3. Poll: Female Attitudes About Appearance

But before you break out the champagne, take a closer look. You actually do not need to search very hard. In fact, all it will take is a glance—one brief, passing glance into any of the thousands of corporate board rooms across America.

As of 2009, a wan 15.2 percent of Fortune 500 board members were women.  That means, for the average 10-person corporate board, there aren’t even two women in the room.  Suddenly the numbers aren’t looking so good. With women making up more than half of America’s workforce, how can there be so few women at the highest level where business decision-making gets done – the corporate boardroom.  The board recruits and retains the CEO and sets company policy.

The great irony is that an ever-increasing body of evidence points to the fact that having three or more women and/or minorities at the corporate board table benefits the business’ bottom line. Most companies with three or more women on their corporate boards financially outperform those without, gaining a greater return on equity (53 percent better), a greater return on sales (42 percent better), and a greater return on invested capital (66 percent better) than do companies with the least board gender diversity.

Having diversity around the board room table demonstrates serious selection. It is a clear and unmistakable signal to stakeholders that the company’s standards for good corporate governance are paramount.  Gender diversity in the board room is about diversity of ideas and balanced representation of a company’s employees and customers; the fair hearing of differing viewpoints; a roll-up-the sleeves willingness to raise, acknowledge, and resolve tough problems and issues; boardroom dynamics that are collaborative and productive; enlightened—and smart—decision making; and a culture of governance that spells success for the company and its bottom line.  Indeed, in a recent SEC issuance, the SEC began requiring boards to disclose how diversity is being considered during the director nomination process.  Companies must tell the SEC – and the public for that matter – about the company’s diversity policy or lack thereof.  If the company has a diversity policy, these companies are now required to explain how the policy was implemented, and how the company is evaluating said policy’s effectiveness.  And as the SEC is becoming more interested in how board members are being chosen, so is the health care industry.  In early January, it was announced that Harvard teaching hospitals will be limiting the pay that their senior officials can receive in exchange for board service.  As a result of these two policies, the opportunity exists for a new group of leaders, hopefully a diverse new group of leaders, to gain new seats around the boardroom table.

In this new decade and in an era of unprecedented diversity in federal governance, corporate America cannot be let off the hook.  Board chairs and nominating committees must be made accountable for creating corporate boards that adequately represent all of America, including the diversity of our labor force.

# # #

Prepared, trained, screened, capable women are available to serve on corporate boards through organizations like the Women Business Leaders of the U.S. Health Care Industry Foundation, which trains and coaches women from the health care industry for board service.  Other sites of interest for those seeking women and other diverse candidates include Catalyst, : National Association of Corporate Directors, Boardroom Bound, and Women in the Boardroom.

Related posts:

1. Chicken Soup for the Healthcare Industry Professional’s Soul
2. Earning less, paying more for health care: fighting a battle on two fronts
3. Health Care or Product Management?

When a company follows capitalistic principles, the goal is to increase value by offering better services at a lower price. The company strives to improve their bottom line by offering more value than their competitor, in an effort to put their competitor out of business. Offering good customer service complements this strategy. In industries other than health care, the result is a benefit to the consumer: quality products and service at a lower price. Southwest Airlines, for example, employs a very effective social media presence. They respond to complaints tweeted by customers, which is has garnered the company praise in addition to a loyal customer base. But does this consumer-centered strategy translate to health care?

Mayo Clinic is held as a model for value in health care, but attributing their success to “consumerism” is off-base. The new media strategies being presented by health care institutions at SXSH essentially boiled down to damage control by tending to disgruntled Twitterers, and analysis of the types of complaints being registered. Though claiming to be influenced by social media mavens at Mayo’s Rochester flagship, the strategy is misguided and far removed. Mayo Clinic works because of a philosophy of care that puts the needs of the patients first—which does not equate to reactionary PR moves on social media sites. Absolutely nothing about their strategy distinguished it from other industries—and in the context of health care, replicating the strategy of Southwest Air and its ilk borders on insulting. Mayo Clinic avoids the noisy Twittersphere when addressing something as important as patient care; when a complaint is registered, that’s what their specialized center for patient service is for. Their Sharing Mayo Clinic blog allows a community of patients, staff, and families to form, which anticipates service problems before they even occur. This is the absolute obligation of companies in charge of delivering health care to a society.

My issue is also a philosophical one.

We all agree that a crucial part of reforming this system is expanding access to care, but new media strategies that are effective in other industries become empty gestures if used, unmodified, in health care. Consumers who can buy greater quantities of higher-quality goods reap the benefit from sellers’ efforts to compete. But what about those who can’t afford it no matter how cheap it gets? Southwest Air, in theory, is trying to put other airlines out of business by offering the best value. Are we trying to put hospitals that are struggling out of business? If you’re truly concerned for the health of the community—for social health—it seems those are the places that need more support, rather than be subjected to market forces.

Patients, on one level, are consumers in the sense that they deserve good service when they walk into a doctor’s office or hospital, but even that is a misnomer; responding to complaints and shortening the wait time is common civility, not a whole customer service strategy. Health is life, it is who you are—it is not something that is consumed, and referring to patients as “consumers” is careless. The PR departments of health institutions must not forget that it is the health of their “customers” that is most important, and are therefore obliged to take their social media initiatives a step further than companies not involved in the health care field. Want to strive for the success of Mayo Clinic? Drop Twitter and start focusing on people- and patient-centered care.

Related posts:

1. FDA Gets Social: Considers Regulating Social Media for Drugs and Devices
2. Health Care and Social Media
3. March Man-of-the Month: Dr. Ted Eytan Interviews Holly Potter, Kaiser Permanente’s VP for Public Relations, on the Use of Social Media in Health Care

The situation: Sara E. was looking at new insurance options because she was concerned that her current policy cost too much and covered too little. A case in point was a recent eye exam. She had to pay for the appointment because she hadn’t yet met the $1000 deductible on her current policy.

The solution: It was clear that Sara did not understand the details of the policy she had purchased. It’s not unusual, but can prove problematic. In fact, we recommend that all of our customers make a list of the medical services they will likely need throughout the year. Before buying anything, we tell them to read the fine print on the policy and ask questions until they are certain they understand what they are paying for – and what will be an additional charge.

Here’s why: The fine print on an insurance policy can be complex. The bottom line is that if you purchase a policy with a high deductible, there will be no coverage until the deductible is paid in full. Deductibles apply to all coverage if you purchase an HSA (Health Savings Account) compatible plan – except for preventative services.

And realize this:

1. Deductibles can also apply to specific services such as lab work and hospitalization.

2. They also apply to services differently depending on whether they are in or out of network.

3. It’s important to know that deductibles may be cumulative or shared, or based on the calendar year or contract year. Know how it works for the policy you purchase.

4. If the policy is a Health Savings Account (HSA) versus a high-deductible plan, you will be able to write off the amount placed in the HSA account up to the maximum allowable by the government. The minimum deductible for HSA plans start at $1200 for a single and $2400 for a family.

5. Do note that there are many after-tax expenditures such as those that are included in the FSA Section 213 of the tax code, which can be written off that are not covered under an insurance policy, which is the advantage of an HSA.

If we were the Health Insurance Ambassadors

Before any new customer signs up for a policy, we’d make sure they were given a short primer course, at the expense of the health insurance company, ensuring that they understand the benefit package they are buying.

We would also have the insured initial a disclaimer stating what is covered, how the deductible works and what it applies to, and what the exposure is based on the out-of-pocket limits. That would alleviate the confusion.

The painful truth

The reality is that there is a cost to pay when you buy health insurance. Realize that you’ll end up paying out-of-pocket either with a deductible or a premium. Nothing is free. And if an employer, or a parent, is footing the bill for the premium, you will still be required to pay out-of-pocket costs when you visit a doctor or hospital. If you are self-employed, and are paying both the premium and the deductible, be careful to analyze the cost of having a policy that includes a deductible plus out-of-pocket expenditures and premiums.

Stay tuned for my next blog entry: Dad is still paying for his daughter’s insurance – and no one is happy.

Related posts:

1. You Gotta Laugh: Life in the Trenches of the Health Insurance Business
2. Top 8 Reasons Single People Don’t Buy Health Insurance — And why they might want to reconsider that decision
3. An end to the health insurance advocate: Will insurance brokers survive health reform?

However, perhaps these goals are loftier than originally imagined.  Newly- published data appearing in this week’s JAMA show that the very research that is supposed to be forging the path for our nation’s health is filled with ills of its own.

An analysis of randomized and observational studies and meta-analyses published in six “high-impact” journals (i.e. NEJM, Lancet, JAMA, Annals of Internal Medicine, BMJ and Archives of Internal Medicine) demonstrated that there is a dearth of CER studies to guide policymaking or clinical decisions. Granted, this underscores the need to expand funding, preferably public funding to fill the gap. However, key findings also showed that only 32% of evaluable medication studies met the criteria for CER, efficacy outcomes were generally emphasized to a substantially greater extent than safety outcomes (only 19% of studies focused on safety), and that a critical element for promoting effective and efficient healthcare, i.e. cost-effective analyses, appeared in only 2% of the studies. Moreover, less than 50% of studies had active comparators and of these, less than a quarter used non-inferiority analyses, thereby obviating the ability to effectively evaluate and compare similar agents with different side effects profiles.

These data raise as many questions as they do answers. Although they provide an essential framework for moving the Nation’s mandate forward, they clearly raise a red flag; as Patrick Conway MD and Carolyn Claney MD write in an accompanying editorial, the decisions that originally guided nationally mandated priorities for CER “had no clear inventory of published studies or research in progress to inform their deliberations.”

With over $1B at stake in an already stressed economy, doesn’t it make sense to take a step back, reevaluate our mandates and fill in the gaps before moving forward too quickly? While it is true that there is insufficient research being devoted to CER, it appears that the research itself (and perhaps even the policy driving it) may also be insufficient.

Source:

Hochman M, McCormick D. Characteristics of published comparative effectiveness studies of medications. JAMA. 2010; 303: 951-958.

Conway PH, Clancy C. Charting a path from comparative effectiveness funding to improved patient-centered health care. JAMA. 2010;303: 985-986.

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3. Comparative Effectiveness Research: What a Difference an X Should Make

By Lois Privor-Dumm. It’s really simple.  8.8 million children die every year.  Not here in the US, but in developing countries where they don’t have access to the same care that we do here.  How much of our global health budget goes to address these basic needs?  Less than $1 of every $10.

Children are the future of every country.  Providing them with basic care to ensure they survive until their fifth birthday doesn’t seem to be that much to ask.  And, it’s a good investment.  Simple antibiotics or oral rehydration solutions along with the basic vaccines that children receive in the US every year are available at a cost that is around many people’s co-pay for a single prescription.

Although pneumonia and diarrhea are leading killers of children worldwide, our government hasn’t made the investment in these simple solutions.  Young babies don’t have a voice; we do though. We can afford to take 30 seconds or less to build awareness about these issues and help guide our global spending budget/

GAVI and Save the Children are joining together to make sure their voice is heard. The Global Health Initiative is citing greater emphasis on women and children, but their current plan doesn’t incorporate all that is available and highly affordable. Let’s make sure they our country focuses on long underfunded priorities.  We can address this problem that many don’t realize is so large.  Tell your colleagues, family and friends that pneumonia and diarrhea are the leading infectious killers of children that we can prevent and treat today.  Vote for fighting the leading child killers on “Ideas for Change” on Change.org.  It will take less than 30 seconds, but vote by March 12^th to help this idea receive the attention it deserves.

Related posts:

1. What Happiness Looks Like: A Chance for Change on World Pneumonia Day
2. Saving Money while Saving Lives: The Economic Argument for Childhood Vaccination
3. Getting life-saving vaccines to those who need it most: the nuanced solution for access

Here’s what the United Nations WomenWatch Directory of U.N. Resources on Gender and Women’s Issues says:

“Women have the right to the enjoyment of the highest attainable standard of physical and mental health. The enjoyment of this right is vital to their life and well-being, their ability to participate in all areas of public and private life.”

Unfortunately, many women around the world do not enjoy this right.

2009 World Health Organization (WHO) report

Consider this information from the report, “Women and Health: Today’s Evidence Tomorrow’s Agenda:”

Despite considerable progress in the past decades, societies continue to fail to meet the health-care needs of women at key moments of their lives, particularly in their adolescent years and in older age… Women provide the bulk of health care, but rarely receive the care they need—up to 80 percent of all health care and 90 percent of care for HIV/AIDS-related illness is provided in the home—almost always by women. Yet more often than not, women go unsupported, unrecognized and unremunerated in this essential role, and health care continues to fail to address their specific needs and challenges throughout their lives.

International Women’s Year

In 1975, during International Women’s Year, the United Nations began celebrating March 8th as International Women’s Day. WomenWatch, an initiative of the Inter-Agency Network on Women and Gender Equality, explained on their Web site that the day’s symbolism has a wider meaning: “It is an occasion to review how far they have come in their struggle for equality, peace and development. It is also an opportunity to unite, network and mobilize for meaningful change.”

The theme for this year’s International Women’s Year is “Equal Rights, Equal Opportunities: Progress for All.” How can we make real progress when women all over the world do not have the right or the ability to attain the highest standard of physical and mental health?

Related posts:

1. This International Women’s Day Let’s Aim to End Maternal Deaths
2. Maternal Mortality Crisis in the US: Amnesty International Issues New Report
3. Celebrate International Women’s Day with CARE

What a tragic loss for our planet when at the same time we in the developed world have turned our attention to new ways of obtaining and sharing information, the latest methods to prolong our lives and even how to conceive and deliver babies well into middle-age. I’m guessing that the founders of International Women’s Day probably hoped that 99 years later, the chances of women dying of pregnancy-related causes would be slim to none.

A new study out of California shows that maternal mortality is hardly something we have conquered in our own country; in fact women die after childbirth at a greater rate in our country than in 33 others! Over the past decade, those statistics have grown increasingly grim in California — rising from 5.6 deaths per 100,000 to nearly 17 deaths per 100,000. The reasons for maternal mortality in the U.S. and around the world are complex and varied, but the fact remains that most of the deaths are preventable. Women simply don’t have to die during pregnancy, childbirth or soon after.

Maternal deaths in developing countries could be slashed by 70% and newborn deaths cut nearly in half if the world doubled investment in family planning and pregnancy-related care, according to a report released two months ago by the Guttmacher Institute and UNFPA, the United Nations Population Fund. The new report, Adding It Up: The Costs and Benefits of Investing in Family Planning and Maternal and Newborn Health, found that investments in family planning boost the overall effectiveness of every dollar spent on the provision of pregnancy-related and newborn health care.

The thousands of delegates from around the world who will gather in Washington this June for the Women Deliver conference are determined to put maternal health high up on the agendas of leaders of nations large and small, developed and getting there. Their ask: $10 billion in additional funding for global maternal health annually, increasing ton an additional $20 billion by 2015.

We mustn’t let this critical discussion get bogged down in ideology about abortion or contraceptives or politics. I challenge you to look into the eyes of your own mother or sister or daughter on March 8 and say, “Sorry, maternal deaths are simply not a prority.” Or you could join me in celebrating International Women’s Day with a pledge to invest in the health and well-being of women.

Related posts:

1. Maternal Mortality Crisis in the US: Amnesty International Issues New Report
2. Dying to Give Life
3. Economic Security and Reproductive Health

Did you watch yesterday’s live chat? If so, what are your thoughts and reactions on what was said? What additional questions do you have for the President as well as the HHS Secretary and the Health Reform Director?

Related posts:

1. Watch, Discuss and Engage: HHS Secretary Sebelius & Health Reform Director Nancy-Ann DeParle
2. Reactions from the Web: Tom Daschle for HHS and Health Reform
3. Bailing out Health Care: My Top 10 Priority List for the Next Secretary of HHS

• Watch the discussion at WhiteHouse.gov/live
• Watch and join the chat through Facebook

Related posts:

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Immediately after the snow stopped falling in Washington DC this week, another news story took DC by storm–the resignation of Billy Tauzin, effective June 30th.

Mr. Tauzin’s departure comes at a critical time for those involved with health reform efforts, not to mention PHRMA’s own thick portfolio of issues that include patents and trade, the economy, taxes (think offshore), and shrivelling pipelines, just to name a few.

The job pays well, but the applicant will surely inherit a daunting to-do list…

Read the rest of Robin’s “Help Wanted: PHRMA ISO New CEO” post.

Stop Running Red Lights AND Pay for Health Care Reform
By Rosemary Gibson | February 1st, 2010

With all the hand wringing about health care costs, it is possible to cut costs without harming patients. Even better, costs can be reduced while making patients better off. Here’s how.

An unspoken truth is that three kinds of medical treatment are provided in the U.S. The first is treatment whose benefit is unquestionable. Surgery to treat a ruptured appendix is an example. Without it, death from life-threatening infection is almost certain. The life-saving medical care being rendered to earthquake victims in Haiti is in this category…

Read the rest of Rosemary’s “Stop Running Red Lights AND Pay for Health Care Reform” post.

A new meaning for super-size
By Lisa Korin | February 10th, 2010

During this blizzard of 2010, I thought about the difficulties an ambulance would have reaching someone in need on an unplowed street—let alone if the person were significantly obese and hard to transport on even an ordinary day. Then today I read an astounding Washington Post article that noted “a patient between 400 pounds and 600 pounds is part of every workweek for many crews throughout the [DC metro] region.” Really? I thought this only happened on occasion in select areas shown on the Discovery Channel. Apparently, not the case…

Read the rest of Lisa’s “A new meaning for super-size” post.

Related posts:

1. February 2010 Man of the Month: Personal Trainer Morris White
2. A new meaning for super-size
3. Top 8 Reasons Single People Don’t Buy Health Insurance — And why they might want to reconsider that decision

The Let’s Move campaign will combat childhood obesity by focusing on four main strategies: helping parents make health family choices, providing healthier food options in schools, promoting physical activity and ensuring that low-income urban and rural areas have access to healthy and affordable food.

One in four Latino youth is overweight, and the result has been an alarming increase in Type 2 diabetes and high blood pressure among children. The causes are numerous and range from a lack of supermarkets in Hispanic neighborhoods to disparities in access to health services. But regardless of the barriers, this growing trend must end.

The mission of Let’s Move is to solve the childhood obesity epidemic within a generation. That’s an ambitious goal, and one that is going to require cooperation between governments, organizations, companies, schools and families at every level. NHMA is committed to doing our part to fight childhood obesity and will be working with the White House and our other partners to educate Latino communities on healthy lifestyles for children – everything from learning how to make smart grocery purchases to finding safe outdoor options for physical activity.

I’d love to hear your ideas for lowering childhood obesity too. What healthy lifestyle measures have worked in your family or community? Let me know!

Related posts:

1. Childhood Obesity: The Time for Action is Now
2. A new meaning for super-size
3. Eating our Way to Better Health

Democrats: We want to get this done by the end of March. We have 9 out of 10 of your wish-list items. Let’s do this.

Republicans: No. We don’t like it. Let’s trash it and start over from scratch.

Democrats: Not possible.

Republicans: Seriously. Let’s start over. Clean page. Fresh slate.

Throughout the day, President Obama pointed out that people on both sides of the table want the same things. He gets letters every day from hard-working people who have lousy (or no) health insurance — people who are losing their house and going bankrupt to pay their medical bills.

He argued that his proposal and the bill that passed in the Senate at Christmastime wasn’t a “radical change” — most people who have health insurance now will still have it, it will just cost a little less. And people who can’t afford it, or who have pre-existing conditions — could get coverage.

While Republicans argued that folks are furious at the idea of Big Government stepping in and forcing people to buy insurance — Obama argued that he just wanted to make sure everyone could have it. The way the FDA makes sure meat isn’t poisoned or drugs won’t kill you. He said there ought to be a little bit of regulation — the same way doctor’s have to go to med school and pass board certifications before they can practice. He just wants to make sure everything is fair, and everything is safe.

At the beginning of the summit, Senator Harry Reid (D-Majority Leader) said, “If you have a better plan for making health insurance more affordable — let’s hear it.”

And the plan that was echoed over and over again is we don’t like this current plan, no one talked to us about it — we should have had this meeting nine months ago — let’s scrap it and do it again. Obama said he didn’t want to “pretend” like he was going to change health care reform and not actually do it.

Instead of tearing apart the bill and nitpicking about what people like or don’t like — Obama proposed that they talk about what they like in the bill. (It seemed like he was trying to salvage what’s there and show people that they don’t hate everything in it.)

“There are a lot more concepts that they agree on. This summit showed that,” says Dr. Elena Rios, President and CEO of the National Hispanic Medical Association.

Still, others didn’t think the legislators sitting around the table telling stories about sick constituents with high premiums was particularly productive.

“It’s a show,” says Stephanie Cohen, CEO of Golden & Cohen, a health benefits consulting company. “They’re not focusing on what the real issues are. None of the things they’re doing is going to help anybody. It’s not going to make a difference.”

She doesn’t think there’s any way the legislation will be completed in the next month.

“I think they need to start over,” she says. “This is an elephant. And you can’t move an elephant so fast.”

Disruptive Women’s Robin Strongin has a suggestion on how to speed up legislation.

“While today’s summit was certainly groundbreaking in what it represented, it’s time to move things along. Every Member of Congress, the Administration and their families should lose their health insurance until such time as they can get their act together and pass health (insurance) reform. Dick Cheney just suffered his fifth heart attack—imagine what that would cost him if he had to pay out of pocket every time his heart malfunctioned.”

“It’s going to be a tough battle,” says Rosemary Gibson, author of The Treatment Trap. “It’s going to be tough. But there’s always hope. Let’s have hope. I still think a lot of reform can still happen.”

Like Nancy Pelosi (D-House Speaker) said: “Health care reform for all Americans is hard, but we will get it done.”

We sure hope so.

Related posts:

1. Missed Opportunities and the Mandate Dilemma
2. Poll: Will We Witness Health History?
3. Broken incentives for patients, providers, and health plan administrators

A personal trainer for 22 years, Morris White has both men and women – and even children as young as 12 – as clients. He helps them with basic fitness, sport-specific fitness and self defense. He also trains people with special needs, including those with disabilities and eating disorders, and those recovering from a stroke and heart attack.

In his own life, he is a power lifter and a practitioner of Kung Fu, Yoga, desert hiking and survival quests and sustainable healthy living. He is currently working on a fitness community site.

I can vouch for his impact. I’m now in my third year with him, with regular work outs at 6 AM. The benefits have been worth every trek to the gym in those before-dawn hours.

Morris, I’m pleased to have the chance to talk about fitness with you. It’s an important topic, but rarely addressed in this blogspace. How did you get started training?

There were three very influential men in my young life. It was the 1970’s. My Father was a pharmacist and successful businessman who took me to monthly Toast Masters meetings and had me working in the pharmacy on weekends. He taught me the importance of physical poise and presence. One of his business partners was a Physical Therapist who mentored me in anatomy and exercise, from him I learned about anatomy and body mechanics At about that same time, I was introduced to Kung Fu by my best friend’s Father who was a Master of the art.  Kung Fu combined all the earlier lessons and helped me to develop my personal philosophy on holistic personal training.

Those were the years of my greatest lessons.

I attended Temple University but my advisors could not grasp what I wanted to become and what I wanted to do with my life. The usual response was, “So, you want to teach phys ed?” No.

From there to the gymnasiums I went, working under different titles until personal training evolved and became popular.

 What about fitness and training makes it your passion? 22 years seems a long time.

Seeing my mother die at young age and my father debilitated primarily by an unhealthy lifestyle, has made me even more intent to give meaning to my existence by living and enjoying life to its fullest and helping others to do the same through fitness.  The bonus is that by helping others achieve their personal goals, I get to meet great people that, in turn, enrich my life through their collective experiences and wisdom.

How do you approach training?

My philosophy of training is:

• Safety first. You should never be harmed or injured in the course of training.

• Strict, proper form. The best form produces the best, most efficient results.

• Keep moving. A body in motion tends to stay in motion.

Follow those rules and you’ll keep at it, making progress. You’ll avoid injuries and won’t suffer any set-backs in your workouts. You’ll also see results and be able to have an increasingly better quality of life. Even if you’re already fit, you’ll see improvements.  As I like to say to my clients, “one foot in front of the other and you’ll get where you’re going,”

Oh, and one more thing, never imitate what you see others doing in the gym.  So many people do their exercises incorrectly. Others may do an exercise properly but their routine may not fit your desired goals.  Always consult a professional about a new exercise or routine.

Do you have any dramatic examples of client improvements?

I could tell lots of stories of women who come to prepare for their weddings. They’re motivated for sure. Believe it or not, they’ve bought dresses three sizes too small and now need to fit into them. Plus, the regular workouts really help them with the wedding-planning stress.

But the one client and story that really inspired me was a 280 lb sedentary banker who lost the weight and became a marathon runner.

As he became physical healthier, his self-confidence and self-esteem also improved.  This newfound self-respect gave him the strength to not only run a marathon but to walk right out of a less-than-supportive, troubled relationship and climb the corporate ladder to a promotion.

(Laughing) Of course, I cost him lots of money – he kept having to replace his wardrobe as his body changed.

Have you ever seen anyone who did not see an improvement in working out with a trainer?

Yes. This is teamwork and a few people were not ready to engage – in part because they were not honest about their goals and readiness to begin.

As you’ve seen in my approach, I don’t just bark orders and count. Training – at least with me – is not bootcamp. When we work out, we work as a team. We’re in constant communication. I’m asking how you feel and you’re telling me. If something hurts, I know immediately from what you say and sometimes from the way you act. That allows me to make subtle changes in the next exercise I choose.

You must be ready to be honest with yourself and you must be ready to trust your trainer to help you.

Yes, I see how easily you detect when I’m compensating, using a muscle other than the one you intended and not doing it right.

Busted!

You see, personal training is not just science, it is an art and it’s very much like life. Life always tosses us curveballs and I have to be aware and be able to read the pitch. Part of that comes from the communication between me and my client. It begins the moment you walk into the gym and asking “how are you feeling this morning.” That’s not just a greeting, it’s a diagnostic question. The answer and your body mechanics tell me what you need today.

I also ask you what you have planned for the day. If you’re at your desk writing, I’ll prepare your body for that. If you’re traveling, you’ll be ready for the flight.

I’ve benefited lots from working out with weights, but notice that it’s rare to see a woman on that side of the gym. What about other benefits you’ve seen in your women clients?

There are a variety of benefits and they’re not just physical. My clients have dropped dress sizes, lost weight, sleep better and have better balance, posture and reaction times. On the emotional side, they are more grounded and have greater self confidence. Some tell me they can “stand up for themselves” better in the workplace and in relationships.

Whatever you feel physically, you’ll feel emotionally.

How do you get women to that side of the gym?

Easy. I take them there when the time is appropriate, focusing on their needs and goals and instilling them with the confidence that they can do the best for themselves. I also point out how “not to” workout, using the examples of others there. This is not intended to criticize those people since you’ve seen me intervene and correct someone who may be risking injury, but to give her the confidence that she can do it right.

Finding you was pretty much luck. I met the gym owner at a party, one thing led to another and I ended up doing something I said I’d never do – meet with a trainer and make a commitment to train. That was more than 3 years ago. If someone reading this was contemplating finding a trainer, what advice would you give them?

Look within yourself first. By that, I mean you must decide exactly what is important to you. What is your present discomfort – physical or emotional? What is your goal? What motivates you?

When you explain that to a trainer, they should do more listening than talking. They should be able to repeat back to you the concerns and goals you stated in your initial meeting as well as to communicate the plan of action to get you started and keep you motivated.

What I find is that someone might begin with one motivation – like dropping a dress size – but then as they work out, they feel better. In some cases, people start feeling better than they have in years. At that point, their motivation shifts and they work out because it keeps them feeling great. Fitness becomes its own reward.

Finally, realize that your success requires that you and your trainer are a team. The two of you must perform like a team. The chemistry must be there.

Do you train older people?

Yes, it’s one of my specialties. There are lots of benefits of exercise, but most people are concerned about cognitive decline in aging and recent research demonstrates that fitness can stem cognitive declines, so this is important.

Older people’s bodies don’t recover as quickly as they once did and this is an area where young trainers can improve on their training techniques. It’s hard for a young trainer to empathize with an older person who needs more recovery time between workouts, or who needs special emphasis placed on balance.

I work with an older person much like an Occupational Therapist, in that I try to help them re-tune with their bodies.

Regardless of what some people may believe, older people can make great strides in training and see remarkable progress.

Sometimes I see couples in the gym and I know you train couples. If a man reading this wanted to get his special woman into gym, what should he do?

The only way it works for a couple is if they have a shared goal for the quality time they spend together, for example, if they have a goal to enjoy a particular sport or an active vacation that requires a set of specific physical skills or fitness. Otherwise, it just doesn’t work.

I’d never advise a man to try to train the woman in his life. The best thing he can do for her is to be sure she has a trainer who is a professional who knows how to train women.  He might coax her a bit, but it has to be her motivation and goals that bring her to the gym.  Trust me, I know this from experience. This statement has been approved by my wife.

Would you recommend that people start a fitness program without a trainer?

No. To build a healthy and solid fitness foundation, I always recommend starting with the guidance of a qualified trainer.

But I do want to stress the importance of actually getting going and starting to move.  Our bodies were designed with motion in mind and our minds were made to think. Our body wants to be used and we feel better when it is. A body in motion tends to stay in motion; a body at rest tends to stay at rest.

Get out there start to move. No excuses. Even a little bit better every day, one foot in front of the other gets you where you’re going. Exercise “gives back” more in time and value than it takes. Remember that the days you don’t want to go to the gym.

Some people think that training is exhausting or should hurt – no pain no gain.

Absolutely false. You need not kill yourself in the gym to see improvement in your quality of life.

Exertion is OK, pain is not.

I remember telling you that your time was wasted on people like me and that you should be training trainers. What keeps you helping folks like me?

I like being a mentor to the younger trainers in the gym and the camaraderie that comes with working with other trainers but what is most fulfilling to me is my role as a personal trainer.

I train individuals and count my blessings. I get to help improve the quality of life for others and in exchange, I get to meet many wonderful and different people – all of whom have enriched my life.

Any other advice for today’s readers?

Don’t overdo it. Do something every day. Safety first.

Listen to your body and learn the difference between when it’s in pain or danger and when it’s just whining.

Try a trainer, and don’t hesitate to change trainers. A good trainer will recommend other training venues – much as I recommended RowZone for you.

Morris, thanks. This has been fun, though I can’t say that about 5:30 treks to the gym in the driving rain! I’m hoping it inspires someone to join a gym or find a trainer and have a motivation, goal and training style discussion.

If it helps, I’ll be pleased!

Related posts:

1. April Man of the Month – Doug Goldstein
2. February Man of the Month: Missy Krasner interviews Matthew Holt of Health2.0 and The Health Care Blog
3. Top Posts For February 2010

I ask that my written testimony be accepted into the record.

Today you will hear from accomplished researchers and leaders in their fields of study from Duke University and Stanford. These individuals are scientists, entrepreneurs and biotechnology innovators.

I come here primarily as a mom. I am here today to address the critical link between my experience as a mother striving for treatments, for my kids and millions of others, and the question before this Committee — How our National Institute of Standards and Technology can more effectively influence innovation in life sciences.

I begin with a plain statement about NIST and its activities — it can appear to be boring, non-interesting, and terribly esoteric. NIST suffers from being hidden, embedded into the foundational infrastructure of the scientific and early commercial enterprise of innovation, as well as having the thankless task of creating measurement standards for a whole array of scientific disciplines. However, it is precisely because of these elements that this Committee needs to champion a more active role for NIST in the life sciences.

Some have argued quite convincingly that the next century of scientific and technological innovations will be most profound in the life sciences. NIST is critical to a robust biomedical enterprise and must contribute high quality materials, methods, and expertise for the field to advance on a platform of certainty and high quality measurements.

My two children were diagnosed with a genetic disease fifteen years ago. As a result, I chose to leave my career as a college chaplain and become involved with the life sciences and biotechnology in a search for a solution for their disease. I started a research foundation called PXE International, organized patient populations around the world, created a biobank, isolated the disease gene, developed a commercial diagnostic, created animal models, and have supported clinical inventions for adults living with the more severe forms of the disease. We still do not have a treatment intervention for my children. We are still hard at work.

We have been stymied by a number of measurement and experimental roadblocks in advancing clear understanding of the disease and the function of the altered protein that causes my children’s condition. We have run smacked into the wall of both scientific and technological limitations.

My foundation’s research work has been written about in prestigious journals as a model of innovation, and an example of the power of patient-driven translational research. Some have said that our work will change the future of biomedical research and medical practice in this country. But I am telling you today we are now limping toward the finish line of our objective because of the current limitations in measurement science. This science has real-world impact on patients, families, and communities.

At this time, each provider of biomedical tests and therapies is creating their own system, leading to widespread inconsistencies between these practices. American’s believe that they are receiving healthcare that is high quality, accurate, valid, useful and consistent. They do not realize that a PSA test from one lab cannot be compared to another lab. They have no idea that the 4 million newborns who received screening at birth this year, are subjected to different screening cutoffs in each of the state programs for the somewhere between 29 and 54 tests. States count the number of screens they conduct differently from one another because there are no standards.  The 2700 genetic tests listed in GeneTests are purported to be actually hundreds of thousands of tests because of the variability across the labs performing these tests in the US and beyond. No one knows how many tests there are, and there are only standards for 35 analytes.

Every technology manufacturer applies relevant measurement technology with their own standard references and controls, in housekeeping genes and general control reagents for example. The Food and Drug Administration, as a regulatory agency, is challenged with ascertaining the accuracy and precision of these technologies based on the manufacturers’ supplied standards. Ultimately they must trust the manufacturers.

NIST must take a leadership role in creating the standards necessary to integrate new technologies into medicine. These technologies, in genetics, genomics, laboratory science and imaging, are migrating into health care, sometimes to point-of-care. It is critical that patients know that these healthcare services are based on the certitude that only standards can bring.

With Congress’s increased support, NIST should:

1. Create a life sciences infrastructure, catalog, and distribution system for reference materials and standards for quality assurance for all clinical diagnostic tests
2. Integrate measurement standards and technologies into the FDA regulatory regime
3. Partner with the National Institutes of Health on resolving the measurement challenges at the intersection of patient care
4. Conduct a comprehensive analysis of the life sciences to determine the highest needs for measurement science

In this age of emerging personalized medicine, delivered through new technologies to patients today, we cannot wait any longer, having far outstripped the standards available to biomedical enterprises. Leading Genetic Alliance, and feeling the urgency of the hundreds of millions of people who need answers today, I know we need excellent leadership in an exceptional age. Let us take this charge seriously. Every one of us has a role to play, and NIST is poised to do great things. Thank you for the opportunity to contribute to the important work of this committee.

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Dr. Jan Gurley just returned from a mission trip to Haiti, 5 weeks after the earthquake hit. In this audio clip, she relays a horrific first-hand account of the current realities of life in Port Au Prince. With no running water, bathrooms, or place to shelter – and packed into a field with 100,000 people – some young women are choosing to stop drinking water in an effort to commit suicide.

Dr. Gurley describes the loss of human dignity associated with the crisis in Haiti, including a near stampede when sanitary napkins were offered in a crowd of women. She explains that the place is becoming dangerous – and the screams of women being raped in the night fill the dark air. In the day time, people huddle together for safety while the stench of rotting corpses surrounds them. With the rainy season approaching, and tent cities perched precariously on land-slide prone hills, Dr. Gurley predicts a second wave of disease, violence, despair, and death in Haiti.

Download audio file (haitiupdategurley.mp3)

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1. My sister in law in Haiti

The very first one, Why don’t Americans think everyone should have reasonable health care (which, my interviewer-to-be noted, seemed very strange to Norwegians) was quickly followed by Why is this matter so controversial in the US? 

Oh boy.  This interview has the potential to be very short; that, or I hope my friend from Europe has a passport with some serious time left on it because explaining this thing we call US health reform could take a while. 

Would love your input.  How would you answer?

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2. Setting Even Higher Sights for Health Care – and Reform
3. An end to the health insurance advocate: Will insurance brokers survive health reform?

And just in time…With President Obama and the Congressional leaders set to roll out their version of reality TV on February 25th. (Look out Jersey Shore, we’ve got Potomac Fever.) Stay tuned for the Health Care Summit Disruptive Women Debrief on the 26th.

In the meantime, please read more about these incredible women and join me in extending a warm welcome.

	Anuradha Acharya, named as one of “25 Tech Titans under 35″ by Red Herring magazine, is the Founder & CEO of Ocimum Biosolutions, a global genomics outsourcing partner for discovery, development and diagnostics.
	Becca Camp graduated with an anthropology degree from the University of Texas at Austin in December ’08. She is now finishing her pre-med coursework at Texas Christian University, with plans to apply to medical school this year.
	Lorraine Lee Friedman, JD, (aka Rainey) started her life-long commitment of advocacy for children with The National Law Center on Homelessness and Poverty, is the Founder and Executive Director of the DreamDog Foundation as well as an award-winning author and songwriter.
	Lynn Shapiro Snyder, Esq., a senior member of the law firm, Epstein Becker & Green, P.C., is the Founder and President of the Women Business Leaders of the U.S. Health Care Industry Foundation (“WBL Foundation”), an organization meeting the needs of more than 1,800 senior executive women and women board members worldwide who do business with the U.S. health care industry.
	Dr. Pamela Cipriano, Editor-in-Chief of American Nurse Today, the official journal of the American Nurses Association, is a distinguished nursing and hospital administrator having served as Chief Nursing Officer and Chief Clinical Officer of the University of Virginia Health System the past nine years, achieving Magnet Recognition in 2006.

Learn more about our new bloggers, as well as all the Disruptive Women.

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3. Five New Bloggers Join Disruptive Women’s Roster