Tagged: Medicine

June 18, 2013

Pet Therapy: Cats and Dogs Benefit the Ill and Aged

Furry friends benefit the ill and aged

Image: University of Illinois Library via Flickr

Pets can help reduce stress and increase both physical and mental abilities among some ill and aged patients suffering from isolation or depression, according to Billie Smith, executive director of Wyoming-based Therapy Dogs, Inc.

“Having a pet helps the senior focus on something other than physical problems and negative preoccupations about loss or aging,” psychologist Penny B. Donnenfeld told Aging Care. “I’ve seen those with memory loss interact and access memories from long ago.” Donnenfeld brings her Golden Retriever to her New York City practice.

Pets are also becoming more common in senior care facilities. Volunteer teams from Wags for Hope bring dogs and cats on visits to nursing homes, hospices and hospitals. Wags for Hope aims to be a “one-stop shopping” organization providing animal visits for therapy purposes in Maryland and surrounding areas.

“Dogs take them back to a time when they were younger, when they had their own dogs. Many of the older people I work with are farm people, who remember their herding or working dogs,” Smith told Life Matters Media. She visits nursing homes on a weekly basis and has been doing so for some 20 years. “God gave us dogs to do what they do,” she said. “Some tell me they like dogs more than they like people.”

Similarly, Therapy Dogs International provides dogs to comfort seriously ill patients and grieving families. “Nursing homes were one of the first settings to graciously open their doors to the concept of Pet Therapy, which was developed by Therapy Dogs International over 30 years ago,” the organization’s website states.

TGI maintains that their pet therapy can benefit some patients’ physical and mental states. According to TGI: ”Therapy Dogs elicit responses from some nursing home patients who are typically withdrawn and limited in their abilities. Stroking the back of a dog leads to more movement from the patient and consequently, increased physical activity. The introduction of dogs increase interaction among individuals and promote a positive change in self-esteem.”

Some of their dogs even visit funeral services, because families accustomed to a certain dog and its handler request them for a “last visit.”

As Sue Halpern wrote in “A Dog Walks Into a Nursing Home,” a chronicle of her experiences visiting nursing homes with her pet, Pransky: “Of all the things I learned going to County with my dog, this was the most valuable: though we are made of memories, we live only in the here and now.”

Changing Costs and Care at the End of Life

Julie Goldstein, M.D., Martha Twaddle, M.D., Mary F. Mulcahy, M.D., Randi Belisomo, M.A — Julie Goldstein, M.D., Martha Twaddle, M.D., Mary F. Mulcahy, M.D., Randi Belisomo, M.S.J.

Palliative care is an expanding and increasingly vital specialty of medicine, said end of life care expert Martha Twaddle, M.D., at a presentation for the Association of Health Care Journalists- Chicago Chapter.

“When I joined the American Academy of Hospice and Palliative Medicine, there were 50 of us– 25 were from Australia and the UK. Now, the membership is well into the thousands,” said Twaddle during the presentation, “Changing Costs and Care at the End of Life,” which included Life Matters Media co-founders, Randi Belisomo and Mary F. Mulcahy, M.D., and Advocate Illinois Masonic palliative care physician Julie Goldstein, M.D.

The presentation sought to explore end of life options in light of the “death panels” controversy, one which effectively eliminated efforts to compensate physicians for facilitating end of life discussions with patients.

Physicians typically only spend fifteen to twenty minutes with each patient. “It’s not a lot of time,” Mulcahy said. “You cannot go into these discussions with an agenda, you really have to speak with the family, the patient.”

In a complex field such as oncology, physicians must not only address disease treatment, but symptom management as a result of that treatment as well. In the course of a twenty minute appointment, treatment and symptoms are often too much to cover effectively; therefore, a robust discussion surrounding end of life issues is often not possible, Mulcahy said. These discussions, because their relevance may seem “far off” for patients, are frequently given low-priority by physicians and thus delayed.

Palliative medicine and hospice care allows patients more comfort at the end of life by reducing aggressive treatments and emphasizing pain management. Still, most patients remain skeptical or unaware of such treatments. Some physicians do not mention such care out of fear of being accused of “giving up” on their patients. Others simply avoid comprehensive end of life conversations altogether.

“When I sit down with patients and they say, ‘What’s palliative medicine?’ It’s easy to contrast it to what it isn’t, i.e. current medical care,” Twaddle said. “Current medical care is based on a biomedical model: here is the diagnosis, here is the treatment.”

However, palliative care is based off the roots of medicine, Twaddle explained, a biomedical-psycho-social-spiritual model. This “allopathic model” aims to cure the whole person, both body and soul- not just the disease. This model has been lost since the time of Descartes and the onset of modern technologies, she said.

“Palliative medicine’s secret agenda is to restore the wholeness of medicine, to bring it back to the person,” Twaddle said. Instead of beginning a doctor-patient dialogue with a discussion about treatment, care starts with a physician asking questions about the patients’ beliefs, ideals and wishes- what Twaddle called “the art of communication in medicine.”

Recently, Frederick Smith, M.D., director of clinical ethics at North Shore-LIJ Health System, said physicians have an ethical duty to inform their patients facing the end of life about hospice and palliative care services.

More from Life Matters Media:

Some Suffering Needed at the End of Life

Faith Influences End of Life Decisions for African-Americans

Switching Roles at the End of Life

June 1, 2013

Duty of Physicians to Inform Patients of Hospice, Palliative Care

Physicians have an ethical duty to inform their patients facing end of life about hospice and palliative care services, said Dr. Frederick Smith, director of clinical ethics at North Shore-LIJ Health System.

Smith’s presentation, part of the University of Chicago’s second annual Conference on Medicine and Religion, criticized the choices of many physicians who urge their patients to continue with more aggressive, painful treatments instead of more comfortable end of life care. Drawing inspiration from Judaism, Christianity and Islam, Smith suggested hospice and palliative care are compatible with religious teachings about death and pain. “A central function of religion is to provide meaning and consolation,” he said.

There are two things a failing patient needs to accomplish the “work of dying”: consciousness and time, Smith said. Dying allows patients time for reflection about life and opportunities for reconciliation. “Jesus wants his followers to seek reconciliation,” Smith said, noting the Lord’s Prayer.

“The Prophet Muhammad placed great value on forgiving the poor man’s debt,” Smith said. “The sacred books of the three great traditions, which originated with God’s call to Abraham, summon their adherence to a righteous life, comprised with loving adherence to God and honorable treatments to family, neighbors and even strangers. They teach that death is not the end.”

Hospice is most often used when curative treatment is no longer effective and a terminal patient is expected to live about six months or less. Palliative care is treatment that enhances comfort and improves the quality of life for patients. When deteriorating persons are not allowed time to begin the “work of dying,” they are more likely to leave feuds and conflicts unresolved, often carried on with the next generation. ”Feuds should not be taken to the grave,” Smith said.

One-third of hospice patients are too frail to begin the “work of dying,” because they are too frail, Smith said. They are transferred to hospice too late, only after aggressive treatments fail. Medicare reimburses for hospice care for up to six months, with extensions for failing patients who continue beyond six months.

Findings published in the Journal of the American Medical Association show hospice is often a last resort.

“Clinicians frequently ignore conversations about the likelihood of survival. If patients with life ending conditions truly knew the end was coming, would not it be better to take advantage of hospice?” Smith said.

More from Life Matters Media:

Switching Roles at the End of Life

National Institute of Medicine recommends improving end of life care

Some Suffering Needed at the End of Life

May 30, 2013

What is a life worth?

Geriatrician argues against bias against the aged and ill

Physicians caring for the elderly and for those nearing the end of life cannot be effective patient advocates until they confront their own deep and widespread prejudices, said geriatrician James Wright at the University of Chicago’s Conference on Medicine and Religion Wednesday.

Wright’s presentation, “The Courage to be a Geriatrician,” examined the bias held by many towards those lacking in independence, particularly those residents of nursing homes. “Most of us share the same prejudice, that life is of less value when lived in dependency,” Wright explained. “We are in a tradition that cultivates freedom, independence and productivity, and that is what we give value.”

“We live in an era of meaningless- now that we no longer fear the sword, plague, even hell, we fear meaningless,” Wright said.

This prejudice thus serves as a blockade to administering comprehensive care to some of society’s most vulnerable- the oldest and most infirm. Medical professionals, those in geriatrics especially, must experience a shift in mindset from valuing life based on independence and instead towards seeing innate human value. The oldest and sickest are long divorced by age and ability from past functions, Wright said, but their lives remain valuable. That value does not stem from any thing they once did.

Prejudices manifest

Prejudices manifest, Wright said, when doctors make quality of life assessments. His research demonstrates that when simultaneous assessments of life quality are made by both physician and patient, the patient almost always scores his or her quality far higher than the physician. “These devaluations matter,” he said.

The discrepancy, Wright argued, arises out of the drive of younger, working people towards self-affirmation. We often think, he said ‘‘I am not only alive, but my existence has meaning.’’ This quest for meaning is why the able-bodied join larger movements- political, civic or social. These movements give us worth.

“We live in an era of meaningless- now that we no longer fear the sword, plague, even hell, we fear meaningless,” he said, and this fear inhibits proper care of those we judge to have none.

Wright pointed towards the leaders of the Protestant Reformation as ones who can teach medical providers intrinsic human value. “All beings have equal value not because they earned it, but they were made that way by God, the source of all value,” Wright said. Both Martin Luther and John Calvin agreed that all of us, as humans, are not good enough, and fall short of our own expectations. However, God who loves without condition.

“We are enough as is,” Wright said, “and that gives us courage to be not as something greater.” The most successful providers see all life as equally acceptable and valuable, simply because that life is human.

“All people are created equal and remain equal throughout the course of their lives,” Wright concluded. “Only with this conviction, can we truly be trusted to value and care for the elderly in a way we all deserve.”

–Randi Belisomo

More from Life Matters Media:

Switching Roles at the End of Life

Resuscitation efforts death ritual in Western medicine

Many seniors have not organized online information for heirs

May 30, 2013

Switching Roles at the End of Life

A physician watches his father die

As the Chief Medical Officer of Vitas Innovative Hospice Care, Dr. Barry Kinzbrunner, an oncologist and palliative medicine specialist, has cared for the terminally ill and their families for decades. But it wasn’t until the death of Kinzbrunner’s own father this January that the physician and rabbi said he truly came to understand the end of life experience.

In a talk entitled “Caring for My Father as He Died,” Kinzbrunner outlined the processes millions of Americans experience each year- watching the slow decline of a close loved one. He delivered his personal account at the University of Chicago’s Conference on Medicine and Religion Wednesday.

Kinzbrunner’s father suffered from progressive Parkinson’s disease at the time he broke his shoulder this winter. That fracture set off a series of events that led to death in a hospice facility. Kinzbrunner’s mother, siblings and children kept a vigil at the bedside for twelve hours prior to his father’s death, a time period Kinzbrunner called “the longest twelve hours in my life.” The difficulty of such a vigil, he said, was one he had not appreciated in his role as a physician- often coming and going from patient rooms in the busy course of a doctor’s day.

When he believed his father had taken his last breath, Kinzbrunner said he rose to check the pulse of his father’s carotid artery. However, he quickly retracted; Kinzbrunner called for a nurse, noting it was not his role to declare his father deceased.

In his personal recollections, Kinzbrunner focused on the often mundane details to which he had to attend to comply with his Jewish Orthodoxy. Each day he visited his ailing father, he wore an old shirt; in the instance his father were to die, he did not want to be clad in a newer, expensive one for “keriyah-” the rending of garments that is the most striking Jewish expression of grief.

Kinzbrunner shaved meticulously each morning following his father’s fracture- were he to die, Jewish law prohibited the use of a razor among the mourners for thirty days after a death. This January marked the first occasion in which Kinzbrunner wore a beard.

On his last trip to visit his father, Kinzbrunner stopped at a 24 hour Walgreens to purchase nail clippers, as trimming nails is prohibited during the sheloshim- the first thirty days of mourning.

Attending to these details and the often complex processes involved in end of life situations, Kinzbrunner said should be discussed more often among medical providers. “I was more comfortable in my role as a doctor than in my role as a son,” he said.

–Randi Belisomo

More from Life Matters Media:

Resuscitation efforts death ritual in Western medicine

Many seniors have not organized online information for heirs

National Institute of Medicine recommends improving end of life care

May 14, 2013

Vermont votes to allow “Death with Dignity”

The Vermont House approved a measure allowing physicians the ability to prescribe life-ending medications to some terminally ill patients seeking to end their lives. Vermont is set to become the fourth state allowing the legislation known as ”Death with Dignity,” following Oregon, Washington and Montana.

The Patient Choice and Control at End of Life Act awaits approval from Gov. Peter Shumlin, a Democrat and supporter of the bill.

“By a 75-65 roll call vote, the House approved a bill largely that copies a law passed by Oregon voters in 1997 for three years and then shifts to a system with less government monitoring,” The Associated Press reports.

This marks the first time this type of legislation has been moved to passage by a legislature. With safeguards similar to the Oregon bill, patients seeking the prescription barbiturates must first state their intentions three times- once in writing. A second opinion from a physician indicating a patient has less than six months to live and proof of sanity, are mandatory. Patients must wait 48 hours before filling the prescriptions.

“It’s an important step for terminally ill Vermont patients,” Dick Walters, president of Patient Choices-Vermont, said after the vote. “It’s a big step forward for the region and for the country as a whole,” the AP reports.

Come 2016, changes advocated by some of the state senators seeking less government involvement during the process will go into effect, including less monitoring from physicians.

“It’s huge,” said lobbyist Michael Sirotkin, who for years has been involved with the issue in Vermont. “I think it’s going to have a major effect on other states’ willingness to vote on this,” he told USA Today.

But not all lawmakers approved of the bill’s passage. ”There can never be a dignified death using a handful of pills or a lethal cocktail,” said Rep. Carolyn Branagan, a Republican from Georgia, VT.

Other opponents were concerned about the radical changes the bill underwent while in the Senate. ”We are passing a bill that has not been vetted,” said Rep. Paul Poirier, an Independent from Barre. “Do we want to pass a bill … just accepting 100 percent what the Senate did overnight?”

More from Life Matters Media:

Many seniors still unfamiliar with social media

Buehler Enabling Garden, an outlet for aged and ill

Unreasonable optimism among physicians common during end of life care

May 6, 2013

Unreasonable optimism among physicians common during end of life care

Unreasonable optimism among physicians negatively impacts patients’ end of life care- often influencing the terminally ill to accept more aggressive, costly treatments with little chance of effectiveness.

Haider Javed Warraich, a resident of internal medicine at the Beth Israel Deaconess Medical Center, recounts his optimism when he first met a woman suffering from heart failure and a condition preventing blood from flowing out of her heart.

“While learning her medical history, I also got to know her,” Warraich writes. His patient was a 50 year-old former artist, derailed by addiction. “At this point, she wasn’t a suitable candidate for heart surgery. But I felt there was still hope,” he recounts in The New York Times Sunday Review.

With perseverance, Warraich convinced his colleagues to order a procedure called alcohol septal ablation. Though the procedure could potentially reduce her symptoms, it came with many risks. His patient died the next day, after a complete heart block and aggressive attempts to revive her.

Warraich explains that he was victim of “irrational optimism, a condition running rampant in both doctors and patients, particularly in end of life care.” These physicians may push for costly and more aggressive treatments as a last resort, even when there is little hope of recovery.

As a study published in 2000 for the British Medical Journal shows, about two-thirds of doctors overestimate the survival of terminally ill patients. ”Doctors are inaccurate in their prognoses for terminally ill patients and the error is systematically optimistic,” concluded the researchers, headed by Nicholas A. Christakis, then of the University of Chicago.

Many times, those poor estimates are never fully communicated to the patient. A 2001 study of cancer patients published in the Annals of Internal Medicine found that physicians only told patients their estimated survival 37 percent of the time. No estimate was given 23 percent of the time. “Around 70 percent of the discrepant estimates were overly optimistic,” Warraich notes.

A 2012 study published in the Journal of Clinical Oncology found that cancer patients who talk with their physicians about how they want to die are less likely to opt for aggressive end of life treatments in the last two weeks of life, and they have much more comfortable deaths.

“Aggressive care at the end of life for individual patients isn’t necessarily bad, it’s just that most patients who recognize they’re dying don’t want to receive that kind of care,” said lead author Dr. Jennifer Mack of Harvard University Medical School.

Similarly, Warraich suggests more palliative care for patients unlikely to survive a serious illness. “Modern palliative care originated in response to the proliferation of new treatments and resuscitation technologies,” he writes. Palliative care not only provides more comfort alongside standard treatments, but it has been shown to help patients live a little longer.

More from Life Matters Media:

POLST form presented at Northwestern Memorial, a seminar from LMM co-founder Mary F. Mulcahy, M.D.

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Illinois POLST form released to public

In America, death is taboo

March 27, 2013

More male caregivers emerge as demographics shift

As millions of baby boomers enter retirement and as medical technology allows seniors to live longer than ever, more men are becoming caregivers for their loved ones, upending stigmas that caregiving is the work of women. As a 2012 Pew Research analysis on family caregiving shows, 45 percent of U.S. caregivers are now men.

The increase has been swift and substantial. Just about fifteen years ago, only some 19 percent of those looking after older or disabled family members were men, according to ABC News and the National Alliance for Caregiving.

“[I]ncreasingly men are being thrust into (or welcoming) the role of caregiver- for their children and/or aging parents- while working full-time jobs,” writes caregiving expert Alexis Abramson for The Huffington Post.

Cultural changes about what constitutes masculine and feminine work also seem to be contributing to the rise in male caregivers.

According to analysis from Leann Reynolds, a contributor to the Good Men Project, “Such an increase in the proportion of male caregivers can be explained by a combination of social and demographic changes,” such as the greater geographic separation of family members, smaller families and shifting gender roles.

As Richard Nix, executive vice president of Aging Care, told ABC News, ”It’s OK for men to cry now.”

Workplace discrimination

Still, some male caregivers face discrimination from the workplace for their time spent caregiving. According to Abramson, male caregivers may “unfortunately face a tougher time than women from employers who are used to caregivers being, well, women!”

She writes how male caregivers are more likely to be victims of “caregiver stigma,” as caregiving is associated with feminine traits, that she insists, are not yet valued in the workplace. ”Sadly a man who requests time off to take his elderly mother to a doctor’s appointment might just as well be announcing plans to attend a retreat ‘to get in touch with his feminine side,’ ” Abramson writes.

Similarly, Fortune and CNN Money report that the growing number of men taking on caregiving roles has contributed to the overall spike in employee discrimination claims, analysis confirmed by the Equal Employment Opportunity Commission.

“Employers are often more relaxed in applying blatant sexual discrimination against male caregivers,” Elizabeth Grossman, an attorney in the EEOC New York district, told Fortune. “When invoking parental leave, some supervisors might say ‘Oh no, that’s for women.’ There are some pretty entrenched stereotypes.”

The Center for WorkLife Law reports how one man was told by supervisors he would be “cutting his own throat” if he took time off to care for his sick father.

From 2006 to 2010, 147 family responsibility discrimination cases brought by male plaintiffs were decided in court, according to data from WorkLife. Fortune estimates this data reflects a 300 percent increase compared to the number of such decisions from 2001 to 2005.

Learn more from the Life Matters Media Newswire:

As Americans live longer, organ donations suffer

Find out what goes on within your local hospital

GSN’s David Goldhill: “American health care killed my father”

March 22, 2013

As Americans live longer, organ donations suffer

As Americans are living longer than ever, many elderly would-be organ donors are unable to donate upon their death, according to analysis from executives of Gift of Hope, an organ donation organization in Illinois.

As Gift of Hope does not accept organs from those older than 85, with certain cancers, HIV or hepatitis B, many in need of multiple organs are struggling to get them. Although the number of living donors has remained steady over time, the number of donors actually able to donate is shrinking. Therefore, an average 65-year-old in need of a liver and kidney waits much longer for those organs.

“What we’re seeing is more people becoming sicker and getting less health care,” Eric Price, a donation specialist with Gift of Hope told LMM. “Because there is a static number of people donating, there are less organs coming from them.” Price also noted an increase in diabetes and cancer in would-be donors.

The biggest obstacle donation specialists face is finding the best time to request organs from grieving families. Specialists typically make this inquiry in the delicate moments before or after a potential donor’s death.

“There is no good time to ask this question,” Price said. “Families don’t want us coming to them in the hospital asking for their loved one’s organs.” But hospitals have an obligation to notify Gift of Hope of every pending death within a facility, or the institution risks losing Medicare reimbursements. If the individual on the verge of death meets the specifications of Gift of Hope, a donation specialist heads to the hospital immediately.

Sometimes, families are reluctant to donate because they hold out hope for a recovery, Price said. Poor doctor-family communication is another reason why more are not organ donors. “So many doctors do a horrible job of explaining death to families in general, but especially brain death,” Price explained. “I’ve been yelled at and even swung at once when speaking to a family about donating their loved one’s organs.”

A sense of urgency pervades organizations like Gift of Hope. There exists a small time period in which vital organs can be harvested, because they require oxygen and nutrients to survive. It is also difficult to find donors, as only two percent of deaths are eligible for donation. An eligible donor must have died a “brain death” within a hospital (like from a stroke) or the patient’s family has decided to withdraw life-saving support.

Deaths in hospice facilities or at home do not qualify, because organs cannot be harvested if not ventilated properly.

Meanwhile, the transplant waiting list keeps growing. A patient awaiting a kidney transplant in Illinois typically receives one after about five years. There are more than 5,000 people waiting for organs in Illinois. Nationally, that number is more than 100,000.

Gift of Hope executives acknowledge the emotional nature of their work and urge families to think of the positives of organ donation.

“After a family donates, we keep in touch with them,” said Karen Cameron, the Clinical Training Coordinator at Gift of Hope. They connect willing organ recipients and the donor’s family “to help show them the impact of their gift.”

More than five million people have signed up to be donors in Illinois, and more than 70 percent of those whom Gift of Hope approach agree to donation.

Learn more from the Life Matters Media Newswire:

Find out what goes on within your local hospital

GSN’s David Goldhill: “American health care killed my father”

Don Berwick on the ‘rhetorical nonsense’ of ‘death panels’: An interview with LMM

March 19, 2013

GSN’s David Goldhill: “American health care killed my father”

Game Show Network President David Goldhill says it was the American health care system that killed his father, not the pneumonia for which he sought treatment at a New York City hospital. He addressed the need for health care overhaul at last weekend’s Association of Health Care Journalists conference in Boston.

Goldhill’s newly released book, Catastrophic Care: How American Health Care Killed My Father- and How We Can Fix It, outlines his helplessness in watching his father acquire a hospital-borne infection and subsequent five-week stay in the ICU. Goldhill argues his death, at 83, was entirely preventable and all too painful for both his father and family.

“If you’ve had a loved one die in the hospital, you’ve likely seen someone tortured to death,” Goldhill said to room filled with journalists. His argument is based in his belief that the health care industry fails to adopt cost-saving, life-saving ideas because the incentives in the business are “fundamentally broken.”

Americans, Goldhill argued, have learned to accept medical mistakes as inevitable, whereas in the restaurant industry, eateries can be shut down after one meal served tainted with something suspicious- often of dubious origin.

“In hospitals, we took the most personal, heterogeneous, important service and we have made it impossible- impossibly expensive, impossibly complex and completely lacking in accountability,” Goldhill said.

His father’s death was one of more than 200,000 each year due to medical error, and his gargantuan medical bill was covered by Medicare. One of Goldhill’s many sources of anger is how a failing product- the health care delivered to his father- could be compensated in full. He writes that high costs, over treatment, bad service and error are the inevitable consequences of an insurance-based system.

Americans typically have more coverage than they need at any one point, and Goldhill cited one of his 23-year-old full-time employees. If she marries, has two children, and her income grows annually at 3 percent, that woman will pour $1.8 million into the health care system- more than her family will likely ever use.

“It’s time to hold this industry accountable to standards of service, quality, consistency and value, and then it will start to change.”

Goldhill said the average healthy senior spends $5,500 each year on health care. “The amount of health care (seniors) are getting is genuinely frightening,” he said.

It is estimated that ten percent of the American population assumes 70 percent of the care, and Goldhill used this statistic to bolster his claim that “we define the whole system on the basis of the most extreme cases.”

How can the health care system change?

Goldhill argued that the Affordable Care Act will not fix the problem. National insurance does have a role, but for catastrophic events only. In other cases, individuals should use health care savings accounts to pay for other things, like routine exams or management of chronic conditions. Goldhill acknowledged such a change will take some time, likely two generations, and will only come about if prices come down.

Prices would drop, he said, if the industry would reorganize itself to serve consumer needs. This reorganization would happen if resources that currently pay for non-catastrophic events transfer to health savings accounts.

As an example, Goldhill cited the development of the personal computer. In its advent, the computer was one of the most expensive products for sale. It’s initial $18,000 cost translates today to roughly $200,000. “If someone had said to you back then that within a few decades, we would have one in every pocket, it would have been an argument for greater spending in mental health,” an amused Goldhill said.

But it happened. Why? “We created billionaires out of people that have figured out how to make them simple, accessible and cheap,” Goldhill answered.

The same, he said, could be true for health care.

“It’s time to hold this industry accountable to standards of service, quality, consistency and value, and then it will start to change.”

-Randi Belisomo

Learn more from the Life Matters Media Newswire:

Don Berwick on the ‘rhetorical nonsense’ of ‘death panels’: an interview with LMM

Geriatrician shortage unlikely to be remedied

What is your ‘Medical Mindset?’: Dr. Groopman suggests you define it

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