Monday, July 6, 2015
People, Homo sapiens, in their current anatomic form, have wandered this planet for around 150,000 years. 93 Billion of us have been born, lived a while, and died. The era of “Modern Medicine” represents about 0.05% of human history and represents the context within which most people currently complete their lives. During this era we have extended our life spans through the application of beneficial medical technologies and improved the quality of living for many of us.
But have we improved the quality of our dying? Has the “medicalization” of aging and death relieved suffering or has it actually made it worse? Some would argue that in all of human history, people have never suffered as much as they do now as they complete their lives. In the past, people lived their lives exposed to the realities of birth, illness, and death. When they faced their own, they were cared for by family, community, and with healers that brought whatever tools they had to soothe, heal, and honor them in their passing.
We continue in the tradition of healers, functioning in a modern context using the tools at our disposal to soothe, heal, and honor. The modern tools and technology are as dazzling and imperfect to us as their tools were to our predecessors. In palliative medicine and hospice care we tend to use simple technologies to advance exactly the same goals while trusting the impact of personal engagement in the same way our forbearers did.
Topic 1: How has the “medicalization” of care for the very ill worsened/improved the quality of dying for human beings?
The economic and regulatory models, as well as the resulting documentation requirements have an enormous impact on the experience of people with illness and their families, not to mention the experience of those of us working in the field. Changes are underway that will radically alter the incentive structures that currently reward doing more TO people rather than FOR them. Value based payment models will align the payers and providers to share risk and savings to deliver on person-centered goals.
Topic 2: How can emerging payment models and future medical records serve to advance/obstruct the well being of people approaching death?
At ResolutionCare, we have taken off-the-shelf videoconferencing technology and applied it to the challenges of providing community based specialty palliative care and improving primary palliative care in rural Northern California. Our current solutions revealed themselves only when we got clear about our view of the soul of caring, then scanned our current environment for tools that would help us restore what had been lost.
Topic 3: What characterizes the soul of caring for you and your teams? What’s in the way?
The infrastructure of society is being transformed at dizzying velocity with information and communication technology. Global Community is no longer an abstraction; it’s a reality. Vast stores of information and artificial intelligence may free the human mind to from obsession with knowledge to its artful use.
Topic 4: If we don’t have to “know everything”, what does it mean to provide care and facilitate healing for people completing their lives?
Michael D. Fratkin is a father, husband, brother, son, and physician. He is the founder and director of Resolution Care, which brings Palliative Medicine to the community using the reach of technology coupled with a spirit of compassion.
What: #hpm chat on Twitter
When: Wed July 8, 2015 - 9p ET/ 6p PT
Host: Dr. Michael Fratkin (@ResolutionCare)
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