Because the events in Connecticut are still so raw in all of our minds and hearts, I’ve hesitated to undertake this topic until now.  Having taught over 2000 students during the first ten years of my professional life, I was exposed to a small percentage of individuals with behavioral health challenges.   I taught some kids who were barely able to function in society, and some who were bipolar and/or schizophrenic, including at least three who evolved into sociopaths and murderers.

As a hospital administrator, I’ve never forgotten this phone call:  “My husband has stopped taking his lithium and the last time he did that, he came after his closest friend.  That would be you.  I’m leaving him, but you need to be careful.”

I’m also familiar with this quote, “If you take five prescription medications there is a 100 percent chance they will interact with each other; we just don’t know what that interaction will be.”   So, is the pharmaceutical industry complicit in this issue as well? Quite possibly.

Back in the eighties, much of the inpatient mental health system all but vanished in this country, and today behavioral health challenges continue to carry a stigma that is not only tenuous but also very detrimental to the well being of not only those challenged individuals but for all of us.  So, yes, behavioral health issues have clearly been a part of each of these attacks. And is that an easy fix?  I think not.  I believe the stigma associated with mental illness is a huge problem, and even if we seek help, it is many times not available.

Let’s discuss the third rail.  As a kid I grew up with guns and target shooting was one of my favorite family pastimes.   I can tell you that we never had a problem due to the fact that we owned those guns.  They were locked up; they were handled appropriately, and they were used for what they were intended.

However, when you see facts like:  There have been 62 gun-related mass murder attacks across this country since 1982, or that approximately 50 million people own about 250,000,000 guns in the U.S., you have to wonder about connectivity to this issue.

The chief medical examiner has said the ammunition was the type designed to  break up inside a victim’s body and inflict the maximum amount of damage,  tearing apart bone and tissue.  So what about gun control?   Do I believe that semiautomatic weapons, armor piercing bullets, extended clips, et al., contribute to the ease of access for these mass murderers? Yes, I do.  I would love to see controls regarding the above mentioned killing devices, but I do not believe this is the only solution.  Should people be permitted to own guns?  Yes.

Is part of the problem because we have created such vicious and mind-numbing video games that glorify showing brain fragments, blood and body parts flying everywhere when the player makes a direct hit with his faux automatic weapon?  Have the countless violent television shows and movies made us numb?   Is the breakdown of the family unit a contributing factor?  In my opinion, the answer is yes to all.

We have also become a uniquely isolated civilization where neighbors don’t know or recognize neighbors.  We walk around with our heads down and our earphones tucked neatly into our ears making sure we have no eye contact.  This isolation also might be a component in this complicated stew of contributing factors. There is no easy solution.  I would hate to see our schools and colleges become modified prisons.  I would hate to see our lives become self-imposed solitary confinement chambers, but clearly excessive access to kill-type weapons, inadequate access to behavioral health treatment, lack of understanding of drug interactions, and excessive exposure to violence seem to have created the perfect storm.

During this holiday season and throughout the year, we need to hold each other and love each other more than ever before.  That’s one thing that we surely do need, lots more love, understanding and appreciation of our common humanness.

So, when Gate Keeping, Patient Education, Discharge Planning and Safe, Timely Hand-offs are NOT ENOUGH what do you do to limit re-admissions prior to 30 days after discharge?   What are you doing to improve your patient and employee satisfaction scores?   Are you doing this through lay-offs, cut backs, hiring only independent contractors, short staffing nursing, and fighting transparency, employee empowerment, and the creation of a nurturing environment?

Medicare will engage in real clinical transparency, insisting on the publication of real-time information about infections and other important aspects of quality and safety as one of its conditions for participation.  How will you deal with these issues?

It was NOT THAT LONG AGO when capitated managed care was lashing at the shores of the medical complex in these United States, and the push back, lack of sensitivity to the real issues and a lack of desire to change created a rush to merge and a fear of change.

What is it going to take to enlighten our internal healthcare leadership so as to allow them to see the forest and the TREES?

A few months ago, I presented a picture of what adding Integrative Medicine modalities could and would do for a health system that was slated to be short changed tens of millions of dollars due to mediocre HCHAPS scores.  When the CEO saw the numbers involved in treating about 40,000 patients a year in both inpatient and outpatient settings with gentle, nurturing attention, he sat back, smiled and said,”All of the salaries of all of those employees amount to the cost of about ONE readmission.”

Did you read that?

What differentiates your facilities from every other facility?  Better equipment?  Better doctors?  Better care?  Is the public educated enough to understand the nuances between a 48 slice and a 128 slice CT?  Does the public understand what the alphabet soup of letters represents after your employees names?  Nope, no, they do not not.  What they hope is that you have good equipment and good people, but what they know is HOW THEY ARE BEING TREATED AS HUMAN BEINGS.

Believe me, if your patients still have to “leave their diginty at the door,” to survive in your healthcare facility, there’s a good chance that you will be consumed by another organization in the not too distant future.

What is Integrative Medicine?

Integrative Medicine — the practice of medicine that reaffirms the importance of the relationship between the practitioner and the patient, focuses on the use of all appropriate therapeutic approaches, healthcare professionals and disciplines to achieve optimal health and healing.

Holistic Medicine — medical care that views physical and mental and spiritual aspects of life as closely interconnected and equally important approaches to treatment of the whole person.

Why not?  It is evidence based.  It produces amazing outcomes and helps significantly cut back on re-admissions.   It treats people with dignity.  It reaches areas that traditional medicine may never reach, and it is INEXPENSIVE.  Offer it to your patients and to your employees.  Many of the top facilities IN THE WORLD are offering Integrative Holistic medicine as part of their treatment plans and so should you.