What has happened to Health Care?

Over the past few months, I have received more phone calls than ever before from physicians who work within corporate health care. They ‘want out’ of this health care model. They feel it is dehumanizing for both physicians and patients.

What happened to health care?
16 years ago I left corporate health care to create a health care system within which I could practice medicine authentically from a place of integrity. I felt the dissonance (in the corporate model) between the mission it espoused to serve and its behavior towards its patients and physicians.

Physicians were caught in the middle of this dissonance and were being feared into treating patients like commodities for revenue. Two decades ago, this behavior was subtle and did not pervade all health care systems. In the past decade, this has become the normal business framework within corporate health care. Physicians adapted to this approach at first, but over the past decade, the consequences of this approach have been harder to bear. Many have had enough. More than
ever, doctors are leaving corporate health care to practice medicine in the community again, to restore meaning to their work.

When I left corporate health care, I wanted to create a system where the business model served not only my vision of health care, but was restorative of its larger vision which had been cast aside by the corporate health care system. I wanted it to be scientifically and medically grounded, yet open to growth and learning, and above all, patient-centered.

What I envisioned were two intersecting circles. One circle represented my vision and mission, and the other the business model. I wanted these two aspects to relate to one another symbiotically, with synergy and resonance.

The health care practitioner in this model would serve its vision while remaining cognizant of the need to be a healthy, sustainable, and cost effective business. It needed to be environmentally friendly and committed to creating minimal waste. [Health care is one of the largest generators of environmental waste in our country]. It would be committed to promoting health in the community. The standard of practice would be of the highest caliber and its patients and clients would be served with expertise balanced with love and compassion.

In this manner, the model I envisioned could bring meaning to both the practitioner and patient, and restore the soul of health care. This model’s success would be
reflected in a change in the health of the community served. One of the markers of this would be a rise in the health food market within the surrounding communities demanded by conscious consumers who desire organic food and options for a healthy lifestyle.

What I realized nearly two decades ago was that the mission of corporate health care and its business model were worlds apart. The separation between the two has only grown wider in recent years. Physicians are courted to join the corporate system, but soon discover that what they are serving is a model run by a ‘profit at any cost’ mission.

Administrators fear physicians into herding patients through their day to increase profit margin while compromising quality of care. The mission of health care administrators (profit) is far removed from the mission of medicine (healing).

This results in a continued loss of meaning for both physicians and patients. The current corporate model is not symbiotic, collaborative, or sustainable. In fact, it is opportunistic. When cells in the body stop collaborating and become opportunistic, we call this ‘cancer’. Corporate health care today resembles the cancer cell in its behavior towards both physicians and patients. It has lost its way.

Years ago when I left corporate health care, I was shamed by administrators who told me I was not a ‘team player’. I did not ‘tow the party line’. Even my colleagues questioned my lack of loyalty to the system to which they had adapted. I refused to adapt to the corporate practices that came between me and the mission of medicine. My conscience would not allow it. After creating The Ommani Center, I practiced alone with no collegial support for well over a decade. I directed my energy towards creating a compassionate yet scientifically grounded health care model based on integrity that embodied a synergy between my vision of health care, its business model, and the essence of Medicine. I wanted it to restore the ‘soul’ of Medicine while honoring the scientific method. This was the only way it could keep patients safe.

Now, 14 years later, my vision and hard work is bearing fruit. Our community has more health food stores, earth based,and organic food than ever before. Fitness centers are plentiful. Even the standard grocery stores have organic choices.

The consumer has awoken to the power of ‘food as medicine’ and has experienced a restoration of health and well-being with lifestyle changes. More people are seeking to be educated in how to keep themselves healthy and empowered.

I am greatly encouraged by the movement underfoot. The consumer of health care and the physicians who are squeezed to perform for profit in corporate health care are waking up to the reality of its shadow. It is only by making its shadow conscious can we transform a system.

As we continue to shine the light on corporate health care’s shadow, it will be forced to transform. My hope and dream is that we emerge on a large scale from this with a healthier and more integrative model of health care, one that honors patients, physicians, and also engages a healthy and sustainable business model.

The Ommani Center has proven that this model is a successful as well as a viable solution to the crisis in health care.

The Ommani Center – A New Model for Healthcare

Rachel Remen M.D. is a physician and mentor who inspired me 23 years ago. An article about her current work, Medicine’s Search for Meaning was recently published in The New York Times. It made me reflect on where I started as a young physician, and where I have arrived today as a physician who holds a vision of a healed health care system in my heart. I was a fledgling 3rd year resident in Internal Medicine at Stanford when I attended the talk that Rachel gave on ‘patient-centered’ medicine. I sat on the steps in the auditorium, listened to her and wept. My heart has remained open wide since that day at Stanford and I have pursued a path of LOVE and DEVOTION for my patients and it has been my hope for health care ever since.

As stories of entrepreneurs go, mine has been lined with challenges as well as immense creativity. I weaved in and out of corporate medicine after residency and left it forever in 1998 when I was told that “wellness is a conflict of interest for health care” and “preventive medicine does not generate hospital dollars”.
I suddenly realized that the business model that corporate health care serves is exclusively a financial one. The dollar is what is served, not health, healing or patient care. Physicians are merely assembly line workers who generate money for the health care systems quarterly profits. My heart continually breaks for my colleagues who work in a corporate model that serves administrators and policies, not patients.

Let me tell you something about what a doctor’s heart is like. As I talk about mine, I can assure you that many doctors entered their profession with similar stories and experiences and were seeking the grace in their work that fulfilled their passion to heal.

When I was little, I remember the first inklings of how I knew I wanted to serve in this capacity. When I was around people, I felt a deep ache in my heart. I didn't understand what this was for a long time. I knew I was always searching for why people got sick and how they could get well. I think I came into the world this way in addition to being raised around the scientific inquiry of my parents who are brilliant scientists. Because I loved science so much, I voraciously read everything I could get my hands on to help guide my understanding. Nothing was as fulfilling for my soul as seeking answers to difficult questions. I knew I had to spend every day of my life in this numinous place. Going to medical school felt like a natural extension of my passion for learning within the healing model available in our society. To be immersed in it and to be able to feel the joy that accompanied complicated problem solving was nothing short of bliss. When I was on the wards during my clinical rotations, that old familiar ache in my heart from childhood resurfaced. I now recognized it as LOVE. This strong and deep feeling, this ache, this love that I discovered I had for my patients has never stopped flowing.

I feel privileged and honored every time I am with them, ever since the first patient I ever saw. She privileged me as a medical student, to study her condition and honored me with her patience during my very green inquiry. Since that very first day, my patients have made it possible for me to explore answers with them. The closest I came to this with colleagues was with nurses during night shifts on call. I watched their dedication and devotion – a Florence Nightingale energy that held their patients in their hearts embrace. I followed them on the wards to learn how to balance intellect with love and to this day, owe my deep learning to them. They
mentored me on how to hold space and how to stay real in times that were stressful, during life and death, illness and health.

When Rachel Remen spoke of patient-centered care in her talk at Stanford, I was just getting ready to graduate from residency and enter my medical destiny track. That day, was the beginning of the rest of my career. It was as if it all came together inside of me and I received an ‘initiation’ of sorts into practicing medicine to honor the soul of my sacred vocation.

After I completed my training, I worked in corporate health care. No such feeling was present in that system. The numinous was unreachable. In fact, if my patients needed time and attention, I was penalized. I soon realized that I was now a worker on the assembly line, towing the party line and making money for administration that served the dollar, not the soul of medicine. After 7 years of experiencing this heartless model, I left it forever. Without a degree in business or any experience in running a medical practice, I took a leap of faith and designed The Ommani Center for Integrative Medicine – a place where I could practice medicine from that same sacred place that unfolded my path through medical school and residency, initiating me in this sacred vocation of science and healing.

Today, my intention for creating this Center permeates its presence. Despite my lack of confidence in running a business, I discovered that in addition to loving it, I was also a fierce advocate for patients. The Ommani Center was born as an answer to what I felt is missing in health care- my love for my patients and for being able to practice with heart and meaning without compromising the scientific method or patient safety.
The Ommani Center is a unique health care model. I created it with a mindset for sustainability, both from a financial and environmental context. The architecture was designed to give the feeling of ‘flow’. The paint used on the walls, the water and teas served, cleaning products and even the soap we use to wash hands and cotton gowns are all environmentally friendly. We recycle everything we can and are fiscally responsible in how we manage overhead and even where we refer patients for lab and diagnostic tests. I believe that we all have a responsibility to keep health care costs down. It takes extra work, time and energy for all. On my end, I pay extra to have my medical assistants enter lab and diagnostic data (into electronic medical records) performed at labs that cost my patients significantly less compared to hospital based tests. I would rather pay the $6000 – 7000 per year for staff time to save hundreds of thousands in health care costs. We must all do our part to transform health care. We cannot underestimate the power of one.

As a physician, I knew I would be sacrificing financial security to do what felt ethically correct for me. My moral compass came at a financial price. As a response to this, I shifted from a profit mindset to a sustainability one. The Ommani Center's sustainable business model has proven to be solid for more than a decade. Since 2001, it has sat gently on the earth, served patients with heart and meaning and kept its carbon footprint light.

Meanwhile, my colleagues in corporate health care, struggle to adapt to endless policies that micromanage them and restrictions that make it nearly impossible for them to practice from heart. Corporate health care is an experiment gone awry. In my least optimistic moments, I gain solace in knowing that The Ommani Center, a sacred health care model that stands in the heart of Pewaukee,Wisconsin is poised to be replicated in communities across America where patients and physicians are hungry to access sustainable, cost and therapeutically effective health care. This is my contribution to restoring the soul of medicine and for bringing meaning back into physicians’ lives who have sacrificed so much to heal others and are less than able to in the corporate system today.

When I see them working under emotionally abusive conditions in the current system, I feel an unbearable pain in my heart. I want them to know that it is now possible to practice with heart and soul and to serve patients rather than policies and administrators. The Ommani Center is like a lighthouse for health care. As it grows and expands in the near future, it will become a haven for physicians looking to restore their souls and reclaim their hearts as they follow the golden thread of their purpose for choosing their sacred craft.
I have come a long way since that threshold day on the steps of the Stanford auditorium. The vision in my heart that was ignited there continues to burn bright and is brighter each day as my beloved patients add their light to it.

Let us create the new model for health care together. Let us all remain true to its sacred purpose and mission so we can finally gain access to health and healing.

http://opinionator.blogs.nytimes.com/2013/09/18/medicines-search-for-meaning/?smid=fb-share&_r=1