Princess Health andAuthors of The Great Diabetes Epidemic will talk on KET about its causes, myths, complications, treatment and prevention.Princessiccia

Princess Health andAuthors of The Great Diabetes Epidemic will talk on KET about its causes, myths, complications, treatment and prevention.Princessiccia

blindness books diabetes prevention television vision

Gusty 16:56 Add Comment

Kentucky Health News

The message that the authors of The Great Diabetes Epidemic: A Manifesto for Control and Prevention want readers to take from their book is that "diabetes is a serious, but preventable disease, if proper early interventions are implemented through a community-based, public health approach," KET says in a press release.

Authors Dr. Gilbert Friedell and J. Isaac Joyner will discuss this message with host Renee Shaw, and look at the root causes of the high number of diabetes cases in the U.S. and what needs to be done about it, on "Connections with Renee Shaw" on KET2 Friday, March 27 at 5 p.m. ET and on KET Sunday, March 29 at 1:30 p.m. ET.

Other topics discussed include common misconceptions and barriers to treatment, belief systems around diabetes that aren't based on fact, and the significant health ramifications of the disease, including complications such as blindness, amputations and renal failure.

"In Kentucky alone, for example, there are 72,000 diabetes-related cases of blindness and visual impairment diagnosed each year � roughly 200 per day," KET notes.

Princess Health andHealth reform law drives a trend to include lifestyle changes in a patient's health care plan, alongside traditional medicine.Princessiccia

Princess Health andHealth reform law drives a trend to include lifestyle changes in a patient's health care plan, alongside traditional medicine.Princessiccia

health care Patient Protection and Affordable Care Act prevention

Gusty 16:23 Add Comment

Lifestyle changes can play a huge role in treating and warding off many health conditions and thanks to the Patient Protection and Affordable Care Act there is now a shift to include helping people make these changes part of their health care plan, Laura Ungar reports for The Courier-Journal and USA Today.

In the first of an occasional series called "HealthVoices" that focuses on "areas where policy, public health and people intersect," Ungar tells the story of Kevin French, who self-describes himself as "the quintessential unhealthy Kentuckian" and how lifestyle changes have made a difference in his health.

French tells Ungar that with the help of medical professionals and The KentuckyOne Healthy Lifestyle Center in Louisville he has "learned how to eat well, handle stress, exercise and "basically change everything."

"My medicine usage has declined somewhat. I'm still on medicines but not the dramatic type like I was. Some of them's been cut in half," French told Ungar. "Several costs of medicines have declined dramatically."

The center provides "medically supervised exercise, nutrition counseling, stress management and classes in disciplines such as yoga" and is the third such facility the medical system has opened in Louisville, Ungar writes.

Experts say that the ACA is driving this "colossal shift" in health care away from the "traditional reliance on pills and procedures by patients as well as the American medical system," Ungar writes, but she also notes that the patient must also make a commitment to these lifestyle changes if it is to work, as French has.

A cardiologist at the center, Paul Rogers, told Ungar about the importance of lifestyle changes, especially exercise. in warding off cardiovascular disease, one of the state's biggest killers.

"Compared to even the best medical therapy, we can decrease heart attacks, strokes and deaths by between 35 and 45 percent by changing lifestyle. The thing I see that holds people back most probably is effort and fear," Rogers told Ungar. "The recommendations these days are 30 minutes of�aerobic activity six times a week. I think if people started devoting themselves to that, that would change the health of our state dramatically."

Princess Health and ZUMBA� Welcome Offer. Princessiccia

Princess Health and ZUMBA� Welcome Offer. Princessiccia

Gusty 15:01 Add Comment

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Princess Health andAt roundtable on food and agriculture, Prince Charles says we need to reconnect with the food system and nature, keep stock.Princessiccia

Princess Health andAt roundtable on food and agriculture, Prince Charles says we need to reconnect with the food system and nature, keep stock.Princessiccia

agriculture food local food nutrition

Gusty 07:47 Add Comment

Prince Charles "called for urgent restructuring of local and global economies to save humanity from itself" in a whirlwind visit to Louisville on Friday, James Bruggers reports for The Courier-Journal.

In addition to a speech at the Cathedral of the Assumption, the heir to the British throne briefly participated in a roundtable on health and the environment and a similar gathering about food and agriculture, at which he said people need to become "intimately acquainted again with the food system and nature," as The Courier-Journal put it.

"I am very keen on connecting people to school gardens," he said, "and encouraging them to keep their own chickens and the occasional pig." Here's The C-J's raw video from the roundtable:

Princess Health andEarth can't afford to keep supporting our consumerist society as it now exists, Prince Charles tells Louisville audience.Princessiccia

Princess Health andEarth can't afford to keep supporting our consumerist society as it now exists, Prince Charles tells Louisville audience.Princessiccia

Gusty 18:13 Add Comment

Kentucky Health News

Transcript of The Prince of Wales�s speech at the Cathedral of the Assumption, Louisville, following an introduction by Wendell Berry (subheads added)

Ladies and gentlemen, it has been an immense pleasure to spend our last day in the United States here in Louisville, guided by a very special lady. Christy Brown, if I may say so, is one of the most remarkable people I have come across; a true force of nature, with an unbounded enthusiasm to bring people together across a whole range of important issues, and with the determined tenacity to make things happen. I know from my own experience, it is very hard to say "no" to Christy Brown! It was she who asked me to articulate the principles of harmony which I have long believed to lie at the heart of how we respond to the immense challenges and dangers facing humanity. So I can only hope you are all prepared to put up with such articulation.

I must say, it is also very special to have been introduced by such a great advocate of harmony, Wendell Berry, who I am incredibly touched said those wonderful words about me. He is a very special son of Kentucky. I only wish I had time to visit his farm. I will now embarrass him by telling you that he has long been a hero of mine. I remember him once describing his farm here in Kentucky. Half of it, he said, sits at the top of a hill and the other half at the bottom, which, as he put it, "is what you call a learning situation�"

Now, to return to Christy's request: In the 1960�s, as I remember so well, a frenzy of change swept the world in the wave of post-war �Modernism.� There was an eagerness to embark upon a new age of radical experimentation in every area of human experience which caused many traditional ideas to be discarded in a fit of uncontrollable enthusiasm � ideas that will always be of timeless value for every generation confronting the actual realities of life on this Earth. I remember it only too well � and even as a teenager I felt deeply about what seemed to me a dangerously short-sighted approach, whether in terms of the built or natural environment, agriculture, healthcare or education. In all cases we were losing something of vital importance � we were disconnecting ourselves from the wealth of traditional knowledge that had guided countless generations to understand the significance of Nature�s processes and cyclical economy. It always seemed to me that in this period of change some subtle balance was being tragically lost, without which we would find ourselves in an increasingly difficult and exposed position. As, indeed, we have.

I have been trying to point out ever since where I feel the balance needs righting and where some of the discarded, but timeless principles of operating need to be reintroduced in order to create a more integrated approach. It has turned out to be a peculiarly hazardous pastime. But I have come to the inescapable conclusion that the legacy of Modernism in our so-called post-Modern age has brought us to a crucial moment in history; prompting a lot of uncomfortable questions.

The first question I want to ask is how we have landed ourselves and the rest of the world in the mess that it now struggles to overcome? We have more than enough scientific evidence that proves this to be so. But what is it that drives us on to exacerbate the problems? Why do we tip the balance of the Earth�s delicate systems with yet more destruction, even though we know in our heart of hearts that in doing so we will most likely risk bringing everything down around us? In the thirty years or so that I have been attempting to understand and address the many related problems, I have tried to ask myself what it is in our general attitude to the world that is ultimately at fault? In doing so, of course, it must have appeared as though I was just flitting from one subject to another � from agriculture to architecture, from education to healthcare � but I was merely trying to point out where the imbalance was most acute; where the essential unity of things, as reflected in nature, was being dangerously fragmented and deconstructed.

The harmonious system of nature is collapsing

The question that should surely keep us all awake at nights is what happens if you go on deconstructing? I fear the answer is all too plain. We summon up more and more chaos. I have also spent a long time wondering that if we could identify the key fault, would it be possible to fix it? And if we could, what would that �fix� amount to in practical as well as philosophical terms? What worries me is that at the moment there is not a lot of attention given to the way we perceive the world. We take our mechanistic view of it for granted and believe that the language of scientific empiricism which so dominates our discussion is the only form of language we need to guide us. So let�s be clear � whereas the empirical view of the world makes observational deductions about the laws of nature, the philosophical deals with the meaning of things; and the religious concerns itself with the sacred presence in things. They each have a role to play.

The way in which empirical enquiry has developed to this position of dominance since the Enlightenment has certainly enabled us to improve the material realm of the human condition. But let us also recognize that this progress was only possible because of an earlier and crucial shift which took us away from a traditional sense of participation in nature to the claim of mastery and exploitation over the natural order that has reaped such a troubling and bitter harvest. That earlier shift, away from seeing ourselves within nature to us standing apart from it, gradually undermined what I have always felt, deep down, to be the true situation � that if we wish to maintain our civilizations, then we must look after the Earth and actively maintain its many intricate states of balance so that it achieves the necessary, active state of harmony which is the prerequisite for the health of everything in creation. In other words, that which sustains us must also itself be sustained.

But we are not keeping to our side of the bargain and, consequently, the sustainability of the entire harmonious system is collapsing � in failing the Earth we are failing humanity. We are standing at a moment of substantial transition where we face the dual challenges of a world view and an economic system that seem to have enormous shortcomings, together with an environmental crisis � including that of climate change � which threatens to engulf us all.

Of course, we have achieved extraordinary prosperity since the advent of the Industrial Revolution. People live longer, have access to universal education, better healthcare and the promise of pensions. We also have more leisure time; opportunities to travel � the list is endless. But on the debit side, we in the industrialized world have increased our consumption of the Earth�s resources in the last thirty years to such an extent that, as a result, our collective demands on nature�s capacity for renewal are being exceeded annually by some 25 per cent.

Back in the 1950�s and right up to the 1990�s it seemed credible to argue that the human will was the master of creation; that the only acceptable way of thinking was a mechanistic way of thinking; that the Earth�s natural resources were just that � resources � to be plundered because they were there for our use, without limit. But for all its achievements, our consumerist society comes at an enormous cost to the Earth and we must face up to the fact that the Earth cannot afford to support it.

Just as our banking sector has been struggling with its debts � and paradoxically also facing calls for a return to so-called �old-fashioned,� traditional banking � so nature�s life-support systems are failing to cope with the debts we have built up there too. If we don�t face up to this, then nature, the biggest bank of all, could go bust. And no amount of quantitative easing will revive it. It seems to me a self-evident truth that we cannot have any form of capitalism without capital. But we must remember that the ultimate source of all economic capital is nature�s capital. Our ability to adapt to the effects of climate change, and then perhaps even to reduce those effects, depends upon us adapting our pursuit of �unlimited� economic growth to that of �sustainable� economic growth. And that depends upon basing our approach on the fundamental resilience of our ecosystems. Ecosystem resilience leads to economic resilience. If we carry on destroying our marine and forest ecosystems as we are doing, then we will rob them of their natural resilience and so end up destroying our own.

We are not separate from nature

No matter how sophisticated our technology has become, the simple fact is that we are not separate from nature � like everything else, we are nature. The more you understand this fact the more you see how our mechanistic way of thinking causes such confusion. Modern agri-industry, for instance, may have made enormous strides to feed the burgeoning world�s population, but at a huge and unsustainable cost to ecosystems, through massive use of artificial fertilizers, herbicides, pesticides and water. It is a reductive approach to one issue that is patently not durable because it sustains nothing but its own decline, solving one problem by creating countless others.

This, of course, is not the way nature operates. In nature the entire system is a complex unfolding of inter-dependent, multi-faceted relationships and to understand them, we have to use �joined-up� thinking. The ancient Greek word for the process of joining things up was �harmonia.� So, �joined-up thinking� seeks to create harmony, which is a very specific state of affairs. In fact, it is the very prerequisite of health and well-being. Our bodies have to be in harmony if they are to be healthy, just as an entire ecosystem has to be. This is the way nature operates. Natural sciences like microbiology and botany tell us very clearly that every kind of organism, be it big or microscopic, is a complex system of interrelated and interdependent parts � which makes each organism a microcosm of its local environment; the very essence of it, in fact. The sum of these parts builds and maintains a coherence � an active, harmonic unity � with no waste. No one part operates either in isolation or beyond the limits set by the whole.

Facing the future, therefore, requires a shift from a reductive, mechanistic approach to one that is more balanced and integrated with nature�s complexity � one that recognizes not just the build-up of financial capital, but the equal importance of what we already have � environmental capital and, crucially, what I might best call �community capital.� That is, the networks of people and organizations, the post offices and bars, the churches and community halls, the mosques, temples and bazaars � the wealth that holds our communities together; that enriches people�s lives through mutual support, love, loyalty and identity.

Just as we have no way of accounting for the loss of the natural world, contemporary economics has no way of accounting for the loss of this community capital. This is why we need to ask ourselves whether the present form of globalization is entirely appropriate, given the circumstances confronting us. There are, clearly, benefits, but we need to ask whether it requires adaptation so that it also enables, as it were, globalization from the bottom up. This, after all, is the way nature operates! At the moment we operate under a form of globalization that tends to render down all the rich diversity of a culture into a uniform, homogenized mono-culture. This is where the Modernist paradigm needs to be called into question before the damage being done is irretrievable. �

One of the chief architects of our present economic model was Adam Smith. Interestingly, he was another who recognized that, although individual freedom is rooted in our impulse for self-reliance, it must be balanced by the limits imposed by natural law. As he prepared his book, The Theory of Moral Sentiments, he moved away from the notion that we are born with a moral sense and preferred the principle of there being a sympathy in all things. It is this sympathy that binds communities together. But there is little chance of such sympathy if what people need is provided through commercial structures that place an ever greater distance between the supplier and the consumer, because economies of scale can destroy the economics of localness. It has become, again, a purely mechanical process with no room for the complexity and multi-faceted dimensions of a proper local relationship between a community and the suppliers that serve it.

A balance between the market and society

Once again, there has to be a balance between the market on the one hand and society on the other, otherwise real problems occur. � This is why city-level policy to encourage healthy local food systems could scarcely be more important. It is a way to ensure a harmonious relationship between the city and its hinterland, fostering greater understanding and respect for the services that the rural environment and economy provide. It is also a means by which a circular economy can be generated where wastes become resources rather than pollution.

So, with that in mind, how could we better empower all sorts of communities to create a much more participative economic model that safeguards their identity, cohesion and diversity � one that makes a clear distinction between the maintenance of Nature�s capital reserves and the income it produces? That is the challenge we face, it seems to me � to see nature�s capital and her processes as the very basis of a new form of economics and to engage communities at the grass roots to put those processes first. If we can do that, then we have an approach that acts locally by thinking globally, just as nature does � all parts operating locally to establish the coherence of the whole.

Here in Louisville, for instance, I met with representatives of your major food and drink manufacturers, and also spent time with farmers and food producers at what, I would suggest, is a very significant idea � the creation of the Food Hub and the development of the area around that proposed site. Re-localizing your food systems and encouraging the many small and medium-sized farms that surround your city to consider how best to offer locally produced food would make a tremendous difference to the long term sustainability of your economy, especially if real attention was paid to the health of the soil. A long time ago it was President [Franklin] Roosevelt who gave a very prescient warning when he said - "a nation that destroys its soils destroys itself." So, of central importance will be how to reconcile our urban and rural development. The actions of leading cities like Louisville can provide a demonstration of what can be done that is of value not only to the United States, but also globally.

Likewise, as far as human health is concerned, I was alarmed to hear from your leading cardiologist here, Dr. Bhatnagar, just how directly the high rates of air pollution you struggle with are related to the high levels of cardiovascular disease. If you recognize that the quality of the air is not just an "environmental" issue, but a very serious economic issue, then you can see that the health of people directly affects the health of an economy. So perhaps, at the end of the day, it might be cheaper to join up the dots and put paid to the pollution, rather than pursue the more expensive option of encouraging people to take yet more pills to help their hearts?

So, having spent the day here in Louisville, I can only offer my warmest congratulations not only for what you have already achieved, but also what you are striving for in the future � a model of truly integrated and holistic thinking on a city scale and a beacon of inspiration for others to learn from � for instance, your work in helping build communities such as at the African American Heritage Centre, the boldness of the vision for the Food Hub project (why wouldn't we all want to shorten the links between consumer and producer?); the remarkable potential of a new discussion between the health insurance companies and your major food companies who, of course, would love to become more sustainable if only the financial climate allowed them.

Could this, then, be part of the solution to the problems we face? Could it be one that might give us hope, for we do still have within our societies and within our existing technologies the solutions that will enable us to transcend our current predicament. All we lack, perhaps, is the will to establish a more entire and connected perspective. There are many examples where communities have replaced the short-term impulse with the long-term plan. But part of that strategy � to my mind at least at the heart of it � is the need for a new public and private-sector partnership which includes NGO [non-governmental organizations] and community participation. It seems to me that for this to work we need to ensure that community and environmental capital is indeed put alongside the requirements of financial capital and that we also develop transparent means to measure the social and environmental impact of our actions.

We certainly need to refine our ability to measure what we do so that we become more aware of our responsibility. This validates the need for �accounting for sustainability,� which has since become known elsewhere as true-cost accounting � a method by which businesses can take proper account of the cost to the Earth of their products and services, and which I initiated and developed 11 years ago. It is encouraging that this approach is being tested by a range of companies, government departments and agencies, and I hope that it can be adopted more generally so that well-being and sustainability can be measured, rather than merely growth in consumption.

We also need, dare I say it, new forms of international collaboration to value ecosystem services. For instance, the world must recognize the absolutely vital utility that the rainforests provide by generating a real income for rainforest countries � where, incidentally, some 1.4 billion of the poorest people on Earth rely in some way on the rainforests for their livelihoods � an income which can be used to finance an integrated, low-carbon development model. Paradoxically, the answer to deforestation lies not solely or even mainly in the forestry sector, but rather in the agricultural and energy sectors.

It is also increasingly possible to enhance efficiency and economic rates of return by linking different sectors together in what are called �virtuous circles.� You can see this in the relationship between the waste, energy and water sectors where the waste product of one process becomes the raw material of another, thereby mimicking nature�s cyclical process of waste-free recycling.

Alternatives need to become mainstream

The trouble is, at the moment, so many of these brilliant ideas sit on the fringes of our economy. They are seen as �alternatives� when they need to become mainstream. But for this to happen and for such alternatives to be effective, it will require a system of long-term consistent and coherent financial incentives and disincentives; otherwise, how else will we achieve the urgent response we need to rectify the situation we face?

Another example of an alternative that needs to become mainstream, and which would enhance both community and environmental capital, lies in the way we plan, design and build our settlements. I have talked long and hard about this for what seems rather a long time � and look what it�s done to me! � but it is yet another case where a rediscovery of so-called �old fashioned,� traditional virtues can lead to the development of sustainable urbanism. This approach emphasizes the integration of mixed-use buildings and the use of local materials to create local identity which, when combined with cutting-edge developments in building technology, can enhance a sense of place and real community.

Our need for these solutions is going to grow exponentially as our global population rises and our ecological and economic crises deepen. Is this not a rationale for investing massively in these new and more integrated approaches which, thereby, could help to create the kind of �virtuous circles� based on environmental and community capital that I have mentioned this evening? Such investment would also, I can�t help thinking, have the added benefit of creating many new jobs.

But are we prepared to take such a step? As Mahatma Gandhi pointed out, �The difference between what we do and what we are capable of doing would suffice to solve most of the world�s problems.� The starting point is to see things differently from the current, dominant world view which in so many ways is no longer relevant to the situation in which we find ourselves. The worst course would be to continue with �business as usual� as this will only compound the problem. We must see that we are part of the natural order rather than isolated from it; to see that nature operates according to an organic �grammar� of harmony and which is infused with an awareness of its own being, making it anchored by consciousness. It is an interconnected, interdependent function of creation with harmony existing between all things.

We are, ladies and gentlemen, at an historic moment � because we face a future where there is a real prospect that if we fail the Earth, we fail humanity. And I don't know about all of you but, as a grandfather, I have no intention of failing my, or anyone else's, grandchildren.

Princess Health andAs part of Louisville visit, Prince Charles attends roundtable on health and the environment with health and environmental leaders.Princessiccia

Princess Health andAs part of Louisville visit, Prince Charles attends roundtable on health and the environment with health and environmental leaders.Princessiccia

built environment environment environmental health

Gusty 13:37 Add Comment

Press pool report by Al Cross, Kentucky Health News

His Royal Highness the Prince of Wales arrived at the foot of the Big Four Bridge, an old railroad bridge recently converted into a pedestrian bridge, at 3:07 p.m. He was accompanied by Louisville Mayor Greg Fischer and was greeted by U.S. Rep. John Yarmuth, D-Louisville. They ascended a stairway leading to the pedestrian ramp and had a discussion on the ramp. Your pool could hear only snatches of conversation, but it was clear that Fischer and Yarmuth were describing the bridge project, which links Louisville to Jeffersonville, Ind.

Dr. Elliott Antman, in sunglasses, speaks as Prince Charles and other participants listen

The group descended the ramp and entered a plastic-and-canvas tent, joining a health-and-environment roundtable that had been in progress for about an hour. The pool was present for introductory remarks by the mayor and by Dr. Elliott Antman, president of the American Heart Association, but there was no amplification and the pool was kept at such a distance that he could not be heard clearly, and we were shuffled out after just a few minutes. Through the opening and the clear plastic we could see that HRH was animatedly engaged in conversation with the participants.

Yarmuth said afterward that the conversation was �about how the health care system by itself, the medical system, is not the thing we should be concerned about in trying to be concerned about the general health and well-being of society,� but rather how to prevent people from entering that system, �and there are so many entities that have role� in doing that.

Gordon Garner, former director of the Metropolitan Sewer District and president of the Kentucky Waterways Alliance, said the broad message of the meeting was �the linkage to both the built and natural environment� when it comes to health. �The big message would be � the overwhelming need we have as a society to raise our level of stewardship .. that public awareness is way, way behind what the needs are. We�ve got to develop some kind of stewardship commitment that we currently don�t have.�

According to an email from Chuck Lambert of Humana Inc. to the participants, a copy of which your pool reporter obtained, following are the invited participants. It could not be confirmed whether all on the list were actually at the roundtable.

INVITEES to roundtable (other than Antman, mentioned above):

Dr. Aruni Bhatnagar, Ph.D., Institute of Molecular Cardiology, University of Louisville

Lt. Gen. Patricia Horoho, 43^rdU.S. Army Surgeon General

Meredith Barrett, vice president of science and research, Propeller Health

Dr. Alonzo Plough, vice president of research, evaluation and learning and chief science officer, Robert Wood Johnson Foundation

Dr. Sharmila Makhija, chair of ob/gyn and women�s health, Albert Einstein College of Medicine, The Bronx, N.Y. (formerly at U of L)

Tom FitzGerald, director, Kentucky Resources Council (Kentucky�s leading environmental lobbyist)

Dr. Ted Smith, executive director, Institute for Healthy Air, Water and Soil; and chief of civic innovation, Metro Louisville government

Peter Crane, dean, Yale School of Forestry and Environmental Studies

Mary Gwen wheeler, executive director, 55,000 Degrees (program aimed at expanding number of college graduates in Louisville)

Dr. James Sublett, president, American College of Allergy, Asthma and Immunology

Hugh Archer, executive director, Kentucky Natural Lands Trust

Barry Barker, executive director, Transit Authority of River City

Margaret �Peggy� Plympton, deputy chairman, National Endowment for the Humanities

Dr. Mahendra Sunkara, director, Conn Center for Renewable Energy Research, U of L

Burt Lauderdale, executive director, Kentuckians for the Commonwealth (environmental and social justice group)

Timothy (Tim) State, enterprise vice president, associate health and well-being, Humana Inc.

Barry Gottschalk, president and CEO, American Lung Association of the Midland States

David Tandy, president. Louisville Metro Council

Craig Anthony Arnold, chair, Center for Land Use and Environmental Responsibility, U of L

Dr Cary Sennett, president and CEO, Asthma and Allergy Foundation of America

OBSERVERS:

Charles �Chuck� Lambert, Humana VP and chair, Louisville Sustainability Council

David VanSIckle, cofounder and CEO, Propeller Health

Paul Tarini, senior program officer, Robert Wood Johnson Foundation

Ben Reno-Weber, director, Greater Louisvile Project

Tad Waddington, CEO, lasting Contribution Inc.

Gordon Garner, president, Kentucky Waterways Alliance

Andrew Smith, student

Stephanie Sido, aide-de-camp, Gen. Horoho

Robert Connolly, chair, Stites & Harbison law firm

Wes Jackson, president, The Land Institute

Deena Adams, development manager, American Lung Association in Kentucky

Dr. Rose Marie Robertson, chief science officer, American Heart Association

Dr. John Johnston, co-director, Norton Hospital Leatherman Spine Center

Princess Health and A $6.6 Million CEO Dreams of a "Doctor-Less" Future. Princessiccia

Princess Health and A $6.6 Million CEO Dreams of a "Doctor-Less" Future. Princessiccia

generic managers Jeffrey Romoff UPMC

Gusty 12:06 Add Comment

The CEO of giant hospital system UPMC, Mr Jeffrey Romoff, has been one of the best compensated CEOs of ostensibly non-profit hospital systems.  As we noted here, his 2013-14 compensation was $6.6 million.  UPMC has become so big and its top managers so rich that a former Mayor of the city of Pittsburgh sued the organization claiming it was not really not-for-profit (look here and here).  The leadership of UPMC has previously supplied us with some interesting examples of conflicts of interest (look here and here). 

The announcement of a new alliance of Pittsburgh organizations provided an interesting insight into the thinking for which such a CEO is paid the big bucks.  Leaders of three big organizations, UPMC, the University of Pittsburgh (with which UPMC is affiliated), and Carnegie-Mellon University announced an alliance to use "big data" in health care (see this article in the Pittsburgh Post-Gazette).

UPMC, the University of Pittsburgh and Carnegie Mellon University on Monday announced the formation of the Pittsburgh Health Data Alliance to 'revolutionize health care and wellness' by using data to detect potential outbreaks as well as create health care innovations that will spawn spinoff companies.

The clinical goal, the leaders of the three institutions said, is to remake health care so that it is at once more computerized, yet more personalized, using millions of gigabytes of accumulated health records to predict and treat patients� health issues in a manner far more specific than is possible today.

Big data now seems to be the latest rage in business schools and among the high-tech crowd, never mind the failures of fancy statistical modeling based on big data that helped lead to the global financial collapse of 2008.  Similarly, despite at least 30 years of research, multivariate prediction and diagnostic modeling in medicine has never lived up to its expectations.  Few models have been demonstrated to be better than mediocre predictors when tested in real-life clinical settings.  Finally, there are numerous concerns about privacy and data security when patients' data is being avidly traded back and forth.

The most striking talk in this meeting, however, was by UPMC CEO Jeffrey Romoff.  The Pittsburgh Post-Gazette noted,

Mr. Romoff said he envisioned 'doctor-less health care,' which is not to say there will be no doctors in the future, but they will be greatly aided by computerized diagnoses, by biometric data gathered on smartphones and transmitted in real time, and by a patient�s own genome. It could result in a new form of  'artificial intelligence,' he said.

The reporter, however, seemed to have edited Mr Romoff to take the edge off what he said.  A video of that part of the conference can be found, for the moment, here.  I transcribed, I believe accurately, Mr Romoff's three most relevant sentences.

The majority of healthcare that everybody receives will be accessible on their handheld device.

We will be thinking about 'doctor-less' healthcare.

We will in fact create an artificial intelligence better than the superb level of intelligence we now have among our physicians and our healthcare professionals.

So, in my humble opinion, it did not sound like Mr Romoff was just envisioning that physicians someday may actually have access to diagnostic or predictive models that are highly accurate for real patients.  He was envisioning replacing physicians with machines, with artificial intelligence. 

Again, never mind that despite years of work and billions of dollars, artificial intelligence so far has proved remarkably dumb.

So furthermore, in my humble opinion, this provided a glimpse into how health care managers now think.  Mr Romoff appears to be a generic manager.  He is not a health care professional, and has no apparent experience taking care of patients (see his official bio, listing his most advanced degree as a Masters in Philosophy).  Generic managers now often seem to think of themselves as some sort of new aristocracy, far removed from the peasants who work for them.  Would not it be easier for such aristocracy to avoid working with such peasants at all?  Machines would be so much neater and cleaner, would not ask for raises or think of unionizing or rebelling (at least outside of the world of Terminator movies).

Leaving aside such fantasies for the moment, the most concerning problem with Mr Romoff's dream of robotic doctors is that anyone who has ever had any direct involvement in health care knows that doctors need to do much more than crunch data and make predictions and diagnoses.  Doctors and other health care professionals have sworn to put patients' interests first.  That implies that doctors must talk to, endeavor to understand, and be empathetic towards their patients.  Many times we doctors may not do this anywhere near perfectly.  But we are human, so can at least try.  Artificial intelligence may be getting closer to making better health care predictions and diagnoses, but does anyone seriously think we are close to making an understanding, empathetic machine?

I believe that Mr Romoff has unwittingly made another argument why he and his fellow generic managers should not be leading health care.  Health care should be lead by people who understand the actual care of patients, uphold health care professionals' values, and are willing to be accountable for putting patients' and the public's health first.