More Than a Pink Ribbon

As October draws to a close and we move away from breast cancer awareness month I ask you to remember one major thing. Families and individuals impacted by breast cancer, or cancer of any kind, need support year round and YOU may be the best person to provide it. Unfortunately, between the chance of a woman having invasive breast cancer (1 in 8)  and the chance of dying from breast cancer (1 in 35). MILLIONS of people are touched by this terrible disease. Those millions need a hug, casserole, cards, gas money or a wig. There are many ways to help and sometimes the helpers need help too. The organizations and businesses that I have curated for you (the helper) below were born because the founders’ lives were touched by cancer or other stressful health event and what they needed to make their loved one’s lives better didn’t exist or wasn’t quite right. Lucky for us they were so industrious– because we can take their labor of love and use it to help support our sisters and families. Continue reading

5 Essential Tips for Nurse Practitioners Opening Their Own Practice

With the demand for health care and qualified nurse practitioners rising, many with an NP license can be wondering if opening their own practice or clinic is right for them.  To help you get a better idea of how to do it right, we have collected a list of five tips to help when starting out on your own.

1. Know the law Each state is different and so too are the requirements for nurse practitioners that want to open their own practice.  For example, some states require that an NP work along side a licensed physician, open a limited liability company, or other.  Be sure and check with your state board first before venturing out on your own to ensure that it is even legal for you to open your own practice.

2. License up Even if your state allows nurse practitioners to have their own practice, it is still vital to have all your licensing documents in order. There can also be certifications, codes, and other standards that the state will want you to have.  Know what they are before you open to ensure that it is worth the effort to you.  The county and city you practice in may also have their own standards for nurse practitioners.

3. Go special  If you do live in a state that allows nurse practitioners to have their own practice, consider a specialty.  Even if it is pediatrics, sports medicine, or whatever your NP training is in, letting the public know that you specialize in this type of care can help your practice stand out.

4. Insurance  Most patients will pay for health services with some kind of insurance from Medicaid to private PPO’s.  Before you open your practice, it is essential to know which plans you will accept, what they pay for, what the rate of compensation is, and all pertinent details before opening.  Again, the state, city, or county may require you to accept insurance plans of their choosing.

5. Malpractice  Insurance isn’t just for patients.  All health care practitioners need some form of malpractice insurance to cover them in case the worst happens.  Knowing what the rates are, what they cover, and how it works is also an essential step to opening your own practice.

Bonus!  There’s more to opening your own NP practice than in the above.  If you are still curious about pursuing the path to owning your own practice or even just to get some leadership tips, there are many useful resources out there.  One of the best is Nurse Practitioner Business Owner which helps nurse practitioners who want to take the next step in their career.

Ally Wagner is studying to become a nurse and also contributes to Nurse Practitioner Programs which helps those studying to become nurse practitioners.

Paula Deen–This Lady Has Your Back

I love Paula Deen. Poor thing has been through the ringer this week, especially in the comments section on places like CNN. She “came out” and told everybody she has Type 2 Diabetes and people used this as an opportunity to rail at her about her liberal use of butter and smiles.

I love that she uses butter.

I love that she smiles.

If she were French we would ask her which red wine complemented our favorite casserole.

I love that she has worked hard and has made a living for herself—when years ago she was home bound due to a phobia that kept her from leaving the house.

I like it when people are resourceful, overcome obstacles and are successful. She could have died a poor single mom with no money for a tombstone. If she had, people could have yelled at her about that too.

Get a grip.

If you don’t want cocaine don’t do it. If you don’t want red hair—don’t go to the hairdresser and pay for it to be dyed red. If you don’t want to eat butter don’t eat it.

Never mind that Type 2 Diabetes for some is more complicated than an over indulgence of butter.

The part of public health that has always amazed me is that in many ways it gains its legitimacy on the premise that people are stupid and must be told exactly what to do and how to do it. And that no one else should be allowed to present a differing message than the prevailing public health message of the time. It’s just too distracting from their good messages.

  • We have praised the disruption in health care that brings power to the patients, consumers and advocates.
  • We want electronic medical records.
  • We want to be able to see our health records without permission.
  • We want accurate nutrition labels so that we can make adult decisions about what to buy and eat.
  • We want patient centered medical homes so that the care is about us medical system.
  • We don’t want closed managed care systems because we want the liberty to choose our providers and make educated decisions about how and where to seek care on our own.

But as I listened to the shrieking about Paula—I realized that people want those things AND to be told what to do.

Let me tell you a story.

I had the good fortune to be a nursing student and then go on to work at the same urban-ish hospital for 5 years. In that time I got to know certain “frequent flyer” patients and their families very well. One of the more infamous patients, I’ll call her Willie Rae, was admitted to the hospital because after she ate two sheet cakes-went into a little diabetic coma—on top of her heating pad (because she had hurt her back earlier) and got a 3rd degree burn. As I’m getting her settled in on the floor and asking her all the admission questions…I have to ask “Why did you eat TWO sheet cakes?”

“Girl, cause they were on sale at Kroger!” says Willie Rae.

They had been on sale. When I saw the sale sign earlier in the week I had wondered who needed to buy two sheet cakes at one time. It may have been graduation season. I don’t remember. We were in Ohio. This picture was taken just a few weeks ago in Ohio. We love to eat sweets and get a good bargain.

Anyway, Willie Rae and I had a good talk. At the end of the conversation I tried to work on behavior modification. To make a long story short—we started negotiating about future eating habits and it ends in Willie Rae agreeing to eat ONE sheet cake at a time instead of TWO.

This was a success. Truly.

Change is hard.

Change takes time and I think we set people up to fail if we don’t give people the tools or remind them of the skills they already have to be successful change agents in their own lives.

When we get all judgmental or create expectations that are so out of line with where people truly are everybody loses.

I’d much rather people cook using Paula Deen’s recipes than go to KFC every day. That means they are going to the grocery store and cooking. Halleluiah!

Her diagnosis is a mixed blessing.

She is planning on making versions of her favorite recipes with a light touch. Paula has the ears and trust of people that most public health interventions just don’t reach.

They might even trust her to use one stick of butter instead of two.

Boomers- Disruptive From Birth

Ahh Boomers. As the saying goes—They changed the world in the ‘60s and in their 60s they may do it again.

Being itinerant in nature—they view life after 65 differently than other generations. They are not interested in going to a nursing home (apparently neither are 75 year olds, per my interview) since those are for “old people.” They do not intend to medically combust and bankrupt Medicare as many policy wonks spend sleepless nights fretting about.

So what are they going to do?

Well according to Barbara Raynor, Managing Director of Boomers Leading Change in Health, lots of things.

In our first interview she introduces their organizational concept and theory of change.

You’ll get most of the goodies below in the Deep Dive which is only available via podcast on iTunes.

  • The rigorous 40 hour training that all volunteers must complete.
    • The curriculum design and how they have tweaked it over time.
  • The importance of evaluation and how JVA consulting  has helped the with that endeavor.
  • How to integrate a cadre of health care workers like health navigators and community health workers into the larger health delivery system.
  • The importance of inter-generational work.

By engaging the Boomers in meaningful work they are also providing a health service to their volunteers. They are keeping Boomers minds and bodies active– helping to keep them healthy and out of their own doctors offices (which as we have been told will cause the end of Medicare as we know it). But as good Pitchfork Optional devotees—we know that there is data to show that this approach actually decreases mild to moderate dementia.

Boomers Leading Change in Health is shaping health care delivery, decreasing costs and improving outcomes.

I guess the alphabet soup generations will have to find something else to fix.

Childhood Obesity: Fitness vs Movement

One Teacher’s Push to Inspire Activity for a Lifetime

Forget the PE of your childhood.

Caitlin Dugre, Middle School Physical Education Teacher and High School Field & Track Coach, shares how she went from not liking gym class and soccer to re-envisioning her life as an active person and sharing her passion with kids as a Physical Education Teacher.

(Click here for video & here for iTunes podcast)

I was skeptical. I asked her about why people talk about “movement” instead of exercise.

I had flashbacks of my 4th grade PE teacher…we were not friends.

I LOVED our Continue reading

3 Must Use Resources For Starting A Health Based Social Enterprise

Breaking News: School Doesn’t Teach You Everything

Problem: You just spent $$$ on your degree and you still don’t know how to do what you went to school for.

Solution: Build Your Own MPH/MPP/MWD/MBA (Master of Public Health, Master of Public Policy, Master of World Domination and Master of Business Administration)

This is easy for me to say because I have some of those degrees anyway. But honestly—when I finished my programs, there were still skills that I needed in order to get to where I wanted to go in life that just didn’t fit into the school experience.

If you are still wondering:

  • How do I get my nonprofit/social enterprise to become sustainable?
  • What are the legal frameworks for setting up a social enterprise?
  • How do I build traction behind my great social enterprise/nonprofit idea?

Here are 3 resources to get the practical skills you need whether working in the US or abroad:

NESsT

NESsT develops sustainable social enterprises that solve critical social problems in emerging market countries.

They have created what looks to be about 157 FREE PUBLICATIONS for the studious Smurfs among you to take advantage of on Issu (a digital publishing platform).

These are serious (but short) documents that range from a legal series geared specifically for social enterprises -to- tested methods that can help you distribute your products to reach your intended market.

Risky Business: The Impacts of Merging Markets and Mission uses analyses of 45 social enterprise cases from 15 countries to examine impact in terms of financial performance, mission/values, organizational culture, relations with stakeholders, etc.

http://www.nesst.org/publications/

Unite For Sight

Unite For Sight is a nonprofit organization committed to excellence in global health. These people throw a real conference. No time to sit and do nothing. Unite For Sight’s Global Health conference is truly jam packed with SO MANY GOOD options that you’ll wish you could split yourself into pieces to attend all the sessions. Go to the conference this April. Register by December 31st for the cheapest rate http://www.uniteforsight.org/conference/

Now that you’re registered for the time of your life, go bone up on your missing skills at the online Global Health University. Enrollment in the Certificate in Global Health is available to any student or professional who is interested in global health. Global Health University helps to effect widespread innovative change in global health through comprehensive training workshops, Global Health Certificate Programs, fellowship and internship opportunities in the U.S. and abroad, social enterprise consulting, and online courses.The total cost to enroll in the Global Health Certificate Program is $65.

Cheaper than grad school—right?

http://www.uniteforsight.org/global-health-university/

Partners In Health (PIH)

These are the leaders in providing preferential health options for the poor across the globe. If you don’t know them check them out.

The best made a Program Management Guide so you HAVE to read it. I just downloaded it last night in a zip file and it rocks!

This 14-unit program offers a structured approach to starting a program, revamping an existing one, or expanding a site based on PIH’s experiences in the field. Program managers can use this guide to anticipate and find creative solutions to common challenges that PIH and other similar organizations have confronted in resource-poor settings.

Table of Contents:
Unit 1 Learning about the local context
Unit 2 Understanding legal matters
Unit 3 Building site infrastructure
Unit 4 Managing a procurement system
Unit 5 Strengthening human resources
Unit 6 Improving programs through training
Unit 7 Improving outcomes with community health workers
Unit 8 Establishing a financial system
Unit 9 Creating a development strategy
Unit 10 Working with partners
Unit 11 Addressing the social determinants of health through a program on social and economic rights (POSER)
Unit 12 Using monitoring and evaluation for action
Unit 13 Conducting research
Unit 14 Maximizing impact through advocacy

Are you still whining about how you don’t’ know where to go for help to get your project off the ground?

How to Use an 8-track…I mean modern technology in clinical practice

I had a wonderful Skype session with Dr. Jennifer Shine Dyer right after Thanksgiving. It was so good that I have been talking about one of her off-hand comments almost every day since then. Since you are going to have to wait for her installment on the Vanguards of Health Innovation Skype Series….let’s start with something that I don’t think should wait.

Dr. Shine Dyer is a pediatric endocrinologist and as such, has the privilege of taking care of teenagers who are diabetic. Now, those of you who have ever spent time with teens know how hard it is to get them to do anything–let alone get a straight answer out of them. So imagine trying to cheer lead them into checking their blood sugar and figuring out if they actually checked it in between visits. Continue reading

A Community Cafe May Reduce Food Insecurity in D.C.

Last year,  50 million people — including 17 million children — lived in food insecure households in the United States. This means that more than potentially someone you and I know were not able to afford an adequate supply of food.  In DC, 12.9 percent of households were food insecure. It has gotten so bad that in October Sesame Street added Lily (a Muppet) to the cast who sometimes cannot afford to eat.

That makes me mad. Really. (as my mom would add for emphasis)

Annette Ryan, Executive Director of Everybody Eats, and her team have decided that there is a sustainable and non-soup kitchen way to address this issue. They will start a cafe.

(If the video does not load click here to view http://vimeo.com/33203229)

Now before you start choking on your coffee and yell at the screen about the high rate of failure in the restaurant industry. Continue reading

World AIDS Day-5 Things You Can Do In the U.S.

Today is World AIDS Day and there are many very eloquent statements about the history and trajectory of this disease.

As innovators in health I challenge you to up your game–particularly in the US.

You can watch my Call to Action with Housing Works here

joy-twesigye

In the United States, public and private sector investments in research, advocacy and education have yielded noticeable progress in HIV/AIDS prevention and treatment since the 1980s. Yet even with this progress, in 2008 the Centers for Disease Control and Prevention (CDC) published the latest estimate of new HIV infections in the United States for 2006– which were roughly 40 percent higher than previously estimated, indicating that the HIV epidemic is worse than previously known.  Furthermore, HIV/AIDS remains a serious problem in the US—particularly among racial, ethnic and sexual minority communities (Centers for Disease Control and Prevention, 2009). Continue reading

Health and Education Innovation Meet to Improve Dementia Treatment

Primary care often gets all the buzz when it comes to innovative services but Dr. Peter Whitehouse shows them up by providing dementia treatment in his K-8 charter school, The Intergenerational School. Provide research data that supports intergenerational learning to improve mild to moderate dementia-check. Next up–he’s starting a school based health center.

Don’t miss out on the deep dive where we cover:

Continue reading