Wrapping Paper, 2016 Christmas Wishes

wrapping paper1

Health care workers represent a lot of different functions and professions whether it be the obvious ones like doctors, nurses, therapists and medical assistants or those that don’t come to mind as readily like food services, engineering, environmental services and even administration.

No matter the role, health care is a difficult business and health care workers have some of the most difficult jobs anywhere. Take a minute to think about the day in the life of a hospital. We’re in the business of saving lives and bringing new life into the world. We are with people at the absolute happiest and saddest moments of their lives.

We deliver healthy babies everyday – what could be happier. We give great news on a daily basis – “your cancer is gone”. We reduce anxiety – “there’s no need to worry, you’re going to be fine”.

We deliver bad news everyday and delivering bad news is especially difficult for health care workers because health care workers go into health care to help people. Sharing bad news is almost as difficult for us as it is for the patient, and family, receiving the news but we never let them know because we have to be strong, or so we tell ourselves. We beat ourselves up when something goes wrong even when nothing could have been done differently. We help people understand how they can help themselves and then do not pass judgment when they choose not to – even though it breaks us up inside. We experience the ultimate highs and the ultimate lows in life – all in the same day and often in the same hour.

Health care is hard work but, no matter how hard, we come back the next day ready for more. The reason we come back is because of the thank you’s we hear and the thank you’s that can’t be said. We come back because there’s a chance to be part of a miracle every day. If you’re not in health care you have no idea how hard it is.

You think we get hardened over time and that we’re jaded. It just appears that way. What you don’t see is that we lie awake at night worrying about things we can’t control and try to fix problems that can’t be fixed. We feel our patient’s pain but our pain can’t be controlled with medication. We’re not able to smile during our patient’s happiest moments because our work requires our concentration even though our heart is about to beat out of our chest.

The job of a health care worker can’t be understood by anyone else, it can only be acknowledged. The job of a health care worker is a lot like the present under the tree. The present is neatly wrapped, looks shiny and perfect.

It’s not the wrapping paper that matters though. What sets the mind to wander is what’s inside but even the gift inside isn’t what matters. In the end what matters is the thought. Someone else thought enough of you to give you a gift. A gift, that while still wrapped, is only limited by your imagination. A gift, that when unwrapped, be it a shiny diamond or wool socks, makes you smile.

Whether the gift is something you’ve always wanted and thought you’d never have or something you’ll never use but someone else thought you might need really doesn’t matter. What matters is that someone thought enough of you to give you a gift.

For the health care worker every day is Christmas. Our patients are our gift. Every day of the year our patients are the shiny, wrapped gift under the tree. Part of our job is to unwrap the gift. We never know what we’re going to find on the inside but it doesn’t matter. What matters is that someone had enough trust and faith in us to share a portion of their life and life is the greatest gift of all.

The real joy in Christmas are the gifts we give not the gifts we receive. You give a piece of yourself to your patients everyday and they give their trust to you. Take a moment over the Christmas holiday to remove your wrapping paper and appreciate what you are on the inside because when all the gifts are gone from under the tree what matters most is who you are and what you give of yourself because that’s what health care workers do, they give a piece of themselves to every patient they encounter.

Merry Christmas.

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Repeal and replace – not so fast


More than 290,000 Missourians have health coverage through the Affordable Care Act or Obamacare.  In the months leading up to the recent presidential election, the ACA was a sticking point for both sides.  President elect Donald Trump repeatedly called the ACA a disaster and promised to repeal and replace the law.

Repeal and replace makes for a good platform but is easier said than done.

President elect Trump’s stance on the ACA has changed a bit since the election.  His position has softened and he’s said publicly that he’s willing to retain certain aspects of the law and replace or eliminate specific portions.  Specifically, Trump has said that he hopes to keep protections for people with pre-existing conditions and to allow children to stay on their parents plans until their mid-twenties.

Republican members of Congress have been trying to repeal the law for years but they haven’t had the votes to do so, until now.  Republicans hold majorities in Congress and there will be a Republican President in January.  It will be interesting to see if repeal continues to be a priority or if prior discussions of repeal were posturing and rhetoric.

A complete repeal, without a replacement plan, would have severe implications on the health care delivery system and may cause the system to unravel all together.  I don’t foresee that happening.  Instead I would suspect that bits and pieces of the law are changed.  Trump is pro business so opportunities for insurance providers to sell across state lines may come into play.  An increased emphasis on health savings accounts might also be a priority.

I would suspect that Medicaid reform will be a priority at both the state and national level.   One way Medicaid could be reformed would be to switch to a Medicaid block grant system.  Trump hinted at using Medicaid block grants during his campaign.  A block grant system would allow for the federal government to disperse Medicaid funding to states and then states could create eligibility requirements.

Campaigns are full of promises and campaign promises, more than any other, are meant to be broken.  The ACA is the law of the land and the health care system has adjusted and is functioning according to rules.  A total repeal will be difficult and without a suitable replacement it could be disastrous.

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Renovation timeline


Here’s an info-graphic that Leslie Lower put together to help illustrate the timeline of current renovation activity at GVMH.  New construction is complete but there’s a lot of renovation activity occurring.  As you can see the coming months will allow services to expand and move into renovated space.  As with all construction activity the timelines are “projected” and are subject to moving.  Once this round of renovation is complete and services vacate space a new round of renovation will begin.  Thank you for being patient as we work to improve facilities to better serve our patients and community.  GVMH is better because of you!

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Award winning Quality at GVMH

Quality Billboard

Golden Valley Memorial Healthcare named recipient of the 2016 Missouri Quality Award

 COLUMBIA, Mo. – The Excellence in Missouri Foundation announces Golden Valley Memorial Healthcare, located in Clinton, MO as the 2016 recipient of the Missouri Quality Award. This marks the second time that the organization has received the award.

A not-for-profit healthcare delivery organization, Golden Valley Memorial Healthcare (GVMH) consists of a 56-bed hospital, a home health service, outpatient services, and four physician clinics located in west central Missouri. GVMH also operates provider and outpatient clinics in Warsaw, Windsor, and Osceola, Missouri.

A 2013 recipient of the Missouri Quality Award, GVMH is guided by the Golden Path to Success, or “GPS”. GVMH uses a robust strategic planning process to align its goals and action plans around 5 Pillars of Excellence: People, Service, Quality, Financial, and Growth. A focus on performance excellence and organizational learning is embedded in the GVMH culture, and is reinforced through a series of processes designed to assure the achievement of its mission, “to provide exceptional health and wellness services with friendliness and compassion” to Henry County and the surrounding areas.

Located near Truman Lake, Golden Valley Memorial Healthcare provides rural residents with big city services, while living up to the community slogan, “Great People, by Nature.” Specialty clinics, state-of-the-art medical equipment, nationally recognized food “room service”, walk-in clinics, and Home Health services ranked among the best in the nation, and complement excellent inpatient, outpatient, emergency and rehabilitation services. GVMH provides a great place for patients to receive care, a great place to work, and a great place for physicians to practice.

 About the Missouri Quality Award (MQA): The MQA is the official state recognition for excellence in quality leadership. Modeled after the prestigious Malcolm Baldrige National Quality Award, the MQA is recognized as one of the strongest state-level quality award programs in the country.

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It’s almost over


I’m typing this particular blog the day prior to election day.  When many of you read it the suspense will be gone and our country will have elected either our first female president or a Washington outsider.  I don’t know about you but the end could not have come soon enough for me.  It seemed to me that this election, more than any other I can remember, was divisive.  No matter the winner, the first order of business needs to be spanning the gap and pulling both sides together.

The second order of business needs to be addressing one of our countries biggest concerns.  A recent study by the Kaiser Family Foundation showed that 63% of the public is concerned that the government is not doing enough to lower prescription drug prices.  Another concern is related to what’s going on with employer sponsored health plans.  Much has been made of premium increases in the exchange but there are far fewer people enrolled in the exchange than those covered by employer sponsored plans.

Employer sponsored health plans rose an average of just 2.4% in 2016 and are expected to rise another 4.1% in 2017.  Anytime increases are kept below double digits it’s a win but there’s more to the story.  During the same period of time drug costs rose an average of 10%.  Employer sponsored plans are holding premium increases at a modest level by shifting more and more people to high deductible plans, last year more than 29% of people in an employer sponsored plan had a high deductible and that number is predicted to go higher this year.

The Affordable Care Act, Obamacare, has done a good job of decreasing health care costs and the table is set for costs to continue to decrease in the years ahead.  Hospitals and other health care providers have been forced to reduce cost and deliver more affordable care.  The pharmaceutical industry has not had the same pressure.  The new president will need to work with both parties to develop a system that encourages drug manufacturers to deliver products at a price patients and insurance providers can afford.

“We’re stronger together” and “Make American great again” were the two major candidate’s slogans in this election let’s hope compromise and the greater good become a legacy as opposed to an empty campaign promise.

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Drug costs keep going up

medsA lot has been made about EpiPen prices increasing by 1,100 percent in recent months.  EpiPen is life saving allergy medication that has a one year expiration date.  If someone has a severe allergy to bee stings or peanuts an EpiPen may be the difference between life and death.  EpiPen controls the market because there are very few competitors that provide auto-injectors like the EpiPen.  When you control the market and you provide a life saving drug, you can set the price wherever you want and people are going to find a way to buy.

Although the EpiPen price increase seems excessive, it is reflective of what’s occurring throughout the pharmaceutical industry as a whole.  A recent report from the Bureau of Labor Statistics found that prescription drug prices grew 7.3 percent from September of 2015 to September of 2016 which is the highest rate of growth since 1992.  The American Hospital Association recently released a report on trends in inpatient hospital drug costs.  The study found that average annual inpatient spending on pharmaceuticals increased 23 percent between 2013 and 2015.  On a per admission basis the spending grew by 39 percent during the same period.  The spending was driven by increased cost and not by increased admissions because during the same period, hospital admissions decreased.

Hospitals like GVMH are working hard to reduce cost and the federal government is putting a lot of pressure on hospitals to become more cost conscious.  The growth in drug costs isn’t sustainable because during the same time frame as referenced above hospital rates only increased 2.7 percent.  As hospitals divert more money to pay for medications provided to patients it limits their ability to invest in other services that would benefit their patients and the communities they serve.

Back to EpiPen, it may be there was an endgame in mind when Mylan, the manufacturer of EpiPen imposed the price increase.  Mylan has applied the have the EpiPen added to the federal list of preventive medical services.  The list currently contains thing like wellness visits and birth control and anything on the list must be provided by insurance companies and federal payers like Medicare and Medicaid at no cost to recipients.

If EpiPen gets added to the list the cost will shift from consumers to the government and insurance companies.  Ultimately the cost would be absorbed by tax payers and anyone paying a premium to have commercial insurance.  The consumer will still be paying but without any real knowledge of sticker price and Mylan will be out of the spotlight.  It’s a  sneaky way to drive profits and a way to do so when no one is watching.


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Survivor and an inspiration



It’s Breast Cancer Awareness Month and there’s been a recurring theme on the blog this month – I’ve been able to share the stories of people who dealt with breast cancer with dignity and determination.  I first shared this story three years ago and to this day Courtney is an inspiration for me.  Courtney is one of the kindest, most positive people I have the honor and pleasure of associating with.  Here’s the blog I posted three years ago this month.

This is the link to a You Tube video. The video is 2 minutes and 14 seconds long. The last 20 seconds are the best and if you watch you’ll get to see one of my hero’s and one of the most inspirational people I know.


God Bless You Courtney, you amaze me every day and your strength, faith and courage are an inspiration to us all!

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