Personalizing Care in a Transactional World

An online transcript is available

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On today's program, host Se��n Collins welcomes Dr. Steven Salloway, Dr. Rudy Tanzi, and David Shenk to discuss recent advances in Alzheimer's research and the possibility of early intervention and prevention. They highlight the significance of targeting amyloid plaques in the brain, but also emphasize the need for treatments that can be administered earlier and more widely ��� the way statins are used to forestall or prevent atherosclerotic heart disease. The researchers discuss the role of public funding in drug research and the challenges of developing affordable and accessible treatments. They also touch on the role of imagination in driving scientific discovery and the importance of accurate and responsible journalism in reporting on Alzheimer's research. Overall, they express optimism about the future of Alzheimer's treatment and the potential for significant progress in the coming years.

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Steven Salloway, M.D., MS

Founding Director

The Memory and Aging Program

Butler Hospital��

Professor of Psychiatry and Human Behavior

Professor of Neurology��

Warren Alpert Medical School��

Brown University

Providence, R.I.

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Rudy Tanzi, Ph.D.��

Director��

Genetics and Aging Research Unit

Director��

McCance Center for Brain Health

Massachusetts General Hospital��

Professor of Neurology��

Harvard Medical School

Boston, Mass.

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David Shenk

Author

The Forgetting ��� Alzheimer���s: a Portrait of an Epidemic����

Senior Advisor

Cure Alzheimer's Fund��

Advisor, dementia-related issues

President's Council on Bioethics

Brooklyn, N.Y.

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A transcript is available online

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Today, host Se��n Collins welcomes Dr. Nwando Anyaoku, Chief Health Equity and Clinical Innovation Officer for Providence. They ��discuss the importance of diversity and cultural understanding in healthcare.��

She shares a personal story about a patient from Liberia who felt understood and cared for because Dr. Anyaoku shared a similar background and experiences. Dr. Anyaoku emphasizes the need for healthcare providers to recognize and address disparities in care based on race, ethnicity, sexual orientation, gender identity, and other factors. She discusses the concept of concordance, where patients and providers with similar backgrounds can have better communication and outcomes. Dr. Anyaoku also highlights the importance of cultural humility and building partnerships with community organizations to address health disparities.��

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Nwando Anyaoku, M.D., MPH, MBA

GVP & Chief Health Equity and Clinical Innovation Officer

Providence

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WATCH Dr. Anyaoku's TED Talk from Bellarmine University, recorded February, 2023.

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MORE READING:

Physician���patient racial concordance and disparities in birthing mortality for newborns ��(PNAS)

Association of Racial/Ethnic and Gender Concordance Between Patients and Physicians With Patient Experience Ratings ��(JAMA)

Association of Surgeon-Patient Sex Concordance With Postoperative Outcomes ��(JAMA Surgery)

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This episode includes discussion of suicidal ideation and planning. If you are thinking of harming yourself, please call or text, in English or Spanish, the Suicide & Crisis Lifeline at 988. �� Help is available. ��Deaf & hard of hearing

Este episodio incluye una discusi��n sobre la ideaci��n y la planificaci��n suicida. Si est�� pensando en hacerse da��o, llame o env��e un mensaje de texto, en ingl��s o espa��ol, a la L��nea de Prevenci��n del Suicidio y Crisis al 988. �� Hay ayuda disponible. ����Sordos e hipoac��sicos

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In this episode of the Hear Me Now Podcast, host Se��n Collins discusses the health benefits of gratitude with Dr. Robin Henderson, Chief Executive for Behavioral Health for the Oregon Region of Providence. They begin by listening to the story of JD, who found practicing gratitude helped him overcome suicidal thoughts and depression. They discuss the science behind gratitude, including its impact on serotonin and dopamine levels in the brain. They also explore practical strategies for incorporating gratitude into daily life, such as journaling, gratitude jars, and sending thank-you cards. They emphasize the importance of gratitude in improving mental health, fostering positive relationships, and creating a more positive and empathetic society. The episode concludes with a discussion on the role of healthcare providers in promoting gratitude as a form of self-care and healing for their patients.

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Robin Henderson, PsyD

Chief Executive for Behavioral Health��

Providence Oregon Region

Senior Clinical Officer

Work2BeWell

Portland, Ore.

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The music heard at the end of the episode is "Dreamers of the Shore" by Volcan Peaks feat. Cody Francis. Used with permission.��

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FURTHER READING:

Key Lime Pie for Thanksgiving (New York Times)

Greater Good Magazine: Gratitude (UC Berkeley)

Health Benefits of Gratitude (UCLA)

The Ignatian Examen (The Jesuits)

"Spiritual Exercises" of Ignatius of Loyola (Ignatian Spirituality) ��text

"Effects of gratitude meditation on neural network functional connectivity and brain-heart coupling" (Nature)

"The effects of gratitude interventions: a systematic review and meta-analysis" (Einstein)

"Gratitude in Health Care: A Meta-narrative Review" (Psychiatry)

"The impact of gratitude interventions on patients with cardiovascular disease: a systematic review" (Frontiers in Psychology)

"A systematic review of gratitude interventions: Effects on physical health and health behaviors" (Journal of Psychosomatic Research)

"The Cultivation of Pure Altruism via Gratitude: A Functional MRI Study of Change with Gratitude Practice" (Frontiers in Human Neuroscience)

"The Scientific Effects of Gratitude: A Review" (Journal of Positive Psychology and Wellbeing)

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A class of drugs called glucagon-like peptide agonists (GLP-1 agonists) is proving to be beneficial for people with chronic kidney disease and atherosclerotic heart disease. These medications are being called game changers because they not only help with weight loss but also provide organ protection and reduce the risk of dying and disease progression.��

These medications have the potential to revolutionize the treatment of deadly conditions and improve population health. However, there are financial pressures and healthcare policies that may hinder access to these medications for patients who could benefit from them.��

On today's program, host Sean Collins talks with two Physician-Researchers working on the front lines of the coming change.

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Katherine R. Tuttle, M.D., FASN, FACP, FNKF
Executive Director for Research, Providence Inland Northwest Health
Professor of Medicine, Division of Nephrology and Kidney Research Institute
Regional Principal Investigator, Institute of Translational Health Sciences
University of Washington

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Radica Alicic, M.D., FHM, FACP

Associate Director for Research

Providence Health Care in Spokane

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Management of Chronic Kidney Disease in People with Diabetes��

Read more about Retatrutide, the triple agonist

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Providence Hospice, Los Angeles County has launched a program to provide hospice care for homeless people. The program aims to support those experiencing homelessness and facing a terminal illness by providing them with the option of a safe and secure environment to receive holistic care.��

Homeless people face unique challenges and vulnerabilities, including an increased incidence of mental health issues, frequent distrust of healthcare providers and environments, and often issues of substance dependence. The team at Providence Hospice, LA County works closely with facility care teams to ensure that patients receive the care they need while also respecting their individual needs and preferences.��

Guests include Martina Meier, M.D., medical director of Providence Hospice, LA County; Nycole Snodgrass, director of operation at the hospice; and Marcella Kubalsky, who was chaplain when the program began. This episode also includes audio from an interview Marcella conducted with "Bob," a patient who had been chronically unhoused when he entered the program this past summer.

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Click here for more information on Providence Hospice, LA County.

For an extended excerpt from Marcella's interview with Bob, follow this link. ��

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A transcript is available online

We explore the kind and quality of healthcare available in rural hospitals in an age of growing technological and resource-heavy medicine. Do we risk a two-tiered system where the best care possible is only available in large cities near major medical centers? And are there options available for people who might have to travel hundreds of miles for specialist care? ����

Guests include Alan Morgan, CEO of the National Rural Health Association; Theresa Gleason and Erica Manor from the Providence Hickel House, a hospitality facility on the campus of the Alaska Medical Center in Anchorage; and with Geraldine Picha, who stayed at Hickel House during her son's medical emergency last year.

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N.B. ��Beginning with this episode, we are shifting the release date of the podcast to the first and third Thursdays of the month.

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An online transcript is available

Does it seem counter-intuitive to say that the future of person-centered healthcare is the use of more and more tools utilizing AI, artificial intelligence?

Dr. Maulin Shah is Chief Medical Information Officer for Providence and VP of Informatics and Engineering. He talks with host Se��n Collins about AI and the ways innovative healthcare sytems will make use of it to free-up precious time for human caregivers: doing everything from taking notes during your visit with your doctor, to suggesting that the clinic call a ride for patients who have uncertain transportation.

Saving clinicians 3-hours each day with improvements to the way they practice is like handing caregivers a chunk of their life back -- and that could be one of, maybe the best, solution to healthcare burnout.

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An online transcript is available

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At the end of last year, The New Yorker and ProPublica documented fraud and mistreatment in some for-profit hospices across the country. The expos�� shouted something that has been whispered for a long while in circles concerned with the care of the dying: hospice needs saving.

Begun as a visionary mission run by charities, hospice care has morphed into a 22 billion dollar industry where margin trumps mission. On today's program, host Se��n Collins discusses the state of hospice, its future, and ways to preserve quality of care when caring for people at the end of their lives. Guests are Drs. Ira Byock and Glen Komatsu, longtime hospice physicians and thought leaders in the field.��

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Glen Komatsu, M.D.

Chief Medical Officer

Providence Hospice, Los Angeles County

Torrance, Calif.

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Ira Byock, M.D., FAAHMP

Emeritus Professor of Medicine

Geisel School of Medicine at Dartmouth

Author, Dying Well (1997), The Four Things That Matter Most (2004), and The Best Care Possible (2012)

Missoula, Mont.��

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FURTHER READING

How Hospice Became a For-Profit Hustle by Ava Kofman (New Yorker)

Endgame: How the Visionary Hospice Movement Became a For-Profit Hustle by Ava Kofman (ProPublica)

Joint statement from The National Association for Home Care & Hospice (NAHC) and National Hospice and Palliative Care Organization (NHPCO) responding to Ava Kofman's reporting.

Dr. Tara Friedman's response to the New Yorker article (President, American Academy of Hospice and Palliative Medicine)

Hospice Needs Saving by Ira Byock ��(STAT First Opinion)

Hospice Industry: Start with Apologies by Ira Byock (STAT First Opinion)

National Hospice Locator ��(Hospice Analytics)

Hospice Compare (medicare.gov)

A simplified description of the person from Dr. Eric Cassell's "The Nature of Suffering and the Goals of Medicine."

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A transcript is available online

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Addiction and overdose rates have reached historic levels in the last several years. And while fentanyl and synthetic opioids are responsible for much of the surge, cocaine and other stimulants such as methamphetamine are playing an increasingly common role. Addiction problems are not rare (it's estimated that 10% of the population has substance use disorder) and they don't go away because someone is pregnant.��

Substance use during pregnancy -- whether of licit or illicit substances -- can complicate pregnancy and may pose a risk for the fetus. And because of the stigma associated with substance use, many people forego prenatal care, further complicating the pregnancy.

Host Se��n Collins talks with two healthcare professionals about their efforts to reach people with substance use disorders to help them care for themselves and their fetus.

Collin Schenk, M.D., is an Addiction Recovery Services physician at Swedish Medical Center in Seattle, Wash. Kirsten Lavery, RN, MSN is the Nurse Manager for Addiction Recovery Services. In addition, we hear from Jennifer Justice, a parent ally at the FIRST Legal Clinic in Seattle, about her own story of recovery and her work now helping others during their pregnancies.��

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An extended excerpt from Jennifer Justice's conversation with Kirsten Lavery is available here.

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Perinatal Substance Use Disorder Learning Collaborative ��(WSHA)

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A transcript of this episode is available online ����� A list of mental health resources is available on our website

"Everyone has anxiety and you can't really survive childhood without some anxiety," says psychiatrist Dr. Maureen Nash. "It is, at least theoretically, what prevents us from doing catastrophically negative things like walking off a cliff, or hugging the stove when it's red hot."

The fight-or-flight response has its place. We're hard-wired to preserve our overall well-being at the expense of a few anxious moments when we're threatened. But, as Dr. Nash adds, "an anxiety disorder is when you have fight-or-flight gone awry and it is either in excess of what is useful to you or it actually debilitates you."

A growing number of young people are showing symptoms of anxiety, in part due to the zeitgeist (consider a future of global warming, longterm economic prospects, and pushback on efforts to foster inclusion and diversity) and nearly continuous stimulus from electronic devices and social media.

"Trigger after trigger after trigger," says Dr. Robin Henderson, Chief Clinical Officer of WORK2BEWELL, a mental health and wellness program focused on providing mental health resources and education for teens, parents, and educators. ��

"When we look at increasing rates of anxiety -- we see numbers as high as 40% of females, 36% of males, young adult, high school having some symptoms, if not a full on diagnosis of anxiety -- we see numbers that has to be what we're seeing out of the pandemic and all of those stressors there and what we're seeing in social media and, candidly, what we're seeing in the political environment, not limited to climate change, politics, racism, and all of those things. It's a very stimulating world."

But there's hope. There are ways to cope with anxiety even to treat it as one's "superpower." ��Today's episode also includes conversations with two college students who not only live with anxiety, but who are working to help others cope with the stressors they face in the world today. And they share their insights into strategies they use to manage their anxiety. Billie Henderson is a college student in Oregon and Dominic Brown attends college in Southern California. Both have worked to help other young people through WORK2BEWELL.

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RESOURCES

Need to talk now? ��or call 988

Anxiety Grounding Techniques

WORK2BEWELL website

WORK2BEWELL Instagram account

State-by-State Mental Health Resources

Anxiety Disorders (NAMI)

"Hiding in Plain Sight" documentary ��PBS | Amazon

Providence ElderPlace

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