Randale C. Sechrest, MD

This is a new book that is just out on the experience of chronic pain (and chronic pain treatment world) written from the lay perspective. I found the book very accurate and consistent with my experience on the other side of the equation (a provider). I think that this will be a book that I recommend to patients as well as providers to bring some perspective to the sometimes difficult relationships between chronic pain patients and their providers.

There is also a great interview with the author here at Salon.

Randale

I am fascinated by evolutionary psychology. Here is a gathering of who’s who in the world of moral psychology brought to you by our good friends at edge.org. There are videos of each speaker with a discussion among the group. Cutting edge evolutionary psychology.

I recently read in the WSJ a short interview Lee Aase, manager of syndications and social media about the Mayo launch into social media. Many of the ideas expressed in this article mirror what we are trying ot accomplish in the orthopaedic realm with eorthopod.com. Here is the full announcement. “The times they are a changin’”.

Randale

The new point and shoot pocket video cameras are incredibly good for recording remote interviews. The Kodak zi8 has the unique added benefit of an external microphone jack. We have worked out a process where we ship a Kodak zi8 camera, mini-tripod and lapel microphone to the interviewee and then use Skype to conduct the real time actual interview. This is an inexpensive method for getting much better quality video and sound than relying on the usual webcam recording method that seems ot be ubiquitous across the web these days.

Kodak zi8 Camera $130
Lapel Mic $20
Tripod $40

If you are looking for a great way to do remote interviews, check out this video (more tutorial howto videos showing the equipment in action available at eorthopod.tv):

Here is the abstract of my recent publication on the Internet and the Patient-Physician Relationship. This article began life as a talk given at the Carl T. Brighton Symposium dealing with Orthopaedic Informatics.

Background

Since the emergence of the public Internet in the early 1990s, the healthcare industry has been struggling to understand how best to utilize this resource. During the last decade there has been an increase in both the interest and participation by healthcare providers in the Internet space, but many observers continue to push for more development of healthcare resources to better support the provider-patient relationship.

Questions/purposes

This paper will review the historical development of the Internet, the core concepts that have driven the emergence and evolution of the Internet as a mass medium of information exchange, and how the healthcare industry can harness the Internet to improve the provider patient relationship.

Where are we now?

The healthcare industry continues to lag behind other industries that have been transformed by the Internet. Numerous industries including travel, real estate, retail sales, and banking have migrated both comprehensive information resources and transactions to the Internet in order to improve efficiency and customer satisfaction. That same process is occurring now in the healthcare industry. Credible and comprehensive Information resources are beginning to mature. Transactions are still in their infancy, reflecting a continued concern about privacy and security.

Where do we need to go?

We need to improve information resources to educate and inform patients. Improving the availability and credibility of information resources will empower patients to make better healthcare decisions and I contend will ultimately reduce the cost of delivering care.

How do we get there?

Orthopaedists must first recognize the value of information resources to the patient. Effective communication with patients is a critical component of providing healthcare services. All healthcare providers should reflect on the importance of developing an effective communications strategy for their own practice and consider the benefits of participating in efforts by professional organizations to improve existing information resources.

Sorry I cannot provide the entire article, but if you have access to CORR you can find the article here:

https://springerlink.metapress.com/content/f500104q13313j64/resource-secured/?target=fulltext.pdf&sid=ktuecgvo0l3z2455ifsnmmuk&sh=www.springerlink.com

DOI: 10.1007/s11999-010-1440-3

I’ll admit that I am a big fan of David Harvey.

I am now a big fan of the RSA. This organization provides a wealth of high quality intellectual programming. Their RSA animate series of lectures are just fabulous.

Members of the US Congress,

Thank you for the opportunity to address you as part of the debate on the critical role of health care reform in our country. My name is Randale Sechrest. I am a physician would like to express my support for a health policy that guarantees every citizen the right to health care.

The preamble of the Constitution of the United States states:

“We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.”

This statement establishes that from the beginning the United States was created with the understanding that the role of government is not restricted to the provision of security and protection of liberty, but also includes the obligation to address the welfare of each and every citizen in a just and equitable fashion. Subsequent amendments to the Constitution have confirmed that these benefits are inclusive and are to be applied to all citizens: Amendment 13 through the abolition of slavery, Amendment 15 by confirming the right to vote by African Americans and Amendment 19 by extending the right to vote to women. These and the other amendments to the Constitution establish that we also recognize the need to adapt as the interests we share in common change in order to better provide for the general welfare of our citizens and guarantee justice.

Health is a critical asset to every person. Health status has a profound effect on the pursuit of nearly all other attributes that an individual values. Insufficient health status can result in unnecessary suffering and mortality, but also has effects on personal autonomy, economic opportunity and self actualization. In order for each individual to achieve and maintain a sufficient level of health status, we must ensure that our public health system is robust enough to recognize and protect our citizens from threats to their health and our health delivery system is accessible to all for both preventative care and treatment of injury and disease.

The complexity, as well as the benefits our health care system can deliver has drastically changed in the two centuries since the Constitution was written. While some individuals may lead a healthy life that requires minimal interaction with the modern health care system, the important role that formal health care plays in most of our lives today is indisputable. The vast majority of the population will need to take advantage of the health care system at some point in order to resolve or manage a critical life issue. The success that our health care system has enjoyed in both resolving and managing these critical life issues has increased the importance of health care in our lives in the last 100 years. Likewise, the consequences of inadequate health care have resulted in a growing chasm between those that have access and those that do not – not only in health status, but in socioeconomic status as well.

The burden of disease and injury is unevenly distributed. The presence of health and disease are determined by an unknown number of variables that none of us can comprehend, much less control. For some, it is clear that some combination of socioeconomic status, race, genetics, behavior and random luck have conspired to place us at a disadvantage and threaten our health status. For many others, we simply have not realized that we, too, are at risk – either through some unfortunate accident or simply though the ravages of time and old age. None of us can eliminate the risk of finding ourselves in need of resources beyond our capacities.

Health status is as important as any other social good. In the same way that our society has evolved to realize that all citizens are entitled to share the privileges and rights elaborated in the Constitution, we must also recognize that health status is now included in this set of rights and privileges. Any meaningful plan of health care reform must provide universal coverage and guarantee access to health care for every citizen of the United States.

Thank you,

Randale C. Sechrest, MD

Our health care system is in crisis.

47 million citizens have no health insurance. An untold number of citizens with insurance quickly find themselves underinsured if they must use their insurance. Together, these two groups represent a population at increased risk of reduced health status, increased mortality and financial devastation.

The cost of health care continues to rise. Left unchecked, the rising cost of health care will increase our national budget deficit, reduce our ability to compete economically in the global marketplace and make health care unaffordable for more and more citizens.

Our current health care system is both unfair and unsustainable.

The vast majority of the civilized, developed nations of the world consider health care an essential human right. This list includes Canada, France, Britain, Ireland, Sweden, Norway, Germany, Denmark, Japan, New Zealand, Australia, Austria, Taiwan, Switzerland and the Netherlands. The United States is unique among all the industrialized nations of the world in that it does not provide universal health care to its citizens.

As health care reform debate continues, the path to a solution grows murky; the real issues obscured by rhetoric, misinformation and downright fear-mongering. We have been overwhelmed with details (perhaps intentionally) – details that tend to obscure the core issues.

One key question before each and every citizen of the United States is clear: “What does the United States consider health care – a market commodity or a basic human right?” The acceptable solutions become radically different once we decide the answer to this key question.

As a health care provider, I believe that the United States needs to join the vast majority of the developed world and recognize that health care is an essential human right.

I believe that the United States needs to enact real, meaningful health care reform that moves toward achieving a goal of universal coverage of each and every citizen of the United States.

I have listened to the arguments that would portray “good health” as merely a lifestyle choice that is within the grasp of each and every individual – if only we exercised the appropriate personal responsibility. But, that is an illusion. While personal responsibility indeed plays a role in improving one’s chances of leading a healthy life, the reality is that none of us can predict if and when we will be stricken – through no fault of our own – with an unforeseen injury or illness that can devastate us and our families. We all stand to benefit from the security of knowing that we will have health care when we need it.

While there may be many ways to achieve meaningful reform, controlling the cost of health care must be a centerpiece of any effective strategy that aims to create a sustainable health care system. Health care decisions must be made based on scientific evidence. Health care cannot continue to be perceived as a market commodity that is rationed by purchasing power and driven by the perverse incentives that characterize the current broken system. Health care is a public good and the health care delivery system must be retooled to recognize and reflect the critical role that health care plays in the security and well being of our society.

I believe that our country will be more productive, our businesses stronger and all of our futures brighter if every citizen is secure in knowing that he or she has access to quality and affordable health care and will not be financially devastated by a medical calamity beyond our control.

I am dismayed by the misinformation and fear tactics that have been used by those who stand to benefit from a continuation of the status quo – a health care system driven by the profit motive rather than the humanistic ideals of compassion and professional obligation. The rhetoric is designed to confuse and cloud the core decision that faces our country today as we call the question: “Will we join the rest of the civilized world and work together to provide all of our citizens health care security as a right of citizenship – or not?”

Randale C. Sechrest, MD