What if everything we needed to realize our aspiration for healthcare was right there in front of us just waiting to be claimed?.
After completing this weeks activities you will be able to:
Explain major theoretical perspectives on organizations.
Examine the basic concepts and dynamics of organizations.
Define and describe primary and secondary organizations.
Discuss ethical issues related to organizations.
Textbook Readings
Kirst-Ashman, K. K. (2014). Human behavior in the macro social environment (4th ed). Belmont, CA: Thomson Brooks/Cole Publishing Company.
Chapter 5-6
Other Articles:
Rebecca Onie:
What if our healthcare system kept us healthy? (Ted Talk you can find this online on u-tube
So my freshman year of college I signed up for an internship in the housing unit at Greater Boston Legal Services. Showed up the first day ready to make coffee and photocopies, but was paired with this righteous, deeply inspired attorney named Jeff Purcell, who thrust me onto the front lines from the very first day.
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And over the course of nine months I had the chance to have dozens of conversations with low-income families in Boston who would come in presenting with housing issues, but always had an underlying health issue. So I had a client who came in, about to be evicted because he hasnt paid his rent. But he hasnt paid his rent, of course, because hes paying for his HIV medication and just cant afford both. We had moms who would come in, daughter has asthma, wakes up covered in cockroaches every morning. And one of our litigation strategies was actually to send me into the home of these clients with these large glass bottles. And I would collect the cockroaches, hot glue-gun them to this poster board that wed bring to court for our cases. And we always won because the judges were just so grossed out. Far more effective, I have to say, than anything I later learned in law school.
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But over the course of these nine months, I grew frustrated with feeling like we were intervening too far downstream in the lives of our clients — that by the time they came to us, they were already in crisis. And at the end of my freshman year of college, I read an article about the work that Dr. Barry Zuckerman was doing as Chair of Pediatrics at Boston Medical Center. And his first hire was a legal services attorney to represent the patients.
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So I called Barry, and with his blessing, in October 1995 walked into the waiting room of the pediatrics clinic at Boston Medical Center. Ill never forget, the TVs played this endless reel of cartoons. And the exhaustion of mothers who had taken two, three, sometimes four buses to bring their child to the doctor was just palpable.
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The doctors, it seemed, never really had enough time for all the patients, try as they might. And over the course of six months, I would corner them in the hallway and ask them a sort of naive but fundamental question: “If you had unlimited resources, whats the one thing you would give your patients?”
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And I heard the same story again and again, a story weve heard hundreds of times since then. They said, “Every day we have patients that come into the clinic — child has an ear infection, I prescribe antibiotics. But the real issue is theres no food at home. The real issue is that child is living with 12 other people in a two-bedroom apartment. And I dont even ask about those issues because theres nothing I can do. I have 13 minutes with each patient. Patients are piling up in the clinic waiting room. I have no idea where the nearest food pantry is. And I dont even have any help.” In that clinic, even today, there are two social workers for 24,000 pediatric patients, which is better than a lot of the clinics out there.
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So Health Leads was born of these conversations — a simple model where doctors and nurses can prescribe nutritious food, heat in the winter and other basic resources for their patients the same way they prescribe medication. Patients then take their prescriptions to our desk in the clinic waiting room where we have a core of well-trained college student advocates who work side by side with these families to connect them out to the existing landscape of community resources.
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So we began with a card table in the clinic waiting room — totally lemonade stand style. But today we have a thousand college student advocates who are working to connect nearly 9,000 patients and their families with the resources that they need to be healthy.
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So 18 months ago I got this email that changed my life. And the email was from Dr. Jack Geiger, who had written to congratulate me on Health Leads and to share, as he said, a bit of historical context. In 1965 Dr. Geiger founded one of the first two community health centers in this country, in a brutally poor area in the Mississippi Delta. And so many of his patients came in presenting with malnutrition that be began prescribing food for them. And they would take these prescriptions to the local supermarket, which would fill them and then charge the pharmacy budget of the clinic. And when the Office of Economic Opportunity in Washington, D.C. — which was funding Geigers clinic — found out about this, they were furious. And they sent this bureaucrat down to tell Geiger that he was expected to use their dollars for medical care — to which Geiger famously and logically responded, “The last time I checked my textbooks, the specific therapy for malnutrition was food.”
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(Laughter)
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So when I got this email from Dr. Geiger, I knew I was supposed to be proud to be part of this history. But the truth is I was devastated. Here we are, 45 years after Geiger has prescribed food for his patients, and I have doctors telling me, “On those issues, we practice a ‘dont ask, dont tell policy.” Forty-five years after Geiger, Health Leads has to reinvent the prescription for basic resources. So I have spent hours upon hours trying to make sense of this weird Groundhog Day. How is it that if for decades we had a pretty straightforward tool for keeping patients, and especially low-income patients, healthy, that we didnt use it? If we know what it takes to have a healthcare system rather than a sick-care system, why dont we just do it?
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These questions, in my mind, are not hard because the answers are complicated, they are hard because they require that we be honest with ourselves. My belief is that its almost too painful to articulate our aspirations for our healthcare system, or even admit that we have any at all. Because if we did, they would be so removed from our current reality. But that doesnt change my belief that all of us, deep inside, here in this room and across this country, share a similar set of desires. That if we are honest with ourselves and listen quietly, that we all harbor one fiercely held aspiration for our healthcare: that it keep us healthy.
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This aspiration that our healthcare keep us healthy is an enormously powerful one. And the way I think about this is that healthcare is like any other system. Its just a set of choices that people make. What if we decided to make a different set of choices? What if we decided to take all the parts of healthcare that have drifted away from us and stand firm and say, “No. These things are ours. They will be used for our purposes. They will be used to realize our aspiration”? What if everything we needed to realize our aspiration for healthcare was right there in front of us just waiting to be claimed?
