Salus University

Salus University

Sunday, November 16, 2014

THE AFFORDABLE CARE ACT AND OUR PROFESSIONS - PLAYERS OR SPECTATORS?

Earlier this week while attending the American Academy of Optometry meeting I wrote a blog posing the question, "How does optometry want to fit into the new healthcare landscape?"  Much to my surprise, while many have had the opportunity to look at the entry, only one person responded - and that person did so in a personal email, not on the blog.  Now that the meeting is over and I’m headed home I'm wondering why the silence?  I think this is a discussion and debate that optometry and all the other health science professions need to have.  

As the effects of the Affordable Care Act take hold on the American healthcare system the number of payment and payer options for our professions will unquestionably change.  Today there are a myriad of payer and insurance companies.  According to the experts I've talked to this almost certainly will change.  In the (very near) future we will see a consolidation of insurance providers and payers much like we've seen in the American healthcare sector.  We've already seen this happen to our airline industry.  Remember when there was an Eastern, National, Pan Am, TWA, and Continental airline?  Well, now there are only a few major carriers.  We're going to see the same thing occur with health insurance carriers.  Optometry, Audiology, Occupational Therapy, Speech, Language Pathology and the other health sciences must be agile in adapting to this new environment, otherwise they risk being "boxed out" by major carriers or worse.  

In my humble opinion, one of the best ways to do this is to ensure we're all part of what will be an integrated system of healthcare providers who are aligned with Accountable Care Organizations, Patient Centric Medical Homes and Medical Neighborhoods and other entities that focus on the delivery of primary care, high quality and value.  As I mentioned in my prior blog I believe this will require all the schools and colleges to work together to develop and teach our students how to best work within this new landscape.  This includes business prowess but also must include in-depth discussions in policy and how to influence policies.  

For optometry, I also believe the profession will need to continue its evolution as a primary care profession to include the management or co-management of common metabolic disorders such as diabetes, hypertension and hyperlipidemia.  As our healthcare system focuses more on the public health, outcome data, access to care and cost, professions such as those were training need to become more involved in prevention and patient education.  Smoking cessation, nutritional counseling, and lifestyle advice need to become integral parts of what we teach and ultimately integrate into our everyday practices.  

There is a great deal to think about as we enter into this new chapter in healthcare delivery.  I want us to be part of the discussion on what this looks like and not the recipient of what others develop for us.  Complacency and sitting on the sidelines is not only an unacceptable course of action but can very well become a devastating behavior that leaves many health science professions subservient to others; something many have successfully worked very hard to avoid over the past 50 years.  


It's time to be bold, creative and responsible.  Educators, providers, researchers, industry and other important collaborators need to come together and have a very candid debate on how we all fit into this new healthcare landscape.   We can choose to be spectators or players - Players determine the outcome of the game - spectators only can brood about the outcome.  I want to play;  I hope you do as well!

Tuesday, November 11, 2014

HOW DOES OPTOMETRY WANT TO FIT INTO THE NEW HEALTHCARE LANDSCAPE?

I just finished participating in a meeting of the Association of Schools and Colleges of Optometry.  That group is composed of all the Deans and Presidents of the nations optometry schools with representation from our neighbors in Canada.  I had the distinct honor to lead a discussion on how optometry, as a profession, will prepare our new graduates to work in the new healthcare landscape that has been developed by the Affordable Care Act.  Along with that I also asked the group to explore how to build the foundation for the expansion of clinical privileges to include the diagnosis and treatment of such pervasive diseases as diabetes, hypertension, hyperlipidemia and other prevalent metabolic disorders that often beckon the doors of optometric practice.  The discussion on expanding the scope of practice was spirited, to say the least.  There was consensus that we, as educators, need to do a much better job of preparing our graduates to succeed under the new healthcare landscape to include understanding the lexicon of Accountable Care Organizations, Medical Homes and other payor models.  I think we agreed to all work together to develop a consolidated curriculum that will address this in the near future.  I'm committed to having Salus take the lead on this.  

There was much more discussion and debate around the scope of practice expansion.  The Affordable Care Act will result in a significant shortage of primary care providers in the country through the foreseeable future. Someone is going to need to fill that void to see those diabetics, hypertensives and others needing care.  While physician assistants, nurses and possibly others will certainly help to fill that void, optometrists are extremely well positioned to provide the necessary care.   Many diabetics and hypertensive patients are often diagnosed or referred for definitive diagnosis following a routine eye exam.  With additional didactic and clinical training, optometrists can obtain the necessary skills to care for those patients.  While much work still needs to be done both academically and statutorily, I believe this is the direction that optometry needs to take.  A little over 30 years ago optometry obtained diagnostic and therapeutic privileges.  For the benefit of the public health, economics and the patients optometrists care for, it's now time for the profession to take the next evolutional step towards the diagnosis and management of the common diseases aforementioned.  Appropriately, there will be much debate over this, but in the end, the profession needs to decide what direction to take as we enter into this new landscape of healthcare delivery.

Friday, November 7, 2014

REFLECTING ON VETERAN'S DAY AND A CALL TO SERVICE

As we approach Veteran's Day next week I can't help but to reflect on the sacrifices those in uniform and their families have made to ensure Americans continue to enjoy the freedoms and quality of life that help to define our lives here.   Those veterans who came before us, as well as those currently serving, have done so out of a sense of patriotism and having the call to serve. 

As we reflect upon all the great gifts we have in our country, I think it’s also very fitting to reflect on how we too, as healthcare professionals, can contribute and give back to society, both here and abroad.  I’m not suggesting or expecting anyone to all of a sudden to join the Armed Forces or volunteer for the Peace Corps (although I also wouldn’t discourage it) but I am proposing we take some time to explore how we can better leverage all of our skills towards the betterment of the public health of Americans as well as others.  The call to serve should be a natural desire for all of us in healthcare.  While many do volunteer to “do good things”, I don’t believe it’s the norm; and I certainly don’t believe there’s enough. 

I’d like Salus to set a new standard and redefine how we reach out to others, both here and abroad, to have an even greater impact than we do now on society.   As many of you know, we currently care for children in Philadelphia, Norristown and surrounding public schools, send teams to Haiti, rural, middle America as well as other locations, but we don’t have a centralized, fully aligned approach to this.  I would like to use this refection on Veteran’s Day and a call to service to challenge the Salus community to work together to see how we can COLLECTIVELY pool our expertise as a University community to positively affect the lives of others.


I don’t believe there’s a single formula for this, which is why I’m challenging you to come up with some ideas.  One idea I’ve discussed is to reorganize SOSH and have them align with others at the university to expand their scope of services and destinations.  Let’s talk about it, develop a plan and then, in the true spirit of caring, generosity, ingenuity, and selflessness, execute something that has the Salus signature on it in honor of all those who have paid the ultimate sacrifice which allowed us to exercise our freedom in being able to choose healthcare as a profession - and then give something back to society as a way of saying "thanks". 

Sunday, October 19, 2014

Today Salus University payed tribute to Dr. Joseph Toland, a gentleman, scholar and true professional who has played a significant role into the evolution of optometry and our institution for several decades. Thanks to the generosity of many of our alumni, faculty and staff we have named the large classroom in The Eye Institute in honor of Dr. Toland.  

Dr. Toland has single handedly trained hundreds of us, took on organized opposition to the evolution of the scope of practice of optometry while at the same time caring for thousands of patients in world-class fashion.  His loyalty to our university, his students, his patients and our profession, combined with his compassion, great sense of humor and keen intellect, has had a significant impact on the quality of care we provide for our patients and the manner in which optometry is practiced nationally.  

If you get a chance, please stop by and say thanks to Dr. Toland for all he's done - and check out his portrait in the Dr. Joseph Toland classroom on the second floor of The Eye Institute.

Thursday, October 9, 2014

I'm taking this Blog in a different direction from my past messages.   This message is about philanthropy and how frustrated I've been about getting folks to both notice and support our outstanding Looking Out For Kids campaign.  This one charity singularly supports the efforts of the University to care for thousands of children in the Philadelphia and Montgomery county school districts who would otherwise not be able to obtain vision, hearing and other health-related screenings.  Furthermore, this fund provides glasses to underprivileged children who cannot afford them.  Needless to say Salus has changed lives through this extremely beneficial service.   

Unfortunately, all of these interventions cost money.  While we've been able to subsidize most of these efforts through the Looking Out For Kids campaign the University often must augment these services with human and fiscal resources that normally would be dedicated to other necessary functions.  Compounding all this, we have a 14-year old vision screening van that is outdated and in need of replacement so we can provide integrated health screenings, not just vision screenings.

I'm frustrated because as much as we publicize our efforts and people talk about the importance of helping children, there's relatively little to show in terms of philanthropic support for these efforts.  We have a fundraising event the beginning of November (invitation and link below) but the amount of money it raises barely covers the cost of gas for our van and a few pair of glasses.  I need your help in the form of suggestions, support and contacts so we can gain some traction on raising the necessary funds to support the youth of our communities.  I'm hoping someone who might be reading this can help provide some additional insights as to how we can best sustain these important functions.  I'd hate to see any support we're giving to children diminish due to lack of funding.

Sunday, October 5, 2014

It's been a very busy couple of months as began the new Fall semester.  In between the time I last blogged and this entry I've been to Egypt, Saudi Arabia, Germany and Israel to learn more about our international programs and help to market the cutting edge educational products we provide globally. It was an inspiring (and tiring) trip.  

We also have spent a great deal of time and effort, with many of your inputs, working on our strategic plan that will help to map the course of Salus University for the next 3-5 years.  Last Thursday and Friday we hosted an "retreat" for members of our Strategic Planning Steering Committee as well as our academic Deans and other key university leaders (that includes students, faculty, staff, the Board of Trustees and administration).  The key aspect of this planning cycle is to ensure we're moving forward as a University, not 4 separate colleges.  Thus each strategic priority will address how Salus will move forward, supported by aligned goals and priorities developed for each college.

At the facilitated retreat we reviewed the results of the environmental scans and landscape team reports.  From this information we developed an updated vision and mission statement for the University as well as formulated 4 overarching strategic priorities.  While these are not yet finalized I can tell you that they clearly embrace the key issues that influence and affect how Salus will interact with our ever-changing healthcare system, our prospective students, alumni, faculty and staff.  Many of these issues you brought to our attention during the scanning processes while others were articulated by some "thought leaders" in American healthcare who we sought out, to include the Acting Surgeon General of the U.S, RADM Boris Lushniak and Dr. Zeke Emanual, Director of the Clinical Bioethics Department at the U.S. National Institutes of Health and head of the Department of Medical Ethics & Health Policy at the University of Pennsylvania.  Both experts had similar thoughts on how Salus and those professions we train, will play a key and essential role in the American healthcare landscape of the near and far future.

Everyone left the 2-day event extremely energized and excited about the prospects for operationalizing the new plan.  Much work still needs to be done but I'm hopeful that within the next few weeks I'll be able to share some of the specifics with all of you.  One decision we did make was to begin to work on some of the key issues that affect student and faculty morale/life immediately.  To that end, you'll be seeing some working groups established that will address Universtiy policies that were identified that will give us some "quick splashy victories" moving forward.  

Finally, as I reflect on my first year at the helm of Salus I can't begin to thank everyone for making Tanis and me feel welcome to our community.  I realize I had big shoes to fill but with the help of many of you I believe we're making progress in building upon the wonderful legacy I've inherited.

Have a great week and keep those cards and letters coming!

Friday, August 29, 2014

I just returned from a trip with our Director of Development, Lynne Corboy, to visit alumni in Maryland and Virginia. It was a great trip as I had the opportunity to see how professionals from both optometry and audiology have used their skills to improve the lives of their patients both here in the U.S. and abroad.  It was also very nice to visit one of our retired alumni who has contributed a great deal to his community and our profession.  More on that later.  During the trip we stayed at the lodging facility on the U.S. Marine Corps Base in Quantico, Virginia.  Having served in the Washington DC area for many years I was very familiar with the base - and it felt good to go back.  One of the high points of my stay was a quick visit to the Naval Health Clinic on Quantico (Navy Medicine takes care of the Marines) where I wanted to show Lynne what an integrated care model looked like in practice.  The clinic integrates dentistry, primary care in the form of a Medical Home, optometry, pediatrics, mental health and other specialities under one roof.  When patients are seen in their Medical Home, if they require specialty care, often they are walked down the hall for either a same day appointment or an appointment within a week.  It's a very effective and efficient way to deliver health care; a model we need to embrace here at Salus.

One of the high points of my visit to the clinic was running into some officers whom I've had the privilege to work very closely with in the past who have become part of my "Navy Family".  It's great to be able to maintain these important relationships even though I've since moved on into academia.  We've followed each other's careers and I've been honored to serve as a mentor for many of these officers over the years.  So why bring this up? (Lots of themes bouncing around in this Blog entry!)

Well, we all develop personal and professional relationships and I would argue, extended families as we move through our professional programs.  You will develop very special bonds at Salus who will become your extended "Salus/Professional Families".  These will be folks you meet during the course of your time at the university that become not only life-long friends but confidants and extended family members you know you can count on (and they count on you) as you navigate through your education subsequently professional lives.  These relationships are something to be nurtured and cherished over time.

Now back to our alumni - our extended professional family.  The most "mature" family member we visited graduated in 1948 and is still active doing gardening, working out and giving advice to his step son, a current optometric provider.  Another of our family members is doing some very interesting work with macular pigmentation while the other is helping to change the lives of children in Kenya leveraging their skills as an Audiologist.   I think it's important to recognize what our extended family members are doing to better the lives of those they touch so we can determine what we might be doing to both augment and build upon their successes.

As we get ready to say farewell to Summer this weekend and get ready to jump into the academic and clinical cycles with fervor it's also a good time to reflect on those special relationships we've developed or will be developing and what they mean to us professionally and personally.  Take some time this weekend to recharge your batteries, energize some of your personal and professional relationships and come back next week ready to tackle whatever comes your way.

Wishing everyone a very safe and fun Labor Day Weekend.