SPEECH BY: TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES PLACE Chicago Medical School, Finch University of Health Sciences, Chicago, Illinois DATE: June 7, 2002
"Preparing Today for the Patient of Tomorrow"
Good morning, and thank you so very much for your kind words of introduction. I'm so very pleased to be here at this distinguished school and to congratulate all the graduates for their achievement on this day.
Before I share some thoughts with you, let me just say to all the graduates, "Congratulations." You have succeeded. That deserves a big round of applause.
And let's all recognize your Moms and Dads, your husbands and wives and the loved ones who helped you get through your studies. They deserve applause, too.
They deserve so much credit … especially since, because of supporting you financially in medical school, they probably have so little credit left.
Of course, the families and friends of the graduates supported them in so many ways other than financially. They gave emotional support, offered encouragement and sometimes a much-needed pep talk.
You've stayed the course, and now are about to formally become physicians, nurses, health professionals. It's a wonderful day.
To the graduates here today, you are here today because you have given your best. You have worked, studied, sweated and lost more sleep than you can readily recover.
Whether you will be a physician or a researcher, a therapist or a scientist, your role in the future of health care in our country will be essential. The art and science of medicine depends on you.
And, as you know, the distance from the research bench to the patient's bedside is closer than ever. So, you truly are a team, interdependent and interconnected.
Each of you is driven by compassion and motivated by a desire to serve. And some of you are going into areas of very specific types of service.
Dr. Doug Blume' is going into general surgery in the Navy. He'll be practicing at the Naval Medical Center in Bethesda, Maryland, not far from my office.
And Dr. Kurt Wohlrab will serve as an orthopedic surgeon in the Army in Hawaii.
On behalf of our Commander in Chief, let me thank you, Drs. Blume' and Wohlrab, for your service to our country. And let me thank all of you who are committing yourselves to work in the Public Health Service … in the Peace Corps … in poor or rural communities. You will be giving so much back, and I thank you for it.
Your residencies will be exciting, because we are living in the most remarkable era in the history of medicine. From prenatal surgery to advances in geriatric health, we are enjoying the benefits of research, new drugs and better treatments that would have left previous generations astonished.
You, my friends -- physicians and scientists, occupational therapists and nurses and physicians assistants -- are poised to lead us into a bright future.
In many ways, we're on the right track. Our medical services and research are tremendous. We're pouring billions of dollars into developing all manner of treatments, pharmaceuticals and medical devices.
Our physicians and surgeons, nurses and health care professionals … indeed, our entire health care system … are the best in the world, bar none.
But the way we provide the high-quality care we now have is inefficient to the point of becoming archaic. Let me offer two scenarios that illustrate what I mean.
First, let me describe the patient of today. There's much that this patient can be thankful for - many advances in medicine that improve the quality and longevity of life and the finest medical system in the world. Yet serious needs exist in the way we provide care.
Today's patient almost always needs to see a primary care physician before getting advanced treatment … and has to deal with multiple referral forms and other paperwork, as does her doctor and his staff.
Today's patient is given care to remedy existing illness and disease and usually is not given the kind of preventive care that forestalls illness and disease to begin with. Preventive care takes a back burner as caregivers struggle to fight the ailments and illnesses that bring their patients in to see them. We're working to change this, as I'll detail in a few moments.
The lab work that is performed is tailored less to the patient than to the disease itself. And after the lab work is completed, the patient of today sometimes has to wait too long for the results to come back and can be confused by the technical information he or she receives.
Coordination and communication of care frequently are poor. The patient has to go to multiple specialists, receives multiple bills for overlapping care and sometimes gets the wrong prescription. Let me suggest that one way to help change that is for physicians to take a course in penmanship …
Today's patient often sees different doctors and nurses each time she goes in for an appointment … the patient's records are kept in manila envelopes that are often inconvenient to store and use.
And if the patient gets sick in another city, it's nearly impossible to get her records forwarded in a timely way.
That's how the patients of today are treated, and how we provide care and coverage to them. We have wonderful technology, but some grocery stores have better technology than our hospitals and clinics.
The bottom line is that our system of health care delivery has not matured at the same pace as our technology.
That brings me to the second scenario: The patient of the not too distant future -- a future that depends on the creativity and expertise you will bring to it.
You are so essential, my friends, to the future of health care in this country. You have shown great initiative, discipline and concern. Let me ask you not to let up, to keep going, to never stop growing in either knowledge or compassion.
As you keep growing, patients of tomorrow will benefit. They will be treated on the basis of advanced preventive strategies. Physicians will understand the genetic basis of disease and will incorporate it into their management of patients.
Patients will be cared for through a home-based system and the patient will routinely contact their physician through the use of telemedicine, the Internet and other electronic technologies. Prevention will be key to medical therapies and will begin in prenatal care and infancy.
We will have computer chips that inform us of our genetic predisposition to illness, medication sensitivities and the environmental risk factors that may trigger these problems. A coordinated team of physicians, nurses and allied health professionals will work together through a paperless system to provide care to the patient, independent of where they are cared for.
If admitted to the hospital, the patient of tomorrow will not be required to fill out elaborate forms. The use of telemedicine will allow one's whole medical record to be sent from one part of America to another within seconds.
We will carry wallet-sized cards that have our latest EKG, chest x-ray, lab tests, operative reports and other critical data encoded in them. And to protect privacy we will use iris scanners -- scanners that evaluate the unique features of the iris in a person's eye -- to activate these cards.
Patients will have diagnoses made with non-invasive scanners and most surgical repairs will be performed through laporascopic techniques using robotics.
Medications will be tailored to our own genetic code and delivered safely through bar-coded systems.
Billing will be processed at the time of care. Patients will know the costs and will be satisfied with the quality of care you provide, but will not be encumbered by mountains of confusing paperwork.
That, at least, is the ideal, one that we can envision as real. But the challenge is a large one -- how to make it happen.
And as an aside, let me tell you that one of my other goals is that the patient of tomorrow will live to see the Chicago Cubs win a World Series. Actually, I hope that will be true for all of us, and that it will be soon.
We will have to fundamentally change the current health care delivery system in our country. The myriad rules, regulations and restrictions that make obtaining good health care I've just outlined difficult, if not impossible, have to be reviewed carefully and, when necessary, jettisoned like useless ballast.
To make this kind of future real, we will have to bring systemic change to our health care system. I'm not talking about tinkering at the edges. I'm thinking of renewal and transformation.
I'm thinking about a system of care that allows men and women like the graduating class before us practice medicine as it should be practiced - with compassion, personal attention, focused knowledge, practiced expertise, limited paperwork and streamlined regulations.
We are taking some significant steps in this direction already. I have established a regulatory reform task force to ferret-out cumbersome, unnecessary rules and regulations.
We're pushing ahead with our comprehensive effort to modernize and improve Medicare. And we're working to extend quality, affordable care to the nearly 40 million Americans who still lack health insurance.
We need to re-think the way we provide health care in our country -- not through some government takeover of one-seventh of the U.S. economy, but through effective action that leverages the coming technological advances with the forces of change we see on the horizon -- a more patient-focused world.
Let me underscore the importance of preventive medicine to the kind of transformation I am describing. One-quarter of the Medicare budget is devoted to caring for people in the final year of their lives. And about 90 percent of health care dollars are spent on treatment, leaving only 10 percent for prevention.
My department has launched a major initiative to encourage Americans to eat better … exercise moderately but consistently, and to stop smoking. Even modest change can bring about significant health benefits.
You see, as I often remind my staff, I abhor the status quo. Just because something exists doesn't mean we have to accept it as permanent if all it produces is mediocrity and dissatisfaction. And the status quo in our health care delivery system no longer earns a passing grade.
My friends, everything I've been saying to you today is best summed up in a statement by one of our country's most beloved philosophers, Will Rogers. As he put it, "Even if you're on the right track, you'll get run over if you just sit there."
I fear that the health and well-being of the American people will, to use Will Rogers' expression, "get run over" because even though we're on the right track, we risk just sitting there and not moving.
I'm committed to doing my part as Secretary of Health and Human Services. Ladies and gentlemen, that's not a rhetorical pleasantry. I mean it. And I need the advice and counsel of the people who have to live with the system as it currently exists. Graduates, I need you to let me know how to make things better.
And I want to ask you to promise not to simply accept things as they are, to adopt the status quo as your own. Raise your concerns. Propose your ideas. Fight for transformation of the health care delivery system. If we each do our part, the patients of the future will benefit more than we can imagine.
As we consider the patient of the future and the great increases of medical knowledge, let us not forget that the principles behind the practice of medicine are unchanging.
I'm thinking of service … compassion … an unrelenting commitment to relieve suffering, bring healing and provide hope.
Service, compassion and commitment to helping others can take many forms. Today, as I speak, brave Americans are serving in Afghanistan and elsewhere to continue eradicating the international terrorist network.
We owe them our enduring freedom and the way of life we cherish. And, as I said, people like Drs. Blume' and Wohlrab will soon join them.
Let me urge others of you to consider joining the U.S. Public Health Service … practicing in a community health center … working in a rural health clinic … serving abroad in the Peace Corps … joining the Centers for Disease Control to work on public health and safety issues ... and serving those most vulnerable and at-risk.
But even as I urge you to serve with passion, energy and ethical conviction, let me also urge you never to neglect the things that give your life balance and renewal.
As health care professionals, stress will be your constant companion … and it can take a tremendous toll. For the sake of your families … your patients … and your own good health, don't let that happen to you.
Faith … family … friendship … and some good old-fashioned hobbies can help you retain the energy and hope each of us needs. As for me, I jog … I read history … I ride my Harley-Davidson ... and yes, I wear a helmet. My Harley is a fine Wisconsin product, I might add.
As you take your Hippocratic Oaths in a few moments, you will affirm the ethical parameters of your service. Let me conclude by urging you never to forget that human life is precious and sacred. You are being given a profound trust. Please, fulfill that trust with care, diligence and compassion.
I know you will. And I envy you for what you will see … and am proud of you for what you will do.
Thank you all so very much, and again, congratulations.