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Posted by on in Current Medical Issues

I hope everyone had a great Thanksgiving, and will have a wonderful holiday season. In my last newsletter I mentioned going upstream, and here is the explanation:


There were four friends walking in the woods alongside a river, when they saw a baby floating by down the river. The friends ran to the river, jumped in, and rescued the baby. Feeling good about what they had done, the friends were shocked to see another baby floating by. Once again they jumped in to rescue the baby. But soon there were more babies floating by, and soon it seemed that the number was increasing. The friends formed a line, a “bucket brigade”, to quickly pass the infants from one to the other to rescue them as quickly as possible. And still they kept coming.


Finally, one of the friends got out of the river and started walking upstream. One of the others called out “where are you going?” The friend replied “I’m going upstream to see who is throwing babies into the river and stop them”.


I call this being an “upstreamist” and I was happy to see that term used in the article I have linked to below. Given the crisis of our healthcare system, we need to go upstream to the source of the problem(s) if we are going to really solve them.

Providing healthcare advocacy is one way to go upstream and avoid problems before they occur and need to be fixed.

Cultivate More Upstreamists to Transform Healthcare 



Posted by on in Current Medical Issues

“Be the change you wish to see in the world”
– attributed to Ghandi

I subscribe to a number of news feeds related to healthcare and our medical system, and the dysfunctional way we pay for and administer medical care in the US is in the news constantly. In fact, it’s in the general news daily especially now that the presidential campaign season is in full swing. So I, like I am sure many of you, am not surprised when I read about how it has gone awry. Nonetheless, reading a personal story about the death of someone’s loved one from this dysfunction is heart wrenching every single time. 

When I saw this article “How American Health Care Killed My Father” by David Goldhill, it was so long that I anticipated skimming it. But I found it so gripping I read the entire piece in one sitting and it held my attention throughout. Not only does he describe what happened to his father, he discusses where the weaknesses in our system are, and then, in the section headed “A Way Forward” comes up with an excellent plan for changing the “medical industrial complex” to make it functional, economically sound, and to improve the quality of care.  

I hope you will take time to read the entire article, and I would love to hear what you think once you have read it.


Following in the path of change of the “healthcare” system, I spent last weekend at a conference for physicians who are looking for nonclinical careers in medicine. These  are not doctors who are just out of medical school or residency, but for the most part were people who had spent years practicing medicine. There were 4-500 doctors at this conference, and I served as a mentor—someone who is doing something different (serving as a healthcare advocate) and advising those who are interested in exploring my field. 

How is this related to the previous article about changing the health care system? I spoke to 60 doctors, and if I had had more time I could have spoken to many more. Doctors are well aware of the problems in our healthcare system, and are aching to change it. Passionately so—I saw that this past weekend. And it is the reason I became a healthcare advocate after 25 years of practice—I felt compelled to go “upstream” (not sure what that means? Stay tuned for next month’s newsletter) and do something about the delivery of healthcare.

Most people, I have found, don’t know that they can access someone to help them through the complex and convoluted medical system, and even more concerning, don’t realize how much they need someone to do just that.

I want to share with you two articles that really spoke to me about the necessity of having an advocate when going through a difficult medical problem.  This first one mentions someone who we all recognize, Tom Brokaw, and what he felt he needed when he was treated for multiple myeloma.


Not only is Tom Brokaw’s daughter an emergency medicine physician, she has worked as a healthcare advocate as well. And with all that he is able to access, he still felt uncomfortable with the “lack of shared dialogue” in his treatment—what I would call lack of coordination of care or project management. This truly does give me pause. If he found this difficult, it is abundantly clear that we would certainly find it so.

The second article is about the ideal coordination of care—sort of a best-case scenario for how to navigate through a health crisis.


The journey of the author of this article and her cat, Humphrey, through the veterinary healthcare system made me envious of this marvelously integrated care. And it also provides a road map for what we could have if we had the will to make it happen.

I would love to hear back from all of you with your thoughts and questions about these articles, or topics you would like to hear about.