As if in answer to the questions raised in my blog Wednesday about how health care might look years from now, former CMS administrator, Institute for Healthcare Improvement hall of famer and Massachusetts gubernatorial candidate Don Berwick introduced some provocative possibilities in his IHI annual forum keynote address later on the same day.
Before his talk, I had foolishly expected him to essentially rehash his themes from the AHA's Leadership Summit this summer (see our interview with him), but instead he delivered the most astounding health care keynote I've ever heard. I must confess that the first time I heard him speak back in 2005, I thought he came across as a little bit too self-assured for my tastes in the way he presented his case for improving quality. But his humbleness yesterday was noticeable. Maybe he's changed, I've changed or we both have.
What he proposed is an argument that the real progress in health improvement may come from what I can only describe as a new agey, power-of-the-mind process under the label of wellness to create healthy bodies. I won't try to reproduce the essence of his talk, because he did a tremendous job of making his case. In the process, he strung together seemingly unconnected events, including a drive to visit his grandson, the invention of a reliable clock and a visit with the Dalai Lama (so he's got that going for him.)
The speech seemed to break new ground — especially for someone from the health care establishment — by embracing what many would consider nonmedical solutions to creating an ideal health care system.
He set the tone with concrete, published examples of the placebo effect, describing studies of medical procedures that indeed did improve outcomes, but no more than the placebo. The physician laments that instead of celebrating the success of the placebo, health care deems the new procedure being tested a failure.
Berwick also goes on to describe how some say that the mind, through such things as acts of kindness and love, actually can improve your health, which would thrill me if true.
Berwick wasn’t suggesting that a mind-body wellness approach is a panacea for curing all that ails the health care system, but he's more than not ruling it out as a major part of the solution.
Berwick contends that current public policy is too far away from the core tenets of a wellness approach. He says one can study the writings of the wellness experts and "never, ever encounter a word, not a word, about markets or extrinsic incentives or controls or regulation."
"What you will read will begin with the discovery of self, with the connection to one's higher purpose, with awareness of the moment, with the discipline of mindful living."
That's a long way from a campaign to save 100,000 lives, that’s for sure, and if anyone can get the ball rolling on this kind of change, Don Berwick can.