Health Care's 'Best Hope'

Re: "The First Line of Offense" by Marty Stempniak, June H&HN

I feel that community health workers represent the best hope for American and, perhaps, global health. They have to be the real deal, selected for their leadership qualities and sense of mission to serve their own communities, where they are true peers of the people they hope to reach ... not folks brought in from outside, however well-intentioned they might be. CHWs should be recruited with community input, supported by knowledgeable managers and organizational advocates, trusted for the unique role they play, and trained or capacitated for skills they themselves know will most benefit their peers. Today, we have a dangerous mix of elements — social and biological determinants of health that are increasingly inequitable, a rapidly changing demographic (language, culture, other factors), and the costly, high-tech, and largely unsuccessful face of American health care. We shouldn't expect CHWs to fix all the dilemmas we've created or allowed, but they are a huge part of the solution.

As a physician, I've had the privilege of working alongside CHWs for almost 30 years and have never seen anything to match what they can contribute to health systems planning. Thus, it's encouraging to see them acknowledged in so many quarters recently.

I'm worried, though, that misunderstandings, underestimation of proper CHW skills and scope, and the usual health care hierarchy may squander our current opportunity to identify, support and utilize more CHWs, instead, relegating them to other roles (as eligibility workers, interpreters, etc.), viewing them solely in a cost-savings mode, selecting them for convenience, and improperly calling them CHWs (e.g., college students wanting a summer job). If CHWs are to promote health, advance equity and build communities, they must hail from those communities and be regarded as professionals ... and be trusted ... by licensed clinicians as full members of the health care team.

Tina Castaneres, M.D.

A Trustee at 24?

Re: "New Blood for Your Board" by Laura Putre, July H&HN

I am 24 and just finished my second master's of science. This one is in health care administration. Is there a possibility of being a junior board member? I am really excited by the prospect of health systems and hospitals looking for new younger board members. I have a fantastic understanding of technology, marketing and general management strategies, especially in health care. I realize that I am young, but I would love to serve a board as a junior member or as a trainee to move up to full member when I have gained more experience.

Engaging Hospital Workers

Re: "New Way to Staff a Hospital" by Charlotte Huff, June H&HN

One thing stands out to me in this article. Redeploying staff and using staff to their maximum skill level are great drivers of engagement. When folks are satisfied, energized and productive (my definition of engagement from years of study and writing), they are happier, better with patients and coworkers and provide safer care. Since boring work is demotivating and can lead to mistakes, your points are well taken. Administrators who work with staff to do their best work at the highest level will also see the ancillary benefits of optimized engagement.

Vicki Hess

Forget Your Ego and Listen

Re: "New Way to Staff a Hospital"

Very insightful article. I especially agree with the suggestion regarding retraining existing clinicians. Effective communication is key and listening is a big part. I always say that it's about doing what's right for the patient and not so much about what is right for your ego.

Jackie Biddle Shuler

Retraining Clinicians, Step 1

Re: "New Way to Staff a Hospital"

I'm happy to read this. Retraining clinicians is the hard part. I think the first step is to help them tell themselves a new story about who they are and why they are there.

Annette Simmons