Legalizing the Use of Marijuana in Maryland

So I thought that I heard it all when Senator Zirkin, who is sponsoring a decriminalization bill (from criminal to civil), said that he is not trying to get teens to smoke pot; he just wants to unclog the judicial system with marijuana possession cases.   Then Delegate Anderson, in sponsoring his bill to LEGALIZE marijuana possession and use, says, "Marijuana is not addictive at all unlike other drugs and alcohol." Well, Delegate Anderson, it's time for a reality check.

Marijuana has proven to inflict a long lasting, negative impact on your brain and the younger you are the worse it is.  Marijuana can result in functional brain deficits affecting communication skills and learning capabilities and shortening one's attention span.  It also affects the lungs and can lead to use of stronger drugs.  Studies have shown that the younger that you start to smoke marijuana, the more dependent that you become on other drugs.   Today's marijuana is not the marijuana that was smoked in the 70's; THC, the main ingredient, is far more potent today than the pot from the 60's and 70's.  And, don't even get me started on the effects of marijuana on the fetus when women smoke it while pregnant.  In fact, researchers aren't even sure what the overall or long-term effects are on children whose mothers smoked marijuana while pregnant. 

If you can't tell from today's blog, I am adamantly opposed to decriminalization and certainly legalization.  I would support a bill legalizing medical marijuana with strict conditions as I think that there are enough people who would benefit from such a law.  Hopefully, some sense will prevail in Annapolis during this legislative session and the bills sponsored by Senator Zirkin and Delegate Anderson are defeated.

Aesthetics of Hospitals

I saw an article the other day, "How Much Should Be Spent Beautifying Hospitals.” The article talks about the limited resources available for hospital design and construction, but yet hospitals continue to pour money into ensuring a hotel or spa-like venue.  Such amenities in hospitals are not usually found outside of the U.S. unless they are privately developed.  Recently, we had a team of Chinese students visit our hospital and they were amazed at what they saw.  Since we opened three plus years ago, we have had a number of international visitors and to a person they said that our hospital was nicer than most of the hotels in their countries. 

When we designed our hospital a lot of thought went into the attention to detail.  First and foremost, we wanted it to be welcoming as a healing environment without being ostentatious.  Our architects and interior designers went to great lengths to capture the essence of our region with the lighting, the earth tone colors throughout the facility, the spaciousness of the interiors and the quality of local art.  Our design also focused on state-of-the-art safety and infection control measures, along with ease of access and egress.  To this day, the exterior as well as the interior remain safe, beautiful and very well maintained.  Most importantly, they enhance the healing environment.

Another aspect of providing a healing environment occurred a little over a week ago while I was in the hospital doing rounds.  I stopped to listen to our volunteer Dion play the donated baby grand piano.  I was watching and listening from the second floor area that overlooks the lobby.  I was amazed at the number of people who walked by smiling--patients, visitors and employees, it didn't matter.  Some stopped to listen; some kept on walking, but to a person, everyone was smiling as they listened. 

Giving folks that calming, feel good environment certainly is an objective that we set out to accomplish when the hospital was being planned.  The environment that we created hopefully allows patients to transcend their illness for a period of time.  What we have done through design and amenities, along with other U.S. hospitals, should be looked at as an added bonus toward the healing process.

South Carolina Gets It Right

I learned over the weekend that Governor Nikki Haley of South Carolina has issued an Executive Order to all Cabinet agencies, boards and commissions to review all current and proposed statutes, regulations and policies that are overly burdensome to the state's economy.  Wow, talk about a Governor who gets it.  Governor Haley is soliciting input on the matter from the public, businesses, professional associations, government employees and others throughout the State.  What a refreshing change it would be to have a governor issue such an order and challenge everyone to get rid of overly burdensome laws. 

In Maryland, it seems that we can't help but to drive business away year after year through excessive regulation and taxes.  It is especially troublesome when we border one of the most business friendly states in the US (Virginia) and that Maryland is one of the most poorly rated states in which to do business.  Maryland seemed to be making some headway in the business friendly rankings, but to make matters worse we are now considering increasing the minimum wage and making sick days mandatory for every employer to provide to its employees.  Neither is that onerous to large businesses in Maryland, but a killer to small business.  I applaud Gov. Haley for undertaking such a visionary initiative in making South Carolina less regulatory burdensome and more business friendly.

Andrew Weil, MD

Last evening, I had the rare opportunity to hear Dr. Andrew Weil speak.  He was the guest of Frederick Memorial Hospital, as was I, and he spoke at the Weinberg Center in downtown Frederick.  For those of you who don't know Dr. Weil is, he is on the leading experts on Integrative Medicine.  When I lost 40 pounds a number of years ago, it was Dr. Weil's approach to a healthier life style that I followed.  I am back at it trying head off a pre-diabetic condition by once again following Dr. Weil's food pyramid which includes red wine (thank God), dark chocolate sparingly, tea (my drink of choice), healthy fats  (I have since acquired a taste for Salmon),  water (my other drink of choice), multi-grain pasta, fruits, vegetables, whole grains, good protein and dietary supplements.  I am still not a fan of soy products, beans and legumes, but who knows now that I like good Salmon.  I have lost 13 pounds in about 6 weeks and brought my blood glucose level down with an A1C now in the normal range. 

I will keep you posted on my progress, but I really enjoyed the opportunity to hear Dr. Weil. I am even practicing his breathing technique that is supposed to be a cure all so we'll see.

The Good, The Bad and The Ugly of Social Media in Health Care

One of the educational programs that I attended when I was in Chicago this week was on Social Media.  This is a topic that intrigues me based on how fast it is growing, and anytime that I can attend such a session, I try to because the information changes so quickly.  I learned that the use of Social Media among older adults is growing rapidly, especially those over 65.  The reason is attributable to seniors being able to Skype directly with grandkids, see photos of them almost daily and the same with videos and messaging.  Up until now, the traditional health care Social Media early adopters have been the young, family caregivers, minorities, Medicaid beneficiaries and patients with complex needs.  I also learned that 82% of American health care consumers feel that hospitals with a strong social media presence also feel that the clinical functions of those hospitals are on the cutting edge.  Also, 80% of health care consumers look online for health information, which is up dramatically from previous years.  Another interesting point was that customer relationship management in hospitals is aided greatly through Social Media as we have found at WMHS.  We have seen a growth in texting, emailing, Twitter, Facebook and the use of You Tube.  We will also begin a more intense look at Yelp, Google +, Wikipedia and Foursquare going forward.  All good stuff; little to no bad and ugly.

The Real Accountable Care

I have been at the American College of Healthcare Executives Annual Congress for the last several days.  What I have found truly amazing by interacting with colleagues and attending the many educational sessions is that the Western Maryland Health System is so far ahead of hospitals across the US in our approach to accountable care.  By accountable care, I don't mean the creation of an Accountable Care Organization, aka ACO; that will come in time.  What I mean is our approach to finding better ways to care for our patients while reimbursement is being ratcheted down and expectations for better outcomes have been elevated. Our approach to accountable care can be found in our initiatives to reduce readmissions, more comprehensive care plans and discharge plans, case managing our high utilizers, the establishment of clinics and medical homes, the creation of primary care practices in the community and a much more comprehensive approach to the care of the patient through initiatives such as Perfect Care and better care coordination.  We should be teaching this stuff.  Great job, everyone!

Sequestration is Being Done The Right Way in Certain Government Depts.

Over the last two weeks, I have complained on a few occasions about the Federal Government's approach to Sequestration.  I am happy to say that there are some in the Government who are approaching their cuts appropriately.  I am in Chicago for the American College of Healthcare Executives Annual Congress.  I try to get here every two to three years for ongoing board recertification purposes as a Fellow in the American College of Healthcare Executives.  Anyway, for this year's Congress, the great majority of attendees from the Department of Defense and Veterans Affairs are not here.  They were not permitted to attend due to the cost associated with their attendance and the unavailability of funds.  The Congress is usually attended by thousands from both Defense and the VA.  There are a few in attendance; however, they are not in uniform this year (of which they usually proudly don their respective uniform whether it's Army, Navy, Air Force or Marines).  I don't know how the chosen few were selected to attend, but again, only a few are here.  In fact, during one of the educational sessions that I attended, an Army officer in attendance revealed that the Army alone is getting ready to release over 80,000 soldiers from their ranks with an expectation of 200,000 over the next few years.  We continue to hear of the cuts that have been put in place to alarm the country; however, some Government agencies are approaching their cuts just as those in business have done when faced with the need to reduce expenses.