From "concierge" services to iPads connecting new parents with their babies in the nursery, Kojo explores some of the patient-centered ideas coming from health care innovation labs at local hospitals.
A healthier lifestyle is a New Year’s resolution for many, and employers are increasingly partners in that goal. With an eye toward reducing health care costs, many workplaces offer wellness programs, including help quitting smoking and incentives for gym memberships. Alternative therapies like acupuncture are also increasingly covered, and some states even require they be included in healthcare plans. We explore how approaches to health in the workplace are changing.
- Robert Duggan Co-founder, Tai Sophia Institute; Consultant, Wisdom Well; author, "Breaking the Iron Triangle: Reducing Healthcare Costs in Corporate America" and "Common Sense for the Healing Arts"
- Howard Ross author, "Reinventing Diversity: Transforming Organizational Community to Strengthen People, Purpose, and Performance" (Rowman & Littlefield); also Principal, Cook Ross
MR. KOJO NNAMDIFrom WAMU 88.5 at American University in Washington, welcome to "The Kojo Nnamdi Show," connecting your neighborhood with the world. Howard Ross is here. Happy Birthday.
MR. KOJO NNAMDIOur New Year's resolutions to get healthy may already be fading, but your workplace likely wants you to stick to that diet and exercise regime. Yes, they care about you. They also care about their bottom line. And healthier lifestyles and preventative care means less money spent on doctor's visits and fewer missed workdays. Most big employers now offer wellness programs like help in quitting smoking and incentives for gym memberships. And alternative medicines like acupuncture are increasingly included in healthcare plans.
MR. KOJO NNAMDISome states will now require non-traditional therapies to be covered in healthcare plans, as they revamp their rules to comply with the new healthcare law. Joining us to discuss this is Howard Ross, Diversity consultant and a principle at Cook Ross, author of "Reinventing Diversity: Transforming Organizational Community to Strengthen People, Purpose and Performance." I said earlier, Happy Birthday. You know people always say belated birthday greetings when they're late. I like to give advance birthday greetings.
MR. HOWARD ROSSYeah, Happy New Year to you, Kojo and the same to you. Yours is tomorrow, so we share…
NNAMDIMine is tomorrow, yes.
ROSS…we share this week, right?
NNAMDIThat is fantastic. Yes, we share this week.
NNAMDIAlso joining us in studio is Bob Duggan. He is co-founder of the Tia Sophia Institute, a center for healing arts in Columbia, Md. He's a consultant with the Wisdom Well, an acupuncture and wellness clinic. He's author of "Breaking the Iron Triangle: Reducing Healthcare Costs in Corporate America," and "Common Sense for the Healing Arts." Bob Duggan, thank you for joining us.
MR. ROBERT DUGGANThank you for having me. I'm delighted to be here.
NNAMDIYou, too, can join the conversation. Call us at 800-433-8850. Do you use alternative therapies like acupuncture, like meditation? 800-433-8850. Bob, you point out that life expectancies in the United States is ranked, when I checked this morning, 38th in the world. Yet, as we know, we spend more per person on healthcare than any other country in the world. In your opinion what are we doing wrong?
DUGGANWell, we have a disease care system, rather than a healthcare system. We are attending piecemeal problems and separating the parts of the body. And that just led us down into a payment structure and outcome structure that's not very useful. So our outcomes, if you measure them, for our extraordinary expenditures, which are much higher than anyplace else in the world, are not producing a well culture. And the main point of the book and the conversation is corporations are beginning to be aware of that and realizing that instead of spending so much on the disease care part of their employee structure, if they keep them well, the workplace functions better and there's more contentedness.
NNAMDIHoward, many of us get our healthcare through our employers and have employers' attitudes toward the health of employees been changing, as Bob just pointed out? What have you been observing over the past decade or so?
ROSSWell, you know, it's really interesting, Kojo. You know, Bob and I are friends and we're actually looking at how do we take this work that he's been doing and move it into organizational life. And for me this is a return back to almost 30 years ago when my mentor, Bob Allen, was starting to do this work in organizations. And unfortunately it got derailed a bit when, in the early '80s the healthcare systems put in the designated, regulated guidelines for healthcare. And so everybody kind of pulled back into the system and stopped doing some of the earlier wellness work that was there.
ROSSBut I think what's happening in a lot of organizations is on one hand we know that there's the rational thinking about yes, healthier employees are more productive. We know that's there. And yet, the fundamental structures and systems of the cultures of organizations are really not designed for people to be healthy. You know, I couldn't help but smile as I was listening to the prior show you had on, just the first hour. We were talking about zoo structure. Because when I was a kid I had a job when I was a senior in high school at the National Zoo.
ROSSYou know, I was a parking guard or something, but it was at the time when zoos were starting to build these new kinds of enclosures that your guest was talking about, which are much more humane if you will, that created an environment. And up to that time of course it was how many animals can we stick into a confined period of time? And they began to realize that animals had shorter life spans. It was costing them more. That there was an actual productivity cost, as well as a humane cost in changing those environments for animals. And yet, we're still at the very early stages I think of most organizations really understanding what that means.
NNAMDIOf course we've seen some of this in our own healthcare plan here at American University. We've got now wellness programs that offer a range of things, free yoga, boot camp, resistance training classes, seated massage, preventative screenings on campus, clinics for flu shots, etcetera, on-campus farmer's market. Bob, you lecture to many companies about new approaches to healthcare and while they may care about their employees, there's another important reason they should be addressing these issues. What do you tell them about costs?
DUGGANWell, the chemical I show in the book, has reported a return of 5.81 for every dollar they invest in wellness. So when a corporation invests in the wellness of their employees there's a huge bottom line. I think they say they project they'll have a $420 million contribution to their bottom line over 10 years from investing in the well-being. Now, one of the issues you mentioned, all of those techniques that you have available at American University, they're all wonderful and terrific. And I've done acupuncture for 40 years and I've been training students at Tia Sophia, but it's a different thing if you have a headache -- and this is the difference -- if you have a headache do you need to have an MRI and a specialist or do you realize you're tired and need more sleep?
DUGGANThat will be the transformative conversation. A man said to me 30 years ago, Bob, I never thought asthma would be my friend. And I said, Charlie, what the hell are you talking about? Asthma will be my friend? And he said, well, I used to be in and out of the ER and I was constantly on Prednisone. He said, now I pick up a little bit of wheezing three days earlier. And if I pay attention to that, realize I've had too much caffeine, haven't slept, haven't talked to my wife, I don't want to get rid of that little bit of wheezing because it reminds me I'm not taking care of myself. So asthma has become my friend.
DUGGANAnd I told that story to a large audience one day and two Olympic-level swimmers came up to me and said afterwards, thank you for telling that story because I have asthma and my asthma actually taught me how to swim, taught me breathing. And so that's the deeper transformation. You can do acupuncture to fix your asthma or you can do acupuncture to awaken what you already know about your wellness, Kojo.
NNAMDIThis is fascinating. You often start your seminars by asking what people's five symptoms are. I sneeze twice a day at least. What's the idea behind that question?
DUGGANWell, what I've discovered over the years -- and we have a fair amount of research now. Everybody I've met has about four or five symptoms that go on. So if you see me here cleaning my glasses endlessly, it means I'm tired and I want a nap, but I'm going to solve it by polishing the glass. Now, if I don't take that nap, in a day or two I'll be peeing more frequently and there's a sequence of five symptoms in my body. The end of it is my left ankle will get swollen, which means I can't stand anymore. At that point I need 36 hours of sleep.
DUGGANBut I did this with a major fortune 100 company with about 80 employees recently. There was a woman there -- and they asked me to do this. So I teased out the symptoms. In 15 minutes this woman's sense of her body was transformed because she had these five mysterious things she took to doctors and she -- in fact, somebody here just said to me, backache went away because they drank more water. We don't ask those simple questions. And that's what I meant.
NNAMDIYeah, and I know who that person is, as a matter of fact. Most of us know we should eat more vegetables, we should exercise more. We should stop smoking, but that doesn't mean we're always able to follow through, Howard. As people struggle to balance busy lives, isn't it sometimes difficult to put this into practice?
ROSSRight. I think that that's true, Kojo. I think one of the things you're pointing to is, you know, the difference between what we might consider our rational knowledge and how we actually behave. I mean, I think every one of us has something in our lives that we know we should or shouldn't be doing and we don't do or not do that thing. You know, how many people wake up every day knowing exactly what they need to do to get their weight back to a healthier level. You know, it's not that complex. Eat less and exercise more.
NNAMDIAnd we proceed not to do that.
ROSSThat's right. And we wake up in the morning and we say, today I'm going to start. And by lunchtime our arm is mechanically putting this food in our mouth without even thinking about it. And I think that that lack of consciousness is one aspect, which is the work that Bob's talking about, which is how do we get people to look more consciously at it. And organizationally, what's really important is that it's difficult for most people to see our unconsciousness by ourselves. It really relates very strongly to the work you and I have talked about unconscious bias in organizations.
ROSSThis is just another set of unconscious behaviors. Mechanically, where the brain is concerned, there's no difference. That is, knowing something doesn't mean that we're doing it. And so the real benefit of creating organizational cultures of support, as we're talking, is that, you know, we spend eight, nine hours a day in our business. Some people even more. It's the single place that most human beings spend the most dedicated amount of time on a regular basis. If we can create communities of support around health and well-being, it's far more likely that not only will I see it in myself, but maybe the person next to me, who knows because we've talked about this, will say, hey, why don't you take a break and take a walk. You feel pretty stressed today.
ROSSAnd I might say, you know, you're right. That would probably do me well. Now, one challenge with that is that most organizations, particularly American organizations are very short-term versus long-term focused. And so we might say, you know, for example, we have recent studies that show that when workplace balance is off people's productivity goes down. So this is a real challenge for people with children for example. So let's say I have somebody working with me who has a child and I know that they are stressed because they're rushing to get to their child's soccer game. And knowing that I might say to them, you know, look, take an half an hour early, go get to your child's soccer game, breathe, you can catch up tomorrow.
ROSSIf I'm thinking long term that's likely to be long term a much more productive employee, healthier employee, happier employee, a more engaged employee. But short term it means, oh, my God, we need to get this meeting done. And so we're in the balance between all of these different competing dynamics.
DUGGANThe way I put it is the should -- we don't want to do shoulds. We ran away from shoulds when we were kids. The question is what's a real-time payoff? If I'm getting a real-time payoff from walking I feel better and I notice it. Then I'm going to walk because I like it. If you're running because you're going to prevent a heart attack you're not going to keep doing it. But if you're running because you feel good or you're tasting your vegetables -- you had a man on, Rob Kapilow, a musician, about a month ago.
NNAMDISure did, yes.
ROSSExtraordinary because I was listening to him and thinking about what I do. And he was talking about the art of listening. And what's the biggest complaint in American medicine, is nobody listens. And he was talking about how we have to learn to listen. Imagine if employees in meetings actually learned they got more when they listened. So there's an internal awareness and satisfaction. I was in a Senate hearing on this issue a couple of years ago and there was a man there testifying on research. And he said, you know, you want to get high school kids to stop smoking? You can keep telling them they shouldn't smoke, it's bad for them, you can do that.
ROSSThe single most effective research is to tell them they'll get kissed more if they don't have that smell on their body. And so this real-time presence of what are the benefits of eating well, of tasting your food, that's revolutionary and it will filter into these workplace programs.
NNAMDIWhen we tried out smoking in high school, our principal caught us and told us that we were simply trying to build up our puny personalities, which of course we already knew. I only wish he had told us that kissing story at that point. Here is Sally in Nokesville, Va. Sally, you're on the air. Go ahead, please.
SALLYHi, Kojo. I avoid allopathic, modern medicine as much as possible. I've really done a lot of research on health and everything. And I choose not to vaccinate my children. We go to the chiropractor regularly instead. I'd really like to find a homeopathic doctor as well as a place that does thermography because I don't want to have mammograms with all the research I've seen on the radiation effects of that and stuff.
SALLYBut we have TRICARE and we've been relying upon my husband's flex spending account and now they're cutting that in half with Obama Care. And I'm not totally against Obama Care like my husband is but yet they're cutting the flex spending accounts and I hadn't heard, is it true -- I mean, what -- or is that a state-by-state thing that they're going to be allowing alternatives We live in Virginia so, I don't know, what...
NNAMDIState by state it is my understanding, but I don't know if Bob Duggan knows anymore. This is a debate I was reluctant to get drawn into, but it looks like I'm gonna...
DUGGANI don't want to be in a fight with Western medicine because it's very powerful. My leg works because it was sewn back together. My daughter had meningitis. Western medicine is very critical and important. You're talking about TRICARE. That's the military medical service so that may not be covered on a state-by-state basic. But I can say that the military has a major interest in all of these issues and they're making breakthroughs.
DUGGANSo I would be asking your TRICARE provider to reexamine because TRICARE can save a lot of money by having you get a lot of wellness things before you use -- it's always about using lower tech before high tech. And I think that's the essence of what you're saying. What's a lower level of technology that's appropriate before you use allopathic medicine.
ROSSYou know, it's interesting because as you're saying that, Bob, I'm remembering when I -- the first time I got acupuncture was probably more than 20 years ago now. And the person I went to was actually Bob's partner in starting Tai Sophia, Diane Connelly. And I had never been to acupuncture before and I was talking to Diane about it. And at some point she said, you know, we're not saying this is good for everything. If I get hit by a car, take me to the emergency room, you know.
ROSSBut I think it speaks to -- I think, Sally, your question speaks to at the heart what one of the challenges that we have as a culture around many different things. And that is that we live in this -- particularly in the West in this profound culture of dualism, this either/or-ness. So we have either what we call -- what's being called traditional medicine versus allopathic medicine. You know, we have either this or that a lot. And this is a good example of where...
NNAMDIWhen, in fact, we have access to both.
ROSSThat's right. There's no reason why we can't have access to both and why we can't, you know, use the traditional Western medicine model and also supported by or vice versa. This is a case where both organizationally and as a society is we have an opportunity for what I call enlightened self interest to do well by doing good. I mean, organizations can do something that's really beneficial to the health of their employees. And, as Bob says, produce at the bottom line as opposed for it having to be a sacrifice for the bottom line of employers for them to have to do that.
NNAMDIGot to take a short break but if you'd like to join the conversation we still have a few lines open at 800-433-8850. Do you know if your health care plan covers alternative medicine or allopathic medicine, 800-433-8850? Send us a Tweet at kojoshow or email to email@example.com. I'm Kojo Nnamdi.
NNAMDIWe're talking with Howard Ross, diversity consultant and principal at Cook Ross, author of "Reinventing Diversity: Transforming Organizational Community to Strengthen People, Purpose and Performance. Also in studio with us is Bob Duggan, cofounder of the Tai Sophia Institute which is a center for healing arts located in Columbia, Md. Bob Duggan is a consultant with the Wisdom Well, an acupuncture and wellness clinic. He's author of the book "Breaking the Iron Triangle: Reducing Healthcare Costs in Corporate America" and the books "Common Sense for the Healing Arts."
NNAMDIIf you'd like to join us -- the conversation that is, call 800-433-8850. Bob, wellness coaching is an area you often talk about. Can you tell us a little bit about what that is?
DUGGANWell, the key issue in American health care is nobody listens. So a wellness coach is actually somebody who is going to question you enough that you begin to be aware of how you're in charge of your symptoms. This is whether you're a very sick person with multiple serious diseases or somebody basically well. I believe every doctor, every acupuncturist, every herbalist, all of them -- massage therapists, should also be trained as a wellness coach.
DUGGANWe have programs at Tai Sophia and that I'm working on this a lot with families, to have families learn to be wellness coaches for each other. So we bring back this awareness of how this body works. And a good wellness coach will do that. Now some of them -- and this is a fine line across the board -- you can have a wellness coach who tells you, you should do this, you shouldn't do that, you should be -- that's one kind of coaching. The other one is to have you wake up to how your body works and how -- your life habits.
DUGGANSo there are two kinds of wellness coaches, two kinds of acupuncturists, two kinds of doctors. Everybody should be asking questions. And we were talking -- I'm looking in Maryland at the health disparities issue in various communities. And if you prescribe doctors and nurses to solve that you miss the value of the community workers. The New York Times decided -- I was amazed at an editorial saying, when do we not need the doctor.
DUGGANAnd it really comes down to this community wellness coach who can reintegrate -- you know, I'm 73 years old. When I was growing up in the '40s we didn't see doctors. Everybody in the neighborhood knew how to keep you well. I was worked through by the neighbors through pneumonia. And I'm not saying that's the best way to do that but I am saying there's a lot of wisdom that my children can't access without going to experts. And we have to return that to the communities.
NNAMDISpeaking of being a wellness coach, we have Craig in Gaithersburg, Md. who, I think, is also a wellness coach. Craig, you're on the air. Go ahead, please.
CRAIGHi. Thanks for having me on. I wanted to talk a little bit more about that, the assessment. We're sort of programmed in this country or in Western civilization to think of ourselves as part. You know, we have work, we have marriage, we have a sore foot, instead of seeing ourselves as entire whole beings. How do you teach people to reassess themselves as whole beings?
DUGGANThat's what I was talking about earlier with the five symptoms. When I ask people to begin to write down symptoms that come and go, not the disease they bring to a doctor, but these little things, the pain in the shoulder. And after a while they begin to say, oh that only happens when I've stayed up late. And they begin to be able to monitor. And it's like a self teaching. But you're also pointing to another thing, Craig. Have you ever been stressed? Have you been stressed, Kojo?
DUGGANEvery day. So you couldn't have said that before 1930. Before 1930 the word stress was strictly a word of engineering. It was about steel and concrete. And then we began to let that term migrate from engineering about the human body. And the human body increasingly became not an organism but a serious of parts.
DUGGANSo a friend of mine, a psychologist at the University of Dallas, researched the word. What did people say before they were stressed? And what people were allowed to say in the 1920s, 1910, it was in all the English language papers, where you'd have the word stress put in the word grief. I've grieving. I'm allowed to grieve how life is. We didn't have to take on this machismo of making everything and pushing and pushing.
DUGGANSo it's a critical point. After that the body begins to have these parts. We turn the parts over to different experts. We give back pain to an acupuncturist or a neurologist. But we've forgotten, Craig, you know, how to live. And that's where the huge cost saving will come when folks wake up. That drinking water, sleeping, eating properly, that's a huge transformer of our federal budget.
NNAMDII like the grieving analogy because -- or the use of that term because it indicates the combination of mind and body.
ROSSYeah, absolutely. That sense of dis-ease if you will. You know, there's something else here too though. We could talk about what one needs to do in all of this, you know, perfectly logical. It's kind of like I said before about eating less and exercising more, all perfection logical. But one of the challenges that we have -- and we were just speaking about this for a second on the break -- is that we have to also look at the mindset, the mental models that we bring to this issue.
ROSSOur mindset tends to be to fix the problem rather than to ask the more important question, which is what is the problem or what's causing the problem or what's causing this presenting issue. So Bob talked, for example, about families or individuals learning to take the time to learn about how is my body operating. Well, you can almost see somebody who's busy listening say, I don’t have time for that. Just give me the pills, you know.
ROSSAnd organizations or even society doing the same thing. If we look societally how we deal with health care, what we do is we look at the problem and figure out how to fix it. Rather than really taking the time to inquire into what is it that's causing this systemic breakdown that's showing up in so many ways all over the place that affects individuals. And rather than that what we do is we deal with the symptoms. And when we deal with the symptoms and address them and keep them quiet we actually enable the bigger problems to continue.
DUGGANI have two examples on that. One is a corporate structure, in health care actually, which had a very high turnover of personnel. And that was very expensive. And they put in some very low tech interventions, more time for this staff to work together and hang out, some transition time. One year they lost nine staff members, the next year zero, almost no cost to the intervention.
DUGGANAnd the other one on this fix-it culture that's at home for me is first graders. Do we put them on a drug or do we teach them to breath and some stretching? You know, classes -- it's well documented that classrooms where kids do stretching and breathing -- I don't want to call it yoga. It's simple and stretching. It's a human thing to do. It's -- and learn to breath. They often become much more compliant, much more learners. They're scores go up. But them on a drug, you're giving them the message that at 15 the answer to life is a drug.
NNAMDIHere is -- and Craig, thank you for your call -- speaking of yoga, Kim in Washington, D.C. Kim, you're on the air. Go ahead, please.
KIMHi, Kojo. it's great to talk to you. And Bob, it's nice to talk to you again. I want to play this thing over and over again because I just love everything you guys are saying, especially the grief thing. I have a question about yoga and injuries because it's been a big topic, speaking of the New York Times lately. I do a weekly spot on NBC 4 with Keith Russell, like educating people and with Boundless Yoga -- I own Boundless Yoga -- so Boundless -- and I come on and just try to talk for 30 minutes a week about how to do safe, good yoga.
KIMAnd just this morning we did a spot on yoga and injuries, the most common injuries. So I wonder what you guys would say to people who, especially in the aging population who hear -- and obviously we all know -- or do we -- about the great benefits of yoga, but how to sort of caution them about doing right yoga and yoga that doesn't cause injuries.
DUGGANOnly Americans could turn Yoga into a competitive sport.
NNAMDICompetitive yoga, baby.
DUGGANI mean, it's crazy. And I have so many people who say -- I've had yoga teachers say people come wanting to be worked out. And other say, I'm actually learning yoga but they didn't teach me how to breath. So you're absolutely right. Yoga is about peacefulness and breathing and not pushing the edge. But I spent -- you're absolutely right. I would suggest that, you know, acupuncture's set up to relieve the pain right next to the yoga center, except it'd be easier to teach the yoga teachers to teach everybody to breath. So thank you for whatever you can do to reinforce that. I'm totally with you.
KIMThank you. Thank you.
ROSSHave a young yoga student in the background there.
NNAMDI...in the background there learning to breath even as we speak.
NNAMDIKim, thank you very much for your call. We move on to Alicia in Alexandria, Va. Alicia, you're on the air. Go ahead, please.
ALICIAHi. Yes. I had two points. One, I'm a veterinarian and I've just had a lot of my clients comment that they wish that their doctors would talk to them and get a history of wellness as we do on animals. Because obviously our patients don't talk so we have to have a lot of history to figure out what's going on with them and what caused it and that sort of thing.
ALICIAAnd my second point was -- and it relates to veterinary medicine as well. The previous caller talking about she doesn't vaccinate her children. And one, I think that it's very irritating. There's a place for alternative medicine and that sort of thing but as a veterinarian -- I've been doing this for 19 years -- I used to see distemper all the time. I used to see rabies more often. And the reason you don't see it is because we vaccinate. And the fact that people rely on herd immunity everybody else getting their children vaccinated so their children don't is why we're seeing -- well, one of the reasons we're seeing huge rises in measles and whopping cough and something like that.
ALICIAAnd I just wanted to point out to people -- I know we're talking a lot about alternative medicine, but there's definitely a place for medicine that's Western medicine.
NNAMDIIndeed, as Bob Duggan said earlier at the very onset of this broadcast, he's not interested in a competition between Western medicine and allopathic added to its -- but go ahead, Howard.
ROSSI was just going to say that, Alicia, you're pointing to something else as well, which is that it really is a function of not just what we need to do but also the structures in the systems that we have to create the appropriate facility to do that. So for -- my oldest son is a physician. He's a cardiologist. And when he was doing his early residency he was working for a managed care provider. And basically he was held accountable to being with his patients for seven minutes. That was the standard that they used. And if his time with his patients went above seven minutes and people would come in and say, you've got to pick the speed up a little bit.
ROSSNow the kind of care that Alicia's talking about, for example, where somebody comes in and a doctor really takes the time to help a patient explore...
NNAMDIYour pet gets more than seven minutes.
ROSSThat's right, your pet gets more than seven minutes. And so unfortunately what happens is we judge harshly the people who are at the effect of that system. In this case, not just the patients but the doctors, who in order to maintain their acceptability, their success in their organization have to fit within the structure, but the structure itself -- the systemic structure itself is the problem. And that happens with us individually. It happens with us in organizations. And it happens with us in whole systems. And so it gets back to looking at what the source of this is rather than just the symptom.
DUGGANAnd I think, Alicia, you will know that in veterinary medicine there's this same dilemma between keeping the way the animal is treated holistic versus reductionist. It can happen there also. I recall a patient of mine who would not change her lifestyle even though it caused her all sorts of dilemmas until one of her animals got sick. And a wonderful veterinarian kept questioning her about her lifestyle and how her dog was when she was stressed versus when she was relaxed. And when she realized her stress was causing the dog to be ill she changed her lifestyle. She wouldn't do it for herself.
DUGGANAnd so I think there's something going on in our culture where people can learn from the animals. And if the veterinary community can keep calling that conversation -- how do animals know how to live -- because humans are animals. It's like our bodies are as wise. And so it's a real issue for the veterinary community, I think, to make sure you don't go down the same dichotomy that's happened in the body mind split in Western thought. That woman always stayed with me.
NNAMDIAlicia, thank you very much for your call. Bob, the fact that health plans, workplaces and the medical community are embracing alternative medicine is a good thing in your book. But there's a danger there too in medicalizing alternative therapies. Can you explain?
DUGGANWell, I don't know that it's a good thing that they're endorsing alternatives. I think alternatives -- the question is, is it empowerment of individuals to live well or is it another set of techniques. So I've been involved in acupuncture but I could speak herbs. I could speak homeopathy, any one of -- I could speak neurology. And I've done this with physicians. The question for anybody who was a healing presence for another is whether they trust the other person's healing ability or saying, no I'll fix you.
DUGGANSo you can't just say what's an acupuncturist in this country. I had the president of a major university from China come visit me years ago and he was telling me how acupuncture fixed various diseases. But they were all modern Western labeled diseases. And I said to him, why are you telling me about this in modern language? And he said, we've lost the history of acupuncture in China. We don't know this natural medicine that you're talking about.
DUGGANSo a lot of acupuncture can simply be a technology addressing labeled diseases. But the richness that's called for by your internists, by your nurse practitioner, by your acupuncturist, by your herbalist across the board, what the companies have got to do is learn to discriminate between a provider who's calling on healing and a provider who's just doing a technique. In Britain they've done this. I was stunned. They did a study in Northern Ireland, British Medical Service. And they cut the cost of care for the elderly but I had seen who was providing the care.
DUGGANAnd I said to the woman who did the study, those are not your average acupuncturists or herbalists or neurologists and so on. She said, oh no, no. We screened for their technical competence and then we went back and screened for their relationship skills with people and their ability to evoke healing. And the outcomes were dramatic. So corporations in this arena have got to be very careful. They will not make money simply by adding more techniques. They've got to empower the individual. Those corporations will make fortunes.
NNAMDIWell, since you mention it, you're one of the founders of the Traditional Acupuncture Institute in Columbia, Md., also known as Tai Sophia Institute. For those who are not familiar with it, can you tell us a little bit about it?
DUGGANTai Sophia started as an acupuncture school in 1975, and now there are about 600, 700 full-time graduate students. It's in a graduate -- it's an accredited graduate school. Programs in acupuncture and wellness coaching, and we just started a new class this morning of about 20 new acupuncture students, and there will be an evening program starting I think this weekend of acupuncture students.
DUGGANBut in herbs we have the only graduate-level studies in herbology in the United States, which is astounding considering how big that industry is. In wellness coaching, in nutrition, the food program, I think there's a new one starting later in the month. People can go to tai.edu, but we're an accredited graduate school, and that's been built over the past 35 years from nothing. This conversation didn't exist when we started. In fact, we were almost put in jail for doing acupuncture in 1975.
NNAMDIWell, we won't put you in jail, but we do have to take a short break in the conversation. When we come back, we'll continue this conversation on alternative medicine in the workplace. It looks like our phone lines are busy, so if you'd like to get in touch with us, send us an email to firstname.lastname@example.org, or send us a tweet @kojoshow. I'm Kojo Nnamdi.
NNAMDIWelcome back. We're talking with Bob Duggan. He is a co-founder of the Tai Sophia Institute, a center for the healing arts in Columbia, Md., a consultant with the Wisdom Well, an acupuncture and wellness clinic, and author of the book "Breaking the Iron Triangle: Reducing Health Care Costs in Corporate America," and the book "Common Sense for the Healing Arts." Also in studio with us on a regular basis, Howard Ross, diversity consultant and principal at Cook Ross, author of the book "Reinventing Diversity: Transforming Organizational Community to Strengthen People, Purpose and Performance."
NNAMDIHoward, we've been having some problems with using this term, alternative medicine, as if there are like different kinds of ways of taking care of one's health.
ROSSI think it speaks to the heart of the problem that I was talking about earlier, Kojo, and that is that even think of the language, alternative. You know, when we build that language and we start with the function that this is not that, and I was sharing with you that the -- years ago when I was working in healthcare wellness, I had a conversation, I was at a hospital -- I was at Holy Cross Hospital here in Silver Spring, and had a conversation with the chief medical officer.
ROSSWe were talking about the kinds of things we were starting to do. Now, mind you, this is almost 30 years ago. And he said to me at some point he looked at me and he said, yeah, but, you know, these people go out running and they get bitten by dogs and things. And the...
NNAMDIHe had to see me.
ROSSAnd I sat there in the face of such an irrational comment and it occurred to me that what was really going on was that this was somebody who was not at all trained, especially in those days, in the things that we were talking about. And so it was actually a threat to his professional standing. It was a threat to his whole structure of payment. Everything about it was a threat to his way of looking at the world, and so that becomes a threat.
ROSSAnd there are similarly people on the other side of the equation, people who are in what we might call the healing arts, who are threatened by western medicine because they feel like it's such a rejection. I know people who had cancer -- my ex-wife died of cancer a number of years ago. She hadn't gone to a doctor in 25 years, and even after being diagnosed, even with a son who was a physician, rejected any support from western medicine, which could have at the very least, clearly extended her life.
ROSSAnd so people can go both directions irrationally without realizing it. We need to look for that center ground in which both can be included.
NNAMDIHence the term holistic. Here is Robyn in Silver Spring, Md. Robyn, you're on the air. Go ahead, please.
ROBYNHi, Howard. It's Robyn Carns (sp?) .
ROSSHi Robyn. How nice to hear from you.
ROBYNYeah. Well, I called in for a couple of things. This a conversation very dear to me. First of all, I want to point everybody to this fabulous new documentary that's come out called "Escape Fire: The Fight to Rescue America's Healthcare System," which is really highlights this exact question you guys have been talking about for this whole hour. The other thing is, I wanted to mention that I worked for six years at Walter Reed Medical Center, and my job was part of a multidisciplinary treatment team that worked with people with acute PTSD coming back from Iraq and Afghanistan.
ROBYNAnd to talk about, you know, that the military is embracing these things in many ways, and that the -- basically the crisis in healthcare is hitting them faster than it's hitting the rest of us, even though it is hitting the rest of us. So my job was to go in and work with these folks who, as part of this team, that I went in and taught them breathing, stretching, and meditation, and believe me, they were -- you talk about skeptical -- extremely skeptical that this could be useful to them in any way, shape, or form.
ROBYNBut they came out of this program after five days a week of learning to train their attention with meditation, to calm their mind and attention with their breath, and to move in a very gentle way to help the energy move in their body, that just 90 percent of them were just blown away by how helpful it was to them. And basically what I was doing was supporting the wholeness in them, seeing the wholeness in them, and helping them reclaim it, and supporting what was their strengths rather than trying to fix them, and helping them learn things that they could do to regulate their own nervous systems.
ROBYNSo what we saw was, insomnia went down, anxiety went down, pain went down, and their general sense of being able to regulate and manage their own emotions just went up tremendously.
NNAMDIThank you very much for sharing that with us, Robyn.
DUGGANWhat often happens, Robyn -- thank you for that. It's a great description, and "Escape Fire" is a great demonstration of this. The effects of what you're talking about with PTSD is quite extraordinary. What you don't mention, and gets left out, is the folks you worked with and were worked with in that study, also save the system enormous amounts of money. The military health budget is something like $50 billion a year and growing at five or six percent.
DUGGANThe application that you were doing to that inner awareness, nobody is yet effectively tracking how much money that saved, and I don't want to have a fight, like Howard was talking about, between mainstream and alternative. Those are -- I think that's a crazy fight. It can't be won. It's like -- the Affordable Care Act has moved money around, but the real issue is the enormous savings to the entire culture and the added well being with the kind of thing you're describing. That very slowly, and I think the military, I'm going to come back to it...
NNAMDII was about to say, Robyn was pointing out something that we've been finding out, that in terms of the federal government, the military is who has been on the cutting edge of this.
ROSSOn many things.
DUGGANCutting edge. I was stunned last year, because as I said, 25 years ago they wanted to put us in jail. I was invited to consult with the military on issues of the future of healthcare in the military, and the first thing I walk in the room and there's a colonel just back from Afghanistan, a doctor, who says, you know, we've been doing morphine for pain control in the military since Gettysburg. He said, I've just instituted in Afghanistan acupuncture and meditation mindfulness as frontline pain care for wounds and pain. I was stunned.
DUGGANI was blown away because they know it's effective. They're looking at what immediately serves, and the kicker, the bonus to this is because the military goes out into the diversity of the whole country. Those families talking about this will have an impact that says I need my doctor my this, I need this for this, and I learned how to take care of myself.
ROSSIt's also important to know, and I want to just acknowledge too that, you know, Robyn's doing, you know, this brilliant work with veterans and I just wanted to -- you know, Robyn and I worked together many years ago, and she was one of the people who really woke me up to looking at some of these things even against my resistance. But the similar thing -- it's not a unique or isolated thing, you know. Similar things are happening with youth at risk, that people are finding teaching youth at risk these telling -- lowers their issues of drug abuse, gang violence, all these kinds of things.
ROSSPrisoners in incarceration, the same thing. And so, you know, there are in these kinds of places where people have a contained audience real breakthroughs that are being made. The challenge is it's not widely known and understood as a fundamental cultural phenomenon.
NNAMDIThank you very much for your call, Robyn. Here now is Jim in Easton, Md. Jim, your turn.
JIMYes, hi. Excellent topic. I've often said a pill alone is not the answer, and I think largely what you've been talking about is integrative and tailored integrative medicine, and this is the way I believe allopathic, and clearly any kind of medicine in this country should be going. Having said all of that though, and beyond preaching to the choir, in all of the books that I've written I've said similar kinds of things.
JIMBut how do we get this into the hands of Congress into the desk and onto the desk of President Obama and Obamacare to actually embrace this integrative holistic approach towards not only wellness and cure and treatment, but prevention. There I think lies our true challenge.
NNAMDIJim wants a fast-track approach here.
DUGGANI think that's gonna happen, Jim, once several major corporations are reporting huge profits to their bottom line. Then the government will turn around and support it. The research won't get us there, and it can't be done by edict, but when some large corporations from the top down realize that they can make a major contribution to society and to their own bottom line, they realize by investing in the wellness of their several thousand employees, and sending less money to the medical system and to the pharmaceutical system, and moving it into other parts of the society, the rest of the country will sit up.
DUGGANI saw this in Congress when the people from Dow Chemical were reporting on the shift in their cost structures. You could see the Senators on the panel sitting up saying how can we have this with the government. So I personally believe right now, because I've worked a lot at getting government change over 40 years. I think the impact will come -- forgive me, but from a basic dollar line shift. When that shifts, the culture will follow.
ROSSWell, I think that's what I talked about, enlightened self interest. But one of the other things that we need to realize, and Congress is a perfect example of what I was talking about, about understanding what the systemic problem is that's creating the result, because the challenge we're having nationally with healthcare right now is not a debate over which kind of healthcare system will work, it's really a debate over who's going to win the debate politically, and unless we're asking the right question, we're never going to come up with the right answer.
DUGGANMy whole book is about asking a different question. That's the whole point of the book.
NNAMDIThank you for your call, Jim. Onto John in Rockville, Md. Hi John.
JOHNHi. Good -- or good afternoon, Kojo. And this is a great topic. I've been a practicing chiropractor now for about 13 years, and I have a clinic in Rockville, and my approach to healthcare has always been we try and create a mixed healing arts approach. So we have three massage therapists, we actually have an acupuncturist who is a graduate of the Tai Sophia Institute, and I've been doing chiropractic in combination with PT, and we've had some really good results, but two things that I've really seen in the last 13 years that I've been practicing, many, many more people are coming specifically seeking the alternative services that we do.
JOHNBut then the other thing I see is how much people are ingrained with the western medical model, and they only see health coming from the outside in such as taking a pill or doing something surgically. And the other thing I wanted to comment on was as a healthcare provider, the biggest challenge for me is to get what we do paid by the insurance companies, and some major medical insurances, including Blue Cross Blue Shield, Aetna, and United Healthcare, they do actually have acupuncture benefits.
JOHNHowever, the documentation that we need to submit to get reimbursed on that is sometimes overwhelming and almost not worth the effort, and that, at the end of the day, kind of takes away from what we do. And I will be quite honest, I see what insurance company each patient I have comes in, and I kind of know what in advance if they will have coverage or not. And I hate to say that that makes a determination how much I time I spend a patient...
NNAMDIJohn, are you suggesting that practitioners of so-called medicine have an easier time filling out those forms for reimbursement than people such as yourself?
JOHNI think it goes at all levels, but I think in general getting reimbursed from the health care companies is getting a lot tougher.
JOHNAnd I think at the end of the day, that really detracts from patient care.
DUGGANI have a -- probably a position on this that I think is probably not going to make most alternative providers happy. I think we can't insure wellness. It's a key measure of the book. We have to figure a different way, except for the disadvantage, to support people keeping themselves well, and return insurance to be for the really catastrophic moment. We can do that through wellness funds and all sorts of incentives.
NNAMDIYou also see teachers as potential frontline warriors on this.
DUGGANSee, I believe that if the school system -- one school system took on delivering wellness to the teachers, very low cost, you'd have an enormously satisfied workforce, and they would learn about how they function, and that in turn will spread to the mothers and the kids. You can't put it into the curriculum, but you can get it in the bodies of teachers in the system, and that system will save a lot of money by doing it. Not by insuring this, but by simply shifting the conversation.
ROSSI think that, you know, at the heart of it -- Bob and I were talking about this as we drove over -- at the heart of it, what we're talking about, and I think teachers are a great source of this, I think the workplace is a great source of this. We're talking about people becoming more conscious. Conscious and more mindful of the way they live their lives, and that shows up when we do our work with diversity, when we do this work with health and wellness, when we do work in any kind of human interaction.
ROSSWe are not as a society geared towards becoming conscious about what's running the show behind the curtain so to speak. And teachers have a phenomenal opportunity to do that.
DUGGANI want to put in a word here for the physicians, the allopathic physicians. Because to be honest, one of them said to me years ago, he said, I'm fantastic when you have an ulcer, but I was never trained what to do on the day before you had an ulcer when you just had a tummy pain. So most physicians are extraordinary at what they do, it's just we're asking them to do things they were never trained to do. And so I want to be very respectful that this is not a bashing of one against the other.
DUGGANThat we have extraordinary physicians, and if we shift the conversation, we will have more than enough physicians to be well-served, and they'll be able to spend an hour with people.
NNAMDIWe got an email from Janice who says, "I was a student of Bob's at Tai Sophia, and have an acupuncture practice in Baltimore. It is such an honor to do this work with my patients. I find that folks come in with several very common stories. One, they want what their friends have gotten out of treatment, and they feel like they have to come up with symptoms before they're allowed to make an appointment. They're almost apologetic about it. They're in such a state with so many symptoms considered odd by western medicine that they think they might be crazy even though they know themselves best. And three, they think what I know about them is more important than what they know about themselves."
ROSSYeah, absolutely. Kojo, I know we're running out of time, but I just wanted to also tell people, if people in organizations would like to have more conversations about this, Bob and I are working hard now to put together a model to help organizations begin to bring this work into their culture. And so if they want to contact either Bob at Wisdom Well, or me at Cook Ross, we'll be glad to talk more with them about them.
NNAMDIHoward Ross is a diversity consultant and a principal at Cook Ross. Bob Duggan is co-founder of the Tai Sophia Institute, a center for a healing arts in Columbia, Md. Bob Duggan, thank you very much for joining us. So good to meet you.
DUGGANThank you for having me.
NNAMDIHoward, always a pleasure.
ROSSYou too, Kojo.
NNAMDIAnd thank you all for listening. I'm Kojo Nnamdi.
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