[Must-read! New health care model. ACEs & TIC mentioned]
"If you were to show up in Alan Glaseroff’s office as a person with diabetes and, let’s say, numerous complications, putting you into that group of 5% of Americans whose care consumes 50% of the national health care spend, he would ask you: What bothers you the most? in order to start developing a patient-centered plan of care....
"Here is the full transcript of our conversation:
"Interview with Alan Glaseroff, MD, Co-Director, Stanford Coordinated Care, Stanford University...
" Well, generally patient education has been dispensed as a punishment to people not doing well....
"...Our payment model, which is not fee-for-service, but rather capitation plus a shared savings arrangement, allows us to the freedom to design a set of services that that accomplish the job of getting people to do better.... So you’re contracting with self-insured employers to provide these services?... Correct....
" ...And this is very, very interesting kind of cutting edge work that we’re beginning to really focus on — they appear to have suffered an inordinate amount of adverse childhood experiences and it’s everything from abuse and neglect to sexual molest and having a parent in jail and a drug addicted or a substance abusing parents, and it’s all of the social disruptions that lead to a horrible childhood.
"And what there’s an emerging area of research that’s really focusing on the adverse childhood events as causing metabolic syndrome which is the precursor of all of the Type II diabetes pain we’re seeing in society right now. So that becomes a very different mandate in terms of how do you approach such people and I’m hearing a phrase called Trauma-Informed Care that I think will be the area of the future in trying to understand why people don’t do everything in their power to live long and feel well which has been the source of ongoing frustration for medicine forever...."
See also:
When your symptoms don't tell the whole story (8 min) [Glaseroff's work is mentioned]
http://acesconnection.com/profiles/blogs/when-your-symptoms-don-t-tell-the-whole-story-8-min
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