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 Response Page - Wilson  Interview -      


These comments are responses to the questions listed below,
which were generated in regard to the
Kent Wilson Interview of
08-05-2011.
 

Overview

Today's discussion covers a Civic Caucus meeting with Dr. Kent Wilson, medical director, Honoring Choices Minnesota, a program of the Twin Cities Medical Society on advance care planning. Honoring Choices Minnesota helps individuals decide and document their medical care and end-of-life preferences in case they are unable to participate in treatment decisions. Wilson describes the inspiration for the program, the model pioneered in La Crosse, WI, and progress already underway in Minnesota. Implications for cost savings and patient satisfaction are discussed, as well as the program's prospects for implementation.

For the complete interview summary see:  http://bit.ly/qYnWgY

Response Summary:  Readers have been asked to rate, on a scale of (0) most disagreement, to (5) neutral, to (10) most agreement, the following points discussed by Dr. Wilson. Average response ratings shown below are simply the mean of all readersí zero-to-ten responses to the ideas proposed and should not be considered an accurate reflection of a scientifically structured poll.

1. Directives urgently needed. (9.2 average response) Health care directives--which outline treatment decisions that might be needed when individuals are unable to participate in those decisions--are urgently needed.

2. Health professionals should lead. (9.0 average response) Physicians, hospitals and other care providers should take the lead in encouraging adults of all ages to prepare such directives.

3. Collaborative approach commendable.  (8.0 average response) A collaborative approach, Honoring Choices Minnesota, initiated by the Twin Cities Medical Society, with partners including the Citizens League, appears to be well planned and deserving of support.

4. Directives shared widely. (8.5 average response) Copies of health care directives should be circulated broadly, among current and possible care providers as well as family members, clergy and others.

 

Response Distribution:

Strongly disagree

Moderately disagree

Neutral

Moderately agree

Strongly agree

Total Responses

1. Directives urgently needed.

0%

0%

6%

22%

72%

18

2. Health professionals should lead.

0%

6%

0%

22%

72%

18

3. Collaborative approach commendable.

0%

11%

11%

33%

44%

18

4. Directives shared widely.

6%

6%

6%

11%

72%

18

Individual Responses:

Chris Brazelton  (10)  (10)  (10)  (10)

2. Health professionals should lead. One never knows when one might be needed.  Hospitals are a logical place to start when there is a planned event, like a non-emergency surgery, but in emergency situations it may be too late.  Families need to have these conversations before an emergency occurs, so it is important to get the word out beyond hospitals.

Polly Bergerson  (7.5)  (10)  (10)  (10)

1. Directives urgently needed. It is important for family to weigh in with the patient. But, I think this needs to begin in the doctorsí offices when first diagnosed. It is important that the doctor and nurses that are giving care at first point of contact begin the process and make sure that it is also available at the facilities that the patient may or may not attend including long-term care facilities and hospitals.

3. Collaborative approach commendable.  It needs to be taken to churches and synagogues to make people more aware.

Duane Welle  (10)  (10)  (10)  (10)

Dave Broden  (5)  (2.5)  (5)  (5)

1. Directives urgently needed. The word urgently is a bit over-stating the situation. There certainly is a need for each family for sort out and defined the path to be taken in these situations. However to place it in the urgent or critical situation is a bit of a must-do, big-brother-says-you-have-to rather than politely stating [that] it will be benefit the individual, the family, and the medical community.

2. Health professionals should lead. This is the fundamental question of who is responsible--the individual, the family, or someone on the outside.  I go with the family and the individual and let the medical community provide the information and the options but not to push.

3. Collaborative approach commendable.  Need more info, and since I missed the meeting cannot answer clearly. Collaboration is a reasonable approach but I will ask is that adding more cost, more administration, more people, etc., always adding complexity or does it simplify the approach? Seems that answers add more not less.

4. Directives shared widely. What does [this] mean? Is someone going to make this a legal requirement for health care or is it a distribution decision of the individual and the family. Some thought required of how to distribute info and who gets the data.

W. D. (Bill) Hamm  (7.5)  (7.5)  (7.5)  (7.5)

1. Directives urgently needed. While many possibilities can be planned for, not all can be foreseen.

2. Health professionals should lead. This is the common sense approach.

3. Collaborative approach commendable.  This appears to be working.

4. Directives shared widely. That is one failure of the VA effort: few see the directives.

Jack Evert  (10)  (7.5)  (10)  (10)

1. Directives urgently needed. Directives would typically generate discussion by the closely related parties, which can only improve the quality of the directive as well as give the provider clear direction as to the wishes of the patient.

2. Health professionals should lead. Have to be sure that they don't get too aggressive wherein people might think they have something monetarily to gain with resultant pushback.  Some people don't trust the health care industry.

3. Collaborative approach commendable.  An initiative including other than health care providers (see above comments) gives it much more credibility, especially when prestigious groups like the Citizens League are included.

4. Directives shared widely. Need to get them in the hands of those who can benefit by having them!

Peter Hennessey  (7.5)  (7.5)  (2.5)  (2.5)

1. Directives urgently needed. For over thirty years in California I have had direct experience with the hospital care of several relatives aged from their thirties through nineties, and in every case the doctor and the hospital required a health care directive or a DNR (do not resuscitate). Admission was not complete without it. I am flabbergasted that in 2011 this comes up as a proposal or an issue at all. I have never met a doctor who did not bring up the question; and it never had anything to do with containing costs, it was always a question of the quality and dignity of life.

2. Health professionals should lead. Your own primary care doctor should have already talked to you about this. Your surgeon should have already talked to you about this, certainly before your admission. You anesthesiologist should have already talked to you about this, when discussing what is going to happen to you in the operating room.

3. Collaborative approach commendable.  Give me a break. This issue requires a formal Program?

4. Directives shared widely. How many millions in government expenditures are being budgeted for this program? You know you can't rely on private parties to do this right, especially not your family, your doctor, and your priest.    Are you really talking about health care directives, or are you talking about a propaganda campaign to sell people on their Duty To Die as the primary means to contain health care costs? Is this seemingly common sense innocuous campaign actually a cover for the limitations on care imposed under Medicare reimbursement rules, and for the death panels mandated under Obamacare? I am surprised you have not mentioned the claim that anywhere between 50% to 90% of a person's lifetime medical costs are run up during the last three months of life.

Don Anderson  (10)  (10)  (10)  (10)

4. Directives shared widely. It's especially important that family members and primary care providers know about your health care directive.

John Sievert  (7.5)  (7.5)  (2.5)  (0)

1. Directives urgently needed. Next of kin must have them and have control of the situation.  I don't trust a health care directive that is a legal document to be held and administered by either the government or the health care provider.

3. Collaborative approach commendable.  There are only two people who should be involved in this process - my doctor and me.  Those directives should be executed by my next of kin, and in their absence, by my attorney.  No one else.

4. Directives shared widely. Again, this is the business of me and my next of kin.  The last thing I think is appropriate is for government, clergy, healthcare providers, etc., to be involved in that process.

Carolyn Ring  (10)  (10)  (8)  (10)

James Weaver  (10)  (10)  (8)  (8)

Rick Bishop  (10)  (10)  (7)  (10)

Al Quie  (10)  (10)  (9)  (10)

Wayne Jennings  (10)  (10)  (10)  (10)

Tom Swain  (10)  (10)  (9)  (10)

Great efforts.  Kent is tops.

Roger A. Wacek  (10)  (10)  (5)  (10)

Estate planners and lawyers should include a health care directive/living will in every trust and will.

Bert Press  (10)  (10)  (10)  (10)

Mary Tambornino  (10)  (10)  (10)  (10)

All health professionals and family members must follow the directive and not substitute their wishes for those of the "patient".  The person making the directive must be honored and their wishes followed.

    

The Civic Caucus   is a non-partisan, tax-exempt educational organization.   The Core participants include persons of varying political persuasions, reflecting years of leadership in politics and business. Click here  to see a short personal background of each.

   Verne C. Johnson, chair;  David Broden, Charles Clay, Marianne Curry, Bill Frenzel, Paul Gilje,  Jim Hetland,  Marina Lyon, Joe Mansky, John Mooty,  Jim Olson,  and Wayne Popham 


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The Civic Caucus, 01-01-2008
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