June 26, 1998

Family-centered care takes center stage

Family-centered care takes center stage

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The Clintons and Gores discussed family-centered health care at VUMC's Langford Auditorium the week during Family Re-Union. (Photo by Billy Kingsley)

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Dr. Harry Jacobson, Vice Chancellor for Health Affairs, and Faye Wyatt, wife of Chancellor Joe Wyatt, greeted Vice President Gore. (Photo by Billy Kingsley)

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President Clinton said now is the time to look at the future of health care. (Photo by Billy Kingsley)

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Vice President Al Gore and U.S. Surgeon General David Satcher, M.D. (Photo by Billy Kingsley)

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Dr. Harry Jacobson spoke about the role a family plays in the proper treatment of patients, especially children. (Photo by Billy Kingsley)

Family-centered health care was the focus of national attention this week as President Bill Clinton and First Lady Hillary Clinton joined Vice President Al Gore and Tipper Gore at the seventh annual Family Re-Union conference held at Vanderbilt University's Langford Auditorium.

Vanderbilt University Medical Center's own family-centered care initiative was central to the conference as it concentrated on strategies aimed at improving family-centered health care (see accompanying story).

A panel discussion on the first day of the event heard from families and professionals about how family-centered health care has changed the lives of patients and health care professionals, how hospitals and communities are changing to be more responsive to the needs of families, and how those changes are impacting medical training and education.

"A health problem facing a loved one may be contained in the body of that one person but it affects the entire family's soul," Gore told the group.

"Yet far too often modern medical practice sees the patient's family as another problem to be managed and not as a critical part of the solution. Too often the family is seen as a roadblock to proper treatment rather than a building block to a healthy future.

"Because our system of medical care, while scientifically ingenious, has not made proper use of the crucial healing power of the family, it has too often left family members confused and abandoned in the waiting room."

Gore's Family Re-Union is an annual forum sponsored by the Vanderbilt Institute of Public Policy and The Children, Youth and Family Consortium at the University of Minnesota.

In 1995 the conference focused on the media and its recommendations led to the proposal for the "V-chip," which lets parents control what their children watch on television. A conference on families and work in 1996 led to a proposal to expand family medical leave.

Clinton, referring to the recent defeat of a massive tobacco bill in the U.S. Senate, encouraged this year's participants to urge Congress to do something about teen smoking and patient rights.

To reduce teen smoking, something must be done about price, access and direct and indirect marketing of tobacco, Clinton told the participants.

The president and vice president are also working to pass a Patient Bill of Rights that would guarantee access to health care specialists and emergency services and create a strong grievance and appeals process so patients can resolve their differences with health plans and providers.

"The patient bill of rights would once again enshrine what we should never lose sight of ‹ the most important goal of any health care system is the well-being of the patient," Hillary Clinton told the group. "We should once again protect the physician-patient relationship and put it above any other consideration. The bottom line of profit cannot ever be permitted to interfere with the bottom line of patient care," she said.

"I don't think you should let this Congress go home without acting on these measures," Hillary Clinton said.

The centerpiece of the Monday portion of the conference was a panel comprised of four people who joined the Clintons and Gores in a frank discussion about family involvement in health care. The panel included Julie Moretz, chair of the Family Advisory Council at the Medical College of Georgia, who is the mother of 7-year-old Daniel, who has had 10 heart operations.

The group talked about ways families should be participants in important medical decisions and how they can best get the information and support they need.

According to the President, it's time to look to the future in health care.

"We need to make sure Social Security and Medicare will be reformed to accommodate the baby boom generation," Clinton told the group.

"We have the finest health care in the world but we still can't figure out how to give everybody access to it in a quality, affordable way. In some form or fashion, every family in America sooner or later runs up against that fact.

"We still have to come to grips with the fact that we still are alone among all the advanced societies in the world in not figuring out how to deal with this issue," Clinton said. "We can all get wise with HMO jokes but the truth is there's a reason for managed care ‹ that it was unsustainable for the United States, with the smallest percentage of its people with health insurance of any advanced country, to keep spending a higher and higher percentage of its income, increasing that expenditure three times the rate of inflation. Pretty soon it would have consumed everything else."

Good things have come out of the better management brought about by managed care, Clinton said.

"The problem is if techniques like that are not anchored to fundamental bedrock principals, in the end the process overcomes the substance and you have the kind of abuses and frustrations that we've been talking about."

Hillary Clinton said that changes need to be made in the way patients are treated, telling the group about how, in her father's last year of life, he went to the doctor's office and had to push a button in the waiting room to sign in.

"An automatic voice came on and asked him who he was and he said, 'none of your business. I'm leaving.'

"We don't want to be treated like numbers and we especially don't want our children and our parents and our loved ones treated like numbers," she said.

Having a Patient Bill of Rights should assure that patients are treated with dignity, she said.

President Clinton said that the number of uninsured children is another problem that must be addressed.

There are more than 10 million children in the United States without health insurance, with 4.5 million eligible for Medicaid. Clinton said it is up to both state and federal governments to do something about the problem.

In February, Clinton asked eight federal agencies, including the Social Security Administration and the Department of Health and Human Services, to find new ways to help provide health care for children.

At the end of Monday's session, Clinton signed an executive memorandum that gives those agencies the power to seek out the 4.5 million children who are eligible for government health care but aren't enrolled.

"If you believe families are the center of every society; if you believe they are the bedrock of our present and the hope of our future; if you think the most important job of any parent is raising a successful child, then surely we have to deal with the health care challenges all of us have been discussing ‹ caring for our parents and grandparents and children," Clinton said. "Surely we have to provide our family with that if we expect America to be what it ought to be in the new century. We'll do our part and I'm proud of you for doing yours."

Also participating in the conference were Surgeon General David Satcher, M.D.; Nancy Ann DeParle, administrator of the Health Care Financing Administration, and Dr. John Eisenberg, administrator of the Agency for Health Care Policy and Research.