hybrid companies are here

I was excited to learn that California just adopted a statue allowing for flexible-purpose corporations. I know — laws, corporations, California — chug that extra shot of espresso and see if you can muster up the mental energy. But here’s the deal. Hybrid corporations are blends of non-profit and for-profit institutions, and what you need to know is that these new companies are not required to maximize their profits. Which means company officers and boards may now use financial gains to pursue a social mission without risking shareholder retaliation.* Let’s hope it means grocery stores and bank branches in urban dead zones, and more and better health care for those without, like I wrote about in House of Hope and Fear.

My guess is that lots of folks out there aren’t in the game just for the money but would love for their work to make a real contribution to the places where they live. That’s what makes this development so interesting and exciting.

*For-profit corporations are required by law to maximize profits for their shareholders.

the art of memoir

Check out this smart, cutting take on the recent flood of published memoirs, by Neil Genzlinger in last weekend’s New York Times book review. Good memoir writers discover and share new truths about their story through their writing, he suggests: “An ordeal, served up without perspective or perceptiveness, is merely an ordeal.”

some people still don’t have health insurance, and it still matters

Excellent piece on life down in the trenches, as told by a primary care doctor, Jonathan Han, who practices in rural Pennsylvania and whom I consider a good friend. Every day in his office Dr. Han sees patients who come to medical attention only after having developed advanced disease, including incurable cancers, because they lack health insurance. Another convincing argument for why we can’t afford to roll back last year’s health care reforms.

chocolate therapy

Excellent story in yesterday’s New York Times on comfort for Alzheimer’s patients. At one Phoenix nursing home, non-drug therapies like companion baby dolls and unlimited chocolate help calm individuals suffering from dementia and its terrifying complications.

I know — hardly sounds newsworthy enough for the front page of the Times. But these ‘therapies’ reduce the amount of sedative and anti-psychotic medication administered, meaning better quality of life for patients, at lower cost and with fewer side effects. In other words, if chocolate was a new experimental drug, people would be frantic to have access.

Not unlike chocolate and dolls is the therapeutic benefit of having a dog — in 2009 researchers at the University of Missouri found that elderly folks assigned to walk a dog twice a week were often able to give up canes and walkers, because overall fitness improved so dramatically. Good food for thought as we all contemplate new year’s resolutions.

global / local

A local hospital helps the King County poor using health care strategies gleaned from sub-Saharan Africa. Do I understand correctly? We’re one of the 50 richest counties* in America, allegedly the world’s most prosperous nation, but if you’re sick / poor you might as well live in Botswana?

Well. The full story is that an executive-level RN at Seattle’s Swedish Hospital will be training community health workers for neighborhoods in Sea Tac and Tukwila. These health workers will connect down-and-out folks with appropriate medical care plus services that help connect the dots, like transit passes, legal assistance, even microloans.

Integrating services is a slick thing to do, for two reasons: 1) it works, and 2) because health depends on more than access to good medical care. Better shelter and nutrition worked wonders for Paul Farmer’s tuberculosis campaign in Haiti, for example. Can it work here in the most literate city in America? Sure sounds promising. So stay tuned.

* as determined by personal per capita income

i heart great bookstores

It only took a year, but I finally got across town to visit Queen Anne Books. Such a sweet little place to browse, and they had so many books on the tables that I’m dying to read. It certainly makes a reader determined to do everything in her power to keep internet retailers and e-books from taking over the world. I signed their stock of House of Hope and Fear — just out in paperback, did I forget to mention that? — and they said they’d have a few at their tent at the Queen Anne farmers market that afternoon.

Indie bookstores are the best.

continuing ed

I’m home after three days of continuing medical education at the Cleveland Clinic. For me being back in the lecture hall feels totally numbing — you’re bombarded with eight hours of Power Point slides daily — yet in hindsight I’m feeling recharged about my day job.

Perhaps the most striking lesson lay beyond the classroom door. One morning I visited a farmer’s market on the Clinic grounds, which is more of an anomaly than you might think; hospitals are far more likely to sell McDonald’s burgers than radishes by the bunch.

Turns out the farmer’s market is one small facet of a massive wellness push at the Clinic that focuses on weight and stress reduction, quitting smoking, and smart nutrition. Of course you already knew this stuff was good for you; the issue is committing to doing it.

At the Clinic a formal program to engage employees in their own health enabled the collective to lose 144,000 pounds in 2009. One man lost 30 pounds in eighteen months simply by deciding to take stairs instead of the elevator. As a result, while health care expenditures were on the rise everywhere else in the last two years, employee health care costs at the Clinic dropped 8%. Bending the cost curve, as the lingo goes.

In the months and years to come I’m betting we’ll hear more about like-minded efforts to promote wellness — much more. And not just because it saves money, but because we’re all starting to wake up to how unsustainably we live. A recent New York Times story about paying patients to take their medications would be a case in point.

new and improved

This afternoon I ventured over to Elliott Bay Book Company’s brand new Capitol Hill location. Which turns out to be so very much like the old location. The same lovely stained glass above the entrance, the same chunky bookcases, and the good Rick Simonson puttering about the front of the house. They’ve really recaptured that wonderful feeling of the Pioneer Square store. However. This place also has higher ceilings, stunning windows, and lots of elbow room around the tables. Not to mention more skinny jeans, funky hair, starving writers, men holding hands. Sometimes newer really is better. Me, I’m just glad to see one of the best bookstores on the planet surviving these uneasy times.

major health care bill passes

Today the U.S. House of Representatives passed a sweeping health care bill that will bring health insurance to more than 30 million people who presently go without. The legislation will also protect those with insurance from being denied coverage because they are — wait for it — sick. Think that’s too awful to be true? Read about this young Baltimore family.

I admit I wasn’t confident this day would ever come. But here we are, and Republicans are already threatening to use the bill as a weapon in the upcoming midterm elections. We’ll see.

let me know when it’s over

I’m happy to report that health care reform looks much less dead than it did two months ago. At this very moment, Speaker of the House Nancy Pelosi is wrestling up support for this weekend’s big vote — that’s right, a vote on the Senate health care bill that passed back in December. Today comes the welcome news that the bill will (somehow) reduce the deficit, or so says the Congressional Budget Office.

These reforms won’t fix everything wrong with health care. Not by a long stretch. But it will bring health insurance to millions of people who didn’t have it before. At the risk of beating a dead horse, we need that. Desperately.