A Win-Win-Win Solution to Help People with Disabilities Thrive
By Matthew A. Weed, Ph.D.
The health of millions of elderly, disabled and chronically ill people is threatened by the disconnect between how we teach and do health care in the hospital or doctor’s office and how patients manage chronic illness and disability in the real world. Managing 150 million Americans’ ongoing health needs has direct and indirect costs measured in the trillions annually. Patients, their families, and co-workers at home and work often suffer because their health providers have never worked with people outside the tightly controlled clinical setting.
I have given hundreds of future health professionals the experience they need to help people with chronic health challenges thrive everywhere we live and work. America can replicate this in a way that will reduce the suffering of millions, save money, and improve real world chronic health management.
I am a totally blind, type I diabetic graduate of Yale, Princeton and Harvard. I have worked for the University of Wisconsin-Madison and National Institutes of Health. Hard work and good fortune have helped me maintain the clinical connections and volunteer assistance I need to be engaged and productive.
Matthew A. Weed on the July/August 2015 Cover of Diabetes Forecast Magazine
Everywhere I have worked, I recruited dozens to hundreds of students in and outside of the health professions to monitor my blood sugar and prepare my insulin dosages because I had no other way to be independent and successful while managing my health needs safely, inexpensively and reliably. These volunteers not only assisted me with my medical protocol, but also with going to university dining halls, doing errands, and getting to and from appointments with health professionals among other things.
Some of them supported me in skiing, hiking, kayaking, traveling around the world twice, and completing a rollerblading marathon.
Although technologies like the self-calibrating continuous glucose monitor have made things easier for me, I still struggle to manage the complex regimens many health professionals who only work in hospitals or doctors’ offices think are easy. Unfortunately, millions of Americans don’t have similar health maintenance resources. Their inability to access needed assistance decreases the life expectancy of millions and costs the United States hundreds of billions annually as well.
A survey of my former volunteers, whose results are excerpted in the February 2012 Archives of Ophthalmology, and video from some of whom can be seen on my website, shows that assisting patients in the real world while in training affects clinicians’ practice. Others proved that exposure early in training profoundly impacts the majority of health professions students who don’t have long-term real world experience of health management before or during their training.
This exposure deficit is inflamed by data from the American Association of Medical Colleges proving many of its members’ admissions committees value laboratory skills over patient care experience. This lack of exposure is not corrected when applicants become medical students. Unfortunately, the AAMC does not require its member institutions to expose their students to work with patients with special needs whether in the clinic or outside of it while they are earning their degrees. According to an October 2022 article in Health Affairs, most physicians are either uncomfortable or unwilling to work with millions of patients with a wide variety of special needs. As of yet, only the commission on Dental Accreditation requires its member schools to give students training in working with patients with special needs, and that requirement only came into place in the 2022-23 academic year.
Building on my success with student volunteers, I am determined to work with health professions programs and potential funders to begin narrowing this dangerous and extremely expensive empathy gap.
Partly due to the impact of Covid 19, I am now working from home in Colorado and get most of my assistance from family. That said, while my volunteer systems were active, I had single students do my med routine. Given the difficulties in today’s society, pairing students to do home visits is probably safer for all concerned.
I propose having a large number of two-student teams do periodic non-invasive health checks on patients to ensure their homes are clean and disability safe and they are managing regimens that may well include many medications taken several times daily. If problems arise, the students seeing that patient can report them to an appropriate health professional.
I propose having a large number of two-student teams do periodic non-invasive health checks on patients to ensure their homes are clean and disability safe…
Data shows at-home visits cut health care costs and increase empathy in health professions trainees. In driving cities like Madison, WI or Colorado Springs, CO where a variety of practical and regulatory concerns mean home visit team volunteers may not be able to drive each other to patients far off campus, savings should occur even if students use taxis to see some people.
Savings could be enormous in cities like New York, where efficient mass transport makes travel inexpensive. A reasonable annual investment to help colleges and health providers connect students and chronic health needs patients could help thousands of trainees monitor 3 or 4 times the number of patients a week. This would prevent health problems, reduce loneliness, and give health professions students a far clearer image of how people with ongoing concerns manage (and often fail to manage) their health in the 99% of time they spend living, working, and yes, dying, outside of the clinical setting.
The literature says outcomes are often better when patients, caregivers, and health professionals have experiences in common. With broad application of programming like the Community Health Assistance Teams, there should be very significant long-term savings along with improved communication, innovation and real world chronic health management.
Community Health Assistance Teams can be win-win-win healthcare at its best. People you know and love will benefit when future health professionals see real world medical management, reduce healthcare costs and improve life for men and women everywhere.
About the Author
Dr. Matthew Reed is a totally blind motivational speaker and college/health professions educational search consultant. He was the first Associate Director for the $150 million Wisconsin Institute for Discovery and has mentored hundreds of students. When he’s not advocating for humane patient centered health care, he kayaks, rollerblades, skies and travels the world.
