On All Kinds of Greed

I preached again this past Sunday at St. Mary Magdalene Episcopal Church in the Village of Loch Lloyd in Missouri. The lessons for Proper 13 led me to a reflection on "stuff," and on all kinds of greed (it's in the Gospel lesson). You can listen here. I hope you enjoy it.

The Best Connection for Endorsement

I have been making some changes to the web site of the Assembly of Episcopal Healthcare Chaplains. One of the changes I’ve requested there I’m also going to make here. The Application form for Endorsement for Healthcare Ministries has a new web site. The best place to connect now is here. In addition to this post, I’ve updated the link in my sidebar.

　

The process hasn’t changed. Complete the form and submit it electronically. It will be received at the Episcopal Church Center. The person who receives it will contact the diocesan bishop for consent, and with the bishop’s consent will forward the application to our Endorsing Officer. That person will then send the letter of endorsement, with copies to the appropriate professional organization and the appropriate bishop. And, of course, you should have picked up from this that the first step is really to meet your bishop so that she or he knows of your ministry.

　

I’ve written before of the importance of Endorsement. It is still important, not only for those seeking certification, but also to raise the visibility of professional healthcare ministries in the Episcopal Church. So, make that appointment if you haven’t; and then get the application in. It serves you, and your colleagues, and the whole Episcopal Church.

The Anglican Health Network Carries On

I learned yesterday that a new edition of the Newsletter of the Anglican Health Network is available. Paul Holley, Coordinator of the Network, has shared that news. It isn't actually up at the AHN web site yet, but you can read it here.

The Network has had some changes lately, including some loss of donors. However, it continues to share information and resources about health care activities across the Anglican Communion. So, take a look at this edition of the newsletter; and then from the web site look at earlier editions. There are many health care ministries across the Communion, and the Newsletter of the Network is helping to spread the word.

Context Is Everything - or At Least an Awful Lot!

An ongoing problem in health care is the use of Emergency Rooms as primary care providers. With that in mind, I was interested to see the story, How Oregon Is Getting 'Frequent Fliers' Out Of The ER by Kristian Foden-Vencil on the NPR web site.

The article describes efforts to address the social needs and issues that keep patients out of primary care, and so in the Emergency Room. It looks at one patient as an example, and speaks to the needs he has for housing, clothing, dependable food - all those things that make for stability. With stability, he has been able to avoid expensive ER care and instead see a primary care physician, get necessary medications, and stay on them. Without stability, he has hardly any choice.

This is a well known problem; and, really, this is not a new solution. However, it's not always the first to come to mind. There is some expense in meeting his social needs and in following through with him so that he uses resources effectively. However, as the article notes, those are only a fraction of the expenses generated with avoidable visits to the ER and avoidable admissions to hospitals.

On the other hand, this is very different from our more common use of resources in health care. It involves spending money on folks who aren't at the time in crisis (leaving aside for the moment that social crises that is defined by the social needs). Our current insurance structure (including Medicare and Medicaid), built as it is on paying for procedures and interventions, isn't oriented this way. Some efforts have been made in the past toward that - think HMO's and "capitated care" (providing so much reimbursement per person) - but they were still oriented toward the traditional categories and the traditional venues of health care: medical and nursing and pharmacy care provided in medical and nursing and pharmacy settings. 

This answer is different, if not original. It is investment, really, in the life and situation of a person to provide the resources that prevent crises and so prevent crisis-level health care expenses. 

There are aspects of how health care is changing under our feet that might better coordinate the traditional aspects of health care. The important buzz words are medical home and accountable care organization. These are new to most of us, but there are good ideas behind these words. That said, they are still focused on how we provide and pay for the traditional categories of health care. It remains the case that for so many without the resources that provide social stability those good ideas won't accomplish all we hope.

A New Look from an Old Friend

I've spoken before about the good work and the good folks at the Center for Practical Bioethics in Kansas City. That's why they are always in my sidebar. Well, if you haven't visited the web site in a while, it's time you looked again. 

The new web site for the Center has more than a new look. There are more resources than ever, from articles and forms to podcasts, blogs, and videos. Of special note are more case studies than ever, there to be shared and discussed. What's more, the entire site is searchable, so you can find what you want. The Center's special programs are easy to see, as are sponsored events.

So, go take a look. The Center for Practical Bioethics is one of the nation's premier organizations for the study of ethics, health, and medicine. The new web site will only make it that much easier for all of us to benefit who work with those issues.