POSTED ON SEPTEMBER 4, 2013:
The Tisdale Project
New ship in Tulsa's health care seas
In the early 80's, Harvard historian/sociologist Paul Starr wrote a Pulitzer Prize-winning book about the strange evolution of modern American medicine and the historic role of nurses, doctors, and paraprofessionals since the outset of the Republic. The Social Transformation of American Medicine was controversial and sparked an enormous amount of discussion, some of which is still with us.
Starr's thesis: American medicine didn't have to be a doctor-centered system. Obviously, something else happened. Docs rule, but much of the current reform frission in American medicine is about a frank elevation, a brash, panoramic reconsideration of the 19th-century role that nurses, paraprofessionals, and physician aids once played.
There is a new healthcare center in Tulsa. Called the Wayman Tisdale Specialty Center, the facility is in north Tulsa and may be the anchor for a fascinating, still-budding biomedical spine in Tulsa's north. Just now, the Tisdale "campus" is one of several oases in T-Town that is a sort of "genesis site" for the healthcare we should all want: the place is becoming a sentinel for a biomedical future that could make Tulsans healthier, wiser, and maybe wealthier.
Obamacare and Beyond
The national struggle to redefine national healthcare is astonishing, given the intensity and the controversy that is has provoked. Few issues have generated the kind of nonstop anxiety we have witnessed here in Oklahoma. Only war and peace, the civil rights struggle, and our economic ups and downs have produced the kind of division that we continue to see. There's no surprise about this, as health care is about our functionality, the quintessential quality of our human essence. It's also, if national statistics are any indication, a $7 billion annual business in the Tulsa metropolitan area.
But providing insurance via Obamacare -- or the even more Rube Goldberg-like conception that Gov. Fallin and some other in-state advocates have cooked up -- is only the beginning of the problem for many thousands of Oklahomans with limited exposure to healthcare, no insurance, modest educations, and often suspicious (righteous) notions about what insurers, doctors, and health care providers actually do.
And Oklahoma's modest socio-econ folks have peers: more affluent, if no less unhealthy counterparts. So part of our problem, part of our deep healthcare dilemma in Oklahoma, goes to building new social vehicles, new norms, and imaginative ways of getting people in a better spot for taking care of themselves, for using physician, allied professional, and medical advice properly and for complying with the advice that they've been given.
Wildly, given the intense opposition to Obamacare that Fallin and her crew have manifested and what looks to be a pretty significant plurality of Oklahoma voters, if polling is any measure, who are also in the no camp, Tulsa is still, believe it or not, at the center of the future of health care in America.
We are at the tip of this spear because of the leadership of Dr. Gerald Clancy of OU/Tulsa, John Silva of Morton, Russ Burkhart of Indian HealthCare Resource Center, Dr. David Kendrick of Tulsa's MyHealth Access Network -- a nationally renowned bio infotech initiative -- and Jan Figert of the Community Service Council. All are advocates for notions at the core of the new Tisdale clinic and its still-spinning-up programs and service portfolio. The "plays" include tightly integrated medical teams that rely heavily on adroit nurses, agile paraprofessionals, and inventive care/health care maintenance outreach notions and nuanced, smart links with primary care providers and regular hospitals in Tulsa.
I spoke recently with Thomas Boxly, who is a strategic projects and diversity executive at the University of Oklahoma/Tulsa. He has ongoing facilities management and community liaison responsibilities for the new Tisdale center. And Boxley was a key team member, part of a muti-speciality cadre assembled by Clancy that conceived the Tisdale center and forged its still-evolving role as a new wave specialty medicine public venture in Tulsa's north.
The "Home" Concept
Tisdale has a growing corps of docs and a superbly trained set of allied medical professionals. On tap, a group of residents and faculty trained in both internal medicine and pediatrics: these professionals, their nursing, physician assistant peers and a carefully selected set of outreach workers, are organized in teams to deliver on one of the great concepts that is reanimating American medicine: the medical "home" for both adults and children, especially those with chronic medical problems.
Clancy, Burkhart, Figart, and Duffy, who recently retired from OU's School of Community Medicine, are stout advocates for the home concept.
Essentially the notion entails having a fully staffed, nimble micro co-op of medical pros who work together intensely, "gossip" about you continuously, and know all about you at your disposal. A medical home is a sort of eclectic prevention/care maintenance "hub." Perhaps as important, it is a handholding and feedback critter for chronic ailments you have or for chronic ailments that you may have at some point in the future.
Boxly told me that "a variety of services are available, from well-child visits to school/sports physicals to chronic care for older adults. Vaccines are also available on site. Specialty services include dermatology, adult psychiatry, nephrology, pediatric gastroenterology, gynecology, endocrinology (both adult and pediatric), and preventive cardiology."
While this might not sound exceptional, it's important to know that this range and variety of services is hard to come by in north Tulsa, and in big chunks of east and west Tulsa as well. Mind you, primary care and hospital-based offerings are available in many places in town, but critical chronic care services -- ones that can help you and me stay functional -- are quite far away for many people who live in north or west Tulsa.
Tisdale and crew are also building a set of superb support groups: patient and informal care groups that research suggests can give chronic disease sufferers enormous help.
Recently, the Tisdale crew has embarked on a set of sports medicine gambits: one of these efforts will aid junior high and high school football players, families and coaches with concussion diagnostics, baseline brain scans and related services: a breakout service for most Tulsa Schools.
More on the Tisdale project later.
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