Health Care: A Personal Perspective

By Mark Neuenschwander

I’ve been thinking about hall of famers, contractors, presidents, and the future of health care.

I like Celtics’ Hall of Famer Bill Russell’s explanation of the difference between major and minor surgery. “When you have knee surgery,” he said, “it’s minor.”

I’d guess you’re not much different from me. When I go under the knife, it’s major. And when it’s my child, I feel it more than when it’s someone else’s.

I heard about a highly respected contractor who took his son under his wing to teach him the trade. The father’s philosophy was simple: Build each home as if you were building it for yourself.

After several years, he assigned a project to the young man, stating that for this one, he was on his own. “I will see you when the house is finished,” he said. “Just remember, build it as if you were building it for yourself.”

The son figured that without his father watching, he could cut a few corners. Who would ever know? So he bought substandard framing materials, lower-rated insulation, and thinner dry wall than his father would have used. Paying less for the materials, he pocketed the savings.

When the house was completed, the father came to see the finished product. On the surface, everything seemed to match the quality of his own projects. “Looks great,” he said. “Congratulations! Now, I have some good news. You have built this house for you and your family. It’s my gift to you for the work you’ve done with me over the years.”

In the winter of 1995, I toured the Centennial Medical Center in Nashville with the director of pharmacy. While walking through the main lobby, we bumped into The Honorable Bill Frist, M.D., and newly elected U.S. senator from Tennessee. After introductions, the senator explained that he had come to visit his father, Thomas Frist, who was in critical care following major surgery. It turns out the senator’s father, also a physician, was the founder of this top-100 hospital and the co-founder of its parent Hospital Corporation of America.

I could not help but think about how this dedicated physician, while building a topnotch hospital for the community he loved, was at the same time (whether the thought ever crossed his mind or not) building the hospital in which he and his children would one day be treated as patients.

Several months ago, my wife was in our community hospital being treated for a staph infection. I watched as a student nurse hung and started an IV, then left the room. Ten minutes later, she returned to scan the bar codes on Cinda’s wristband and IV bag to confirm a match. Up to that point, I didn’t know our hospital had bar-code point-of-care verification technology in place. So I asked the nurse, “I’m interested in this bar-coding thing. Can you explain how it works?” While she didn’t have a clue that I have had a nearly two-decade obsession with bar coding, she apparently sensed she had been caught administering a drug before instead of after scanning to verify a match with her patient.

The next day, the charge nurse of a new shift came into the room to hang another IV. This time she scanned both patient and bag before starting the infusion. Again, I said, “I’m fascinated with this bar-code technology. Tell me how it works.”

To my surprise, she hesitated, then asked, “Are you Mark Neuenschwander?” How did she know? After all, my wife’s last name is Peters. “I read your monthly articles,” she said, “and we leaned on your technology reports while getting ready for bar coding.” Turns out, this nurse is the hospital’s bar-coding champion, and her director of pharmacy had attended The unSUMMIT for Bedside Barcoding, of which I am a co-founder. Not only had I helped motivate my community hospital to adopt bar coding, but I had also contributed to its developing best practices for identifying patients and matching them with the right medications and treatments at the point of care.

It honestly had not occurred to me before this encounter that by helping others achieve safer points of care, I was contributing toward protecting my wife and eventually myself when it’s my turn to be stuck with needles and taking the meds.

Abraham Lincoln said, “Whatever you are, be a good one.” If asked to expand on what it means to “be a good one,” there’s a good chance our current president’s favorite president would have pulled out, as I understand he often did, the good old Golden Rule: “In everything, do unto others as you would have them do unto you,” e.g., contribute to building a health system that you would want others to build, if they were building it for you.

We who are involved in shaping health care are not only shaping it for others, as if that were not reason enough. We will eventually sleep in the beds we have made — and so will our loved ones.

Nothing minor about any of it.

What do you think?

In December 2010, Mark Neuenschwander received the Institute for Safe Medication Practices’ (ISMP) Lifetime Achievement Award. The ISMP’s highest award honors individuals who, throughout their careers, have made ongoing contributions to patient safety and have had a major impact on safe medication practices. Neuenschwander is the 10th recipient of ISMP’s Lifetime Achievement Award — previous winners include Lucian Leape, M.D., Harvard Medical School; Kenneth N. Barker, Ph.D., R.Ph, Auburn University; and Don Berwick, M.D., head of Centers for Medicare and Medicaid Services (CMS).

Mark heads The Neuenschwander Company, which provides reports and consulting services for technology companies and health care providers across America and around the world. The company is committed to promoting and facilitating wise development and sound deployment of medication-use automation, including drug distribution and dispensing technologies, and specializing in bar-code verification and documentation technologies for the prevention of errors at all points of care.

Trained as a pastor, Mark was senior pastor for a large church in Bellevue, Wash for 10 years.