Plan For Massive Hospital Complex Provokes Even Bigger Controversy

Plan For Massive Hospital Complex Provokes Even Bigger Controversy

One might think that something as pleasant sounding as the construction of a hospital might be relatively uncontroversial in San Francisco.

But, as the picket line in front of California Pacific Medical Center's Davies Campus in the Duboce Triangle demonstrates, the issues surrounding the Sutter Health affiliate's plan to develop a massive, 15-story, 555-bed health center on Cathedral Hill--complete with a three-story underground parking complex--are among the most contentious of any development project in all of San Francisco.

(SCROLL DOWN FOR PHOTOS)

The protesters are striking over a disagreement with management over their pay scale: CMPC's offer is lower than what union members earn at other Bay Area hospitals owned by Sutter and they want to get paid the same as their union siblings on the other side of the Bay.

"They told us they need the money to build their new hospital," union rep Joseph Klein told the San Francisco Bay Guardian. "[CPMC negotiators] don't even question whether they can afford to pay us comparable salaries. They just say they want to spend the money on that project."

The amount of money CMPC plans to spend on a new hospital at the site of the old Cathedral Hill Hotel on Van Ness Avenue is substantial. While the exact number has bounced around a bit, the most recent projection has pegged it at $1.9 billion. That figure is only a portion of the overall $2.5 billion system-wide renovation project that CMPC has planned, which includes a complete rebuild of St. Luke's Hospital in the Mission.

San Francisco's Planning Commission gave CMPC's proposal its preliminary approval on Monday, but the project still faces a whole host of obstacles before getting the final go ahead (despite the full-throttle support of Mayor Ed Lee). Lee largely backs the plan due to CMPC's promise that the project would create 1,500 new jobs (five percent of which are required to go to San Francisco residents) and bring $2.5 billion into the local economy. CMPC is already the second-largest private employer in the city.

The San Francisco Examiner reports:

[CPMC] CEO Dr. Warren Browner said he was "very pleased" with the vote. He called some of the criticisms “fundamental misunderstandings” of the deal, but conceded that other areas may need “additional clarification.”

“This is an incredibly important project for the folks who live and work and visit here, and we want to see it happen,” he said.

To get officially approved, the deal must go before a highly skeptical Board of Supervisors, many of whose constituents have expressed concerns about the drain the giant development, expected to draw 10,000 cars per day to one of the busiest intersections in all of San Francisco, will have on city services.

While City Hall is confident the project will eventually become a reality, a measure approving the hospital's construction has yet to receive the official sponsorship of a single supervisor.

Due to a deal negotiated between Lee and CMPC leadership, the hospital would provide care for 10,000 of the new Medi-Cal beneficiaries projected to be covered under the new federal health care law for a full decade, give $86 million in annual charitable care to low income patients, put $64 million towards affordable housing ($29 million of which will go to CMPC employees), give $20 million to community health clinics and another $31 million toward public transportation and pedestrian safety improvements.

These concessions weren't enough for some activists, who staged a protest on the steps of City Hall on the same day the deal was announced. The coalition of union and community leaders, calling itself San Franciscans for Healthcare, Housing, Jobs and Justice, expressed doubt that these were the most favorable terms the city could have gotten on the deal.

"The proposed development agreement as we understand it is a special deal that is good for Sutter/CPMC, but bad for San Francisco," said coalition spokesperson Leighton Woodhouse in a statement. "[It's] a deal that falls far short of the Mayor’s original 'asks'; that relieves Sutter/CPMC of responsibilities met by other private non-profit hospitals; that does not provide the healthcare and jobs City residents need; that fails to address the affordable housing, traffic, and neighborhood impacts the project will produce; and that leaves City taxpayers to foot the bill for the project’s failures in each and every one of these areas."

Others joined the chorus of criticisms. The San Francisco Chronicle reports:

That [10,000 Medi-Cal patients] figure was derived as an average of the CPMC's charitable care over three years, even though the medical group has been criticized for spending proportionately less on care for poor residents than other private nonprofit hospitals in the city.

"They're using as a baseline CPMC's history, which is lousy," said Bob Prentice, a former deputy director at the city's Public Health Department. "They're letting them get away without that past, without some kind of correction."

Others voiced concerns that St. Luke's Hospital, which largely serves lower-income and minority patients, will no longer be able to adequately fill the needs of the surrounding community as its renovation plans call for decreasing the number total of beds at the facility by more than half.

For its part, CMPC asserted to Bay City News that the remodeled facility will offer its patients a higher level of care.

In an editorial in the Examiner, Chamber of Commerce President Steve Falk waived off all these criticisms as just the typical griping that accompanies virtually every development project in the city.

"In this case, CPMC critics claim the agreement does not 'go far enough' in providing benefits to the community. Yet, beyond providing two new hospitals at no cost to taxpayers, the CPMC agreement guarantees $1.1 billion in added investment for San Francisco," wrote Falk. "By any measure, CPMC’s investments are sure to benefit thousands of residents and visitors."

The project returns to the Planning Commission for a final vote on April 26th. If all goes according to plan, CMPC hopes to open its new Cathedral Hill campus in 2016.

Check out this slideshow of pictures showing what the new hospital is going to look like:

CPMC Cathedral Hill

1  of  7

Source: www.huffingtonpost.com

Sara Calabro: 7 Acupuncture Points To Ease Your Allergies

Sara Calabro: 7 Acupuncture Points To Ease Your Allergies

Spring is in full swing. For some, it's time for warm air! Fresh flowers! Longer days! For others, it's time for runny noses! Itchy eyes! Sinus headaches!

But people with seasonal allergies should know that spring need not be an unavoidable period of suffering. Nor does it require dependence on Claritin or fear of leaving the house without Kleenex.

Acupuncture offers tools for both preventing spring allergy symptoms and getting rid of them. Specifically, there are seven acupuncture points that can work wonders for preventing and relieving spring allergies.

Seven Points, Seven Fingers Is All It Takes

Acupuncturists use these seven points all the time to alleviate seasonal allergies. It's ideal to go for acupuncture before allergy symptoms kick in. Now is a great time since not everything is fully bloomed yet.

If you miss the preventive window, the same points can be used to eliminate symptoms, especially nasal drip, itchy eyes and sinus headaches. It is not uncommon for people to notice an immediate clearing of the nasal passages after receiving these seven acupuncture points.

But the best part is, you can alleviate allergies with these seven acupuncture points all by yourself. All it takes is seven fingers and a little concentration and coordination.

In most cases, stimulating the points yourself is not a substitute for real acupuncture. However, as a preventive measure, it can delay the onset and lessen the severity of allergy symptoms. It also can prolong the effects of acupuncture treatments so that you're able to allow more time between appointments. And it comes in really handy as an on-the-spot remedy for sudden allergy attacks.

The New Face of Spring

Imagine a world where the first thing that comes to mind when we think of seasonal allergies is not someone running through a field in a drug commercial, but rather someone poking themselves in the face. How sweet it would be.

So, where to poke?

You're aiming for six points on the face: Large Intestine 20, Stomach 2 and Bladder 2. All three points are pressed twice, symmetrically on both sides of the face, equaling six points. (The seventh is explained below.)

The picture shows how it should look when you're pressing all six face points. You're going for just outside the nostril, just below the eye (you'll feel a little indentation in the bone there -- that's the point), and the inner end of the eyebrow.

In addition to point location, you also want to pay attention to the direction you're pressing. This is where concentration and coordination come in.

Large Intestine 20, the points outside the nostrils, should be pressed diagonally upward, as if you're aiming for your eye on the opposite side. Stomach 2, the points below the eye, should be pressed downward toward the mouth. Bladder 2, the ones on the eyebrow, should be pressed upward toward the top of the head.

Maintaining the right point locations and directions may feel awkward at first but it gets easier with practice. For myself and most people I've recommended this technique to, the pinkie, ring and middle finger combo seems to work best. But everyone's fingers and hand coordination are different, so play around with it and do whatever feels most comfortable for you.

Lucky Number Seven: Spleen 5

The six points on the face are considered a local acupuncture approach. In other words, needles (or fingers) are placed at the site of the problem -- in this case, near the nasal passages and frontalis muscle on the forehead since this is often where allergy symptoms occur.

But as is true of all conditions, allergies from an acupuncture perspective derive from an underlying imbalance. In addition to the six points on the face, acupuncturists often incorporate a seventh point to address the root cause of seasonal allergy symptoms.

This point is Spleen 5, located below and distal to (toward the toes) the medial malleolus (the prominent bone on the inner ankle). It is done only on the left side.

So why Spleen 5? Many reasons, depending on who you ask, but the primary logic behind using Spleen 5 to treat allergies has to do with its role in resolving what acupuncturists refer to as "Dampness."

We could spend a whole article -- book, actually! -- talking just about Dampness. But for the purposes of this article, suffice it to say that Dampness in the body creates fixed, heavy obstructions. Also, when Dampness accumulates, it can turn into Phlegm, which is not exactly but close enough to the phlegm we're all familiar with and afraid of during allergy season.

Holding Spleen 5 at the same time as the six face points is kind of ambitious. You don't have to do them all together. Spleen 5 is easy to press while watching TV, reading or doing anything seated that doesn't require use of both hands.

For me, sitting cross-legged is best. It comfortably exposes the inner left ankle and allows me to access the point with my right index finger. From a desk chair, you can prop your left foot onto your right thigh, which also allows for easy access. Again, it's important to find the position that is comfortable for you.

It's unfair that so many seasonal-allergy sufferers view spring as time to stay indoors. No more, thanks to acupuncture. It's merely time to put on a new face.

For more by Sara Calabro, click here.

For more on personal health, click here.

Photo credit: Sara Calabro

Source: www.huffingtonpost.com

Richard C. Senelick, M.D.: The Healing Power of Storytelling

Richard C. Senelick, M.D.: The Healing Power of Storytelling

"To be a person is to have a story to tell. -- Isak Dinesen

I love telling stories when I give a lecture, visit with my patients, or lunch with my colleagues. However, over the years, many of the best stories have come from my patients -- sometimes in a moment of crisis, and other times during a routine office visit.

I have a clear memory of the elderly Scandinavian ship captain who sported a huge white beard and filled me with tales of his life at sea. I always asked my office to block out twice the usual amount of time so I could get a double dose of his spellbinding stories. Equally foreign, but just as enlightening, were the stories of the immigrant woman who, despite blinding migraine headaches, worked two jobs so that she could assure that all four of her children received an education. Their stories provided the fabric and context that taught me more about these people as individuals, as opposed to just the person in exam room number three.

Last week, I took my 95-year-old mother to the doctor. The young medical assistant, dressed in jeans and a T-shirt, sat with his back to us as he asked his rapid-fire questions and typed the answers into the required electronic medical record. We might as well have been answering a robot, for when he was done, he knew no more about my mother than when we first sat down. The printer spit out a lengthy description of all the things that she did not have, but it no more described who she is than the five previous patients he entered into his "clinical station."

If we cannot stop the implementation of the electronic medical record (EMR), there must still be a way to acquire the rich stories that our patients have to tell and assemble a complete picture of our patients as people.

Equally challenging is educating our patients about their illnesses and being certain that they understand our instructions. As we careen into the digital age, the fistful of pamphlets that we stuff into our patients' hands will be as ineffective in the future as they have been in the past. Storytelling, in its various forms, may be one way to connect more meaningfully with our patients, to both help us get to know them individually and help them understand their physical condition.

The Storytelling Tradition

The use of storytelling goes back to pre-literate societies and ancient cultures, who used it as a means to convey their history and traditions. Many cultures would identify specific individuals to adopt the role of tale-teller. The information was passed along via performance before a live audience, and the performer would adapt, change, and embellish the information to meet the needs of the specific audience.

Stories based in truth have a greater impact, and people are more likely to remember the information when it is related in the form of a story. The practice of medicine is filled with stories, but they are widely under-appreciated. Health care professionals usually relay stories to their patients in a flat, staccato, and detached manner. Health care providers complicate the problem by using complex language that the patient and their family may not comprehend. Patients are more likely to remember a story than a listing of individual facts.

An article that looks at storytelling in health care gives us examples of why storytelling is an effective tool. Stories are:

• Are mentally richer than simple instructions

• Engage and involve the patient

• Trigger empathy

• Are more likely to be remembered and retold

• Promote a two-way conversation

• Transfer knowledge

Healing Stories

Storytelling is a two-way street. Illnesses unfold as stories, and physicians need to learn how to listen to those stories. The same is true of giving advice, for if good advice is given in the wrong way, the patient will not follow it. Stories are a powerful part of support groups and peer visits. I can tell a patient why they feel so ill and what the future holds for them, but having someone who has walked in their shoes come visit them in the hospital is much more powerful. They will believe the story of someone who has shared their same experience.

In 2011, a study published in the Annals of Internal Medicine evaluated whether storytelling could improve the blood pressure of people with hypertension. The study divided 299 African-Americans who suffered from high blood pressure into two groups. The first group watched peers who also suffered from hypertension tell stories that described their experiences with hypertension, lessons learned on how to interact with physicians, and strategies to increase medication adherence. The second group watched health-related topics not related to hypertension. The group that watched stories related by peers who shared their problem were more successful in lowering their blood pressure than the other half. A story told by a friend or peer is most effective in creating a lasting memory.

Storytelling has been one of the keys to the highly-successful book series Chicken Soup for the Soul. It encourages people to submit their own stories and compiles them into a single book to help people cope with specific issues like grief, stress, or spiritual matters. This well-known brand has recognized the power of narrative in health and has formed a partnership with Harvard Health Publications to take storytelling and health to the next level. They are introducing a new series of books that will combine the latest medical advice with real stories from real people to help their readers live healthier lives.

Over the years, I have eaten chicken soup with kneidlach (dumplings) made by my grandma, mother and wife -- first only at holidays, then at times when I had a bad cold. Now I can order up a serving of Chicken Soup for my patients that they can digest slowly in book form and not just for a cold. It may be time for storytelling to take a more prominent role in how we treat our patients. Take a moment to tell us how stories have helped you.

For more by Richard C. Senelick, M.D., click here.

For more on health care, click here.

Follow Richard C. Senelick, M.D. on Twitter: www.twitter.com/RichardSenelick

Source: www.huffingtonpost.com