Wednesday, April 8, 2020

Dr. Yes – A Personal Tribute to Senator Tom Coburn, MD

I met Tom Coburn during his first run for the U.S. Senate in 2004. His reputation was well known to me—conservative, fiscal hawk, term limit advocate, uncompromising. Eventually, his inflexible position on pork-barrel politics would frustrate Republicans and Democrats alike, earning Senator Coburn the nickname “Dr. No.” Upon his passing, I felt compelled to take a break from the COVID-19 pandemic to honor Senator Coburn by offering my personal tribute with a different perspective on his “Dr. No” moniker.
There is no doubt that Tom Coburn had a certain singularity to his thinking. When he became passionate about a purpose or mission, he was moved to action. For example, when he survived near-terminal cancer as a young businessman, he changed his career to become a physician.  When he grew concerned about the future of our country, he became a U.S. congressman and senator. Tom Coburn was a risk-taker and problem solver on issues of importance. As an engineer and entrepreneur, I identified with these qualities. It was on this basis that we became acquainted and engaged.
In our first meeting, Dr. Coburn came to my office to learn more about my web-based invention, designed to help solve our country’s health, healthcare delivery and healthcare cost crises. Our meeting was relatively short, and he asked no questions. I had been warned that Dr. Coburn had many preconceived notions, and was not a particularly good listener, so I was convinced he had not understood or accepted much of anything that I had shared with him. I would soon learn how wrong I was.
Once elected senator, I was pleasantly surprised when Dr. Coburn invited me to his Washington office to meet with the administrator of the Center for Medicare and Medicaid Services (CMS), Dr. Mark McClellan. With a medical degree from Harvard and a PhD in economics from MIT, Dr. McClellan is considered one of the smartest people in healthcare. The purpose of the meeting was to gain Dr. McClellan’s support for a CMS study to test my invention. I assumed Senator Coburn would make introductions, and then have me explain my program to Dr. McClellan. Instead, Senator Coburn leaned forward in his chair, and with great clarity, explained my invention in detail, including how and why the rather intricate doctor-patient aligned-incentive mechanism worked. He went on to press Dr. McClellan for a commitment to test the program. Although the CMS study never materialized, Senator Coburn persisted.
In 2009, after President Obama was elected, Senator Coburn asked if I would like an audience at the White House.  Needless to say, I was thrilled at the prospect, but did not quite understand how he could make this happen.  After all, the president and senator were on opposite ends of the political spectrum.  What I learned is that, in 2005, when then Senator Barrack Obama and Senator Coburn were being inducted into the same freshman class, the two of them, and their wives, became fast friends. My White House meeting was a beneficiary of this friendship.
The meeting took place right in the middle of the great debate over Obamacare. I had the privilege to present my program to the president’s top healthcare advisor, Dr. Ezekiel Emanuel. At the end of the nearly hour-long session, Dr. Emanuel kindly described my program as “brilliant,” but said the government could not endorse a private venture. I explained I was not seeking an endorsement, rather, our firm was willing to risk everything in a public demonstration. He said he did not share the president’s high regard for Senator Coburn, and, therefore, wished me good luck. 
I reported my experience to Dr. Coburn. He was very gracious about our failed attempt to offer a solution, and advised me not to expect much from government. Despite this apparent setback, nine years later, in 2018, I was pleased to learn that Dr. Emanuel co-authored an article in The Journal of the American Medical Association (JAMA) that essentially recommended my patient-doctor mutual accountability concept, citing a recent study by researchers at the University of Pennsylvania. So, perhaps the White House meeting Senator Coburn arranged was not a complete loss, after all. 
Once he left the Senate, Dr. Coburn and I corresponded infrequently, but he was always keenly interested in my progress, and ready to assist in any way he could.
In retrospect, those who saddled Tom Coburn with the nickname “Dr. No” got it all wrong. When he opposed pork-barrel politics, Senator Coburn was saying “yes” to fiscal responsibility. When he self-imposed term limits, he was saying “yes” to selflessness and incorruptibility. And when he recognized commonsense solutions to important problems, like mine, he was saying “yes” to our country and her generations to come.
Indeed, when it comes to the future of the country he loved so much, I trust Tom Coburn will be remembered by people of all political persuasions, as “Dr. Yes.”

Friday, April 3, 2020

Coronavirus, Fear, and Information Therapy

Fear is a natural human response. It helps keep us safe. We characterize this type of fear as “healthy” or “respectful.” On the other hand, irrational and chronic fear can disable us, both mentally and physically. This type of fear is also a foundation for human strife. During this pandemic, we must do all we can to mitigate irrational and chronic fear.

The root of this type of fear is the unknown. The cure for the unknown is something called “information therapy.” It is defined as providing people with the right information, at the right time, in the right way, so they can make informed decisions. Research has shown that information therapy alleviates the ill effects of inadequate health literacy, one of the strongest predictors of a person’s health status, life expectancy, and incurred healthcare costs. But to fully understand how the term mitigates fear involves examining its psychological components.

The word “information” is described as the facts we need to acquire knowledge. In turn, knowledge empowers us, and motivates us to take action. Receiving the wrong information, at the wrong time, in the wrong way, however, can cause irreparable harm. As such, the word “therapy” is the essential qualifier. It signifies a type of information that is soothing and healing, i.e., therapeutic. Therefore, the term “information therapy” implies empowerment, motivation, healing—a cure for the unknown.

While I did not invent the term, my colleagues and I have been the chief purveyors of “reward-induced information therapy” for over a decade. Throughout our experience, we have witnessed how reward-induced information therapy improves people’s health, lowers costs, and saves lives. But don’t take my word for it. Please read the independently validated study in the peer-reviewed Journal of Medical Internet Research, entitled “REDUCED HOSPITALIZATIONS, EMERGENCY ROOM VISITS, AND COSTS ASSOCIATED WITH A WEB-BASED HEALTH LITERACY, ALIGNED-INCENTIVE INTERVENTION: MIXED METHODS STUDY.” You will find that this study includes a few of the thousands upon thousands of testimonials from patients and doctors about information therapy.
My concluding bit of advice is that now, more than ever, information therapy is needed to overcome the unknown that drives unhealthy fear associated with the coronavirus pandemic.

What say you?