Repertoire April 2023

Healthcare is not

Awareness of the benefits of oral and medical care integration is growing. But implementing it will present some challenges, not only among providers, but patients too.

‘Revolutionizing

Easy.’

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Spring Into Action

With spring in the air, it’s time to spring into action. Last month I wrote about what are we doing now to have future growth. What is our game plan to grow our skills, business, relationships, and ourselves? Knowing that plan, writing it down, and springing into action brings it to life.

I actually took my own advice and did this for myself and for the future growth of Repertoire and Share Moving Media. This took a huge weight off of me that I didn’t realize I was carrying around. Billy Harris, one of my mentors, used to tell us that “sometimes you need to step back and work on the business versus working in the business.” He would also follow up with “people only respect what you inspect.”

Let’s unpack those two statements. What is the difference between working on your business or your life versus working in them? It may sound obvious, but I think it’s worth stating. We all spend 99% of our time working day-to-day, whether it’s in business, relationships or self-growth. We do this because of deadlines, routines, checklists, etc. But what if you took 10-15% of that time and made a plan of ways to deepen your relationships and grow your skills, or your business? Then you incorporated that plan into your daily routine. My belief is it could be life-changing and rewarding.

The key is once you have the plan and start working it into your daily life, you must use the second component of inspecting what you added. Is it working? Can I see growth? Am I learning a new skill? Are my relationships improving? If yes, then keep doing it and keep inspecting. If no, then tweak your plan and inspect until you see the results you want.

The key to both is you must spring into action for either of them to benefit you. This spring, along with clearing out the clutter in your life, think about adding a new plan that will benefit you ten-fold moving forward. Working on all aspects of your life is as important as living it.

Dedicated to the industry,

R. Scott Adams

editorial staff

editor

Mark Thill mthill@sharemovingmedia.com

managing editor

Graham Garrison ggarrison@sharemovingmedia.com

editor-in-chief, Dail-eNews

Pete Mercer pmercer@sharemovingmedia.com

art director

Brent Cashman bcashman@sharemovingmedia.com

circulation

Laura Gantert lgantert@sharemovingmedia.com

sales executive Amy Cochran acochran@sharemovingmedia.com (800) 536.5312 x5279

publisher Scott Adams sadams@sharemovingmedia.com (800) 536.5312 x5256

founder Brian Taylor btaylor@sharemovingmedia.com

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Repertoire is published monthly by Share Moving Media 1735 N. Brown Rd., Suite 140, Lawrenceville, GA 30043 Phone: (800) 536-5312, FAX: (770) 709-5432; e-mail: info@sharemovingmedia.com; www.sharemovingmedia.com

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Understanding Sepsis

Knowledge is key to better outcomes for post-sepsis patients.

In the past, I have written a fair bit about sepsis, so this column will have some familiar elements. But there is a lot that is new, including an update on diagnostic methods and new information on the incidence of sepsis in the general population, how often it is initially diagnosed in primary care, and some updates on the cost to the healthcare system. In addition, I want to again reinforce that treatment of post-sepsis patients falls directly onto primary care. We need to know and understand sepsis well, and be prepared to have meaningful discussions with our key physician practices, to understand their experience with sepsis diagnosis, as well as their needs to manage post-sepsis patients. As a practical matter, since patients who have survived sepsis experience a broad range of both physical and psychological symptoms, the more you and your customers know, the better the outcomes for the patient post-sepsis.

By Jim Poggi

I plan to tread some familiar ground in this column to provide a review of what sepsis is and what causes it. The reason is that there continues to be a lot of misconceptions about sepsis. For instance, while 72% of the American public can identify the symptoms of stroke, only 12% of the public can do so for sepsis. In addition, 39% of all Americans believe sepsis is contagious. Clearly education about sepsis is needed. The better informed we are, the greater our ability to convey needed knowledge to our customers as their consultants. So here goes.

What is sepsis?

It may start as an infection, but sepsis is not an infection at all. As we have learned, sepsis is not a disease and it is not contagious. It typically results from an infection, some that seem trivial and easily treated, but sepsis is actually the body’s overly aggressive reaction to the infection. Sepsis is defined as “the body’s overwhelming and life-threatening response to infection which can lead to tissue damage, organ failure, and death.” It results from our immune system becoming over-stimulated and the creation of a feedback loop

keeping the immune system highly active. From a metabolic standpoint, sepsis typically unleashes a powerful immune response, resulting in what is described as a “cytokine storm.” Cytokines are a part of the immune system that pass messages to the immune system to attack a foreign substance and rid the body of it. In healthy conditions, their signaling stays in control and results in the removal of the infecting substance. But in sepsis, their signal goes out of control and unleashes a far greater immune response than is appropriate.

What causes sepsis?

Sepsis causes include respiratory infections such as COVID, pneumonia, group A strep and influenza urinary tract infections, enteric diseases including C. difficile and skin infections including MRSA. While we think of respiratory infections and skin infections as relatively minor issues which are usually easily treatable, this is not the case for everyone. Our recent experience with COVID and patients who experience lingering symptoms well after their initial diagnosis (long COVID) showcases how complicated some of these seemingly innocuous clinical conditions can be.

Risk factors for sepsis/who is most likely to develop sepsis

Unfortunately, sepsis risk factors target those most likely to develop several other serious adverse health outcomes. Those at risk include adults over 65, people with compromised immune systems, those with chronic medical conditions, those who recently experienced a serious illness or hospitalization, former sepsis survivors and children younger than one. As we help create awareness

of sepsis and patients most at risk, the situation regarding chronic illnesses is important to consider at greater length. We know that heart disease, diabetes and chronic lower lung disease factor into the ten leading causes of death (now along with COVID at number five) but consider the chronic conditions of the patients our customers see frequently. Nineteen percent of U.S. adults 55 years or older have three or more chronic conditions. For adults older than 65, the percentage rises to over 23% according to CDC data. This leaves a substantial percentage of the patients our customers see every day in a high-risk group for sepsis and other conditions.

Incidence of sepsis and costs to the health care system

So, knowing all this, what is the current incidence of sepsis? According to the Sepsis Alliance, there are 1.7 million sepsis cases diagnosed annually in the U.S., with 350,000 fatalities annually. Sepsis has a 20% fatality rate, and over 30% of sepsis survivors go on to have “post-sepsis syndrome” with a range of physical symptoms including fatigue, shortness of breath and difficulty sleeping. Psychological symptoms include panic attacks, flashbacks, depression, memory loss and others. Management of the “post-sepsis syndrome” patient largely falls to primary care practices except in seriously acute conditions where hospitalization will be required.

The most recent estimates of the impact of sepsis on the health care system make it clear that sepsis’s impact is growing, not declining. Latest cost estimates show the annual cost of sepsis to hospitals at $27 billion according to the Sepsis Alliance. This does not take into

account primary care visit costs. Sepsis continues to be the leading cause of death in hospitals as well as the leading cause of readmissions.

It is estimated that the cost of sepsis has increased by 20% from 2015 to 2018. While our understanding of means to diagnose and treat sepsis have improved significantly in the past 20 years, the burden on the health care system continues to grow. Most experts believe faster, more accurate diagnosis and more

targeted treatment methods are the keys to improving outcomes and reducing costs. There is a lot of work to be done to achieve these goals.

Sepsis diagnosis

This brings us to try to understand current diagnostic tools for sepsis and to what extent out customers encounter sepsis in their practices. First, we need to know that 10% of all initial diagnoses of sepsis take place outside of the hospital. These

For instance, while 72% of the American public can identify the symptoms of stroke, only 12% on the public can do so for sepsis. In addition, 39% of all Americans believe sepsis is contagious. Clearly education about sepsis is needed.

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diagnoses are made in primary care practices, urgent care centers and free-standing emergency facilities.

Unfortunately, there is no single biomarker that can rapidly diagnose sepsis definitively today. Typically, a combination of “signs and symptoms” are evaluated along with lab

data. Signs and symptoms include high heart rate, weak pulse, fever, shortness of breath, mental confusion, clammy or sweaty skin, and extreme pain or discomfort.

Lab diagnostic tools include complete blood counts (CBC), lactate, coagulation tests including

prothrombin time, d-dimer and platelet counts, as well as procalcitonin. Microbiology tests can assist in determining the type of infection and the most likely antibiotics to counter it. Presumptive positives for sepsis require reflex testing for ALT, AST, BUN and creatinine to determine whether there is also organ damage taking place. Between developing more experience with COVID patients who may develop sepsis as well as increased focus on early detection of sepsis, a greater understanding of CBC interpretation is developing. It is well known that infections create an increase in while cells, but other patterns are emerging. As white cell production increases dramatically, the white blood cell differential shifts resulting in an increase in bands (immature neutrophils) and immature granulocytes. Monocyte distribution width also changes, with monocyte distribution width greater than 20 indicative of sepsis. A normal monocyte distribution width indicates a sixfold decrease in the likelihood that the patient has sepsis. Each of these changes are red flags that the patient may be experiencing sepsis. As our knowledge of how to interpret CBC data to help diagnose sepsis continues to grow, this area of lab diagnosis is growing in importance. Stay in close touch with your key hematology manufacturers to take advantage of their expertise as these findings continue to evolve.

As dangerous as sepsis can be, if diagnosed and treated early and aggressively, the patient outcome is usually favorable. More than 70% of those who suffer from sepsis will recover fully if treated promptly. The key is recognizing the symptoms of sepsis and rapidly taking action to

Most experts believe faster, more accurate diagnosis and more targeted treatment methods are the keys to improving outcomes and reducing costs.

TIMELY RESULTS, TIMELY DECISIONS

overcome it. The classic symptoms of sepsis include:

ʯ Temperature: elevated or below normal.

ʯ Infection: sepsis typically presents as a result of an infection.

ʯ Mental confusion/decline: the patient may be sleepy, easily confused, or difficult to rouse.

ʯ Extremely ill: patients frequently state that they are concerned they may die.

Clinicians frequently use the acronym TIME when they describe the symptoms of sepsis. It’s worth putting into your vocabulary.

Once the sepsis patient becomes ill enough to be hospitalized, the patient management includes assessment of blood gases and electrolyte values and also shifts to developing and following the patient’s SOFA (sequential organ failure assessment) score. This score helps determine the prognosis of the patient; the higher the score, the more serious the prognosis. There are six elements of the SOFA scoring system: respiration, platelet count, bilirubin, hypotension (low blood pressure), Central Nervous System Glasgow Coma score and creatinine. Each has a value from zero to 4. Scores above 11 are associated with a very high risk of death. As you can see, lab results continue to be important both in the primary care realm as well as the hospital, since these

specific lab results point to impending organ failure, which is a serious complication of sepsis and development of septic shock.

Patient treatment and management in the hospital setting includes therapeutic measures including aggressive antibiotic treatment, supportive therapy including supplemental oxygen, pain management and IV fluid replacement.

than the average patient upon hospital discharge. Understand your role as consultant and work to understand the network of health care professionals needed to complete the patient’s successful recovery.

Sepsis resources

There have been several organizations working diligently to develop awareness of sepsis, effective diagnostic

Post sepsis management: back to the community

About 1.4 million Americans survive sepsis annually and return for ongoing care. Their needs are special and require physician practices to understand the trauma they have recently undergone and develop a care plan to deal with both physical and psychological elements of their recovery. They will need to have routine monitoring of their lab tests including organ tests (ALT, AST, BUN, creatinine, electrolytes and CBC at a minimum). They may also require counseling and physical rehabilitation to resume normal activities and return to health. Their treatment plan is likely to involve far more health care practices and personnel

The classic symptoms of sepsis include:

ʯ Temperature: elevated or below normal.

ʯ I nfection: sepsis typically presents as a result of an infection.

ʯ M ental confusion/decline: the patient may be sleepy, easily confused, or difficult to rouse.

ʯ Extremely ill: patients frequently state that they are concerned they may die.

and treatment tools and the need to treat it with the urgency required to assure patient recovery. Key among them are the Sepsis Alliance and the Society of Critical Care Medicine. Both organizations post a wealth of information on their web sites to assist you and your customers in learning far more than can be delivered in this column. I recommend you spend the time to review their resources, think with your key lab manufacturers about how to integrate this information into your customer consultation, and become more well informed. In addition, September is Sepsis Awareness Month, a time for you, your key lab manufacturers and our customers to focus our thinking on sepsis and how to effectively manage it. This complex disorder requires exceptional knowledge and coordination between you, a large number of our manufacturers for lab and other products, and the health care professionals in your community. Commit to make a difference. It will save lives.

Unfortunately, sepsis risk factors target those most likely to develop several other serious adverse health outcomes.

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Steve Dennison: A presence missed

People will remember Steve Dennison for his knowledge, humor and talent. But just as important, they will recall his interest in and love of the people around him. The director of vendor relations for IMCO died in January at the age of 68.

“He knew every product, product number, manufacturers’ history and every time the name changed,” says IMCO CFO Ashleigh McLaughlin. “We called him our walking encyclopedia. But most of all, Steve knew people. He genuinely cared about everyone and had an amazing sense of humor. We will all miss his laugh and the nicknames he had for everyone in the office. He was an incredible mentor and friend. What we wouldn’t give to have had the opportunity for just one more conversation with him.”

Steve Dennison

“It isn’t really one thing” that distinguished Dennison from others, added Angie Euston, IMCO’s director of member relations. “It was him being available to talk through things, providing the extra ‘oomph’ when affirming a decision and his crazy photographic memory when it came to products and product numbers. He was a mentor and helped me build confidence in different areas that I took on throughout the years at IMCO. ... Steve’s biggest impact was his ability to understand people and to listen. He was happy to help even if it didn’t directly benefit him as long it helped the other person.”

California roots

Born and raised in Bakersfield, California, Dennison graduated from Bakersfield College in 1974, according to Lexi McLaughlin, IMCO’s content marketing specialist, who researched biographical information for a memorial. “During his time in college, he worked in food service and as a front desk clerk at a Hilton Hotel, which he loved, as he was able to meet all kinds of interesting people,” she said.

Supply-Bakersfield branch for over 28 years. There he gained experience selling exam room equipment, laboratory instrumentation, supplies and pharmaceuticals to physician practices in California and Nevada. In May 2008, Steve and Pam moved to Florida so he could join IMCO as director of vendor relations.

a little harder?’ Then I would realize that he was doing all those things, but with a different approach that no one saw coming. He could orchestrate a conversation in the same way that he could music.”

Karen D’Arcy, IMCO’s director of marketing services, said, “We called him ‘The Professor’ because he had the answer to any question

On the job

“Steve had an incredible command of product knowledge and understanding as well as a deep thoughtfulness when helping others out,” said Euston. “He always took the time to talk and dive into his rationale when discussing a business issue or question.”

Ashleigh McLaughlin said, “It’s hard to put into words the legacy that he leaves within the IMCO family and our industry. I have never

you had. He could recite product numbers, packaging, pricing for any product, even if it was from 20 years ago. This was a priceless resource not only for our staff at IMCO, but for our membership. And he always made time to answer your questions, no matter how busy he was. He really enjoyed those one-on-one conversations with everyone.

He began his career in 1975 with Gunner Medical Supply delivering prescriptions and ultimately assuming responsibility for ordering. It was at Gunner that he met his wife, Pam, whom he affectionately called “Cranky.” In 1979 he joined San Jose Surgical Supply, managing its Mid-Valley Surgical

heard anyone speak negatively about Steve. He had the same calm, collected approach under pressure in a stressful situation as he did casually drinking a beer and talking about music. I can remember the first few times I sat with him during negotiations. I would be thinking, ‘Why isn’t he being more aggressive or pushing

“He was a great mentor to many and an ambassador for distribution and IMCO, even if he did not know it,” she added. “We have heard from a lot of people ... about how much he taught them, just by sharing his time at tradeshows, meetings or on the phone. He wanted our members to succeed and for our vendors to have success selling to distributors. He was great at bringing them together.”

Vendors remembered Dennison fondly as well. “In an industry full of good guys, Steve was one of the best,” said Joel Robinson, executive vice president, Innovative Healthcare Corporation. “He was perpetually happy, always calm, and he liked to make everyone feel relaxed. He

‘What we wouldn’t give to have had the opportunity for just one more conversation with him.’

‘He had a major impact on the medical sales community through his contributions, expertise and knack for bringing people together.’

always offered valuable advice on how dealers would look at a particular promotion and how sales reps would respond to different offers. If you ever had a sticky situation, Steve would offer up a rational solution often accompanied by a joke. He could always calm the mood.”

Dennison used to call Sabrina Sinclair, sales coordinator for AMD Medicom, his “young friend,” she said. “Attending my first conference as a junior salesperson over 10-years ago was intimidating to say the least. Steve took me under his wing and made me feel like I was part of a family. He had a major impact on the medical sales community through his contributions, expertise and knack for bringing people together. He inspired and supported me throughout my career with Medicom and helped pave the way for collaborative ideas to help build our relationship with IMCO and its distribution partners.”

with my 8-year-old daughter,” recalled Angie Euston. “While working from my home office, I would be on the voice-over-IP phone with Steve when my daughter would come home from school. He always made a point to ask her about school, things going on in her life and how she was enjoying her piano and singing classes, as music was a lifelong passion of Steve’s. He would follow up our conversation with videos or songs for her to listen to, which was so touching.”

Bluegrass

“Steve was an excellent bluegrass musician, and his knowledge of guitars was no second to his knowledge

formally and was only a call away to play as a guest with others,” said Lexi McLaughlin. “He also had a special love for guitars and mandolins and could always be found with a guitar pick in his pants pocket and wallet. Steve and his bass, Bass-y Lee, would regularly jam with some of their friends in the St. Augustine, Florida, area. You can find music from his band, Pacific Crest, on Apple Music.”

His presence missed

“There’s been a noticeable emptiness in the IMCO office since Steve’s passing,” Lexi McLaughlin added. “His presence was felt with his welcoming hellos, personalized nicknames and genuine conversations.”

“I know Steve is surrounded by a loving family and a network of business associates,” said Teresa Allen, sales specialist, Major Rugby. “His presence will be greatly missed.”

Always laughing

“Steve saw the humor in everything, even if it was not easy sometimes,” said D’Arcy. “We laughed a lot on our end of the building. He took a real interest in what was going on in our lives and families. He loved hearing about our kids and our pets. He loved animals and I would bring mine in the office to visit him.” He and Pam adopted many specialneeds animals over the years and gave them a dignified and loving life, she added.

“Some of my most fond memories with Steve were his conversations

of the medical industry,” recalled Joel Robinson. “My favorite story about Steve is the time we walked into North Beach Fish Camp in Jacksonville. There was a guitar player and singer in the next room. Steve quickly told me that the guy in the other room was playing a Martin model D-28. I asked how he knew that, and he told me he could hear it in the tone of the guitar. I walked into the other room and sure enough, the musician had a Martin D-28. I was surprised Steve didn’t name the guitar’s color.”

“Back in California, Steve was the bassist of two Bluegrass bands

Sabrina Sinclair said, “Steve had a way of making everyone feel incredibly special. I am going to miss his voice, his infectious smile, and most of all, the singing, dancing and laughter.”

“Steve was a terrific colleague and better person,” said Angie Euston.

In honor of Steve Dennison and his love of music, IMCO is creating an honorary scholarship in his name to help local students of all ages explore their musical passions. Donations can be made to the Volusia County Music Teachers Association (www.VCMTA.org).

‘He always offered valuable advice on how dealers would look at a particular promotion and how sales reps would respond to different offers.’

‘He could orchestrate a conversation in the same way that he could music.’

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Henry Schein Medical Hosts 2023 National Sales Meetings

East and West Area Meetings brought together more than 1,200 Team Schein Members, supplier partners, and exhibitors to discuss ‘The Human Touch in a Digital World.’

Courtesy of Henry Schein Medical

Henry Schein Medical, the U.S. medical business of Henry Schein, Inc. (Nasdaq: HSIC), recently hosted its 2023 East and West Area Sales Meetings, bringing together more than 1,200 attendees, including Team Schein Members (TSMs) and supplier partners who exhibited their products and solutions to the sales team. The theme of this year’s meetings was “Connected: The Human Touch in a Digital World.”

Held at the Marriott in New Orleans and Caesars Palace in Las Vegas, the Area Sales Meetings featured presentations from Henry Schein Medical’s leadership team, with presentations on the benefits and importance of the human touch, both in business and society, to build and strengthen relationships. Additionally, presentations encouraged Team Schein to advance the Company’s 2022-2024 BOLD+1 Strategic Plan.

Ty Ford

Tami Cates

“It was exciting to be back together again for our Area Sales Meetings, which emphasized the importance of face-to-face interaction,” said Ty Ford, Vice President and General Manager of U.S. Medical Sales. “While we can transact business virtually, being in person builds bonds of trust, and the Area Sales Meetings were the perfect example of the power of teamwork and togetherness.”

The importance of culture, working as a team, and managing change was reinforced by motivational and inspiring keynote speakers, including management leaders who addressed Henry Schein Medical’s upcoming breakthrough technologies and innovations to improve service and support, as well as top sales representatives who were recognized during the Meeting’s annual Awards Ceremony. This year’s awards recognized 2022’s top Team Schein Members, supplier partners, and products.

Henry Schein Medical TSMs also participated in the We Care Global Challenge, a companywide initiative in which TSMs at 14 Company locations in six countries assemble comfort kits for people fighting cancer around the world. At the Medical Area Sales Meetings, more than 5,000 kits were

assembled to support the American Cancer Society’s Hope Lodge program. These kits will be distributed to Hope Lodge locations throughout the U.S. Each Hope Lodge offers cancer patients and their caregivers a free place to stay when their best hope for effective treatment may be in another city. Henry Schein Cares partnered with Heart to Heart International to handle the logistics of the We Care Global Challenge kit building events, including the management of all shipments of the completed kits. This event embodies the Foundation’s mission to “help health happen” for people living in underserved, at-risk, and remote communities.

Story Selling

Why telling stories is the most powerful way to sell.

By Brian Sullivan

Several months ago, on the way home from the airport, I popped into a Waffle House, sat down, and ordered some lunch. As I turned to my right, I noticed a woman in tattered clothing sitting alone with her head down in a booth. Hoping to brighten her day, I said hello. She quickly perked up, smiled, and shot me a, “What choo do for work?” After telling her I teach people how to sell and how I travel a lot for work, she said to me, “Name’s Wilma. And Wilma says you get your butt home. And don’t forget what’s most important. It’s your wife and kids. And on the way home, you get that wife some flowers at the Price Chopper. That’ll make her feel special.”

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After chatting for a while with Wilma, I jumped in the car and drove home. And as I pulled into the Price Chopper, I realized that while my aim was to help brighten Wilma’s day, it was Wilma who brightened mine by reminding me who my number one customers really are, my family.

The story above is a condensed version of a real one I use in one of my presentations to illustrate how there are learning lessons all around us. I also sometimes use that story when I want to make a point about understanding who our number one customers are: family and friends. At other times I use that story to discuss the importance of being a good listener.

Now let’s say I didn’t use a story to illustrate my point. Let’s say I just stood in front of an audience and said, ‘Okay everybody. You are all spending way too much time at work and not enough time with your loved ones. You need life balance!” Do you think I would move my audience? (Probably, because they would be moving to the exits.) But instead, by telling a story, a point can be made that allows the audience to paint their own picture. And in that picture is the lesson. The story helps them better understand your message.

creates laughter. If you are a product manager who must train your team on the use of your product, get rid of that bubble graph PowerPoint slide that can comatose a gallery and instead tell them a story about the first time that product truly excited you … because it worked better than you ever thought it would.

Medical salespeople need to be able to connect with potential customers on an emotional level, and stories are an effective way to do that. Research shows that our brains are not wired for linear logical thinking or for retaining facts for long periods of time; instead, they are wired to process and remember stories. Stanford Graduate School of Business Marketing Professor Jennifer Aaker explains that a story is a journey that moves the listener, which in turn creates an emotional reaction. This emotion can lead to persuasion and even action on the part of the listener.

Past success creates great stories

So how can you use it with sales prospects and existing customers? For example, if you personally witnessed your product doing something great for a patient, tell the heartwarming story of how it saved a patient’s life. Be as specific in the details as possible. If you are sales manager who at one time blew a major sales call only to learn a lesson, open your next team meeting with a story that

When we listen to a story, our brains release a range of neurochemicals that elicit powerful emotions. These could be anything from empathy and affection to happiness, pain, and fear. These reactions are what allow us to form a strong connection with the client and establish an intimate relationship with them. This is because stories tend to elicit far more powerful emotions than facts and figures do.

Medical salespeople need to be able to connect with potential customers on an emotional level, and stories are an effective way to do that. Research shows that our brains are not wired for linear logical thinking or for retaining facts for long periods of time; instead, they are wired to process and remember stories.

Early prospecting pitch

So when can you use a story? First, you can use it to create curiosity with a new prospect.

For example: “Dr. Jones, we were working with the ER staff at St Luke’s who recently invested in one of our latest technologies. On the first day they owned it, an elderly woman entered the hospital and was wheezing and coughing almost uncontrollably. She was panting and her skin was yellowish white. At that point, the staff immediately jumped to use this product and they believe it ultimately saved her life. And so too does that elderly woman.”

I can promise you that story would create way more curiosity than, “Dr. Jones, I would like to show you some features on our product X.”

To make sure you are using the story that will illicit the most emotional attachment, you first need to “interview” the prospect with discovery questions. Once you have a better understanding of what’s important to them, you can then match the perfect story with that client.

Develop several

Take time this week to think of your focus products. Then think back to real-world scenarios where those products helped your clinicians, users, or decision-makers. If you don’t have much to pull from, it’s time to go back to them and go “story hunting.” Ask your existing clients to give you specific details about when and how your solution performed. Yes, details are important, because they make for a better story, and will create more emotional connection the next time you use it.

So, this week, think of a presentation, meeting, or sales call that you will soon participate in. Then deliver one of more of your prepared (and rehearsed) stories that will delight, enchant, touch, teach, recall, inspire, motivate, and challenge your prospects.

Brian Sullivan, CSP is one of 10% of speakers worldwide to have earned the Certified Speaking Professional Designation awarded by the National Speakers Association and the International Federation for Professional Speakers. President of Kansas City-based PRECISE Selling, Brian delivers seminars and internet training programs on sales, customer service, leadership, and presentation skills to companies of all sizes. To find out more, visit him at www.preciseselling.com or email Brian at bsullivan@preciseselling.com.

Changing the Idea of Leadership

A conversation with bestselling author and speaker Kevin Brown.

By Pete Mercer

How has your perception of leadership changed over the years? Leadership is a buzzword that circulates online, through the keynote speaker circles, across multitudes of blogs – both professional and personal – and in hordes of books designed to help people discover what they might be missing in their approach to the concept of leadership. While the idea of a good leader (i.e., someone people want to follow) might seem pretty standard across the board, good leadership doesn’t look the same to everyone.

Repertoire Magazine recently sat down with Kevin Brown to discuss what leadership means in 2023 and how we can better dismantle it to the very basics of the idea. Brown is a motivational speaker and bestselling author of “Unleashing Your Hero,” where he redefines the idea of who a hero can be. He created the philosophy of The HERO Effect, which “separates world-class organizations and high-performance people from everybody else.” He’s used this idea to build a platform to help people realize and develop their potential as leaders. Brown breaks down the concept of leadership in 2023, how the “HERO Effect” plays a part, and pinpoints some great habits that any good leader should have.

What leadership looks like in 2023

According to Brown, leadership has always been tough, on both sides of the equation. “John Maxwell said that leadership is influence – nothing more, nothing less. I think that still rings true,” he said. “I think what we are seeing though is that there’s been a shortage, a scarcity, of real leadership. And I think the pandemic and

Kevin Brown

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everything that happened through that season of change really shined a light on the fact that there’s a shortage of real leaders.”

It’s hard to find good leaders, and it’s hard for good leaders to find their place. Good leadership requires equal parts charisma, compassion, vision and willingness to step into the arena. For Brown, one of the areas where leaders miss the mark is getting stuck on older paradigms that worked in the past but don’t fit today’s climate. Flexibility and agility are key here, because the world and the way we work is constantly changing.

Even the recent push for remote work is hard to maintain as the world continues to shift in the wake of COVID. While we might have gained

a more flexible work environment, we have certainly lost the potential for a deeper connection with our prospects and customers. Technology can’t replace culture, and it’s up to leaders to navigate a way forward.

“As leaders, we have to look for those touchpoints. Technology can only take us so far, even if it got us through a really painful season. But technology can’t solve everything, and it should never replace human connection. Especially in the sales arena – the essence of selling is building relationships with our customers.”

“The HERO Effect”

Brown’s philosophy of the “HERO Effect” is essentially being your best when it matters the most. He said, “The truth is, the great leaders are at

their best when it matters the most. They cultivate that in their people.”

The HERO Effect is a great philosophy for people in positions of leadership because it can help them to create an exceptional experience for the people around them. Taking care of your people on your side of the sales equation will ensure that they are taking care of your organization and the customer on the other side of the equation.

Additionally, Brown argues that heroes have a different perspective on life. He said, “Heroes see life differently. They see life through the lens of optimism – they see what’s possible, not what’s probable. They see the industry, they see the landscape, they see the competition, but they process it differently.”

Because of that perspective, leaders have a unique opportunity to radically change an organization from the ground up. If your organization has a past that involves hurt and frustrated employees, that will eventually trickle down to your customer experience. It’s important for leaders to remember that when people leave their jobs, it’s not usually because of the organization –they are leaving bad leadership.

With a mantra like The HERO Effect, you can invest in your teams in a way that will not only make them want to stay, but also bring other great people in to support your organization. “Never treat the world outside your organization better than we treat the world inside the organization,” Brown said. “Everything we do in front of the customer is just an extension of the experience that we have inside the organization.”

Supporting one another

With all the ways that leadership has changed in the last few years, how can leaders best support their sales teams in 2023? For Brown, it comes down to valuing their teams. The value of the sales team is much greater than the numbers they bring in. With the support of a good leader, sales reps can bring in the numbers that your organization needs.

“The sales leader’s job is to clear the deck of all of the obstacles, all of the business interruptions that can affect sales performance. I don’t want my sales team spending all of their time doing reports. I don’t want my sales team trying to figure out and solve problems within the corporate construct. I want them out there being creative and solving problems for our customers.”

On the flip side of that equation, sales reps have a responsibility to

support their leadership as well. It’s important for sales reps to be able to recruit high performers by becoming the mouthpiece of your organization. “The sales performers, the high producers, are the ones who have the ability to be a de facto leader on the team. You can lead from any position – it’s not about tenure and it’s not about the position. Leadership is a personal thing. You’re either a leader of one or a leader of none.”

individual and stay at the top of your game as a leader. Brown said, “We cannot give what we do not have. When we stop having something to offer our team, that’s when they leave us and find somewhere else to be edified.”

Take care of yourself. Self-care has become a trending buzzword in the last few years for a reason. Without the room to take care of yourself mentally, physically, psychologically,

Creating a winning culture requires the efforts of both sales reps and leadership. Supporting each other in these efforts is the best way to improve your company culture and exceed all your goals together.

Habits of great leaders

More often than not, your habits will define how effective you are as a leader. What are you committing your time to? Are you working to create better habits for yourself? Building better habits will help you to become a more effective leader for your team and your organization. Brown laid out three great habits that can help anyone to become a better person and a better leader:

Don’t stop learning. Leadership starts with self-mastery, and we have more information than we could ever need at the tips of our fingers. Invest in digital resources that will allow you to grow yourself, which will then help you to truly lead effectively. Platforms like YouTube, Masterclass, and Audible are great tools to help you grow as an

and spiritually, how can you expect to take care of a team of people? “Take care of yourself physically so that you’ve got the energy, stamina, and the clarity of mind to be able to do the things that high performance sales organization requires of its leaders.” Brown is the first to admit that he doesn’t have all the answers. “I make no bones about it: I have a physical coach, I have a spiritual coach, I have a mental coach. Life is really hard and it’s not getting any easier. In fact, it’s getting more complex – so taking care of yourself is really important.”

Stay relevant. Keep track of trends in the world and within your industry to stay relevant in a constantly changing world. Relevancy will help you to see the nuances in your own market, while helping to address the questions that your team might have about what your company is doing for your customers. Not only will it empower you to make better decisions for your customers and employees, but it will also give you a much-needed edge against your competitors.

“The truth is, the great leaders are at their best when it matters the most. They cultivate that in their people.”

MedPro and VapoCoolShot Partner on Breakthrough Pain Management Solution

VapoCoolShot, Inc., a leading innovator in pain management technology, has partnered with MedPro, the nation’s top contract medical sales organization, to bring CoolJect® to acute and non-acute markets across the U.S. CoolJect, a cutting-edge FDA-cleared device and spray, offers precision comfort with fast, effective, lower-cost topical anesthetic for injections and minor surgical procedures.

Bill Sparks, MedPro CEO, commented: “CoolJect’s revolutionary technology is a vastly superior solution for topical anesthetics; current solutions are time consuming and costly which drains the healthcare system of billions every year. We’ve already had some great wins based on the practicality of converting to CoolJect and we are seeing marked acceleration as more patients and caregivers experience the product.”

CoolJect is intended for topical application to skin, intact mucous membrane (oral cavity, nasal passageways, lips), and minor open wounds.

This year alone, nearly 100 million Americans will experience fear of injection pain, according to a recent industry study1. As a result, these patients will delay or entirely avoid recommended procedures (i.e., cannulations, insulin injections, bloodwork, vaccinations, etc.), giving rise to comorbidities and introducing tremendous long-term costs to the healthcare system2. VapoCoolShot is the first company to address all these issues in a more efficient package with its flagship product CoolJect.

The device promises to anesthetize quickly and accurately with its Targeted Mist™ technology, providing gentle, consistent, and targeted coverage that drastically reduces waste and lowers costs to healthcare providers. CoolJect combines a high-efficiency nozzle with a non-toxic, nonflammable gas canister and is used to provide a targeted cooling effect on the skin which lessens pain associated with injections. It is also used for minor surgical procedures such as lancing boils, incisions, drainage of small abscesses and sutures, and the temporary relief of minor sports injuries like sprains, bruising, cuts, and abrasions.

Ethan Mandelup, VapoCoolShot CEO, commented: “We are incredibly proud to see the swift expansion and embrace of CoolJect due to overwhelmingly positive feedback from patients and physicians alike. VapoCoolShot is a company dedicated to empowering healthcare providers to deliver more comfort to their patients and it’s thrilling to fulfill this commitment by providing a low cost, highly effective tool to use across a myriad of use cases. What’s more, we know that we’ve found the ideal partner in MedPro and their national sales model to help us bring CoolJect® to caregivers and patients across all healthcare markets.”

The results and savings are clear; users are sure to provide improved care while enjoying space, cost and shipping savings by switching to CoolJect®. Its canisters are roughly half the size of comparable vapocoolant products, use up to 50% less gas than the competition per second while offering the same number of effective uses, and require no Hazmat shipping fees.

Contact your local MedPro rep to learn more about CoolJect®

Past, Present, Future of Surface Disinfectants

Knowledge of the market is a key part of growing your infection prevention business.

By Paul Girouard

Environmental hygiene is a significant component to an infection prevention program. The simple process of cleaning and disinfecting has become more complex post-pandemic. Staying up to date will help you be of value to your customers and build your infection prevention business.

In the beginning there were cleaners and disinfectants. There is a big difference between the two and there aren’t many shortcuts. In short, cleaners’ clean particulate matter on surfaces, and disinfectants kill pathogens on the surface. You need both for a complete program. Most of what will be addressed here will be on disinfectants due to their complexity. The complexity comes from what is needed to do the job. Many variables come into play:

ʯ Format – liquid, spray, wipe, other.

ʯ Environment – Where is the product being used and are there specific pathogens of concern.

ʯ Convenience – Who is using product, how often, and how quickly do they need to clean/disinfect.

The market began with disinfectant liquids and sprays and evolved into disinfectant surface wipes. In the pre-pandemic period, annual growth in the healthcare market was low single digits for liquids and sprays, but in the low double digits for wipes. Disinfectants are regulated and must be registered with the Environmental Protection Agency (EPA). The EPA registration numbers are found on all disinfectant product labels.

Label information can be verified by using the registration number and searching on EPA.gov.

Depending on the needs mentioned, there are many different types of disinfectant surface wipes to choose from. Preference is based on kill-times needed to disinfect, number and type of pathogens killed, and formulation. Typical formulations are quaternary ammonium, alcohol, bleach, hydrogen peroxide or a combination of these. Kill-times vary by pathogen. The overall time needed to disinfect is based on the longest kill-time listed on the label.

In the last few years technology has improved greatly. Product has been improved with additional kill-claims, reduction of kill-times, and the growth of more userfriendly formulations like hydrogen peroxide. The pandemic introduced and helped drive the growth of newer technologies like ultraviolet lighting, and electrically charged disinfectant sprayers.

Manufacturers and the EPA are planning for future outbreaks and pandemics by testing for “emerging viral pathogens.” The National Institute of Allergy and Infectious Diseases defines these as those “that have newly appeared in a population or have existed but are rapidly increasing in incidence or geographic range.” Manufacturers apply for an emerging viral pathogen claim, even before an outbreak occurs, based on previous EPA-approved claims for harder-to-kill viruses.

Next steps

During the pandemic, disinfecting surface wipes were in short supply and the market moved to whatever was available. This created supply chain disruption and bad behavior in the market. This is an important reason to review what customers might be using. Product has evolved significantly and there is opportunity to provide better disinfecting options.

You can help by reviewing what the account is using.

ʯ Have kill-times improved compared to what they are using?

ʯ Is there an option to use a product with additional or emerging viral pathogen claims?

ʯ Are their more user-friendly options?

If it’s a little overwhelming, use your manufacturer partners to provide additional guidance. Now is the time and opportunity to grow your infection prevention business.

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Supply Chain as a Strategic Differentiator

Henry Ford Health’s supply chain team is the organization’s “horsepower under the hood.”

Henry Ford Health believes that everyone benefits when all businesses are afforded an opportunity to compete in the healthcare marketplace. To that end, it reinvested in its supplier diversity program, partnering closely with its strategic sourcing to ensure that diverse suppliers are identified, included, evaluated and awarded appropriately as part of the formal bid process.

“We’re one of the health systems that signed a pledge as a member of the Healthcare Anchor Network (HAN), and it’s multifaceted goals from supply chain to sustainability to hiring,” said Bill Moir, senior vice president of supply chain management for Henry Ford Health, and this year’s JHC Contracting Professional of the Year. “We have some lofty goals around supplier diversity which we aim to achieve through our multi-disciplinary Supplier Diversity Champions Committee.”

“This isn’t just a supply chain issue at Henry Ford, it’s an everyone issue,” he said.

Moir has served as senior vice president of supply chain management for Henry Ford Health since January 2021. His responsibilities involve overseeing all supply chain functions, including strategic sourcing, supplier diversity, purchasing, accounts payable, linen, supply chain systems and analytics, supply chain operations, and distribution and logistics.

He has held supply chain leadership roles in some of healthcare’s leading organizations such as Advocate Aurora Health, Ascension Health and Trinity Health. He

is a champion for integrating supply chain management into clinical and financial outcomes and putting the stakeholders and communities he serves first.

Increasing diversity spend uplifts communities

Henry Ford Health’s supply chain connects with departments from across the integrated, nonprofit health system to increase diversity spend in different areas that have targets for growth. Sourcing diverse and local suppliers is critically important to the health system that serves Detroit and south central Michigan, while bringing domestic manufacturing back to Detroit is an even larger goal.

“Domestic manufacturing not only helps to derisk the supply chain, but also helps to create jobs, which is huge for health equity,” Moir said. “It’s not just about sourcing. It’s about creating income and wealth because you cannot keep people healthy if they cannot afford food, housing or insurance. So, creating jobs in those communities we serve at Henry Ford is what supplier diversity is about. It’s an easier pathway to health equity and we’re very committed to it.”

Henry Ford Health also hosts community outreach events for strategic introductions between suppliers and system stakeholders. It is strategic around partnering with vendors in the community that have been historically marginalized and making the community healthier.

“Supplier diversity lives in our Community Empowerment pillar within our Henry Ford Health Diversity, Equity, Inclusion and Social Justice Plan,” Moir said.

The health system partners with community organizations like

United Way for Southeastern Michigan to create a community information exchange – a grassroots council that targets patients, especially senior citizens, who are experiencing food insecurity. It’s called Closing the Loop and it’s a partnership between United Way for Southeastern Michigan, Henry Ford Health, Templin Medical Center, Gleaners Community Food Bank and Fish & Loaves Community Food Pantry.

A Henry Ford Health doctor notifies a United Way representative about a patient’s food needs. That representative then calls the patient to set up an appointment at Fish & Loaves, which provides the patient with free, nutritious food at their location. Then, a United Way representative follows up to support the patient throughout the process and help with other needs.

“This has the capacity to serve over 500 patients by the end of 2022. That’s the goal,” Moir said. “And we plan to identify and recruit at least five other healthcare organizations to scale these efforts in 2023. We

plan to complete 350,000 food insecurity screens and 75,000 full social need screens by the end of 2023.”

The Healthcare Anchor Network Impact Purchasing Commitment

Collaborating with other healthcare organizations is important to Henry Ford Health.

In 2021, it signed the HAN Impact Purchasing Commitment with 12 other HAN member health systems across the country to build healthy, equitable and climate-resilient local economies through what and how they spend their dollars. This includes increasing spending with Minority and Women Owned Business Enterprises (MWBEs) as well as local and employee-owned, cooperatively owned and nonprofit-owned enterprises by at least $1 billion collectively over five years.

For sustainability, signatories committed to selecting a minimum of four Core Sustainability Goals and to achieving each goal within five years. For community wealth building,

INSIGHTS

signatories committed to establishing and tracking progress toward five-year spend goals with vendors that are locally headquartered, owned and operated at the neighborhood or regional level, and majority employeeowned, cooperatively owned and nonprofit-owned enterprises.

Finally, signatories committed to implementing strategies, policies and practices to incentivize internal departments, vendors and GPOs to engage in impact purchasing.

Investing in domestic manufacturing and mitigating manufacturer risk

“Resiliency must be a strategic pillar of the healthcare supply chain,” Moir said. “It’s critical we have the supplies we need. Historically, supply chains have pushed for the lowest cost – high quality, but lowest cost – and that created some of the challenges we had in the pandemic. Now, we’re looking at how to derisk the supply chain and a cornerstone of that strategy must be domestic manufacturing, but that’s not the only answer. Supply Chain resiliency

must be diversified like your personal investment portfolio.”

Henry Ford Health has invested with Premier, its GPO, and 15 other Premier members in Prestige Ameritech, a diverse American manufacturer based in Texas, for masks. It has also invested in DeRoyal Industries in Tennessee for gowns. And it’s participated in a domestic glove resiliency program with Honeywell.

It’s also part of a group of Premier members working on risk scoring manufacturers. “Everyone is trying to get this information,” Moir said. “We’re figuring out how to make the resiliency variable more objective to include in our strategic sourcing selection scorecards.”

“If Vendor A has a risk score of 10 with low risk and Vendor B has a risk score of 90, then that should be considered when you select supplies through the sourcing process,” he said. “And if 90% of your manufacturing is in Shanghai, China, that’s not diversification.”

Moir says scale is going to be the key, not only with obtaining more manufacturer data but also in efficiency.

“Ten individual IDNs doing this score carding separately would be a heavy lift. Why would you duplicate efforts? It’s another good collaboration opportunity with partners like Premier and others in the industry,” he said.

Rolling out supply chain inventory management and analytics, and overhauling P2P

Henry Ford Health has rolled out its Point of Use Supply Chain Inventory technology in the past year, which is predicated on safety, revenue and data capture.

“A lot of people think inventory management when they think Point of Use, and that’s certainly a benefit, but our goal is to translate data capture into actionable outcomes,” Moir said. “We’re just starting phase two of continuous improvement with data capture, but what makes us unique is our methodology and approach with a direct connect between our EMR and ERP.”

The Point of Use strategy is a collaboration with Henry Ford Health’s IT, clinical stakeholders and operators, and supply chain team. “This is going to be the bread and butter to make us successful. It’s a huge initiative,” Moir added.

The health system has also overhauled its Procure to Pay (P2P) program from start to finish. “P2P is really moving from the sourcing to the implementation of the products, making sure we have the right controls in place around financials and controlling the supply chain in cost and care,” Moir said. “The only way to make sure we control the supply chain is through our collaborations with our clinicians.”

Moir says Henry Ford Health has a strong history of clinical

INSIGHTS

collaboration but it’s seeking even more transparency around supplies and a wider net for cooperation with medical groups and private physicians. These strong relationships will be leveraged toward a more consistent and inclusive sourcing methodology.

Its strategic sourcing leads 14 system-wide value analysis teams that meet regularly to assess current and potential new products, services and equipment, and it manages the health system’s GPO relationship with Premier.

“We had a really great foundation when I arrived at Henry Ford to build from,” Moir said. “Leadership and executive buy in at Henry Ford has made it a point to say supply chain must be a strategic differentiator. We’ve invested in our data management systems and analytics team, and we’ve brought in diverse talent and collaborated with multiple stakeholders.”

Moir believes people truly are the strategic differentiators in healthcare organizations and supply chains. His servant leadership approach intends to enhance engagement with his customers, stakeholders and team. Moir believes this engagement and collaboration must be centric to challenging the status quo related to supplier diversity, analytics, resiliency and realizing value in supply chain.

“We have a phenomenal Supply Chain team at Henry Ford Health, they truly are the horsepower under the hood,” Moir said.

The supply chain team at Henry Ford Health partners with the quality team and IT analytics team to drive value, and it partners with the service lines delivering care as well as external collaborators like Premier.

“We’re still evolving using data and analytics. Our objective is to ensure you are capturing what you

use in cases to effectively derive an actual cost-per-case. If this is not done successfully your clinicians will likely have to use modeled data, which will be less informative and actionable, yielding lower value for utilization efforts,” Moir said.

“Data capture has historically been ineffective in the healthcare supply chain for years,” he said. “But we’re working with Premier, our service lines, operators and our analytics team to develop a true cost-per-case model.”

Consolidated service center and distribution center opening in 2023

And finally in another project aimed at bending its cost curve down, Henry Ford Health is slated to open its consolidated service center (CSC) and distribution center in 2023. The first floor will be dedicated to physician preference items in med/surg products, and the second floor will be committed to pharmaceutical distribution.

“It’s intended for high-dollar density items and those physician

preference items,” Moir said. “It won’t be as big as some CSCs at other health systems, but we aim to drive greater value through our unique design and products selected.”

Henry Ford Health will use the CSC to manage its inventory more effectively and help in its resiliency strategy.

HAN IMPACT PURCHASING COMMITMENT SIGNATORIES

ʯ Advocate Aurora Health

ʯ Banner Health

ʯ Baystate Health

ʯ Bon Secours Mercy Health

ʯ Cleveland Clinic

ʯ CommonSpirit Health

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ʯ Intermountain Healthcare

ʯ Kaiser Permanente

ʯ Providence

ʯ Rush Health

ʯ Spectrum Health

ʯ UMass Memorial Health

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Researchers and healthcare professionals have studied the connection between oral health and systemic health for some time. The U.S. Surgeon General drew attention to that connection in its 2000 report, “Oral Health in America.” Subsequent reports have only strengthened the case for integrating medical and dental care.

Understanding and accepting the connection represents progress, but doing something about it is another matter. Integrating oral and medical care can mean co-locating dental and medical professionals and equipment; integrating digital dental and medical records; and enlisting professionals who are eager to stretch their understanding of healthcare and work with people they never worked with before. In other words, it’s a lot of work.

Despite the challenges, integrating oral and systemic health at the practice level is occurring throughout the country. For example, in December 2022, UCSF Health and UCSF Dentistry in San Francisco merged their medical and oral health records into an electronic health record. Here are some other examples:

ʯ Delta Dental of Colorado administers the Colorado MedicalDental Integration (CO MDI) project, which integrates registered dental hygienists into medical care teams. Its clinics have provided more than 60,000 visits for patients who otherwise may not receive care due to insurance status, transportation, geography or socioeconomic status. (Delta Dental Plans Association is a not-for-profit organization which offers dental coverage in 50 states through its network of Delta Dental companies, including Delta Dental of Colorado.)

‘Revolutionizing Healthcare is not Easy.’

Awareness of the benefits of oral and medical care integration is growing. But implementing it will present some challenges, not only among providers, but patients too.

Healthcare is not Easy.’

ʯ Zufall Health, headquartered in Dover, New Jersey, with service locations in seven counties, has provided primary care in the region since 1990 and oral health since 2000. “This allows our dental team to consult on medical patients who may appear with oral issues, and to help them address acute or chronic medical conditions that are affecting medical care,” says Rina Ramirez, M.D., chief medical officer.

ʯ In December 2022, Pacific Dental Services, a nationwide dental support organization (DSO), announced a partnership with MemorialCare, an integrated health system in Southern California, to open at least 25 joint locations in MemorialCare Medical Group health centers throughout Orange and Los Angeles counties over the next five years. The two organizations use the Epic electronic health record system, which is expected to facilitate sharing of medical and dental information. Already, PDS supports four medical practices in the Las Vegas, Nevada, area, and it was the first DSO to partner with an accountable care organization –Commonwealth Primary Care ACO in Arizona.

Colorado

Delta Dental of Colorado began co-locating dental hygienists in selected Colorado medical practices in 2007 and has expanded the program to more than 20 locations. “We started by co-locating dental hygienists into medical clinics, meaning the hygienists had their dental operatory in the same building and saw medical patients who were referred to them,” says Patricia Braun, M.D., a Denver pediatrician and program evaluator for the Colorado Medical-Dental Integration project. “As the program evolved, the dental hygienists became integrated members of the medical team. They either saw the patient before or after the medical provider or scheduled a future visit if the dental hygienist was busy with another patient.”

Hygienists provide a broad scope of dental hygiene services, including sealants, X-rays, and scaling and root planing in the medical setting, says Dr. Braun. Many practices have seen a reduction in untreated dental disease in patients with more than one integrated dental hygiene visit. This is a result of preventing dental caries as well as navigating patients with untreated dental decay to dentists.

New Jersey

Zufall Health takes seriously the synergistic relationship between medical and dental teams, says Dr. Ramirez.

“Untreated oral disease can be associated with infections, diabetes, weight loss and malnutrition, and can negatively affect individuals’ eating, sleep, work performance and social life,” she says.

Most of Zufall Health’s facilities provide medical and dental care within the same building or adjacent buildings. At its Somerville, New Jersey, site, where a forthcoming construction project will add dental exam rooms, the community center’s mobile dental van is available to patients weekly. “The proximity of medical and dental care, coupled with an integrated electronic dental/medical record, allow patients to receive medical and dental care at the same location and strengthens interdisciplinary provider collaboration,” she says. The medical and dental teams both use eClinicalWorks software to maintain patient information.

The following programs and initiatives exemplify the cross-functional approach to medical and dental care at Zufall Health:

ʯ Pediatric HPV vaccinations as prevention for oropharyngeal cancer. Human papillomavirus (HPV) causes six types of cancer and is spread through sexual skin-to-skin contact, Ramirez points out. HPV vaccination can prevent 90% of cancers caused by the virus, and it is most effective for children between ages 9-12 and provides prevention before exposure. To overcome parents’ aversion to HPV vaccination, Zufall Community Dental Health Coordinators provide education and motivational interviewing that focus on oropharyngeal cancer, the fastest growing HPV-related cancer. The HPV vaccination rate nearly tripled in a project cohort.

ʯ Periodontal disease and diabetes management. Diabetes can increase the amount of glucose in saliva, leading to bacterial growth and plaque accumulation, says Dr. Ramirez. Zufall dentists identify patients with high A1C levels and provide deep cleanings to prevent or treat periodontal disease.

ʯ Coordinating dental care for Ryan White (HIV services) patients: People living with HIV and AIDS often face numerous barriers to accessing affordable preventive and restorative dental services, resulting in higher burdens of oral disease.

ʯ Medical and dental services offered in mobile medical van: Dental care is part of Zufall’s Peds in the Park program, which uses a mobile medical van to conduct pediatric assessment and vaccination events throughout low-income neighborhoods. “It was created to

‘Revolutionizing

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Healthcare is not Easy.’

counter the dramatic drop in the number of children receiving their routine childhood immunizations due to the pandemic,” says Dr. Ramirez.

ʯ Pediatric obesity prevention: During dental visits, pediatric patients are evaluated for BMI, and families receive appropriate nutritional counseling. Additionally, Zufall’s Children’s Oral Health Program provides fluoride treatments and education in its pediatric fitness program – Ándale – and at asthma clinics.

ʯ Cross-disciplinary training and referrals: Zufall’s pediatric medical providers apply fluoride varnish to children who are not actively seeing dentists, perform caries risk assessments, and make directed referrals to dental care. Conversely, the dental team frequently does blood pressure screenings and refers patients unvaccinated for HPV to the medical office for vaccination.

Southern California

Stephen E. Thorne IV founded Pacific Dental Services in 1994 with his first dental practice management contract in Costa Mesa, California. His interest in integrating dental and medical care came soon after.

“I wanted to understand more about the connection between oral health and overall health, so in 2015, I put together a team to study the science on what was then called the oral-systemic link,” he says. “We ended up defining the Mouth-Body Connection® as the link between oral health and overall systemic health, and the role that harmful bacteria, inflammation, and bone loss in our mouths plays in chronic, systemic disease.” In 2018 PDS created a digital book titled “32 Reasons to Learn About the Mouth-Body Connection®” and began providing chairside education on the topic to patients.

“We’ve redesigned the look and feel of our newest supported practices to provide for an immersive, educational experience as soon as patients enter the door,” says Thorne. The phrase “Oral Health Means Better Health” is displayed prominently on the lobby walls, along with supporting collateral and interactive educational opportunities.

Through its “Smile Generation” brand, PDSsupported dental practices distribute a quarterly digital magazine focused on the connection between oral health and whole-body health. Patients receive oral

CDC encouraging medical dental integration

In 2021 the Centers for Disease Control and Prevention’s Division of Oral Health awarded funding to the National Association of Chronic Disease Directors to develop a National Action Framework for medical dental integration. The framework would outline opportunities to integrate medical and dental services in different healthcare and public health settings to support populations with unmet oral health needs and associated chronic diseases.

Following research on oral health and chronic disease plans, NACDD, CDC and KDH Research & Communication (KDHRC) identified four pillars that are necessary to support whole-person integrated care, says Barbara Park, RDH, MPH, public health consultant for NACDD:

ʯ Awareness. Increase recognition, knowledge, understanding and perception about equitable, whole-person integrated care and the oral-systemic connection across the lifespan.

ʯ Workforce development and operations. Prepare

healthcare professionals and other professionals to work across disciplines; establish organizational structures to facilitate collaboration; and empower staff to use systems that support whole-person integrated care.

ʯ Information exchange. Share and promote access to meaningful and actionable information.

ʯ Payment. Implement sustainable financing, reimbursement and incentives for systems and patient care that support equity and optimal patient health outcomes.

“We have learned ... that medical dental integration is ‘easier’ to implement in closed systems of care,” says Park. Such systems include Federally Qualified Health Centers; HMOs such as Kaiser Permanente, which include dental services; Veterans Affairs facilities; and safety net clinics that provide coordination of health services – medical, behavioral, dental, etc. – for their clients, many of whom have multiple chronic conditions that put them at high-risk for complications from unmet dental needs.

CDC DOH, NACDD, and KDHRC were at press time preparing a 90-minute panel session on the initiative for the National Oral Health Conference in Orlando, Florida, April 17-19, 2023.

‘Revolutionizing

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health and Mouth-Body Connection® education through their MyChart app and monthly emails with information. “In addition, we share news and updates on this topic through our websites and social media channels. One of our most important initial learnings has been that patients quickly get it. Patients accept the Mouth-Body Connection® as obvious. For them, it seems common sense.”

The fact that both Pacific Dental Services and MemorialCare use Epic electronic records was a factor in their partnership. “The interoperability of Epic, along with chart reconciliation, make it easier to close care gaps, enable early intervention and ultimately reduce overall healthcare treatment costs,” says Thorne.

“This will naturally create opportunities for physicians and dentists to collaborate on medical and dental issues,” says Mark Schafer, M.D., CEO, MemorialCare Medical Group. “For example, a dentist may see in a patient’s record that they are diabetic but have not recently had a check-up. The dentist could touch base with the MemorialCare physician to see what is recommended. This may

lead to a blood test that day and a follow-up visit with the doctor, or a same-day visit with a nurse practitioner.”

At press time, PDS was still in the planning phase for its first office in the MemorialCare partnership. “We are envisioning having a shared reception area/lobby for patients, advertising both medical services and dental services,” says Thorne. “In the clinical areas, there will be a dental clinical space operated by PDS and a medical space operated by MemorialCare.”

Social determinants

Studies support that oral/systemic health integration can benefit just about anyone. But it may be particularly important to those who live with challenging social determinants of health.

“The benefits of integration are greatest for Zufall Health patients who are most vulnerable or who experience the highest barriers to care,” says President and CEO Frances Palm, MPA. This includes people who have little to no English language skills (about

Putting together the medical/dental team

Medical-dental integration works best in offices with shared electronic patient records and physical layouts that facilitate collaboration. But it can’t work without medical and dental professionals who embrace the concept and welcome a new way of practicing healthcare.

“We have learned that integrating a new kind of provider into a medical team is challenging and takes time and support, but that with the right people and commitment, it can be successful,” says Patricia Braun, M.D., a Denver pediatrician and program evaluator for the Colorado Medical-Dental Integration project. “We have developed a change package, which is a set of key drivers of successful medical-dental integration. These include buy-in from leadership and providers, the right hygienist who is willing to work in a non-traditional

setting with a very different team, and time to create efficient workflows. Communication is key.

“The medical team members must buy in to the importance of oral health and add it to their priorities for the visit,” she says. “This means identifying patients who would most benefit from seeing the hygienist and completing a warm hand-off to the hygienist. Prioritizing the needs of the patient is also important. Sometimes their oral health is one of the biggest needs, and at other visits, there are more important health priorities.”

Mark Schafer, M.D., CEO, MemorialCare Medical Group in Southern California, says, “While there has been a lot of medical literature over the last 20 years about the mouth/ body connection, it is not emphasized in medical school or subsequent training. MemorialCare and

Pacific Dental Services physicians and staff will spend some time at the beginning of our partnership to educate each other and become more knowledgeable about each other’s area of expertise.”

Organizational culture is a key ingredient to integrating medical and dental teams, according to Frances Palm, MPA, president and CEO of Zufall Health, headquartered in Dover, New Jersey. “Medical and dental providers and staff are motivated by the same goal – reducing barriers to healthcare and facilitating improved health outcomes for patients. They recognize the essential nature and connection between oral health and the rest of medical care, and Zufall providers participate in continuing education training that covers both medical and dental topics.”

‘Revolutionizing Healthcare is not Easy.’

Five ways oral health can influence overall health

1. Respiratory health. Patients with ventilator-associated pneumonia (VAP) who engaged in regular toothbrushing spent significantly less time on mechanical ventilation than other VAP patients.

2. Adverse birth outcomes. Gum disease among pregnant women is associated with preterm births,

low birthweight babies and preeclampsia, a pregnancy complication that can cause organ damage and can be fatal.

3. Diabetes. Diabetes raises the risk of developing gum disease by 86%.

4. Stroke. People with gum disease are three times more likely to

have a stroke involving blood vessels in the back of the brain, which controls vision and other bodily functions.

5. Blood pressure. People who delayed dental care during their teens and early adult years are more likely to be diagnosed with high blood pressure.

Source: DentaQuest, https://whatsnew.dentaquest.com/critical-connections-five-facts-about-oral-healthsinfluence-on-the-body/

66 percent of Zufall patients), low health literacy, low income (88 percent of Zufall patients), limited transportation access, and no health insurance (more than half of Zufall patients).

Zufall Health dental patients receive oral healthcare from dentists, including dental residents; registered dental hygienists, and community dental health coordinators, or CDHCs, who help vulnerable patients overcome barriers to dental care and navigate the dental care system, she says.

Where’s it headed?

“The concept of having a doctor and dentist together in the same office is new, so we may encounter some questions and it may take time for patients to understand and take advantage of the opportunities,” says Dr. Schafer at MemorialCare Medical Group. “But we believe the added convenience and access to both medical care and dental care will quickly create many supporters of the concept.”

“Health care systems, including hospitals and federally qualified health centers, are thinking of patient-centered care and building healthcare provider teams,” says Tamanna Tiwari, BDS, MDS, MPH, a board member of Delta Dental of Colorado and an author of Delta Dental Institute’s white paper on medical-dental integration models. “However, the sustainability of [medicaldental integration] models also depends on bi-directional interprofessional training and practice, including training medical professionals on oral healthcare, and dental providers on overall health.”

Says Thorne, “Given the linkages between oral health and certain systemic diseases, it is clear there are many benefits to reimagining healthcare around each patient, including reducing medical costs and annual hospitalizations. But the biggest benefit of collaboration is the overall improvement of patient health.

Still, he says, “Revolutionizing healthcare is not easy.”

Who’s selling to medical/dental practices?

In 2020 Henry Schein created its Surgical Solutions Team to serve the needs of oral surgeons and periodontists, as well as ambulatory surgery centers. Repertoire asked Scott Jackson, vice president of surgical solutions, and Kathleen Titus, director, community health centers and corporate relations, to talk about the team and the challenges and opportunities facing sales reps offering both medical and dental solutions.

Repertoire: How do the specialized needs of oral surgeons and periodontists differ from those of general dentists?

Scott Jackson: An oral surgery practice orders more medical supplies that resemble what one might see in a surgery center and/ or a medical surgical practice. This includes surgical kits, packs, trays, forceps and needle holders, surgical blades, sutures and more. Oral and maxillofacial surgeons (OMSs) can offer dental implants, wisdom teeth removal, facial trauma surgery and reconstruction, among many other procedures. They provide more complex surgeries, thus needing the proper surgery products and solutions to ensure patients are receiving exceptional care.

Recognizing a growing need among surgeons, Henry Schein’s Surgical Solutions team was created to help deliver oral surgery practices with both medical and

dental solutions. This team consists of Team Schein Members with expertise in both the dental and medical fields. This structure aligns with the company’s “One Distribution” strategy announced in 2021, which is designed to leverage functions, talent, processes, and systems more fully across Henry Schein’s distribution businesses.

Repertoire: Do oral surgeons address dental and medical issues in a way that general dentists typically do not? If so, how?

Scott Jackson: Typically, training for oral and maxillofacial surgeons includes four years of dental study and then four to six years of residency training. Two of those residency years contain acquiring a medical

‘Revolutionizing Healthcare is not Easy.’

Scott Jackson

degree. For OMS professionals, training has a heavier focus on medicine and surgical expertise. With this in mind, they often serve as a bridge between the two disciplines and play a vital role in terms of treatment planning for patients.

Repertoire: How do the product/equipment needs of ambulatory surgery centers (ASCs) resemble those of oral maxillofacial surgery practices?

Scott Jackson: Ambulatory surgery centers and oral surgery practices share many attributes. For example, within both facilities, medical physicians provide surgical care to patients in the outpatient setting. From a product standpoint, a lot of the medical, surgical and prescription products are the same, with key differences related to the specific needs of a facility.

The main care setting difference between ASCs and oral surgery practices is that ASCs operate in an “operating room” environment while oral surgery practices operate in a “procedure room” environment. The two have different protocols. An operating room has restrictive infrastructure requirements, and because invasive procedures are performed, specific sterilization guidelines must be met. A procedure room is defined as “a room designed for the performance of patient care that requires high-level disinfected or sterile instruments and some environmental controls, but is not required to be performed with the environmental controls of the OR,” according to Health Facilities Management.

Repertoire: Do ASCs address both the medical and oral health issues of their patients?

Scott Jackson: Some ASCs do have participating oral surgeons that bring their oral surgery cases to ASCs, but the number of oral surgery cases as a percent of the ASC industry’s overall case load is relatively

low. What we are seeing however, is an increase in the number of freestanding oral surgery-focused ASCs that operate as single specialty ASCs. Oral surgery practices are unique in that they order both dental and medical products – many times from different places, which can cause redundancies in ordering patterns, increases in freight and handling charges, and inefficiencies in their supply chain. Having one point of contact that can address their questions and concerns helps to increase efficiency and cost-savings and streamlines the process. That’s why having a versatile sales team is important.

Repertoire: In practices that are coordinating oral and medical care, does the Henry Schein Medical rep take the lead?

The Henry Schein Dental rep?

Kathleen Titus : Where we have dental groups taking on urgent care groups or building medical facilities, the dental and medical teams work in unison. Oftentimes for FQHCs, for example, it’s a collaborative effort between our dental and medical salesforce. As customers look to integrate oral health with total health, I view it like the coordination of any other medical specialty that rolls up under an integrated delivery network or healthcare group. We will still need our experts in each field to effectively serve our customers and work together as Team Schein.

Repertoire: Anything to add regarding the coordination of medical and oral health?

Repertoire: Oral/maxillofacial surgery aside, is Henry Schein seeing coordination of oral and systemic health services among your customers?

Kathleen Titus: Yes, we serve Federally Qualified Health Centers (FQHCs), which have a long-standing tradition of integrated care. We are also now seeing a select number of cases in which dental groups are exploring a tighter integration with medical. Gaining traction will require the intellectual rigors of healthcare providers, technology, and business leaders to formalize a real world, adaptable, and affordable model that has private sector acceptance and financial and commercial scalability.

Kathleen Titus: One way [for integration of oral and systemic health to occur] is through information-sharing of electronic health records between dentistry and medicine. Henry Schein One has a number of initiatives underway to support this collaborative effort. For example, our “Consistency of Care” builds a one-to-one integration between our academic software in the dental school with their medical partner software. There is also a new offering which creates an integration with Carequality health information exchange, offering real-time access to data from the patient’s full range of medical and health data regardless of medical software used. We must think outside the box to change the status quo regarding the coordination of medical/dental health. While certainly this is one of the most complex challenges of our generation, we believe integrated delivery of care is a critical piece of the puzzle to make the world healthier.

Kathleen Titus

The Long, Hot Summer

Summer’s almost here. That’s good news, especially for those Up North. But too much heat can be too much of a good thing.

Global temperatures and the frequency and intensity of heatwaves will rise in the 21st century, says the World Health Organization. Debating the cause of rising temperatures may be a job for politicians, but addressing the health implications will fall to hospital emergency departments, public health authorities, community health centers and primary care physicians.

Heatwaves can acutely affect large populations for short periods of time, often triggering public health emergencies, excess mortality and cascading socioeconomic impacts, including lost work capacity and labor productivity, says WHO. But extreme heat has a long-term impact on health as well. Extended periods of high temperatures create cumulative physiological stress on the human body, exacerbating the top causes of death, including respiratory and cardiovascular diseases, diabetes and renal disease.

“We need to start with ensuring that we appreciate that temperatures not typically thought of as hot may pose real risks to health,” says Aaron Bernstein, M.D., interim director of The Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE) and a pediatrician at Boston Children’s Hospital. “We need to be able to identify those patients who may be most at risk, and we need to start taking action before heat sets in. That’s why we’ve created resources to help providers

LAB/PHYSICIAN CUSTOMER INSIGHTS

April 12, 2023 | Virtual Event

ACUTE/ASC CUSTOMER INSIGHTS

May 5, 2023 | Virtual Event

The Latest Trends In The Lab &

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Help Your Entire Team To Better Understand Your Customers’ Shifting Challenges And Priorities In 2023

Hot Topic Sessions:

Lab & Diagnostics: Trends And Outlook

Mara Aspinall, President and CEO, HealthCatalysts

Understanding The Lab Regulatory And Reimbursement Landscape

Adam Borden, SVP, Policy & Strategy, ACLA

Customer Insights: How Lab Providers Are Addressing Challenges And New Opportunities

David Dexter, President & CEO, Sonara Quest Labs

Jane Hermansen, Manager, Outreach & Network Development, Laboratory Medicine and Pathology, Mayo Clinic

Steven Serota, President, Wisconsin Diagnostic Laboratories Moderator: Meagan Roloff, Director, Membership – Acute, Physician & Lab, HIDA

Discover New Trends Within The Acute And

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Explore Financial Drivers & Operational Challenges That Drive Your Customers’ Decisions

Hot Topic Sessions:

Understanding How Acute Care Providers Make Product Decisions

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Linda Rouse O’Neill, Senior Vice President for Supply Chain Policy, HIDA

make plans in advance for hot weather. With plans in place, which include where to go to stay cool, patients stand a better chance of staying safe. When warm temperatures are forecast, clinics can make outreach to patients at risk to remind them to follow their plans.”

The stuff of headlines

Globally, extreme temperature events are increasing in their frequency, duration and magnitude, reports WHO. Between 2000 and 2016, the number of people exposed to heatwaves increased by around 125 million. In 2015 alone, 175 million additional people were exposed to heatwaves compared to average years. In 2003, 70,000 people in Europe died as a result of the June-August event, and in 2010, 56,000 excess deaths occurred during a 44-day heatwave in the Russian Federation.

In the United States, extreme weather events, especially heatwaves, are the leading cause of weatherrelated deaths, according to the Centers for Disease Control and Prevention. In the summer of 1995, for example, the City of Chicago endured a heatwave that resulted in at least 469 heat-related deaths and 739 excess deaths during the most intense period (July 14–July 20).

During the last days of June 2021, Pacific Northwest areas of the U.S. and Canada experienced temperatures never previously observed, according to World Weather Attribution, an initiative among climate scientists and climate impact specialists around the world. Temperatures exceeding 40 degrees Celsius (104 F) occurred from Sunday to Tuesday, June 27-29. It is noteworthy that these record temperatures occurred one month before the climatologically warmest part of the year (end of July, early August).

The CDC reported more than 3,500 emergency department visits for heat-related illness in May and June of that year in Alaska, Idaho, Oregon and Washington State. Nearly 80% of the visits occurred between June 25 and 30.

Who’s most vulnerable?

Extremely hot days, as well as days with moderately high ambient temperature and high humidity, can cause increased levels of illness and death by compromising the ability of the human body to regulate its

internal temperature, according to the CDC.

A portion of blood from abdominal organs – and in severe cases, all organ systems – is redirected to the skin to accommodate the dissipation of internal heat. Maintaining a steady blood pressure during such significant vasodilation requires an increased cardiac output. The cardiovascular systems of the young and healthy can usually adapt to such demands. However, in the elderly and those with preexisting cardiovascular conditions

(e.g., ischemic heart disease, coronary heart disease, heart failure), the heart is not as proficient at meeting the increased demand required to rid the body of the excess heat.

Others who can be adversely affected by extreme heat include:

ʯ Pregnant women and babies. Studies have shown that the fetuses of pregnant mothers are vulnerable to increasing temperatures, and that exposure to extreme heat during pregnancy can cause congenital heart defects,

especially if experienced during particular weeks of gestation, reports CDC.

ʯ People prone to migraines. Dehydration can trigger migraines, according to CedarsSinai Medical Center in Los Angeles. In extreme heat events, it’s best to retreat to a dark, quiet room.

ʯ People with multiple sclerosis. MS symptoms – including vision problems, weakness,

pain and confusion – can be aggravated when the body gets overheated. This is called the Uhthoff syndrome.

ʯ People with autoimmune conditions, such as lupus and rheumatoid arthritis. Direct sunlight can cause joint pain and fatigue.

In October 2022, researchers reported in JAMA Network Open that the incidence of appendicitis appears to increase when temperatures rise. What’s more, evidence suggests that climate change will affect those with neurological disorders in the near future, including Alzheimer’s and non-Alzheimer’s dementia, epilepsy, Parkinson’s disease and stroke, according to research reported in the journal PeerJ.

Other at-risk groups include people who work outdoors, outdoor athletes, the socially isolated and those with incomes below the federal poverty level, as well as communities of color, reports the National Institute of Environmental Health Sciences. In addition, people living in densely populated cities are more likely to be impacted by the urban heat island effect, where manmade surfaces absorb sunlight during the day and then radiate the stored energy at night as heat.

After studying extreme summer surface temperature events in 1,056 U.S. counties, researchers from the School of Global Policy and Strategy at UC San Diego reported that the poorest tracts (and those with lowest average education levels) within a county were significantly hotter than the richest (and more educated) neighborhoods. In addition, neighborhoods with higher Black, Hispanic and Asian population shares were hotter than the more White,

non-Hispanic areas in each county. They ascribed the disproportionate heat surface exposures faced by minority communities to more builtup neighborhoods, less vegetation, and – to a lesser extent – higher population density.

Children are at risk too, given their higher-body surface-areato-mass ratio and lower sweating capacity, says CDC. In fact, among those suffering heat-related illness, children compose almost half (47.6%), according to researchers at Johns Hopkins University School of Medicine. “In the pediatric population, the most common forms of heat-related pathology occur in exercising adolescents and in children left unattended in vehicles or excessively warm environments,” they found. “Pediatricians must effectively counsel caregivers in recognizing the dangers related to heat exposure and preventing dehydration and [heat-related illness]. When prevention fails, prompt

recognition and treatment of heatrelated illness become paramount.”

What to do?

“Our rapidly warming climate is bringing us into uncharted territory,” according to World Weather Attribution. “Adaptation and mitigation are urgently needed to prepare societies for a very different future.”

In April 2022, Harvard Chan C-CHANGE announced it would collaborate with relief/development organization Americares in the “Climate Health Equity for Community Clinics Program.” Funded through a grant from Johnson & Johnson, the three-year programs are intended to improve operations in more than 100 safety net health clinics in

Climate-related toolkit for frontline clinics

areas where climate change disproportionately impacts the health of vulnerable communities.

“While we tend to see the greatest effect of heat on health in the first few days of extreme heat, prolonged periods of high heat may promote power outages, affect mental health (in no small part due to people having to curtail normal activities), and in many parts of the world, reduce crop yields and make water scarcer, each of which can affect health too,” says Dr. Bernstein. “Primary care providers can help plan for power outages in particular, especially for patients who rely on electric devices (e.g., CPAP) and through giving appropriate guidance on medication use.”

To help community health centers and clinics better manage care and protect patients from climate risks, the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health (Harvard Chan C-CHANGE) in collaboration with Americares and with financial support from Biogen, released a new “Climate Resilience for Frontline Clinics” tool.

Materials on extreme heat are dedicated to protecting patients with certain health conditions that require tailored guidance, such as asthma, cardiovascular disease, COPD, chronic kidney disease and end-stage renal disease, diabetes, dementia, multiple sclerosis, pregnancy, and mental health conditions. For providers, the toolkit includes chapters on:

ʯ Chronic kidney disease and end-stage renal disease and heat.

ʯ Chronic obstructive pulmonary disease, asthma and heat.

ʯ Cardiovascular disease and heat.

ʯ Dementia and heat.

ʯ Diabetes and heat.

ʯ Mental disorders and heat.

ʯ Multiple sclerosis and heat.

ʯ Pregnancy and heat.

ʯ How to establish a heat action plan.

ʯ How to access weather alerts.

The toolkit can be accessed at www.americares.org/what-we-do/community-health/climate-resilient-health-clinics/#toolkit

‘We need to be able to identify those patients who may be most at risk, and we need to start taking action before heat sets in.’

Promoting Sustainability in Health Distribution

Approximately 80% of greenhouse gas emissions associated with healthcare come from the supply chain. Distributors are uniquely positioned to work with both upstream and downstream partners and can offer streamlined solutions that benefit the whole supply chain.

Climate change mitigation in the healthcare sector has become a key priority of the federal government. More than 600 hospitals and health systems have taken the Health Care Sector Climate Pledge launched by the Biden administration. This pledge invites organizations to commit to lowering their greenhouse gas emissions and building more climate resilient infrastructure. These stakeholders have committed to reduce greenhouse gas emissions 50% by 2030, and achieve net-zero emissions by 2050.

Healthcare distributors have developed many processes and best practices to help providers achieve climate change and other environmental sustainability goals. These solutions include:

Greener Transportation

In our inextricably global supply chains, the emissions cost of product transportation can have a larger carbon footprint than the raw materials used to make a product. Distributors are moving to more electric vehicles and other environmentally preferred modes of transportation.

Data-Driven Warehouses

Distributors can reduce emissions by consolidating shipments from multiple suppliers and/or to multiple customers. By using data analytics, specializing in inventory management and operating from centralized distribution centers medical distributors can make more consolidated product shipments, reducing the final carbon footprint associated with products.

Reduce Packaging Waste

Another huge contributor to supply chain emissions is the “Russian doll” model of packaging in which each individual product is wrapped in a plastic, inside a larger cardboard box inside a larger cardboard case inside a case etc. In healthcare, this is an especially demanding challenge due to the importance of maintain product sterility. Distributor centers can right-size product packaging and remove the need for filler; they can also work towards more sustainable packaging alternatives; and work with their end users to promote recycling at the end of a product’s lifecycle.

Decarbonizing supply chains remains one of the most complex challenges facing our industry. But it is one of the most effective ways to reduce emissions and promote sustainability across the entire healthcare sector.

Manpreet Kaur Sandhu, Program Manager: Supply Chain Collaborative, Health Industry Distributors Association (HIDA).

By Manpreet Kaur Sandhu

Cancer Control Month: Past, Present and Future

Raising awareness for cancer prevention and treatment through the United States

By Pete Mercer

As the second-leading cause of death in the world, cancer is one of the few words in the English language that carries enough weight to stop a person in their tracks. It’s the kind of diagnosis that everyone takes seriously, because most of us know someone that has been affected by the burden of cancer. By recognizing and participating in Cancer Control Month, we can honor those who have battled cancer by finding new ways to reduce the burden that a cancer diagnosis causes.

The month of April is recognized as Cancer Control Month, which is dedicated to raising awareness for cancer prevention and treatment through the United States. In 1943, President Franklin D. Roosevelt found that cancer was a deadly enemy that took the lives of nearly 150,000 Americans each year. While the country was fighting abroad during World War II, President Roosevelt decided to start fighting cancer on the home front.

Roosevelt designated the month of April as Cancer Control

Month in 1943, calling upon medical professionals, schools, universities, and media to join this movement. From there, he instituted an annual proclamation from the sitting president, calling on all Americans to pay attention to factors that can reduce individual cancer risk. Each year, the month of April is meant to honor the millions of Americans who are currently battling cancer, cancer survivors, as well as those that did not survive their fight with cancer by raising awareness about cancer prevention

and the importance of continued research into better treatments.

Goals of Cancer Control Month

Despite the long history of Cancer Control Month, millions of Americans are still affected by the burden of cancer. The American Cancer Society estimates that 1.9 million people in the United States were diagnosed with cancer in 2022. This is not to say that we’re fighting a losing battle – in fact, a study conducted by The American Cancer Society found that there has been an overall drop in cancer mortality of 33% since 1991.

However, there is still plenty of work to be done. Because of the rates of positive cancer diagnoses, Cancer Control Month has five goals to shape the way in which it is enacted:

ʯ Cancer prevention – According to the National Foundation for Cancer Research, about 30-50% of all cancer cases are preventable. Cancer prevention is a costeffective, long-term strategy for controlling cancer through raising awareness, reducing exposure to known carcinogens, and equipping the population with the information they need to live a healthy life.

ʯ Early detection of cancer –

Early detection of cancer greatly increases the chances of successful, cost-effective treatment. Early detection is a two-pronged strategy: education and screening. When people are educated about cancer risk factors and symptoms, they will better understand the benefits of early detection. Screenings are the tests that determine whether an individual has cancer or not,

usually before the onset of symptoms. Screenings are preventative measures like pap smears, mammograms, and colonoscopies that can assess the likelihood of cancerous cells forming.

ʯ Improve cancer treatments –Not all cancer is preventable, so we need measures to improve existing treatments and source the development of future treatments. Chemotherapy is a common and effective cancer treatment, but the success rate of chemo depends on several factors. This is a harsh treatment that causes significant side effects, necessitating more research to provide better methods to treat cancer patients.

ʯ Increase survival rate of cancer –Research is the key to increasing the survivability of cancer. Without the copious amounts of research that scientists have done over the years, a cancer diagnosis would be much bleaker than it is now. Research has provided answers to some of our biggest questions regarding cancer over the years – more importantly, research provides hope to the millions of Americans facing a cancer diagnosis.

ʯ Improve quality of life – Cancer is difficult. It’s a hard diagnosis to live with physically, mentally, and emotionally for patients and their loved ones. No one gets out easy, and it’s a lot to process on both sides of

the diagnosis. This is where reducing the burden of cancer becomes a sort of call to action to support patients and their loved ones during this difficult season.

One year anniversary of Cancer Moonshot reignition

The Cancer Moonshot is an initiative launched by former President Barack Obama in 2016 in an effort to cut the death rate from cancer by 50% over the next 25 years, while improving the experience of the people and their families living with cancer. In 2022, President Joe Biden reignited the Cancer Moonshot initiative to continue to work towards the mission to “end cancer as we know it today.”

“The progress we’ve realized to date in understanding and achieving

better outcomes for the more than 200 diseases known as cancer is inextricably linked to the collective investment and dedication of the government and the private sector working side by side,” said Dr. Karen E. Knudsen, chief executive officer at The American Cancer Society.

This commitment from the government works to shine a light on the disparities and shortcomings that exist in the current system, giving experts hope that more can be done to fight the burden of cancer on every front. Lisa Lacasse, president of ACS CAN, said, “We call on lawmakers and policymakers in Washington and every state across the country to continue to pick up the mantle and play an instrumental role in reducing cancer incidence and mortality through investment in research, promoting evidence-based prevention, including proven tobacco control; advancing innovation in cancer screening and early detection; and reducing barriers to affordable, comprehensive health care from prevention through survivorship.”

The American Cancer Society and The American Cancer Society Cancer Action Network are supporting the Cancer Moonshot’s five priority areas:

1. Close the screening gap

2. Understand and address environmental exposure

3. Decrease the impact of preventable cancers

4. Bring cutting-edge research through the pipeline to patients and communities

5. Support patients and caregivers

While recent reports from The American Cancer Society have shown the incredible progress we’ve made since the 90s, it also found that there

is a stark disparity in cancer burden between men and women. From 2012 to 2019, there has been a significant drop in cervical cancer rates in women (ages 20-24) after the development of an HPV vaccine.

Rebecca Siegel, senior scientific director, surveillance research at the American Cancer Society and lead author of this report, said in a media release, “The large drop in cervical cancer incidence is extremely exciting because this is the first group of women to receive the HPV vaccine, and it probably foreshadows steep reductions in other HPV-associated cancers.”

for everyone, it is imperative for us to focus on cancers where trends for incidence and mortality are going in the wrong direction.”

Because of this increase in prostate cancer, The American Cancer Society is launching a new initiative called IMPACT or Improving Mortality from Prostate Cancer Together. The report says that IMPACT is designed to eliminate barriers and address needs to ensure that everyone has the same opportunity to be healthy and cancer-free by funding research programs, as well as funding additional programs to enable the expansion of patient support to

Conversely, prostate cancer increased by 3% every year from 2014 to 2019, after a two-decade long period of decline. Alarmingly, much of this increase was driven by the diagnosis of advanced-stage prostate cancer. The report says, “Since 2011, the diagnosis of advanced-stage (regional- or distant-stage) prostate cancer has increased by 4% to 5% annually and the proportion of men diagnosed with distant-stage disease has doubled.”

“The increasing percentage of men presenting with advanced prostate cancer, which is much more difficult to treat and often incurable, is highly discouraging,” said Dr. Knudsen. “In order to end cancer as we know it,

facilitate access to quality prostate cancer screening and care.

Additionally, IMPACT will help advance public policy designed to directly address the burden of prostate cancer. Dr. William Dahut, chief scientific officer for The American Cancer Society said, “We must address these shifts in prostate cancer, especially in the black community, since the incidence of prostate cancer in black men is 70% higher than in white men. IMPACT will fund bold new cancer research programs that connect the laboratory, the clinic, and the community. These studies will help discern who is most at risk for prostate cancer and how to prevent it.”

The American Cancer Society estimates that 1.9 million people in the United States were diagnosed with cancer in 2022. But a study conducted by The American Cancer Society found that there has been an overall drop in cancer mortality of 33% since 1991.

Addressing Caregiver Burnout

Why more positive point of care experiences for caregivers have never been more important, and the role equipment can play in improving those experiences.

The last few years have not been kind to the health and well-being of healthcare workers in the U.S. Indeed, the COVID-19 pandemic has put extreme stress on the healthcare workforce in the U.S., leading to workforce shortages as well as increased healthcare worker burnout, exhaustion and trauma, according to an issue brief from the Assistant Secretary for Planning and Evaluation (ASPE) Office of Health Policy, part of the Department of Health and Human Services. “These pandemic-related challenges have taken place in a context of significant pre-existing workforce shortages and maldistribution, as well as in a workforce where burnout, stress, and mental health problems (including an ongoing risk of post-traumatic stress disorder) were already significant problems.”

Some points the ASPE made in its brief:

ʯ Many healthcare workers who were not directly caring for COVID-19 patients faced being furloughed or having their hours reduced, particularly early in the pandemic. In May 2020, approximately 15% of hospital workers reported being unable to work at some time in the past 4 weeks because their employer closed or lost business due to the pandemic, compared to 23% of non-hospital healthcare workers. These numbers declined to 1-2% by the end of 2020.

ʯ Total employment in the healthcare industry declined during the early months of the pandemic but has gradually recovered since summer 2020. The relative decline in employment was substantially larger for ambulatory care employees compared to hospital employees.

ʯ Many hospitals have reported critical staffing shortages over the course of the pandemic, particularly when case numbers were high. During the Omicron surge in January and February 2022, the 7-day average of hospitals

reporting critical staffing shortages peaked at 22% during midJanuary 2022.

“Even after the pandemic, many of the effects the pandemic has had on the healthcare workforce will likely persist,” the ASPE said. “Addressing these impacts as well as the underlying challenges that predated the pandemic can help build a stronger and more resilient healthcare system for the future.”

A need for support

A recent Pulse on the Nation’s Nurses Survey, conducted by the American Nurses Foundation, examined the impact of the pandemic on the nation’s nurses. Some of the findings:

ʯ Nurses reported high levels of feeling stressed (71%), frustrated (69%), exhausted (65%), burned out (49%) and overwhelmed (58%).

ʯ Millennial and Generation

Z nurses (age 34 and under) conveyed these feelings more than their older counterparts: stressed (81%), frustrated (76%), exhausted (77%), burned out (69%) and overwhelmed (69%).

ʯ Nurses of color echoed these feelings. They report feeling stressed (73%) and burned out (55%).

Additionally, an American Nurses Foundation survey in August 2021 found that 34% of nurses do not feel emotionally healthy and 42% report experiencing trauma because of the COVID-19 pandemic. Fifty percent of nurse respondents said they are considering leaving the profession.

Efforts are underway throughout the industry to address the burnout. For instance, in December 2022, the United Health Foundation,

the philanthropic foundation of UnitedHealth Group, announced a three-year, $3.1 million grant partnership with the American Nurses Foundation to fight nurse burnout with the Stress & Burnout Prevention Pilot program.

The program is designed to transform organizational culture, remove the stigma associated with seeking mental health support and offer nurses a new burnout prevention model to help them use mental health resources earlier and more effectively, with a particular focus on Millennial and Generation Z nurses, as well as nurses of color, “to ensure their unique experiences are recognized and addressed,” the organization said in a release.

“Given the complexity, intensity and intimacy of what nurses do every day, nurses’ need for mental health support has always existed. This has been exacerbated tenfold by the COVID-19 pandemic,” said Kate Judge, executive director of the American Nurses Foundation. “Burnout cannot just be addressed one nurse at a time. This new partnership addresses burnout at the systems level, especially for those most impacted including younger nurses and nurses of color.”

The American Nurses Foundation will pilot the program, implemented as a train-the-trainer model, in four health care organizations representing over 15,000 nurses in rural and urban locations in acute, primary and long-term care settings. Participating health systems include:

ʯ BayCare Health in Tampa Bay, Fla.

ʯ Indiana University Health in locations throughout Indiana

ʯ University of South Alabama Health Hospital in Mobile, Ala.

ʯ Wayne Health Care in Newark, N.Y.

Learnings from these pilot sites will be used to iterate and evolve into a national awareness campaign reaching over 50,000 nurses nationwide.

The pilot program is based on a framework originally developed for the military and since deployed in other demanding professions. It

is designed to identify and reduce stress reactions before they develop into lasting issues. It goes beyond identification of burnout to intervention by helping nurses speak about their stress/burnout using a common language, normalize talking about it, and provide support to

“Even after the pandemic, many of the effects the pandemic has had on the healthcare workforce will likely persist. Addressing these impacts as well as the underlying challenges that predated the pandemic can help build a stronger and more resilient healthcare system for the future.”

their peers. Program learnings will also be incorporated into a national awareness and education campaign, providing free anti-burnout resources for frontline nurses and nurse leaders.

The role clinical design plays

Kurt Forsthoefel, director of marketing, Midmark Medical, believes better clinical design can play a key role in building a stronger healthcare system and healthier workplace for our nation’s caregivers. In a blog post on the subject, Forsthoefel wrote that it’s important to not overlook the role clinical design can play in helping non-acute facilities reduce burnout and retain healthcare professionals. “Especially how equipment

design, workflows and technologies used in this environment can help create a more positive point of care experience for caregivers.”

Forsthoefel listed several examples:

ʯ Exam rooms configured and designed to improve standardization, enhance patient-caregiver interaction and accommodate needed equipment and supplies at the point of care. The exam room should also provide adequate space for caregivers to easily move about or remain seated to minimize unnecessary straining and increase comfort.

enabling caregivers to easily reach frequently accessed supplies without unnecessary bending, stretching or constant overreaching.

ʯ Mobile workstations that can support the needs of nearly all users in the clinical space, allowing them to work from an ergonomically correct position whether seated or standing as to not cause unnecessary strain on the caregiver›s back, shoulder and neck.

ʯ Wearable locator badges equipped with a call button that helps improve worker safety by enabling healthcare

ʯ Exam chairs that are fully adjustable to prevent caregivers from having to overreach, twist or bend their back or torso too much during exams, and can lower to a height that allows patients to transfer onto and off of the chair without being lifted by a caregiver.

ʯ Vital signs acquisition devices bring automation to the vital signs workflow to help ensure a higher level of standardization and minimize human variables, while also auto-connecting with a computer using zero clicks to import data directly into the EMR and eliminate manual transcription errors.

ʯ Cabinetry that is designed for average-height healthcare workers,

workers to request immediate help and providing security officials with the worker’s name and location so they can respond in a timely manner.

“As these examples illustrate, clinical design has become a strategic component at the point of care, helping healthcare organizations place staff well-being and satisfaction at the same level of importance as clinical outcomes, patient satisfaction, efficiency and profitability,” he said. “Whether it’s equipment that feature ergonomic principles, technology that offers safety and less clicks or room configurations that deliver standardization and increased efficiency, the end result is a better care experience for caregivers.”

“Clinical design has become a strategic component at the point of care, helping healthcare organizations place staff wellbeing and satisfaction at the same level of importance as clinical outcomes, patient satisfaction, efficiency and profitability.”

Addressing Burnout

The AAPA’s Task Force seeks to provide education, support and research to mitigate the risks of burnout for PAs and other caregivers.

In 2019, the Board of Directors and House of Delegates of the American Academy of Physician Associates created a Joint Task Force on Burnout (JTF). Eric Tetzlaff, MHS, PA-C, DFAAPA, Chair, AAPA Task Force on Burnout, explained some of the reasons behind the formation of the Task Force: “The AAPA board of directors, the house of delegates and the PA community at large recognized the increasing and multidirectional demands on PA professionals with resultant detrimental impacts on professional well-being of PAs and the ability to provide high quality care to patients.”

The risk of professional burnout was not unique to PAs in healthcare as it is workplace syndrome suffered by all members of the healthcare team, Tetzlaff said, but there was an unmistakable unmet need to provide education, support and research on PA burnout to mitigate the risks of the burnout and help improve team-based care provided by PAs. “Although other organizations were addressing provider burnout, prior to the formation of the AAPA task force on PA burnout, there was no uniform and coordinated effort to address PA burnout.”

In an interview with Repertoire Magazine, Jennifer M. Orozco, DMSc, PA-C, DFAAPA, AAPA President and Chair of the Board, discussed burnout among today’s healthcare workforce, how quality of care can be affected, and some initiatives the AAPA is undertaking to address the issue.

Repertoire: Why are PAs particularly susceptible to burnout?

Jennifer Orozco: Addressing burnout across healthcare professions has been a priority for the medical community for years, but the strain of COVID-19 on our healthcare system put a spotlight on how critical it is to foster clinician well-being

as healthcare workers are quitting at alarmingly high rates.

AAPA has been proactively working to support PAs and fight burnout within our profession for many years. Prior to the pandemic, in 2019, AAPA established a taskforce to uncover the root causes of burnout in healthcare and identify meaningful, long-term solutions – not just treatments for the surface symptoms.

Though the task force’s official work was completed in 2022, addressing PA well-being remains important to AAPA’s work, and we continue to gather insights to inform the resources and support we provide to the profession.

AAPA’s 2022 Salary Report found that while 46.3% of PAs reported experiencing some type of burnout, 79% of the PAs remain optimistic about the PA profession.

Repertoire: What are some of the most demanding aspects of a PA’s role within the care setting?

Orozco: Across the country, PAs are experiencing the challenges of meeting patient needs with an ongoing healthcare workforce shortage. There are not enough providers to meet patient needs today, and the situation is expected to become even more dire in the coming years, creating a perfect storm. According to industry estimates, 99 million Americans lack adequate access to primary care, and 158 million Americans lack adequate access to mental health care.

One of the many learnings from the COVID pandemic is that the U.S. healthcare system has reached a tipping point – a “perfect storm.” We are at the convergence of healthcare workforce shortages, a mental health crisis, a growing aging population, and a rise in chronic diseases like obesity and diabetes.

An analysis of EMSI data show there will be a shortage of up to 3.2 million healthcare workers by 2026. BLS data shows that 2%

Jennifer Orozco

of the healthcare workforce quits every month.

Without modern, integrated, team-based healthcare, the U.S. healthcare system will simply not be able to meet these growing needs. We must remove outdated and burdensome requirements and laws that weigh down healthcare teams across the country. In many states, PAs are still required to be supervised by a physician, despite the ongoing and growing physician shortages. PAs are highly trained healthcare providers who should be allowed to practice to the full extent of their training and education. With more than 500 million patient visits annually, PAs are a crucial part of the solution to healthcare provider shortages. By removing unnecessary restrictions, PAs would be better able to meet patient needs where they are greatest.

Repertoire: How could this affect the quality of care?

Orozco: Outdated healthcare laws directly impact a patient’s ability to access high-quality and safe healthcare. For many patients, PAs are their primary care provider, and may be the only provider in town. Despite a growing healthcare workforce shortage, the PA profession is expected to continue growing rapidly. The BLS estimates the PA profession will grow 28% between 2021 and 2031, much faster than the 5% average growth rate for all professions. In fact, the PA profession is growing eight times faster than the physician profession. This is why AAPA continues advocating for legislation that ensures all providers are allowed to practice to the full extent of their training and education.

Repertoire: What are some of the goals of the task force? Any initiatives or priorities in 2023?

Orozco: When the task force was created by AAPA’s House of Delegates in 2019, it was tasked with identifying and sharing strategies to reduce the impacts of burnout on PAs. The taskforce was responsible for identifying resources and strategies that lead to burnout, leading educational efforts on ways to prevent burnout, and raise awareness of the burnout issue impacting PAs nationwide. Three years later, the task force has met these calls to action, in part creating free CME models that are accessible to all PAs, launching an

online burnout resource center, and leading a wellness symposium during AAPA’s 2022 Conference in Indianapolis to educate PAs about burnout and ways to prevent it.

In 2023, AAPA will develop further continuing medical education (CME) on burnout and encourage dialogue to break the stigma surrounding mental health and treatment for mental health. In addition, AAPA is also providing funding to support the National Academy of Medicine’s National Plan for Health Workforce Well-Being.

Team Godfrey

How a husband-wife sales team has found success and work-life balance amid their professional careers and a challenging health diagnosis.

By Pete Mercer

What would it look like for you and your spouse to wake up every morning and go to work together? Many couples might shudder at the thought of working at the same company, especially if you both were to work in the same department.

With that in mind, Team Godfrey might seem like something of an anomaly – a happily married couple that work together as account managers at CME Corp., the largest healthcare equipment centric distributor in the country. With over 2,000 manufacturers, CME provides their customers with an array of items, based on what they need.

Team Godfrey consists of Chris and Julie Godfrey, a husband-andwife duo who are co-account managers at CME. The Godfreys manage large accounts for Connecticut and Maine, as well as a large retail clinic on a national level, which has locations throughout the entire country.

Settling in at CME

Chris has worked with CME since 2014, with a total of almost 40 years in the industry. He started his career in 1983 at Mohawk Healthcare of Utica, before moving to CME in 2014. Julie has been with CME since 2018, a career change after working in the field of radiology.

Once she and Chris moved from New York to Rhode Island, she could no longer work as a tech assistant because of the different educational requirements. After she realized that in the state of Rhode Island she could no longer be hands on in

the field of radiology, she needed a career change.

Shortly after their move, Chris went to his VP of Sales, KC Meleski, and said, “We’ve got a real talent here in Julie. I’d love for her to come work for CME.” Based on his recommendation, Normand Chevrette, the president and CEO of CME, reached out to Chris to make sure it was a good fit for the couple and organization. Julie spent the first two years at CME as a customer service specialist, but eventually moved to account management to work with Chris.

At the time, their largest client was opening over 200 clinics across the country, which would be a big enough job for just one person. Further complicating things, Chris started to experience some health issues that made mobility difficult for him. He was eventually diagnosed with ALS in 2022.

“When I became an account manager, Chris had gone through two neck surgeries and a shoulder surgery,” Julie explained. “He was finding mobility hard. At the time, we didn’t know it was ALS. They kept ruling it out. He needed help maneuvering his keyboard and stuff like that.”

When Julie first started at CME, Chris was the director of business development from 2017 to 2018, a corporate leadership role that required a good bit of travel. While they were still unsure of what Chris’ condition was, he eventually made the transition back to account management, which was a much better fit.

Better together

They became Team Godfrey, working together to serve CME’s customers. While many people might

not want to work with their spouse, Chris and Julie have made it work. They both work from home, in separate offices, which allows them to divide and conquer. Julie said, “It was an adjustment, but Chris and I have always been able to communicate. We have always had that kind of relationship where we respect each other’s opinions.”

If there are days that don’t go well, Julie said she takes a break from work to check on the dogs or figure out something for dinner. They connect in the afternoon about how the workday has been going and finalize

everything together before calling it a day. It’s a good system that gives each person the space and independence they need to get their work done.

The most challenging part for Chris is breaking out of his old habits. While Julie uses his many years of experience to her advantage, Chris admits, “I was set in my way. For 38 years, I did it my way. All of a sudden, I have this smart chick over here going, ‘Hey Chris, what about this way?’ And I have to bite my tongue a little bit and say, ‘You know what? You’re right.’ It’s a good give and take.”

“Our advice to the younger sales reps would be, don’t forget the human side of it. Get in front of your accounts and let them know who you are as a person. I think that’s important in sales.”

– Julie Godfrey

There are more good days than bad though, giving them opportunities to collaborate and celebrate their wins. Chris said, “The most rewarding part of it is when all of a sudden you get that big purchase order in the inbox. I can say to Julie, ‘Honey, guess what? That quote you did for $125,000 just came through!’ To be honest, it makes you feel good.”

Julie agreed, saying, “The give and take is good because our thought processes are not the same. He’ll get to an end result one way, and I might take a totally different path. Ultimately, we end up at the same end point. It’s interesting to see how people think differently from each other. When all is said and done, we both teach each other.”

The Godfreys have been married for 13 years now, creating a blended family with four children between the two of them from previous marriages. No marriage is perfect, but Chris says that the best marriage advice he can give is to marry your best friend. Julie emphasized the need for mutual respect for each other’s opinions, professionally and personally.

Planning for the future

ALS is a very serious neurodegenerative disease that affects nerve cells in the brain and spinal cord, making planning for the future difficult.

“The give and take is good because our thought processes are not the same. He’ll get to an end result one way, and I might take a totally different path.”

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Without a clear picture of what their future is going to look like, the Godfreys are taking everything one day at a time. Julie said, “We had plans of retiring and playing golf all the time. We used to take 20-mile bike rides on the weekends. With his diagnosis, we’ve had to kind of revamp our activities and just be happy that he’s still here and still walking.”

Living in Rhode Island gives them access to beaches and beautiful waterfront vistas where they can watch sailboats drifting into a golden sunset each night. During the warmer months, Chris and Julie take advantage of their beautiful state, walking the dogs and enjoying the ocean breeze. Aside from their outdoor activities, they love to watch hockey and baseball together. While Chris is still healthy and mobile, they have plans to travel to Europe later this year.

On their work at CME, Chris said, “Professionally, we’ve got a couple of larger projects in the works and we’re hopefully going to see those through to fruition. After that, I’d like to retire. I’ll be 61 in April, and with no cure for ALS, I could be around another year or even 10 to 15 years. I would love to see those projects through and sail off into the sunset.”

As they prepare for an uncertain future, they understand that the industry has completely changed from what it was like before. Automated platforms like Salesforce help to streamline all of their processes and communications with clients, simplifying a lot of the administrative work of the medical sales rep. But the emergence of digital tools, applications and platforms can pose a threat to what many old school sales reps consider

to be the foundation of the business: the human touch.

“Our advice to the younger sales reps would be, don’t forget the human side of it,” Julie said. “Get in front of your accounts and let them know who you are as a person. I think that’s important in sales. You can’t always just be behind a computer; you need to be connected with your accounts in other ways. Don’t ever forget that person-toperson relationship.”

Chris made a point to advise the younger sales reps to lean on their more experienced counterparts. “I find that the younger crowd is either afraid or doesn’t know how to approach a guy like me that’s been in the industry for so many years. You would think a

younger rep starting out would be like, ‘Hey, how do you do this?’ Or, ‘What do you suggest for this?’ I would always say that collaboration and communication go hand-in-hand.”

One of the other pieces of advice Julie wanted to offer young sales reps is to find a good worklife balance. Unsurprisingly, her husband’s diagnosis has her more focused on the priorities in her life. With an uncertain future, she wants to encourage younger reps (especially those with children) to prioritize what’s truly important. She said, “We try to keep living in today because it makes you more aware of everything you do during that day, the importance of little things, and just how fragile time is.”

Ready to Connect

3 Ways RepConnect Provides Reps a Next-Gen Business Experience

In the annals of digital technology, the iPhone’s release (June 29, 2007) is celebrated as ringing in a new era of innovation in communication. And rightfully so. But it could be argued that almost 13 months after that infamous debut came a just-as-important launch.

On July 10, 2008 Apple introduced the App Store. There were 500 apps in the store’s initial offering. By the beginning of 2023, there were more than 1.96 million.

All facets of not just the economy, but our individual lives, have changed from the development and implementation of apps. Getting around cities has become easier thanks to Uber. Connecting has gotten more streamlined due to mobile apps (Think Facebook, Twitter, Instagram and SnapChat). Entertainment options are endless and at the tip of our fingertips 24/7 with gaming and streaming.

Yet not all apps are created equal. For every Uber and Instagram launch, there’s been dozens of failed attempts. And the same goes for business-oriented apps. That’s why the designers behind the relaunched RepConnect app were focused on the details to make the user-experience a powerful one for distributor reps. Among the key features:

No. 1: Instant accessibility

RepConnect provides reps instant access to their manufacturer partner’s rep lists, contacts, brochures, product information, website, white papers and more. The listings are free to use and easy to scroll. It

allows you to more effectively prepare for client appointments, and be ready with materials during your meetings rather than having to waste time scrounging for the right paper products or having to get back to your client at a later time.

No. 2: Up-to-date news

As we all can attest to during the last few years, things change quickly in the U.S. healthcare supply chain. The RepConnect app includes an updated tracker with the latest industry specific news. Supply chain disruptions, mergers and acquisitions,

products launches and industry news – it’s all there.

No. 3: Training videos

In the med/surg industry, movement is life. RepConnect provides opportunities for reps to enhance their product knowledge and selling skills, so you’re always pushing forward in your wisdom and skillset.

RepConnect is a next-gen app with the right mix of tools, news and resources reps need to success in the field. To download the app, visit the Apple or Android store.

Linda Rouse O’Neill promoted to Senior Vice President for Supply Chain Policy

The Health Industry Distributors Association announced that Linda Rouse O’Neill has been promoted to the position of Senior Vice President for Supply Chain Policy.

“In 12 years at the forefront of HIDA’s advocacy, Linda has positioned distributors and HIDA as trusted partners for policymakers in Washington,” said Matt Rowan, HIDA’s President and CEO. “Her work enhances the nation’s preparedness and resilience efforts by building collaboration between government and medical products distributors and manufacturers.”

O’Neill’s issue portfolio includes the full spectrum of supply chain issues impacting the medical products industry and includes engagement with an expansive range of federal agencies focused on healthcare, preparedness, transportation, and related commercial issues. She also engages with allied trade associations to magnify the collective impact of industry advocacy efforts.

Her recent accomplishments include convening HIDA’s first-ever Pandemic Preparedness Summit and engaging major shipping ports to alleviate ongoing transportation issues.

O’Neill’s prior experience includes Director of Federal Affairs at Premier, legislative assistant to Senator Craig Thomas (R-WY), and Senior Specialist for Government Affairs and Policy at the National Rural Health Association.

Henry Schein Medical helps champion the advancement of ambulatory surgery centers

Henry Schein Medical recently participated in the Ambulatory Surgery Center Association’s (ASCA) National Advocacy Day on Capitol Hill in Washington D.C. as part of Henry Schein’s commitment to amplify the value of ambulatory surgery centers (ASCs) and their role in helping to drive down heath care costs and deliver quality patient care.

In an effort to build relationships with the policymakers who make the decisions that directly impact the ambulatory surgery center community and its patients, Scott Jackson, Vice President of Surgical Solutions at Henry Schein, along with 91 members of the ASC community representing 31 different states, met with representatives and their health staff to discuss the issues that are currently impacting ASCs and their patients. In particular, meetings addressed the Outpatient Surgery Quality and Access Act of 2023, which, if enacted, will ensure Medicare beneficiaries’ continued access to highquality outpatient surgery.

“Ambulatory surgery centers have such a positive impact on the health care ecosystem, and being able to stand alongside ASCs to advocate on behalf of the surgery center community in the United States was an incredible experience,” said Jackson. “It is important that ASCs have their voices heard. By working together on the federal, state, and local levels, we can create change, and help make an impact on legislation that will elevate and advance the ASC industry.”

According to ASCA, approximately 6,100 Medicarecertified ASCs provide care to America’s patients across the country. ASCA’s 2023 National Advocacy Day event was the first in-person event of its kind since 2019.

B. Braun launches online e-university platform for healthcare providers

B. Braun Medical Inc., a leader in smart infusion therapy and pain management, unveiled B. Braun e-University, an online education platform for healthcare providers designed to improve clinical practice and patient care. This user-friendly, web-based platform, accessible across devices, complements B. Braun’s full offering of value-added live and virtual clinical and technical training. The learnings in B. Braun e-University help providers stay current with education, even during changeover and shortages in the education departments of some healthcare facilities.

B. Braun e-University currently hosts over 50 on-demand and microlearning video courses covering Infusion Systems, IV Fluids and Irrigation, IV Sets and Access Devices, Vascular Access, Closed System Drug Transfer Devices, Compounding, Drug Preparation and Pain Control. The open platform allows the user to explore the content for a customized learning experience.

Continuing Education (CE) courses are also accessible through B. Braun e-University. The current selection includes: “Are You Ready for Smart Pump –EMR Interoperability,” Ultrasound-Guided Peripheral Intravenous Catheter Insertion, and Pediatric and Neonatal Peripheral Intravenous Catheter Insertion Education. Additional courses for credit will be added based on customer needs.

In addition to B. Braun e-University, which focuses on hospital and outpatient markets, the Company has collaborated with the Association for Vascular Access to provide free online education on improving Peripheral Intravenous Catheter Insertion for healthcare schools (AVA- B. Braun PIV Education).

Better BP® is Better Care

Midmark designed the only fully integrated point of care ecosystem to help promote a more consistently accurate blood pressure measurement by targeting 3 key areas

Proper Patient Positioning

Patient positioning during blood pressure (BP) capture can impact the accuracy of BP measurements. The American Medical Association (AMA) recommends the patient’s back be supported, feet fl at on the fl oor, legs uncrossed and arm supported at heart height. 1

Accurate, Consistent BP Capture

Automation at the point of care can help ensure a higher level of standardization, minimizing human variables while maximizing consistency and data accuracy.

EMR Connectivity

Seamless connectivity to the EMR saves time and reduces the likelihood of data transcription errors.

Learn more at:

INVENT. CREATE. PROTECT.

revolutionized personal hand protection forever with the invention of the world’s first nitrile exam glove. Since that time, the integrated manufacturer has accomplished a “Legacy of Firsts” for health care providers:

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1990

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 First 510(k) for the world’s first nitrile exam glove

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