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3 Vaccine Confidence from page 25

So, it is important for my kids to be vaccinated.” Others did not have such personal experiences with vaccine-preventable disease, primarily because vaccines have been so effective. Other participants found vaccines were necessary merely because they were a requirement for school.

Building Trust

While most patients reported that vaccines were safe, some did have safety concerns. Several individuals believed that vaccines caused illness; for example, flu shots give people the flu. One stated, “In early childhood, everything is developing newly. Those side effects are tremendous and can be more harmful than the infection itself.” Another person said early childhood vaccines could put children at higher risk for Autism and other diseases, adding “their chances would be different had they not been vaccinated.”

Not getting vaccinated is not risk free.

nobody because everybody lies. I’m doing my own research now and determining what’s best for me. At the end of the day, it has to the right decision for me and my family.” Another person said trust is “earned, not just given. I lost my dad to COVID, and it took the trust away.” This participant went on to say that ongoing conversations about health concerns with his primary care provider could potentially restore trust. During an infodemic, the volume, noise and social media algorithms of misinformation can easily influence a patient’s viewpoint, especially if they are lacking a trusted relationship with their health care team.

During this community assessment, a common theme emerged. Participants were most interested to receive their health information from trusted sources. The majority of participants indicated they first trusted a health care provider followed by a family member and then a trusted community leader. This approach was shared equally among racial/ ethnic groups. However, sometimes a reputable, trustworthy source was lacking. One person indicated she does her own research; “I don’t trust

Trust between the health care team and patient is under-valued. We sometimes place greater emphasis on academic credentials, titles, years of experience, patient load, etc. However, our patients may expect otherwise from us. One participant stated, “Doctors should have conversations with their patients, listen to their concerns and then guide them in the right direction with sound medical advice.” Notably, this participant stated a provider should listen first, and then offer medical advice. In busy clinics where one patient arrives late, another arrives early, and appointment slots are only 15 minutes long—it is easy to only offer the essential medical advice. Devoting time to sit in the space of uncertainty with a patient, acknowledging and seeking an understanding of their fears and concerns, may not result in an immediate positive vaccine decision, but it may build on the development of a trusting relationship. As providers, it is difficult to compete with the technology and speed of anti-vaccine information. Investing in strategies and partnerships to provide culturally sensitive, accurate vaccine information and developing trusted relationships with our patients is imperative.

Primary Care

We are an independent physician-owned multi-specialty practice with 180 providers located across 13 sites, and-state-of-the-art facilities. Recently voted one of the 14 coolest urban spaces in America, Mankato is a short drive from the metro with abundant nearby recreation opportunities, safe, charming and affordable neighborhoods, outstanding schools and a thriving arts community.

We offer highly competitive compensation, generous benefits and a career choice you will never regret. Leave the burnout and stress behind. We can design a work schedule around your needs and let you concentrate on what you do best – by taking care of patients. If you would lie to learn more please contact:

Dennis Davito Director of Provider Services

1230 East Main Street

Mankato, MN 56001

507-389-8654 dennisd@mankatoclinic.com

Physicians are a trusted source of vaccine information and advice. When the opportunities arise, it is important to be curious about the patient’s concerns and empathize. When we meet a patient “where they are”—not just physically but in terms of values and communication style— the level of trust will grow. It can be helpful to acknowledge how difficult it can be to process so much competing, often unreliable information from social media, the internet and other sources. Even something as simple as noting scientific facts, such as “you can’t catch a disease from the vaccine”, or addressing vaccine fertility concerns, such as reassuring patients that mRNA cannot be incorporated into our DNA, may be helpful.

Our research clearly identified physicians as a trusted source for information to help families make vaccine decisions and to keep the dialogue around them open. If you have personal experience of a patient or infant contracting a vaccine-preventable disease, it can help build trust to share these stories. It can also be helpful to encourage vaccinated patients to encourage their friends and families to do the same. These people can be powerful advocates, and everyone should remember that not getting vaccinated is not risk-free.

Sheyanga Beecher, CNP, MSN, MPH, is the medical director of pediatric mobile health at Hennepin Healthcare. She is a pediatric nurse practitioner with a Master of Science degree in Nursing and a Master of Public Health degree from Johns Hopkins.

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The Caregiver Stabilization Act from page 23

2022 demonstrated a staggering 2,000 patients who were eligible for discharge but unable to transfer due to lack of capacity in post-acute care settings. Other studies show children with medical complexity represent only 1 percent of the pediatric population, but account for an estimated 30 percent of pediatric health care costs and 86 percent of hospital charges in US children’s hospitals. However, only 2 percent of Medicaid spending is attributed to home health care. We can do better by investing in home care services.

While Medicaid and commercial insurance plans help with the financial burden, the economic and emotional costs are significant. Home care is not only the more cost-effective option for medically complex patients, but it also allows the family unit to be in an environment where everyone succeeds. When nurses are available at home, parents don’t need to sacrifice their career and split their time between hospital visits, work and home.

It is very important to see the Caregivers Stabilization Act move forward so that home care nursing will have the ability to competitively recruit and retain these exceptional nurses for our families in need and get these children at home where they belong. This bill addresses the critical flaw in a system that has undervalued the importance of experienced, knowledgeable and professional caregivers in a home setting and instead keeps children in the hospital.

Dr. Brooke Moore, a pediatric pulmonologist at Children’s Respiratory and Critical Care, understands how the home care nursing shortage is affecting not only the families, but the hospitals as well. She is advocating for change in hopes of turning the crisis around. “With the lack of home care nurses, it is difficult to send our medically complex children home where they will thrive when they are stable enough to do so,” says Dr. Moore. “This shortage has a ripple effect on the health care system. It’s keeping children in the hospital longer than necessary, and it’s preventing admitting other children who need specialized care due to space restraints in hospitals. We must be the voice for this change, so these children and families, present and future, can improve medical outcomes with quality care in a home-based setting by nurses who are compensated fairly and equally for the level of care they provide.

Working Together for Change

In a medically complex world, many advocates for those who are affected is the key to making sure their voices are heard and a sustainable change is made. Passing the Caregiver Stabilization Act will allow home care nurses to be recognized for the care and skill they bring as opposed to the environment where they practice. It will help children transition out of the hospital as soon as they are medically stable, ultimately saving valuable state healthcare dollars.

To support this critical legislation (SF 1830/ HF 2087), please contact your representative and senator to share the importance of this reimbursement increase. This topic has support in both the House and Senate, as well as from both political parties. Medically fragile children’s lives depend on these changes. Please reach out today.

results to date. As previously mentioned, physical therapy is often a first line intervention for patients. If psycho-social stressors are present, behavioral health consultation is warranted. Additional workup such as diagnostic tests and imaging will then be considered if indicated. Once this workup has been initiated, the pain physician can hopefully find the source of the chronic pain and begin interventions and allied therapies in a more targeted approach. This all happens concurrently with the patient working with physical therapy, seeing a behavioral health therapist, and optimizing a medication regimen along the way as indicated. A comprehensive pain clinic often has physical therapy and behavioral health specialists on site as a part of their practice and can offer a multidisciplinary approach to chronic pain under one roof.

A Focused, Intensive Approach

Many pain specialty practices offer a chronic pain program—an intensive, focused initiative designed for patients who may have exhausted their therapeutic options, are no longer seeking a specific diagnosis or additional interventions, and are simply living with chronic pain they are likely to have for the rest of their lives. Our program, and programs like it around the country, combine education with physical and behavioral therapy. Patients learn principles for self-management: quality nutrition, good sleep hygiene, smoking cessation, benefits of exercise in improving mental and physical health—basically how all the components of their own behaviors are going to help them manage their pain better and improve their quality of life.

These programs are usually quite intensive, with patients coming every day or several days a week for the duration of the program, which may be four to eight weeks in length.

Educating Patients and Setting Expectations

When we think of patients achieving relief from their chronic pain, we typically mean their pain has become minimal enough that it doesn’t unduly affect their daily life. Chronic pain is challenging to treat; the longer the body experiences a hyper-excitable state while in pain, the more the brain remodels and adapts to the chronic pain state. This phenomenon is known as central sensitization and can present as a vicious cycle which can be hard to break. Breaking this cycle is what a pain specialist’s care team works toward. A key part of chronic pain management is educating patients about their health and their options, making sure they understand time to therapeutic effects, setting realistic expectations for each modality and helping them play a positive role in their pain relief journey.

Today more than ever before, there are options that can help nearly every patient. Taking a multimodal, multidisciplinary approach gives us the greatest chance of achieving significant pain management and improved quality of life.

With more than 35 specialties, Olmsted Medical Center is known for the delivery of exceptional patient care that focuses on caring, quality, safety, and service in a family-oriented atmosphere. Rochester is a fast-growing community and provides numerous cultural, educational, and recreational opportunities. Olmsted Medical Center offers a competitive salary and comprehensive benefit package.

• Dermatology

• Rheumatology

What types of improvements to implantable devices are you working on?

Implantable devices have revolutionized the field of orthopedics by providing effective treatments for a variety of musculoskeletal injuries and diseases. However, there is always room for improvement when it comes to these devices, and we are actively working on developing new and improved implantable devices.

One area of focus for the lab is improving the mechanical characteristics of implantable devices. This includes load to failure, which is a measure of how much stress a device can withstand before it breaks or fails, and fatigue failure that occurs when a device breaks down over time due to repeated loading and unloading. By improving these characteristics, the lab hopes to develop devices that can withstand higher loads and last longer in the body.

In addition to these areas of focus, the lab is also working on developing new and innovative implantable devices that can provide better outcomes for patients. This includes devices that can be customized to individual patients, devices that can promote tissue regeneration and repair, and devices that can be used in minimally invasive procedures.

We are incorporating 3D printing into our research by creating implantable devices and surgical tools.

Overall, the lab is focused on developing implantable devices that are safer, more effective and longer-lasting, and that can provide better outcomes for patients with musculoskeletal injuries and diseases. By leveraging the latest advances in materials science, engineering and medical research, the lab is making significant contributions to the field of orthopedics.

How can physicians get involved with this new research facility?

A lot of doctors, and other healthcare professionals, end up finding personalized ways to care for orthopedic patients. Sometimes these innovations are viable improvements of standard best practice. These pioneers may want to share and develop their ideas, but do not have the resources or connections to move forward. We can provide assistance in these instances. Further opportunities exist around fine-tuning surgical and diagnostic skills, keeping up with the latest scientific advances, and even improving rehabilitation practices. We were designed to advance the field of orthopedic medicine and are here to collaborate with our colleagues in the field in any way that is possible.

Corey A. Wulf, MD, is a surgeon at Twin Cities Orthopedics with specialized sports medicine training. He played a key role in the development of the Twin Cities Orthopedics Bioengineering Lab.

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• Full-time position equaling 36 patient contact hours per week

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• Practice supported by over 17 FM colleagues and APC’s and over 50 multi-specialty physicians

• Subspecialties in – IM, OB/GYN, Ortho, Spine, Urology, Interventional Pain, Gen Surg., and many more

• Competitive comp package, generous sign-on bonus, relocation and full benefits

A physician-led organization, CRMC has grown by more than 50 percent in the past five years and is proudly offering some of the most advanced procedures that are not done else where in the nation. The Medical Center’s unique brand of personalized care is characterized by a record of sustained strength and steady growth reflected by the ever-increasing range of services offered.

3Privatized Medicaid and MinnesotaCare from page 16

Alice Mann and DFL Representative Tina Liebling, would restore to MA recipients the freedom to choose their doctor. SF404/HF816 is a very simple bill. It amends the statute that authorizes DHS to “develop criteria to determine when limitation of choice may be implemented in the “experimental counties” by adding this clause: “but shall provide all eligible individuals the opportunity to opt out of enrollment in managed care.”

There is obviously a moral and an economic argument for the freedomto-choose bill. The moral argument is that the legislature should never have forced MA recipients to choose between having health insurance and retaining their freedom to choose their doctor. Can you imagine the uproar if Congress had tried to do that to the elderly?

The benefit of SF404/HF816 to taxpayers should be obvious at this point:. If a substantial number of MA recipients were to leave the MCO MA program and enroll in the FFS MA program, that would create the “credible comparison group” (to use former DHS commissioner Goodno’s phrase) that DHS and other analysts need to derive a more precise estimate of how much privatization has cost the taxpayer.

Deprivatization, however it is achieved, will deliver at least two benefits to doctors. Returning the MA program to its original form—a public agency that reimburses all doctors according to the same FFS schedule— will eliminate differences in physician payment that are due primarily to differences in the negotiating clout physicians have vis a vis the MA plans they contract with. It will also restore autonomy over decision-making to MA patients and their doctors. A third possible benefit is an increase in MA reimbursement rates. That might happen if the legislature were to decide to allocate some of the savings from deprivatization to higher physician pay.

Last month, hearings were held on the public option and freedomto-choose bills in the House and Senate health policy committees. If one or both of these bills do lead at long last to a debate about the pros and cons of privatization, we can be sure the insurance industry will urge legislators and the public to adopt a double standard, one for the insurance industry and one for all of us who think privatization was a mistake. The industry will promote evidence-based health policy for critics of privatization, but will apply to themselves the bloviation-based, “because we say so” standard that brought us privatization in the first place. For any observers—legislator or non-legislator—who might find themselves confused by the debate about whether privatization saved money, I suggest a simple tie-breaker: support deprivatization on moral grounds. Forcing MA and MinnesotaCare recipients to give up choice of doctor in exchange for health insurance is just plain wrong.

Kip Sullivan, JD, is a member of the advisory board of Health Care for All Minnesota.

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