Thursday, April 29, 2010
A great appointment by Obama

By Dr. Anthony Policastro

A little noticed presidential appointment is one that President Obama announced last week. He has selected Dr. Don Berwick to be the new head of the Centers for Medicare and Medicaid. Don Berwick is a name that few people know, however, I am very familiar with his body of work. As you know from reading my columns, my feeling is that health care reform will not work if the system is not fixed. The government funded Medicare and Medicaid programs are the largest insurance companies in the country and the best place to start is with fixing them. In August 1989, I became the commanding officer of the Air Force Hospital at Langley Air Force Base in Virginia. My goal was to make the hospital the best that it could be. I was there for six years. Four of those years the hospital was recognized as being in the top 10% in the Air Force by earning consecutive Outstanding Unit Awards. Six months after I left, the Air Force IG team gave the hospital the second highest rating in its history. While it would be nice to take the credit for that success, I can't really do so. The credit belongs to the men and women who made things happen. The guidebook that I used as the blueprint for the effort was called "Curing Health Care," by Dr. Don Berwick, which was published in 1990. Dr. Berwick created a road map for improving the way we do business in medicine. He looked at processes and worked to make them better. The focus was changed from finding someone to blame to finding what was wrong with the processes involved. My mantra became, "What's wrong with this process?" It improved accountability and it had individuals finding better ways to do things. Our suggestion program had over 100 suggestions a year and 75% of them were implemented. Most of those were changes that occurred within 72 hours of the suggestion. After he wrote his book, Dr. Berwick went on to form the Institute for HealthCare Improvement (IHI). They now serve as national and international consultants in health care. Dr. Berwick's vision for health care is an adaptation from the Institute of Medicine's six improvement aims for the health care system. Care should be safe, effective, patient-centered, timely, efficient and equitable. IHI calls this the "No Needless List":

  • No needless deaths
  • No needless pain or suffering
  • No helplessness in those served or serving
  • No unwanted waiting
  • No waste
  • No one left out
These are the kinds of principles that we need to see throughout our health care system. These are the kinds of things that Dr. Berwick can help foster in our government centered medical services.Hopefully, the partisanship in Congress will do nothing to sidetrack what to me sounds like a brilliant appointment.

New York Life reinstated In a move that will allow nearly 100 state employees to keep their life insurance coverage, State Treasurer Velda Jones-Potter and State Insurance Commissioner Karen Weldin Stewart confirmed the reinstatement of New York Life as an approved vendor for the State of Delaware's 403(b) program solely to service existing life insurance policies. New York Life first joined the state's 403(b) program in 1978. In January 2009, newly adopted IRS regulations went into effect, forcing 403(b) plan sponsors to adopt a Plan Document, identifying the State Treasurer's Office as the Fiduciary of the plan. New York Life, at the time, was unable to comply due to some system capability issues. The State Treasurer's Office, Insurance Commissioner's Office, and New York Life worked together to develop a grandfathering provision to allow pre-tax contributions to flow to vendors provided that these pre-tax contributions are the only allowable means for paying life insurance premiums under 403(b) coupled life insurance policies.

Wellness Program funding available Obesity, which is the second most preventable cause of death in the U.S., has reached epidemic proportions. The Delaware Division of Public Health (DPH) announces that a two-year funding opportunity is available to support two Delaware municipalities in implementing a sustained approach to healthy eating and active living. The Municipal Wellness Leadership Program assists with planning, assessing, initiating or expanding environmental systems to support healthy lifestyles. To apply, municipalities led by city/town mayor or management must be able to mobilize a partnership that includes representatives from schools, businesses and municipal, governmental, faith-based and community organizations. The deadline to send responses to this grant is June 15, at 11:30 a.m. A pre-bid meeting is required. The meeting will be held on May 11, at 10 a.m. at Delaware Health and Social Services, Herman Holloway, Sr. Social Services Campus, Main Administration Building, Sullivan Street, 1st Floor, Room 198, 1901 N. Dupont Highway, New Castle. All bidders must be present on time at this mandatory pre-bid meeting. For more information, contact Michelle Eichinger at 302-744-1011.

Bayhealth sponsors stroke seminar Stroke is the third leading killer and the top cause of disability in the United States. Bayhealth Stroke Care Coordinator Dawn Fowler, MSN, RN, PCCN, will join Bayhealth Neurologist Joel Rutenberg, MD, during Bayhealth's upcoming Stroke Seminar, Wednesday, May 19 and Thursday, May 20. Dr. Rutenberg will lead a discussion about prevention and treatment for stroke, while Fowler will provide insight on how strokes impact entire families. The seminars will be held on the following dates and times: Wednesday, May 19, 5-8 p.m., in the Board Room & Conference Center at Milford Memorial Hospital, Milford. Thursday, May 20, 5-8 p.m., in the General Foods Conference Room at Kent General Hospital, Dover. For more information, visit or call 302-744-6584.

Chickenpox in Sussex County Delaware's Division of Public Health (DPH) advises families that at least five cases of Chickenpox (Varicella) have been confirmed in the Delmar Middle and Delmar High Schools. A child diagnosed with Chickenpox on April 17 brings the total number to five cases, meeting the official definition of a chickenpox outbreak. All students diagnosed with Chickenpox have recovered or remain at home to reduce the spread of this illness. DPH is working with school officials to monitor the cases and prevent spread of the illness. Chickenpox is generally not a serious disease and there is no specific treatment. Chickenpox is spread through exposure to infected fluids from the nose, throat, or skin rash of someone with the chickenpox. Parents should look for symptoms that include aches, fever, fatigue, irritability, sore throat and an itching, blistering rash. The itching can be controlled by cool baths, dabbing the spots with calamine lotion, and avoiding spicy, acidic or hard crunchy foods that may irritate mouth sores. Aspirin should never be given to children with Chickenpox who are less than 19 years of age. Recovery time is usually between five to 10 days, or when the rash has scabbed over. Children can be vaccinated usually between the ages of 12 to 15 months. A booster shot is recommended at 4 to 6 years of age for further protection. People age 13 years and older who have never had Chickenpox or received the Chickenpox vaccine receive two doses of the vaccineat least 28 days apart. The vaccine is very effective, with eight to nine of every 10 people vaccinated becoming completely protected.

Free diabetes program On May 3, from 11:30 a.m. to 1 p.m., the Laurel Public Librarywill host a free Lunch and Learn for people with diabetes and their caregivers. The presentation will cover: a basic understanding of the disease; typical healthcare needs of a person with diabetes; meal planning as a critical component for diabetes management; supplies and equipment required for diabetes care; importance of physical activity in diabetes management; local, state and federal resources to help control diabetes; and communicating effectively and keeping good records. Bring a light lunch. Bottled water and healthy snackswill be provided. Pre-registration is required. For more information and to register, call 877-3184.

Stroke and osteoporosis screenings Residents living in and around the Blades community can be screened to reduce their risk of having a stroke or bone fracture. The Blades Town Hall-Hardin Hall will host Life Line Screening on May 17. The site is located at 20 W. Fourth St. in Blades. Appointments will begin at 9 a.m. For more information regarding the screenings or to schedule an appointment, call 1-877-237-1287 or visit our website at Pre-registration is required. Life Line Screening was established in 1993, and has since become the nation's leading provider of preventive screenings.

Lunch and Learn about diabetes The Sussex Child Health Promotion Coalition Diabetes Prevention and Control Program will hold Lunch and Learns throughout Sussex County for individuals with diabetes and their caregivers. Participants will learn more about diabetes and how to manage the disease. The following area lunches are scheduled:
  • Clarence Street Church of God, Seaford - Thursday, May 20, 11:30 a.m. - 1 p.m. To register, contact Pastor Cannon at 629-9443 by May 14.
  • Laurel Public Library - Monday, May 3, 11:30 a.m. - 1 p.m. To register, call 875-3184.
  • Delmar Public Library - Thursday, May 20, 11:30 a.m. - 1 p.m. To register, call 846-9894 by May 14.

5K benefits Breast Cancer Coalition The Delaware Breast Cancer Coalition announces its First Annual DE-Feet Breast Cancer 5K Run/1M Walk sponsored by Tanger Outlets will take place on Sunday, May 2, at 9 a.m. The 3.1 mile course will begin and end at Applebees restaurant at Tanger Outlet Center, Rehoboth Beach. The family event is open to runners and walkers of all ages. All proceeds from Tanger's DE-Feet Breast Cancer 5K/1M will benefit the Delaware Breast Cancer Coalition (DBCC). Advanced registration, which is recommended, is $20/person. On-site registration is $25/person, beginning at 7:30 a.m. on race day; and the first 100 people registered receive a long-sleeve T-shirt. There's even a "Sleepwalkers" category for those who are unable to attend but want to show their support. Sleepwalkers simply register for $20, check the "Sleepwalker" category and then sleep in on Sunday. To register, visit or

Registration open for Walk MS Registration is now open for this year's Walk MS season in Delaware. Organized by the Delaware Chapter of the National Multiple Sclerosis Society, the goal is to raise awareness and funds for the programs and services needed by more than 1,500 Delawareans with MS and their families. Each of the five events takes place on an accessible 5K route, and plenty of support is available as well as the opportunity for lots of fun with family and friends. Two events take place in Sussex County:
  • Walk MS: Twilight at Heritage Shores steps off at Providence At Heritage Shores, One Heritage Shores Circle in Bridgeville, on Friday, April 30, at 6 p.m.
  • Walk MS: Twilight at Baywood Greens steps off at the Baywood Greens Golf Course, 32267 Clubhouse Way in Long Neck, on Friday, May 21, at 6 p.m.
Day-of registration begins one hour before the event. For more info or to register, call 655-5610 or visit