It took some convincing for leaders at Tucson Medical Center to invest in a program that aims to put hospitals out of business.
But they took the plunge, reasoning that they should no longer be in the hospital business anyway. It's the 21st century. Tucson Medical Center needs to be in the health business, and that is an entirely different world from the hospital business, they say. The business model of putting heads in beds and taking care of sick people is changing.
To that end, the hospital has entered into a partnership with the Canyon Ranch Institute, which is the nonprofit arm of the upscale local Canyon Ranch resort. While the joint effort will be modeled after a 12-week "life enhancement program" that Canyon Ranch Institute operates in other places, including the Cleveland Clinic and the local El Rio Community Health Center, the Tucson Medical Center effort will mark the first time the program will be extended to families with young children.
The aim is to improve health literacy and inspire behavior change that will last a lifetime. The long-term result officials hope for is preventing chronic diseases such as diabetes, cardiovascular problems and obesity, which are draining the country's health dollars and keeping a steady flow of patients needing hospitalization.
The Canyon Ranch name is often associated with luxury and high expense, but the life enhancement program is free and aimed at low-income people.
The program is evidence-based and has been proven successful in other communities, including the South Bronx in New York, Canyon Ranch Institute officials say.
The results are measured by bloodwork taken at the beginning of the program that is then compared with follow-up bloodwork testing three months and a year after the program ends, said former U.S. Surgeon General Dr. Richard Carmona, who is vice chairman of Canyon Ranch and president of the board of the Canyon Ranch Institute.
The follow-up testing has consistently shown reductions in stress, depression, cholesterol and in C-reactive protein levels, which are found in the blood and rise in response to inflammation, he said.
"Most chronic disease results from inflammation in the body," said Andrew Pleasant, who is Canyon Ranch Institute's research and health literacy director. "We are getting people to move their body more. They've changed the way they eat and drink. They drink more water and a decreased amount of sodas, which is perhaps more significant. They are statistically significant changes."
The program requires a three-hour weekly time commitment, and those who participate have personalized attention from about 10 hospital staff members from different disciplines, including a dietitian, pharmacist and registered nurse. Sessions are operated in groups who often form lasting connections through joint activities like exercising together.
Leaders say it is part of an inevitable transformation in health care, where patients will have the community support to lead healthier lives. It may take a generation or two to stick, but it has to happen or else the country's expenditures on health care could eclipse 20 percent of the gross domestic product, Carmona says.
Tucson Medical Center board members were initially reluctant about the joint venture, since it costs money in staff time.
"It really took us a long time to think it through, to really understand the implications," hospital president and chief executive officer Judy Rich said. "The concerns were, are we going to just take some staff, teach a program and send them out and have it be another program, another flavor of the month? … We have a lot of finance people on our board and they have a fiduciary responsibility."
Another concern was that the program's ideal result is fewer hospitalizations, which means less volume and revenue.
"Our board is 100 percent behind this but boy, we have spent many hours doing the analysis of what the tipping point is," Rich said.
But the program is actually continuing a direction Tucson Medical Center has already begun. It recently added a "director of wellness" to its staff. That director, Mary Atkinson, works at fostering exercise, healthy weight and healthy eating among employees. Now her job is extending into the community, too.
"There's an argument for having a director of wellness for your own self-insured employees. We pay first dollar for every employee who gets sick," Rich said. "How do you make it for everyone who we are not paying first dollar for? In fact, it is quite the opposite. I am getting paid to take care of them.
"Every decision we make going forward says we will not add beds. We believe in the future we won't need as many beds. We have semiprivate rooms and no one wants to be in a semiprivate room, so we are going to privatize our rooms, which is an acknowledgement that our business is going to be different."
The partnership has done a trial run with 14 adults. Atkinson is trying to put together two classes for late summer and fall with a total of about 50 adults and children.
"We take a small step approach. People come in and say, 'I want to lose 50 pounds.' And we say, how about one?" Pleasant said. "They will take that small step. It feels good, and you want to do it again. It's that reward they get in their lives that makes it sustainable. The more you do, the better you feel."
Ovarian cancer survivor Jean Darland was in the 14-member trial group and said she was not very excited to participate. She has back pain and arthritis in her foot, among other things. She felt weak and unmotivated. She set a goal with each Tucson Medical Center staff member and is now walking regularly with other group members.
"I came home feeling happy and I hadn't felt happy in a long time," said Darland, 71. "I think I have a chance of feeling healthier. If people want to improve their lives, there's a way to do it - with help and people who care if you do it."
Carmona predicts that shifting hospitals to doing more outpatient and education work is a good health and business decision.
"You have to develop a different economic model," he said. "We can't afford to continue on this trajectory. We have to drive preventable disease out."
How to take part
Tucson Medical Center is putting together two upcoming Life Enhancement Program classes. Individuals and families with children ages 5-9 who are interested in participating should call Mary Atkinson at 324-5227 or email firstname.lastname@example.org .
Contact reporter Stephanie Innes at email@example.com or 573-4134.