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North Shore-LIJ Health System President and CEO offers keynote address at Health Expo

SIEDC's Fourth Annual Health & Wellness Expo

Held on September 27th at the Hilton Garden Inn, Staten Island Economic Development Corporation's (SIEDC) fourth annual Health & Wellness Expo included informative seminars, medical screenings and fitness demonstrations designed to educate Staten Island residents on ways they can improve their health. Staten Island University Hospital was one of the leading sponsors of the event. Michael J. Dowling, President and CEO of the North Shore-LIJ Health System, opened the daylong conference with a thought-provoking keynote address.

Focusing on healthcare reform, Dowling stressed the importance of staying positive amidst the heated national rhetoric. He asserted that the challenges we face as a nation are due to our successes not our failures. In the past 100 years, modern medicine has extended life by more than 35 years. As people live longer and technology advances, the costs of care inevitably increases. Healthcare will need to expand and change in the future, fueled mostly by the demand of over 72 million people that will turn 65 by 2030. This healthcare reform will not be simple, and may never be fully resolved.

As wellness information and medical innovation grows, so will the national dialogue regarding the topic. Dowling believes the future of healthcare (discourse) will revolve around the following eight topics.

Who should be covered? Healthcare reform must identify the scope and scale of the population that will receive coverage as well as the optimal benefit package.

How much should we spend? The dialogue will always focus on the dollar amount allocated to each individual patient. What is too much or too little?

Are we getting quality care for the amount we pay? Dowling argues that better outcomes are worth the cost and that there should be a direct relationship between patient outcomes and pay.

Where should healthcare be provided? The future of healthcare delivery will change dramatically.  In the future, patients will receive more advanced care in ambulatory care centers, outpatient practices, and even at home. Hospitals will continue to provide specialized care, but the scope and scale of services offered outside this traditional clinical setting will vastly expand as telemedicine innovates. Family caregivers will need to be trained to provide these enhanced home care services.

Who should provide the care? Nurse practitioners are the future of healthcare. They are trained to provide the same level of care as Primary Care Physicians. They can practice independently and have the ability to treat patients, diagnose illnesses, and write prescriptions without the supervision of a doctor. The focus will shift from MDs to other conventional and holistic care providers.

How can health promotion be integrated in to medical care? Dowling believes that the traditional model of hospital compensation should change. He suggests that hospitals and healthcare systems be paid for managing populations and keeping people healthy, as opposed to only receiving compensation when patients are hospitalized.

Who should be held accountable for our poor lifestyle choices? What is the role of individual responsibility (versus the food industry's culpability with their inclusion of salts and sugars)? 70% of illness is due to lifestyle choices. Childhood obesity is a huge issue that will lead to additional financial burden in the future. Dowling believes that it is our collective responsibility to ensure that all Americans maintain healthy, active lives.

How does the environment affect our wellbeing? Dowling believes that there is a direct relationship between people's health and where they live.

Staten Island has unique health challenges. It is an island of two populations, the north and the south. There is a high morality rate associated with heart disease and cancer. 28% of the population is obese. However, there have been successes. Smoking rates on the island have decreased dramatically. Dowling believes that forums, like SIEDC's Health and Wellness Expo, are critical to improving other health indicators as well as advancing the health of the island.

In closing, Dowling challenged Staten Island to become the healthiest borough, explaining that this can be done with better access, education, diversity and the formation of a collation of providers dedicated to making people healthy. He calls for a public health initiative where hospitals and healthcare professionals work together. Dowling believes that, "Health reform must happen on a local level, we can't wait for Washington or Albany to fix it. We must take charge locally."

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