I just got back from a blog workshop at the Canyon Ranch Institute in Tucson, co-led by yours truly and the lovely and charming Kerri Morrone Sparling of SixUntilMe. We had a wonderful time with the locals, acquainting them with social media terminology, and teaching them how to blog and Tweet. We were also immersed in their culture, which largely meant that I lectured (for the first time in my physician career) in yoga pants, and enjoyed small portions of food rich in fruits and vegetables.
Despite the arid, inhospitable environment, the Arizona desert is teeming with life. Quail, rabbits, lizards, javelinas, humming birds and woodpeckers, bob cats and coyotes – all roam around freely near adobe homes nestled between flowering cacti. The extraordinary liveliness of the desert takes the casual visitor by surprise, and the variety of scrubby plants, aloes, and cacti of every imaginable shape, size, and pricklyness is a horticulturalist’s dream.
Since I was on east coast time, I was willing to participate in the 6:30am speed walks in the desert each morning. The lovely landscape inspired reflectiveness in the walkers, though I was somewhat distracted by the roaming hoard of javelinas (very large peccaries who resemble wild boars, smell like skunks, are virtually blind, and live to eat flowering plants). The javelinas had new babies with them – described by one Canyon Rancher as “footballs with legs.”
In between workshop lectures, Kerri and I were treated to some spa services – (regular readers know that I’m a huge fan of massages) which were welcome respites from our very busy work lives. But best of all, we got to spend some time with Dr. Richard Carmona (who attended our workshop), and we discussed how social media could be the key to inspiring behavior modification in Americans who need to eat more healthily and get more exercise.
As beautiful as the Canyon Ranch is, the healthy lifestyle it promotes won’t reach beyond its own walls if they don’t engage people in ways that fit their budgets and time constraints. Now that 70% of Internet users are engaged in social media, and Facebook, Twitter, blogs, and online support groups are growing exponentially, there’s never been a better time to find ways to reach people with disease prevention messages and strategies. As Washington gears up to support preventive health initiatives as part of healthcare reform, innovative non-profits like the Canyon Ranch Institute can play an important role in helping us get America back on track in terms of weight management and fitness. Online communities like SparkPeople or the Canyon Ranch Institute could be one avenue for change.
Of course, if you can afford to vacation in Arizona, the place itself has a calming, therapeutic effect. If that’s not in the cards for you, you can still emulate the lifestyle in your own javelina-free environment. As I take my regular walks back in DC, I’ll be sure to remember those cute little footballs with legs, and wear yoga pants as often as possible during future lectures (if the NIH looks at me quizzically next month during my NLM presentation, I’ll just blame Rich Carmona).
Merrill Goozner has been speculating about who will be nominated as the new Secretary of HHS. He reviewed his most likely candidates (David Cutler or David Blumenthal), and threw in a “dark horse” potential nominee: Ken Thorpe (whom I’ve interviewed several times on this blog and spent time with during Obama’s inauguration ceremony).
Tommy Thompson told me that the nominee is likely to be a current or former democratic governor (such as Kathleen Sebelius or Howard Dean).
But I’ve been pondering the “long shot” question and think that Goozner may have missed a more obvious choice – someone who works with Ken Thorpe at the Partnership to Fight Chronic Disease: former Surgeon General Dr. Richard Carmona.
Here are the 10 reasons why Richard Carmona would be a smart choice for Secretary of HHS (in random order):
1. He was confirmed by the senate as Surgeon General in 2002 and lived under their scrutiny during his term of service, meaning he has no hidden secrets, tax or nanny problems likely to embarrass Obama and could be confirmed rapidly – perhaps in under a week.
2. He has forged extensive good relationships with both parties over the course of his tenure as Surgeon General and is known internationally.
3. He has been the CEO of a large, public health system (including hospitals, Medicare and Medicaid clinics, nursing homes, and emergency medical systems in Arizona).
4. He has been a paramedic, nurse, and physician and understands the healthcare system from the inside out.
5. He has a track record of leadership in prevention, preparedness, health disparities, health literacy, global health and health diplomacy. He has worked on both sides of the aisle, including assisting Senator Kennedy with issues of disability and socio-economic determinants of health.
6. He is Hispanic, which adds additional diversity to the Obama leadership team.
7. He has experience managing local, state and federal health programs, including significant experience in immigration and border health issues.
8. He demonstrated competency and leadership as manager of the US Public Health Service of over 6000 uniformed public health officers both nationally and internationally.
9. He has extensive military experience, and is a combat-decorated Vietnam veteran. He maintains a strong relationship with military surgeons general and the department of defense.
10. The fact that he is a political independent might actually provide a middle ground for parties with differing agendas in health reform.
Is point number 10 a deal breaker? It may be, but Obama could look farther and do much worse. And while the clock is ticking and credibility is paramount (as Maggie Mahar wrote, “Reform needs to be overseen by someone who is perceived as being above suspicion—purer than Caesar’s wife”) I think the Obama/Biden team needs to take a closer look at Dr. Carmona. He’s actually the most experienced, low risk candidate under discussion – and could truly hit the ground running at HHS. And wouldn’t it be nice to have a physician who is also a health policy expert with advanced managerial experience at the head of the healthcare reform table?
Dr. Richard Carmona
I’ve interviewed Dr. Richard Carmona (the 17th Surgeon General of the United States, and former EMT, nurse, and surgeon) several times on this blog and have been intrigued by his insights and approaches to health. In our most recent interview, he discussed obesity from a provocative new angle: national security.
Dr. Val: What do you mean that obesity is a national security issue?
Dr. Carmona: There are many competing interests on Capitol Hill – the war, the economy, etc. and obesity is something that just doesn’t get enough traction. When I was serving as Surgeon General, I realized that obesity was acting as an accelerator of chronic disease and was the number one health threat to our country. But after several failed attempts to get attention focused on this issue, I realized that I had to present the message in a unique way in order to get it to resonate. It occurred to me that if I used different language to describe the threat, people would allow me to connect the dots and explain the problem fully.
Retaining EMS, police, firemen, soldiers, sailors, and airmen has been challenging because many of them can’t pass their physical fitness tests due to obesity and sedentary lifestyles. Health is therefore inextricably tied to national security. Describing the health threat in these terms helped legislators to understand the complex ramifications of the condition.
Dr. Val: How rigorous are these fitness tests? Are we talking about soldiers not being able to run a 5-minute mile, or is it less challenging than that?
Dr. Carmona: The fitness tests are based on research from the Cooper Clinic in Texas and include a measure of aerobic capacity, strength, and flexibility. There are standardized minimums based on gender and decade of age, and although I don’t have the exact minimums memorized for each age group, they’re very reasonable. We’re not talking about having to run a 5 minute mile. More like having to run a mile and a half in 15 minutes or having the flexibility to touch your toes in a seated position. As far as push-ups are concerned, the qualifying range is about 20-45.
Dr. Val: One of my blogger friends relayed a story recently about a surgeon who asked his hospital cafeteria to serve healthy options instead of fried food. They responded that no one would buy the healthy food and they’d go out of business – so economic necessity required that they continue to serve unhealthy food. What would you say to that surgeon?
Dr. Carmona: I’d invite that surgeon to come out to Canyon Ranch where we serve healthy gourmet meals every single day. Our chefs are very innovative and entrepreneurial – they make healthy food taste delicious, and at a cost-effective price. Americans need to learn how to make healthy food delicious. My friend Toby Cosgrove is a surgeon at the Cleveland Clinic, and he was able to spearhead a healthy food initiative there that has been very successful. We strive to find new and creative ways to prepare healthy food at Canyon Ranch – and are always coming out with new recipes and cookbooks to keep people interested in healthy eating.
I caught up with Dr. Carmona at the STOP Obesity Alliance briefing about the new GPS (Guide for Policy and Program Solutions) initiative. Please click here to learn more about the STOP Obesity Alliance.