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The first arm was doing research, both clinical trail research and quality of life. So we have both research arms there. Then in-patient and out-patient services, which is a command center for all of my administrative activities plus a four-room clinic.

Delivering in-patient/out-patient services in an acute care facility like Columbia, or any place like it, we're not going to illicit a lifestyle change to anybody because we only have patients for five to seven days. All we can hope to be is a very effective wake up call. That there are potentially different things that can help people but they, not us, need to learn them. To be empowered to utilize them for the long haul. So with that said, how do we know they're going to keep doing it?

Many patients, when they experience our different techniques, have an epiphany. They say, "Wow. Where can we get this when we leave here? In a medically supervised environment so we can make sure this stuff is safe, and be nurtured along for the long haul?" As we know, it takes time to shift your lifestyle. Many of the people who leave our hospital still are sick and they need care. So that was my concept of the After Care Wellness Center; to actually refer people to these different locations so they can get nurtured along, so we can continually collect the data. To figure out what are the not just short-term benefits but what are the long-term benefits. And more importantly, are people complying with what's being offered to them? As we know, in our age in the United States, our culture is not one of compliance for the long haul. Look at our health clubs. We all make promises the first of the year, but we fall off the wagon two or three months into it after we've put down many hundreds, possibly thousands of dollars for lifetime membership. So, The After Care Wellness Center completed that loop, and we can keep collecting information.

The fourth division is the data warehouse. To be able to collect this information, not just from the in-patient side and not just from the out-patient side but also to partner with other facilities across the nation. To make some sense out of what is working, to what degree, what are the cost-benefit ratios? This is evidence-based outcomes now. Clinical trials are needed, they're costly, they take years before you answer one question. My thought process is that this database could help us query the information so we could look at the trends that ultimately -- if there's something trending in the right direction -- we can drive clinical trials so we can be more effective in doing it.

LD: Are you going to make that information available like in a newsletter or on the web, or are you still gathering?

JW: That information I continue gathering but ultimately the main goal is to partner with insurance companies, HMOs and third parties because we're an aging population and we have an increase in chronic illness. If we don't give them information that makes sense to them -- in a business model as well as a clinical-evidenced outcomes model -- this movement is not going to get out of it being for the affluent, because that's all the movement is right now. What do we do when Mrs. Smith, who doesn't have any money do you tell her she can't have a massage when the person next to her has insurance or can afford it out of pocket? That tears my heartstrings, and I've been in that position too often. So who's going to reimburse for this stuff? Who's going to pay for this stuff? And our health care crisis isn't with the affluent who have the ability to change. Go to the emergency rooms.

LD: A patient at Columbia now, say they're a heart patient about to go into heart surgery, is the complementary care part of the package or how does that work?

JW: No, it's a fee for services. Let me give you the last one and then I'll jump back into that. The last division is education. To educate the patient as to what is real and what may not be beneficial to them. Depending upon where they are, many of these modalities could potentially cause harm. Even basic massage, with an ill patient. If I go back to hearts for a second, diabetic patients -- which is about 50% of the heart patients -- have problems with coagulation and they also have stasis in blood vessels. They have clots in their legs, many of them. If you have an ill-trained massage therapist go bounding into a patient's room and start massaging the patient's legs because they're having any sort of discomfort in their legs -- you can dislodge that clot. It goes to the lungs and you could have a dead patient on your hands. There's contraindications to these non-invasive modalities! So to educate people as to what has value, what doesn't, and when. Also to tell the family members at the same time what's good and what's bad because when the patient leaves the family has got to be on the bandwagon too, nurturing this person back to health.

I find it interesting when I talked to nurses who've been trained after the year 1980, I discovered that few of them even know that massage is in their licensur, that it's legal do, for free. Isn't that interesting? That's scary. So, the allied health professionals need to be educated on what they can do, deep in the trenches, with very simple techniques that can make a profound response in patient care -- without a fee. Basic breathwork, basic touching. These are basics. For free!

So then the clinicians need to hear it a little differently and then the administrators of the hospital. Going back to your question of what do we provide our patients and how does it get paid for -- it's not part of covered service. This is separate from the institution.

LD: But the goal is to...

JW: The goal is to...right now the institution is not giving me one dollar for this. I've got 18 years worth of international business experience and knowing that, wanting to float a "spec" like this -- that we call the Complementary Care Center that turned into a department... if you ask an institution, "Hey I want you to fund this," the first thing they're going to say is, "Well, why?" So if you come forth and say, "Oh, it's great, it'll provide patient comfort, it will deal with quality of life issues..." And then they say, "Well, where's the substance?" The substance really isn't there yet to substantiate our existence. Yes, the data is coming forward but the reality of it is, if we cannot substantiate cost-benefit ratios, a business model, as well as basic comfort to patients and care -- that quality of life could increase -- they're not going to fund it.

To develop the infrastructure, to develop a model of something that's never been done before in an acute facility like we've done is very, very costly. And the institutions are going to say no. And they're not really going to give you space to work out of because they think it's a spec. What do you do? Well you either don't do it or you do like I did. I knocked on a philanthropist's door. A donor who wants to remain anonymous, who listened to the dream of mine, of the five components. He heard one thing. That it had to do with caring for patients and for people.

LD: Wow. That is amazing.

JW: Yeah. So what is the greatest form of giving? Giving from your heart without asking for anything in return. And that's virtually what this group has done. The only thing that they want is that they want this to succeed. They know that the cost of developing something like this is astronomical. So they gave us the breathing space. They took us off the respirator, so to speak, so we can create the infrastructure. It will make this not just a great way to deliver care, but at the same time, how do we make this cost effective so it stays in business for the long haul?

LD: With the evidence there...

JW: With the evidence, as well as, can we make sure that we open this up so all people, of all ethnicity and all backgrounds, no matter if they're rich or poor, can receive these services?

Many people, organizations, hospitals are coming into this movement because they see it's a trend, they see it's a market and they want market share. They want to ring the register. Well where's the patient and client who's dying in pain in that model? I've seen three of these places go forth with great intent, they're out there marketing, pounding the pavement, getting referrals. After three years, they say, "Ahh, this is costing too much money," and they shut it down. You know what the patients felt like? Abandoned, hurt and all of their disease processes, their signs and symptoms, came back and manifested themselves worse than they were before. To me, that's a disservice!

Ultimately, it's really to make this here for the long haul. That's the goal. Not just to ring the bell or the register, but really, how do you transform health care, the delivery of it, so it does two things: it maximizes the patient quality care. It meets the patient where they need to be met. It meets their needs and goals, as well as making it financially sustainable. Now, that's a trick.