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Camden Coalition: Kathleen Noonan
30 Plays2 months ago
Season 4, Episode 2: Kathleen Noonan is president and CEO of Camden Coalition which seeks to improve the health and well-being of people with complex needs. Listen to Kathleen discuss ecosystems of care, regional health hubs and Camden Coalition's Housing First program.
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Transcript
Introduction to The Wound Dresser Podcast
00:00:09
Speaker
You're listening to The Wound Dresser, a podcast that uncovers the human side of healthcare. I'm your host, John Neary.
Guest Introduction: Kathleen Noonan
00:00:21
Speaker
My guest today is Kathleen Noonan. Kathleen is president and CEO of Camden Coalition, which seeks to improve the health and well-being of people with complex needs. She previously worked at Children's Hospital of Philadelphia, where she co-founded the Policy Lab at CHOP to connect clinical research with real-world health policy priorities.
00:00:40
Speaker
Kathleen Noonan, welcome to The Wound Dresser. Hello, thanks for having me. so I'd like to start by asking you about the the mission and vision of the Camden Coalition.
History of the Camden Coalition
00:00:52
Speaker
ah what What is the Camden Coalition and what do you seek to do at your organization? So the Camden Coalition is about 20 years old. ah We started in Camden, New Jersey, just as a breakfast group with Jeff Brenner, who was a ah physician, private practitioner at the time, and some other ah practitioners from Cooper University Healthcare, care ah some community groups, and really just focused on the fact that their care for patients
00:01:27
Speaker
who had very complex health and and social needs, ah felt like it wasn't really doing a damn bit of good. um They were going into the hospital. So they sort of cooked up the idea of um helping people outside the hospital to maybe keep them out, to keep them from the hospital. You had to help them outside the hospital and help them not just with health, but with other issues. And so 20 years later, we are an organization that has focused on care management and care navigation for the most complex people um with you know two to three chronic health conditions and and and social issues, substance use. But we also have become really expert at the system it takes to actually ah help people. And so I would say we're now an organization that focuses on sort of helping people with complex health and social needs directly, but then also helping other providers and systems with policy, data, advocacy to support all those issues.
00:02:42
Speaker
Yeah, I saw on your, your, I was looking through your website preparing for the, this episode, which is a great website, by the way. And, um, I saw that you currently kind of have 12 ongoing programs. Could you kind of summarize, like, what are the different focus areas of those different programs?
00:02:57
Speaker
Sure.
Addressing Healthcare Gaps
00:02:58
Speaker
Yeah. I mean, our from the beginning, we've always focused on not being just a traditional provider because there are so many good providers, but instead to really focus on gaps and to potentially demonstrate a gap and then ah basically push it out um as something that other providers will do, not just in South Jersey, but around the country. And so I'd say, you know, in 2007, when we started a program that was a nurse and a community health worker and a social worker, you know, not everyone was doing that. And now that's a very commonplace thing. And so our work isn't focused as much
00:03:43
Speaker
on that team anymore because there's a lot more care management support. And instead, our programs are focused on things that we don't see in the system. So supporting um women who are pregnant in OBGYN offices that don't offer substance use treatment. um Helping people with legal services embedded in substance use or behavioral health, mental health clinics um to connect them to care. um
00:04:18
Speaker
helping um women who are substance using during pregnancy um to be as healthy as they can um and to have healthy births. So we really focus on gaps in the system and then try to syndicate that practice around the country.
00:04:39
Speaker
I'd just like to take a second to define some terms that I think you've already, some of them you've already used for like, first off, like complex care. Like how do you define that?
Integrating Complex Care
00:04:48
Speaker
So complex care is care that is that brings together both ah health physical health um care, and typically it involves um mental health or substance use care, but then also care that integrates what um a person's social needs are.
00:05:13
Speaker
So are they in stable housing? Do they have, um are they trying to work and they can't work? And so they don't have access to um health insurance. Are they, um can they get to where they need to get to for health appointments, for work appointments? So, you know, one of our earliest clients, we have a picture of him was a young guy who had some substance abuse issues, but also the physical health issues that come from sort of trying to manage your substance use on the street. And we asked him, and we did it in a very sort of, you know, ah traditional way, just asked him to write down what his needs were. And number seven was substance use um support. But number one through six was ID and help with a social security number, and help with employment, you know, he really couldn't even get himself to the point of accepting substance use treatment until he had the things he needed to be stable.
00:06:22
Speaker
And so that, you know, was an important insight for us into, you know, how we, how we could help. And so complex care takes all those things into consideration.
00:06:33
Speaker
Yeah, that's quite eye opening. You'd think someone who has a ah substance use issue, that would be, you know, really close to the top of their list. But um I guess realistically speaking, you know, there are a lot of things that need to be put in place before they can get the care they need for that. Well, if youre if you are if you are ah living on the street with a substance use issue or serious mental illness,
00:06:55
Speaker
you might've picked up some kind of petty citation that resulted in a bench warrant and then you didn't show up. And so your civil issue is now a criminal issue.
00:07:08
Speaker
um And so you can't even qualify for a lot of benefit support with that, those things on your record. And so, you know, you literally cannot get the help you need until you have some of that stuff cleaned up. And, you know, that's what we've tried to focus on is what are those gaps still that prevent people from getting the help they need?
00:07:35
Speaker
Two other terms i I saw that your organization uses a lot are care management models and
Exploring Care Management Models
00:07:43
Speaker
ecosystems of care. Could you talk about like, are those ah similar overlapping terms or or how they differ?
00:07:50
Speaker
Yeah, they are. They are different terms. So care management models to us. um are how we started. So our model in the beginning was a very intensive, hands-on, relational model. We still believe in those models and have evidence, not just from us, but from others, that those models really support connecting people to care.
00:08:14
Speaker
um and And those models are, a it could be ah a team, a nurse, social worker, doctor, um community health worker. It could be just a community health worker, but um it could be on the ground, face-to-face. It could be telephonic. I mean, there are a lot of different care management models now, but they're really a model where a person or team ah is helping someone sort of navigate the health care that they need and social care as well.
00:08:47
Speaker
An ecosystem of care is really that a whole system that's needed to help someone. I mean, the United States is, um we believe that the Camden Coalition is ah is a country that has really great point in time um sort on-site health care.
00:09:08
Speaker
But that healthcare actually, and the effectiveness of that healthcare is actually diluted by weak ecosystems. And so the person might get a referral to outpatient care maybe outpatient care outside of the health system that they're working with, or they might get a ah referral to some social care support or to some home support. And we really have very weak connections between all of those um parties.
00:09:41
Speaker
And so because of that, the really good healthcare that someone might've received in a hospital setting, for example, is diluted um because the system around them um is so weak.
00:09:56
Speaker
And so that's what we mean by an ecosystem of care. And the the last term I'm curious to define or to hear more about is regional health hubs. um As I understand, it's related to like information sharing, but um yeah, if you could tell our listeners more about that.
Strengthening Healthcare Ecosystems
00:10:12
Speaker
Sure. So um in 2020, Governor Murphy signed legislation making New Jersey one of only just a couple of states, I think, that um it it basically has ah nonprofit organizations. The Camden Coalition is one of four organizations.
00:10:31
Speaker
In New Jersey, there's also one in Newark and Trenton and Patterson. And um we basically serve as partners to the state Medicaid program. And as partners to the state Medicaid program, we all run regional health information exchanges, which basically strengthen that ecosystem I talked about.
00:10:55
Speaker
by being able to connect ah health and social care partners all together on a data exchange. um Because not everybody has Epic, which is the most ah popular and probably expensive electronic health record to have. Most providers outside of big health systems can't afford that.
00:11:20
Speaker
um And then the regional health hubs also help with connecting directly to Medicaid members. And so making sure that they understand ah the benefits that they have, helping if they are at risk of disenrollment, um helping them get COVID shots during the the the COVID, um the pandemic, a lot of different things um to support the the Medicaid program. I mean, the Medicaid programs in a lot of states now are really run through managed care entities. And so the state is much more further removed from the ground
00:12:01
Speaker
and providers because they contract with managed care entities and those managed care entities um really are the conduit to providers and and and Medicaid members. And so the four nonprofits are a way for the state to have ah ah ah a closer and a quicker connection to the ground.
00:12:23
Speaker
Yeah, it's, it sounds like, you know, a lot of what you do really at the its core is like trying to get different like parties that that can help patients like communicate with each other. And you know, I guess there's, there's healthcare, care there's public health, there's social care, housing, education.
00:12:40
Speaker
um And like, I feel like sometimes it's even hard to like communicate within like hospital walls, like just, just within one institution, it's hard to communicate. So like, what have you found that's worked?
Improving Communication for Patient Care
00:12:51
Speaker
I guess probably, you know, some of the the things we've already mentioned, but like what, what has worked to like get all those different parties to communicate with each other so complex patients can get the care they need?
00:13:02
Speaker
Yeah, well, I think that, I mean, I was at, I'm ah a lawyer and a policy person, and um i I did work at the Children's Hospital of Philadelphia. And i I think that there's a lot of work that's happening, you know, within hospitals and certainly some, I think, good tested tools on how within the hospital, you you know, the different departments can work better together. Although I think that's just an, I think that's just an ongoing challenge. It's just a challenge of the work. um
00:13:34
Speaker
So one thing is just for the health system itself to continue to work on that. Right. um And um you know, the nice thing about the creation of all these navigators is you have people helping patients, but those navigators don't necessarily have access to the clinicians. Right. So figuring out how, what the workflow is between a navigator and ah the clinical team is is really important. That's just within the institution. Across institutions, I mean, we do a lot of different things at the Camden Coalition. um We've created a process ah where actually providers from across health systems and healthcare
00:14:20
Speaker
ah mental health clinics can come together and and and and really almost you know do ah you know what you might do in the hospital. It's like you know an M&M or, i know you know what I mean, a mortality and morbidity review or some kind of case review that's done within the hospital. We actually do those across systems.
00:14:41
Speaker
um And that's a really valuable way to actually, first of all, just introduce people um from in and outside the hospital walls, but then also to really use a couple of different cases to try to problem solve um a so a system fix to some ah problem you might see in every case you're working on. um So an example is ah someone that we we did this um complex care case conference, we call it. And it's ah we looked at people, a couple of people who had showed shown up at the emergency departments of four medical systems in South Jersey.
00:15:24
Speaker
So this is, these are patients who show up at Cooper, Inspira, Jefferson, and Virtua to all of their emergency departments. um ah and And in most of those cases, they're showing up with some kind of mental health um issue. And so, you know, the health systems ah don't know from their record because they don't have access to the records of the outpatient behavioral health providers ah through Epic. um They don't know whether this person is seeing someone regularly within one of those clinics.
00:16:01
Speaker
It's very hard for them to look quickly and see that they're being cared for across four health systems. And so one of the things we use this conference for is to figure out, like, what are the fast ways that an ED doc in one system might be able to know that this person is under the care of an outside clinic or um ah is really getting their primary mental health support from another health system.
00:16:30
Speaker
Yeah, that that sounds like a really interesting, I never like, you know, thought of the M&M concept being like extended outside of a hospital, but that sounds super cool. Do you find that like when you have the different parties involved in those sorts of like cases that you mentioned that, you is there, you know since everybody's coming at the the patient or the case with a different lens that there are disagreements on like, what is actually the problem with the patient? And, and like, you know, one person might think it's more of like a, um, occupational problem versus like a mental health problem. You know, do you yeah kind of have those sorts of, of course, yeah cash those things out to say, yeah that's the fun of it. I mean, come on. I mean, we're people, we're bumper cars, you know, we're sort of bumping around each other. And, um,
00:17:14
Speaker
And that is great. And that's exactly what these things are for, you know, is to figure out, um, you know, sort of what is, um, you know, what, how do we come together the next time this person shows up at one of our EDs or how do we avoid, how do we prevent that?
00:17:35
Speaker
Um, and, um, you know, that, that, that's the point. I mean, I worked at the children's hospital of Philadelphia for 10 years and I, You know, I heard physicians disagree all the time. um The question is, you know, can they work that out and have some kind of shared advice for the patient or shared agreement on at least what the next step is they're going to take? um So, yeah, I mean, these are hard cases. They're not easy cases. So there will be disagreements.
Insurance System Challenges
00:18:09
Speaker
On the line of insurance, I'm curious to hear about how sort of the ongoing uncertainty and change within our insurance systems, how has that affected your work at Canada Coalition?
00:18:20
Speaker
You know, when you're in this work, it's a little bit like um Live to Die Another Day. It's a little bit like a James Bond movie. You know, it's it's there's just always something. yeah.
00:18:33
Speaker
and um And so, you know, I've been in this work for a really long time. um And um i think there are just always a lot of different struggles. There's always uncertainty. There's always financial issues.
00:18:50
Speaker
You know, I remember when the ACA was passed and 28 states sued President Obama. And i was glad we had that kind of give and take. And we have a different type of give and take happening now. and You know, we're just we're we're just doing everything we can to sort of survive the yeah the tides.
00:19:13
Speaker
But I guess are our folks coming to you and saying like, you know, health care that I could count on a year, two years, five years ago is now no longer available to me.
00:19:25
Speaker
We haven't seen that so much yet. There are some programs that have been cut. Um, and, um, and certainly i think that, um, you know, there's a free clinic in Cherry Hill, the Cherry Hill free clinic. It's actually run by our chief medical officer, uh, Jabril Oyemi and supported a lot by Virtua Health System. Um, they've seen their numbers go up a lot.
00:19:52
Speaker
Um, So I do think that um um not just um that there are some programs that have been cut, some federal programs around diversity that that helped people, um ah also programs related to HIV.
00:20:14
Speaker
But I just think the cost of health insurance, even the cost for people who are employed, um is so high that they're turning to places like the, you know, the Cherry Hill Free Clinic or even the the federally qualified health centers like CamCare in in Camden.
00:20:33
Speaker
I want to switch gears and ask more about um housing. ah The first time I heard about Camden coalition ah was a number of years back. I think it was like an NPR piece about like the housing first movement, like, you know, housing lays the foundation for better health for a lot of these patients with complex needs. So you can, can you talk about the importance of housing um and and ongoing work with that?
Housing First Program Insights
00:20:56
Speaker
We started the Housing First program in 2015 because we saw that a lot of the people who were going out of the ER, who were coming up through our sort of daily look at um the ED numbers, as I said, um were housing unstable, right? So they were either living on the street or they were couch surfing and that it was really hard to try to help them um when they didn't have ah permanent housing. um And I know that right now this is, you know, the Housing First program is is really under attack. um
00:21:35
Speaker
And the White House um has has said that they don't wanna support Housing First programs, although they originally had said they were going claw back funding on that. And I know that New Jersey was one of the states that sued um the administration over that. And the administration has put a pause on that.
00:21:56
Speaker
um But I just really want to say for the record that there's a lot of rhetoric out there about housing first programs being programs that give people the choice to recover or not. um And um that, ah you know, that what the the White House is talking about is a treatment first program. And I just want to say that we have always viewed the housing first program as a treatment program.
00:22:25
Speaker
Um, there isn't anyone in our housing first program that isn't there because they want to get better. Um, they may come into the program and not be in full recovery, but certainly their goal is to get healthier and, um, to get to, um recovery that allows them to live a healthier life. And, um, you know, just doing the things you need to do to Survive in a Housing First program means you show up for a lot of interviews and appointments and you take out your garbage and you're a good neighbor. And there are a million things that you need to do to survive in and and stay in a Housing First program. and um
00:23:10
Speaker
And all of that involves a lot of treatment and a lot of um wellness conversations. And so, um you know, i'm i'm not I'm not sure where the debate is today, but we certainly see housing first as a treatment and a housing program.
00:23:29
Speaker
Yeah, you're saying there's a lot of of rhetoric around ah housing first. do do is Is there also like similar ongoing things related to harm reduction where where different parties in our our country or state like don't see eye to eye on like harm reduction?
00:23:44
Speaker
Yeah, there there is. and it's um you know I just think that um that it's it's become a sort of um a lightning rod. And i think that the reality is is that this is very much a continuum. It's like somebody who you know has cholesterol issues or somebody that's trying to get their heart healthier. Like it's not all or
Harm Reduction in Substance Use
00:24:11
Speaker
nothing. And we don't demand that in our healthcare, care right? We don't say you either have to get a hundred percent heart healthy right now, or we're not going to treat you.
00:24:22
Speaker
Um, it's, it's just not the way that we, we, we go about care. Um, and, um, and so the fact that we um think about substance use that way or serious mental illness that way is really just, um it just, it's just inconsistent with sort of how, how, how healthcare care is approached when you're looking at other chronic conditions that may actually be conditions that have something to do with choices somebody made.
00:24:54
Speaker
um So, um, you know, the harm reduction debate just seems to be the sense that um people in the in the treatment community, like us, believe that people should just be allowed to, you know, sit on the street and use up in front of people. And and that's certainly not the, that that's not what comes to mind for us as we're doing our work every day.
00:25:21
Speaker
um Besides like, ah you know, a harm reduction approach and, you know, housing, Camden Coalition obviously works with a lot of people with substance use disorder. What else have you found that really works? What's in ah the approach that works to helping folks with those ah substance use issues?
Medical Legal Partnerships
00:25:41
Speaker
Well, I mean, one of our um our our best programs that, you know, is really, ah you know, we would not have told you this what if you were talking to us in you know, 2011 when Atul Gawande wrote about us, but, you know, what we found from our data, um and we did, you know, a randomized control trial with a J-PAL at MIT and ah found some statistically significant effects and and and other null effects, but we've really deconstructed all that data. And we found that
00:26:17
Speaker
you know, if you had a single arrest in the past six months, it was very hard to engage you at all. And we um knew that a lot of our clients that we were trying to engage or who we talked to, but maybe didn't, we couldn't engage them in our programming, um had some kind of arrest, like I said before. And that arrest could be, by the way, for something super petty, right? Super, I mean, they shouldn't have done it.
00:26:45
Speaker
Let me be so clear, like we're not We're not you know petty or not petty. like We're not condoning any of this. um but um But they just continued to get themselves into legal trouble. They get picked up, or maybe they try to get themselves picked up because they were cold and sick of sleeping on the street. um And so we actually um created a medical legal partnership. The Camden Coalition did that back in 2017.
00:27:14
Speaker
um And that medical legal partnership really worked at first with our own clients just to help them. um But over time, through ah collaboration with the Cooper Center for Healing, which is their phenomenal addiction medicine ah treatment center um and practice, um we actually ah ah had a ah a lawyer and a community health worker sort of embedded yeah at the Center for Healing. And that has just shown really phenomenal results.
00:27:50
Speaker
um in terms of a doctor or a nurse or a social worker there, a med tech, anybody saying them, you know, we have a legal team that could really help you with some of these issues. um And have found that a lot of people that probably would have avoided us um or maybe were avoiding the the emergency department so they wouldn't have even come across our numbers um are you know, getting the help, getting help from us that they wouldn't get otherwise and allowing them to sort of clean up their record in a way that they can get other support services. So we're really, really um just, we can't say enough about the value of that kind of program and and hope someday that that will be standard of care, a little bit like the care management program that we started way back in 2007.
00:28:45
Speaker
A lot of what we talked about so far today involves data. And you just mentioned like the randomized control trial you did with J-PAL. um I'm curious, like I would imagine with a lot of these patients, it's so hard to get like, like serial follow-up. So i'm I'm curious to hear if there's strategies for, for, for getting like good data in patients with complex needs.
00:29:06
Speaker
Well, you know, the, the, you know, if they are a Medicaid member and a lot of them are in New Jersey, we have a, you know, we have a very generous state as far as Medicaid. And so, um, you know, we, um, some of that tracking that we did over time was through payment data.
00:29:28
Speaker
Um, and so that's how we were able to, um, you know, do the randomized control trial. Um, um, The other data is encounter data, um which is a little bit, um you know, it's it's it's not as robust as the as the as the payment data, but we can still use that to sort of track people. um And especially a health information exchange that can track people, not just um in the hospitals, but, you know, in other outpatient settings, even um
00:30:06
Speaker
you know how you know, housing settings. um Of course, this is all, and I just want to say, obviously, front and center with their consents. Although our experience has been that people, you know, people don't mind, they they just want you to do the right thing with them with them and their data. You know, they're not...
00:30:26
Speaker
um They just, they they there there isn't, ah there are there there aren't a lot of our clients talking about their rights and privacy. They're just talking about, why are you asking me for this again? i thought that we had connected data now. So I think they'd just like us to do good things with the data.
00:30:48
Speaker
I guess to to wrap up here, social determinants of health, that's like ah that's a ah a huge term for for obvious reasons. It's really important for everybody. It's really important now in medical education where we're we're constantly talking about social determinants of health.
00:31:02
Speaker
um And it's like, it's sort of, i feel like for a lot of you know providers like myself, like you can kind of just get this helpless feeling where you're like, these are characteristics about a person that are either not changeable or very hard to change. So how do you like as an organization try and address those, like, can you change the social determinants of health for a person, for a community?
Changing Social Determinants of Health
00:31:28
Speaker
Yes, you can. I think if we didn't believe that we couldn't do this work, I think for providers um like yourself, I think it is, it is rough going and you need time off and um time away. And I think a lot of times,
00:31:45
Speaker
You know, you you have those point in time, you know, it's it there's just so many point in time interactions where you don't see the follow-up story.
00:31:57
Speaker
um And I think that is some of the structure of our medical system right now is that, you know, providers are sort of missing the follow-up story, you know, because of the way things are structured.
00:32:09
Speaker
um But it takes time. you know, people don't change overnight. um None of us do. Right. And um and so um but absolutely. I mean, if you look at the 95 people that have been in our Housing First program since 2015, know, 83% of them have stayed housed.
00:32:33
Speaker
Um, and these are people who were chronically homeless, met that definition, living on the street. Um, we reduced their emergency room use by about 73%, um, between being housed and not being housed. And we, um,
00:32:51
Speaker
reduced their ah inpatient admissions by about, you know, over 30%. Now, I do want to say, like you know, the health system alone can't fix all these things. And I do hope that, you know, you're not feeling, you know, as the doctor, that that it it's your job alone. i mean, many of these issues are are other issues that require other social supports and social systems. I mean, the health system cannot solve all these programs these problems, which is why we are focusing so much on the teaming aspect of all of this.
00:33:26
Speaker
um Because, you know, certainly when we started our program, helping people within an emergency department that needed mental health care, for example, you know, the the the doctors and the nurses were just, they they were, it was sort of, they were at their wits end, right?
00:33:42
Speaker
because the person is not acute enough to admit or send a crisis, but they have a really serious mental health issue. And the question was, how do we actually, what can we do to make a better connection between the emergency department and the primary, ah the the sort of the mental health clinics that they did not have relationships with or so have have sort of sight into in their ah medical record?
00:34:10
Speaker
Yeah, i guess to To zone in more on the, I was thinking about like, like housing to the, for, for let's say like social determinants of health of like, like say for instance, I live in Camden and my zip code is 08103. So you hear about like, you know, the zip code destiny.
00:34:26
Speaker
If you, you know, get people back on their feet, like, Is part of that too, like retaining them in that community? Or if, you know, are are we sort of, you know, building people to better health and that they're going to move out of the community. And then still, if you have that zip code 08103, no matter what, you know, you're it's going to be like a a strike against you in terms of your health, I guess.
00:34:49
Speaker
you know i think that for some people, we hope that they can stay in the community. i mean you know the The interesting thing is probably you know how many people you might see in your in that zip code that actually do have strong family connections or do have you know are working two jobs Um, so, um, so yeah, I mean, our goal is not always to sort of move somebody out of the community at all. Um, you know, although a lot of them do want to move, especially with substance use, want to move away from sort of trigger points. Um, but a lot don't. And I, i think that the goal is, is, is to try to build up, um, um,
00:35:34
Speaker
you know, people so that they can stay in the community that they want to stay in. But, you know, i mean, we've always, you know, had people in this country who, you know, are are are struggling or are trying to move out of poverty into better lives. And, you know, that that just has ah been part of the history of like civilization in some ways, right? Or at least modern civilization. And so the question is, what do we what do we do as a culture?
00:36:06
Speaker
um and And is there like a baseline that we think should be available to everybody? And so, you know, a lot of that are issues around universal income and and and what kind of health support we give everybody. But um um But, but yeah, I certainly, i mean, I hope it's not a revolving door, um but, you know, for it not to be a revolving door, we do have to probably change some of the social support policies we have in this country.
Education and Collaboration in Healthcare
00:36:36
Speaker
I know you have a ah lot of, you know, educational resources, training courses on your website and whatnot. What do you, what do you want, you know, physicians and other clinical health professionals to to learn from the Camden Coalition?
00:36:49
Speaker
Well, i i i I want them to learn from the Camden Coalition. I certainly want physicians to learn from our our research and the work that we've done that care management works even for patients who are the most complex with health and social needs. um we We want them to know that there's a community for them. you know Come to our conference where physicians come every year. it's going to be in Oakland.
00:37:15
Speaker
this coming year. Um, and John, we should talk about you coming. Um, and, um, uh, and just to meet other physicians, you know, one of the things that physicians say who actually come to our conference is that it's the only conference where they can bring their team.
00:37:32
Speaker
Um, and so, um, you know, a nurse and, you know, a peer and the whole group to come together. So I would say, you know, health is a team sport. It really is.
00:37:44
Speaker
um And ah we need to learn a lot from you know other, I think, um industries that have really worked on sort of teaming. um And um because right now, i think some of that really burns out the physician. I mean, I am worried about physicians like you, John, who are seeing that patient and feeling hopeless. Yeah.
00:38:10
Speaker
And that leads to a lot of burnout. And so, you know, somehow if we could just build a stronger team and you felt supported by that team, ah just like the patient, right? You'd have a little bit more resilience um to come in the next day.
00:38:27
Speaker
so Yeah, i really appreciate you mentioning that. You know, there's there's definitely been moments where you you put a lot of work into a patient and and discharge them and then you see them readmitted a day or two later. And it's just like, it can be very deflating. And and and so it's nice to hear that, you know, you're you're you're thinking about those things at the Camden Coalition. Yeah. Well, and it's also possible, remember, that they're coming back because...
00:38:51
Speaker
you did a good thing for them and they're coming back to get a little bit more. And the question is, how can you continue to use that so that they don't have to come to the hospital for that, right? That that support um can be given somewhere else, right? So sometimes they come back to you guys because you really treat them well. And so the question is, as I said, right, I started by saying, we have really great point in time interventions that get diluted when people leave the hospital.
00:39:20
Speaker
And so the question is, how do we strengthen that on the ah the whole ecosystem?
Personal Favorites and Mentors
00:39:26
Speaker
With that, it's time for a lightning round, a series of rapid fire questions that tell us more about you.
00:39:32
Speaker
Sure. um So where's your favorite place to eat in Philadelphia? Oh, my God, that is so hard. OK, well, first of all, I love Bonner's for a grilled cheese.
00:39:44
Speaker
um Bonner's Pub. um It reminds me of the Irish pubs that I grew up around. i grew up in a town in Long Island with a psychiatric center and a lot of Irish people. And so we had pubs like Bonner's everywhere.
00:40:00
Speaker
um So that's really, ah ah that's a really major go-to place for me, I would say. ah Who's a mentor you'd like to give a shout out to who's helped you throughout your career?
00:40:15
Speaker
Oh, my God. ah Gail Neoweth, mentor extraordinaire from New York City, who was my boss when I was 22 and um is still my boss in so many ways and a colleague and a friend. um Yeah, just amazing.
00:40:35
Speaker
And Lou Besage, my board chair at Cooper University Healthcare. Just amazing. what ah What's a fun activity you enjoy doing on your birthday? Fun activity I enjoy doing on my birthday. I love ah champagne and pizza.
00:40:52
Speaker
So having those two things together. Yeah, I love Sally. I like, you know, um ah so very pia I love pizza with, you know, sort of a cheesy pizza with champagne. So that is definitely something I want to do on my birthday.
00:41:11
Speaker
When is your birthday, by the way? ah June 3rd. June 3rd. Okay. I'm June 14th. So pretty cool. Oh, nice. Yeah. Yeah, exactly. but um Champagne and pizza seems like a nice late spring kind of fair. so Oh my God. So good.
00:41:25
Speaker
Yeah. And really junky. It's really good with junky pizza too. I just want to say really junky. Yeah. um When you're at the grocery store, what's a ah special treat you'll pick up for yourself?
00:41:38
Speaker
Okay, Oreos, double stuffed all the time. I have a giant jar of double stuffed Oreos in my house, ready to be eaten at all times because my mother said they were the good cookies and we were not allowed to have them except except for special occasions.
00:41:55
Speaker
And so I've decided I must have them all the time. Yeah, big Oreo fan too, right there with you. And ah lastly, what's one thing that gives you hope?
00:42:07
Speaker
Oh, I mean, come on, like people like you and and all of the people working on these issues. And, um you know, just the, the perseverance of like the, the, um, the, you know, of, ah of, of, of humans, you know, i mean, yesterday i was on a train and I bumped someone with my bag by accident. And, um, you know, this was a person who, you know, whatever. And, and I said, I am so sorry. And they were like, that is okay. And I just thought we have just had a great human connection. And so that gives me hope.
00:42:47
Speaker
Yeah, I would say, yeah, just working in healthcare in general, like in the media, you see like a lot of, you know, what what what can seem like very, ah maybe be antisocial or destructive people, but there are just a lot of people trying to do a lot of good things. So I think, yeah,
00:43:03
Speaker
it's, it's, it's always, uh, you know, refreshing to, to, to meet those people. So, so much, you just have to remind yourself, like for the person that gets you married, just try to remember all the people who let you walk in front of them or behind them or save the elevator or smiled when you bought something, whatever it is, like you have to count those people too, or you will go nuts.
00:43:31
Speaker
Kathleen Noonan, thanks so much for joining The Wound Dresser. Thank you so much for having me. Hope to connect again. Thanks for listening to The Wound Dresser. Until next time, I'm your host, John Neary.
00:43:52
Speaker
Be well.