A JOLT of Health

Cutting-Edge Advances Shaping the Future of Health Care


The future of healthcare was the topic for the Thurston County Chamber of Commerce’s monthly Forum luncheon. But you don’t have to take my word for it: You can watch the entire meeting on Thurston Community Media’s video-on-demand service, here. And you might want to.

The presenters were Darin Goss, CEO of Providence Health and Services Southwest Service Area and Will Callicoat, president of MultiCare Capital Medical Center.

In April of 2021 MultiCare became the first nonprofit owner of Capital Medical Center. Mr. Callicoat shared his personal connection to Capital as a long-time member of the community, and as the place his children were born and family members cared for. I felt both his status in a large health care organization as well as his heart in this position.

Healthcare as an industry

Providence, CEO Goss shared, is now the largest employer in the county, with more than 6,000 staff serving our healthcare needs. He welcomed Capital’s contribution to ‘our industry,’ using this term in many of his comments. 

Take heed of a person’s choice of words, as they reflect thoughts and attitudes, which ultimately lead to actions guided by those attitudes. Industry is not a term I associate with healthcare service organizations. Neither is it a word that any of the Sisters of Providence I trained with would have used. Engineering firms that design and build CT scanners, balloon catheters and artificial joints, and manufacturers of  PPE (masks, gowns, gloves), are healthcare industries. They support the dedicated professionals and their support systems (hospitals included) that provide direct care to human beings in distress.

Both Callicoat and Goss emphasized the critical state we find ourselves in, with demand for healthcare services continuing to outpace resources.

Why the imbalance between supply and demand in healthcare?

There are a number of causes for this imbalance. One is a drastic increase in Medicare enrollees, to the tune of 10,000 boomers added to the rolls nationally every day. This same generation has seen epic retirements. Both alluded to the Affordable Care Act as an additional factor, presumably because now everyone can be insured and have access to healthcare.

Is this a problem? Not from my perspective. It is a boon. The problem is the lack of foresight and preparation for the predicted increased access and demographic transition. I see these issues in healthcare as an extension of our generalized American cultural short-sightedness.

Adding to the woes of our hospital systems is that reimbursement from Medicare and Medicaid has not kept pace with cost, with no increase in Medicare or Medicaid payments in 20 years! Both MultiCare and Providence are experimenting with ways to provide care in lower-cost settings than hospitals, the most expensive place to provide healthcare. Each system is experimenting with promising alternative models and locations to provide care (see below). Time will tell if these are viable solutions.

Current labor shortages worsen access. They add to healthcare professional burnout and career abandonment, further exacerbated by the intense demands of the pandemic. It was mentioned that the current physician shortage was predicted years ago. See my February 7th column for some insight into this issue. The shortage of registered nurses (R.N.s) is being addressed by training more medical assistants/aides and licensed practical nurses to relieve the burden of less skilled tasks that R.N.s are now expected to do. According to an R.N. colleague at St. Peter Hospital,  these tasks simply cannot be reasonably accomplished during an understaffed shift -- and they are ALL understaffed.. Apparently, this ‘nursing relief plan’ is considered cutting-edge today. In the 1970s-80s, having adequate LPNs, RNs and aides on the ward every shift was business as usual.

There are lights on the horizon with the following ‘cutting edge advances’:

  • Telehealth, a progeny of COVID, currently provides 20-40% of medical care. It improves access, is less costly and eventually will be available thru apps. This may be a good thing, albeit with caveats. Tech cannot replace the importance of touch and connection in something as important and vulnerable as our health.  Whether it is the right and best way to provide care in the long run, if used appropriately, remains to be seen.
  • Post-hospital services in the home after complex hospitalizations for those most vulnerable to prevent costly and traumatic hospital readmissions. Hospital Home thru Providence has already enrolled 200 patients to provide team home support to patients with complex health issues
  • MultiCare’s Moxi is assisting in automated tasks and moving objects thru the hospital
  • Dispatch Health, now owned by MultiCare, sends mobile emergency care teams to people’s homes to assist the most fragile and immobile as well as to reduce unnecessary emergency room visits
  • In December 2023, MultiCare plans to open its new 10-bed Emergency Room in Lacey

Meanwhile, as the healthcare system is working to catch up, what can you do?

  • Stay as healthy as you can be! Practice good self-care habits.
  • If you need help, seek it. Don’t delay your healthcare needs, as unattended problems can worsen and become more serious and difficult to treat. This delay has been another factor increasing demand post-COVID.
  • Be your own advocate: make a list of your needs and questions for your appointments. Take notes. Bring a family member or friend with you as a support person and notetaker if you like, as another set of ears can be very helpful.
  • Know about your own state of health because there aren’t enough people to keep close tabs on you. Know your medications. Your physician, whether M.D., D.O., N.P. or P.A. often doesn’t have time to review your chart before they see you, a terrible consequence of the pressures on healthcare professionals in these times. There are bilateral agendas in a healthcare encounter: yours and theirs and they do not always overlap. Both are important.
  • If you need to be hospitalized, have an advocate visit often, ask a lot of questions and call out inadequate care.  

It will take time to train more healthcare professionals, improve the culture of our healthcare systems and make them equitable and available to care for us in a timely manner. It will also require patience, hope and support of those caring for us in the interim who are working over capacity to do so. 


  • God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine by Victoria Sweet, M.D. is a beautiful account of how healthcare was and what happened to its heart thru the changes in the last 40 years.
  • Crossing the Quality Chasm: A New Health System for the 21st Century a study published in 2001 by the Institute of Medicine describing how far we have to go to bridge the quality chasm in healthcare in our country. Twenty two years later, the corporate trajectory in healthcare has, in my opinion, only widened the chasm. Looking at improving healthcare in the USA will require deep and wide inquiries as well as action. Bottom line number crunching in service organizations not ever designed to be profitable is not only irrelevant, it is inhumane.

Debra L. Glasser, M.D., is a retired internal medicine physician who lives in Olympia. Got a question for her? Write drdebra@theJOLTnews.com


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