Tuesday, August 19, 2014

EXCLUSIVE: An Inside Look at Livestrong After Lance Armstrong

Livestrong and Univ. of Texas announce historic new cancer program

Like many of you, I was both furious and forlorn when Lance Armstrong admitted last year that he had lied for years about taking banned substances such as EPO and steroids. The famed bicyclist and cancer survivor's stilted confession to Oprah Winfrey that he cheated was not exactly a shocker. I just wanted to believe he had been telling the truth. As a four-time survivor of stage IV non-Hodgkin's lymphoma, patient advocate, and athlete, I bought into his entire narrative. I was in deep denial.

I'd been a diehard supporter of the Livestrong Foundation, the innovative and inspiring cancer organization Armstrong founded at just about the same time that I was initially diagnosed with cancer. I've used many of the foundation's services, and for years I've known and admired the foundation's president and CEO, Doug Ulman, who is also a cancer survivor and is both genuinely kind and uniquely savvy.
I proudly wore that yellow wristband. But for me it was never really about Armstrong. Or Ulman. It was about all cancer patients and, more selfishly, about me. It represented the good, the bad and the ugly aspects of my 18-year cancer journey. It was a badge of sorts. 
 The fact that Armstrong took performance-enhancing drugs didn't change any of that. It also didn't change the fact that Armstrong is a cancer survivor. For all his flaws, which are now so public, he remains one of us. He was told that he had cancer. Period. Unless you've experienced this, you respectfully can't know how it can profoundly change a person.  
There has been some talk recently about Armstrong returning to Livestrong. But Ulman and other leaders of the organization who are still on board have made it very clear to me that this will never happen. They know that bringing Armstrong back would be a fatal blow. 

Armstrong was a conceited bully and a liar, which he now admits. But we all deserve forgiveness. Armstrong is a flawed human being, but I know of very few truly accomplished and famous men who are not flawed. Bill Clinton comes to mind. And Steve Jobs. And just about every President of the United States since George W (Washington, that is). Most of these men have never painfully confessed their sins before the judging public the way Lance did. 

There are other mitigating factors, too. Namely that Armstrong has helped literally millions of people with cancer. And the fact that he was juiced in a sport in which most if not all of his fellow athletes were juiced. That doesn't make it right, of course, but there is some glaring hypocrisy among his loudest critics in the bicycling world. 

It's likely that you think of Armstrong now as a villain and a pariah. That's understandable. But I choose to forgive. It isn't easy, but Armstrong has made a positive difference in my life and I will always appreciate it.

But more importantly, what about Livestrong? It took an enormous punch to the gut when Armstrong finally came clean. Several major sponsors bolted, including Nike', whose departure was a huge financial blow and seemed particularly harsh and selective given the fact that the shoe company did not abandon dog-killer Michael Vick or serial wife-cheater Tiger Woods after their falls.

There have been rumblings that the foundation might not survive. But I was confident that people like Ulman, a three-time cancer survivor, former college soccer player and eternal optimist, would keep it alive. Doug told me last week that Livestrong was alive and well and that in addition to its ongoing programs and navigation services, the organization is looking at new and innovative models where to serve the cancer community. 

"The foundation, our existing partners and longtime supporters are also excited about Livestrong's commitment to create and sustain a patient-centered cancer care model that will benefit the lives of patients and survivors today and in the future," Doug said last week.

This morning, Doug raised the bar for all other cancer organizations when he announced at a press conference on the campus of the University of Texas at Austin that the foundation is launching the Livestrong Cancer Institutes, which will create an original model of patient-centered cancer care in partnership with the university's Dell Medical School. 

Livestrong will provide a whopping $50 million grant to the university over the next 10 years to advance the treatment of and quality of life for cancer patients and survivors and establish replicable models of care. It's an ambitious, even historic move for Livestrong, which Doug says will work with the medical school to educate the next generation of oncologists and practitioners to put cancer patients at the center of the healthcare ecosystem. 

“Livestrong's groundbreaking work with the global cancer community has informed all of our efforts over the past 17 years, and that knowledge will help us create new models that treat the whole person, not just the disease,” Doug said this morning. “The Livestrong Cancer Institutes in partnership with The University of Texas’ Dell Medical School will allow us reach more patients not just here in Texas but around the world, as we create a replicable and scalable model of care."

Doug continued, "This is not about new buildings in one physical location but rather about radically shifting a culture of care and reshaping the ecosystem to be more inclusive and provide care for all of those who need it. The Institutes are a game-changer for us and a game-changer for the cancer community, as a whole.”

Dr. Clay Johnston, Dean of the Dell Medical School, added that Livestrong has been "incredibly innovative in supporting the full patient and survivor, and this is exactly what we want to support at the Dell Medical School through education, care, and research. We’re kindred spirits in that we both recognize the tremendous opportunity to improve the lives of those we touch and to create new models of care that improve lives everywhere. Our team is energized by the spirit and the power of Livestrong’s global community, and we look forward to working together to change the way patients and survivors live with, through and beyond cancer.”

I'm elated for all the future cancer patients who will benefit from this new program. Cancer is the world's number one cause of death, and countless lives will be saved and empowered as the result of this remarkable new relationship between Livestrong and the University of Texas.

And I am truly happy for Ulman, who recently told me that Livestrong "has spent 17 years working alongside leaders in the healthcare industry and finding the best ways to improve the lives of people affected by cancer now – it’s our main priority." 

That has indeed always been Livestrong's genius. The foundation is relentlessly patient-focused. It always puts patients first. It's never really been about one man. It's about everyone who has heard those three life-changing words, "You have cancer."

Olympic gold medalist Eric Shanteau, who used Livestrong's services after being diagnosed with testicular cancer before the Olympics in 2008, tells me that the foundation is still strong post-Armstrong because it has "never lost sight of its core objective, which is helping people and their loved ones who are currently fighting cancer. The focus has always been getting support to those who need it now. This concept and the foundation's unwavering acceptance of it is why I continue my support."

The good news about the Cancer Institutes follows up on the fact that a number of new sponsors have joined forces with the foundation since Armstrong left. One of them is American Green Technology (AGT), which is creating a lighting system in hospitals that kills 99 percent of germs that are airborne. This will help stem the 20 percent of people who leave a hospital with a different disease than what they had when they checked in, according to Livestrong. 

Livestrong's spokesman Andrew Tanker tells me that AGT is now one of the sponsors of Livestrong's Big C competition, a global social innovation challenge aiming to change the way the world lives with cancer. According to Tanker, AGT is "spreading the message to the world about Livestrong through its AGT Rea Racing team."

Tanker adds that the the newer Livestrong sponsors "are with us for the right reasons. The new ones, we know why they are here: to help improve the lives of people affected by cancer, not for ancillary reasons."

Meantime, it was Ulman's determination, above all else, that kept the Livestrong dream alive. Unlike many former Livestrong employees who bailed after Armstrong's confession, Doug, like any good captain, was willing to go down with his ship. Turns out, Livestrong is not the Titanic, it is in fact the coolest and fastest racing boat on the water. Today's announcement shows that the foundation remains a vital and innovative player in the nationwide and global cancer communities. Cancer patients should be very comforted to know that Livestrong is still strong.

Friday, August 15, 2014

COMMENTARY: The Department of Veterans Affairs Will Never Be Fixed Until Corrupt Hospital Directors Are Removed

Remember that shocking, far-reaching scandal at the Department of Veterans Affairs? You know, the one that broke just a few months ago in which it was revealed that some 110 VA facilities across the country had a secret waiting list for veteran patients seeking care, and that many of our veterans were harmed and even killed as a result? Well, guess what? Most of the directors of these VA hospitals enmeshed in the mega-scandal are still on the job. And it's unclear if or when they will be disciplined, let alone removed.

Last week, President Obama signed the Veterans Access, Choice and Accountability Act of 2014. The accountability provision of the law, which grants new VA Secretary Robert McDonald complete authority to fire senior executives, took effect immediately.

So when will the department use the additional firing authority that’s part of the new law? It doesn't appear to be any time soon.

As AP reports this week, the department is in the process of holding dirty employees accountable. But McDonald is not saying how many people are being fired, who they are, or for what they're being fired. Does this sound familiar?

McDonald told reporters at the VA hospital in Memphis on Thursday that VA employees who are being removed are allowed due process, but that the agency is working as fast as it can to punish and even get rid of corrupt employees.
"You've got to treat that person with respect," he said. "They have to be allowed a certain due process that's allowed them by law or by statute or by policy. And, so, we can't talk to you about names, we can't talk to you about individuals, even though that's what you would like. We can't do that because that would be disrespectful.
"On the other hand, we've got to deal with it as quickly as we can," he said. "We've got to deal with it deliberately and we've got to deal with it appropriately. I can tell you, we are going to hold people accountable, and we're going to do that as quickly as we possibly can."
As NBC News reported this week, VA says it has recommended disciplinary actions against six employees at VA medical facilities in Colorado and Wyoming for manipulating patient wait times, but the punishments for these employees remain unclear. 

The VA, which announced the disciplinary actions against VA employees in Cheyenne, Wyoming, and Fort Collins, Colorado, said in a July 29 statement that “certain supervisors in these facilities were found to have personally manipulated data, instructed their subordinates to manipulate data, and withheld accurate information from their superiors.”

OK, so why not just get rid of them? The new law makes that pretty easy. These "disciplinary actions" in Colorado and Wyoming are just recommendations. A Congressional source who is very familiar with the situation tells me this week, "Nobody at VA has actually been disciplined. Not one person. The only thing that has happened is a proposal in Wyoming, but nothing's been done yet. The President signed the bill. It is immediate. When will VA use this authority?”

The Congressional source adds that if these employees didn't know what was going on, "they were negligent. If they did know they are corrupt. At a minimum, if they fudged numbers, that is altering federal documents, which of course is not allowed. If those alterations and schemes resulted in a bonus, that is some sort of fraud. And if the manipulation caused harm of a veteran that is something more serious.”

Bottom line? When it comes to revealing what specific executives did at specific VA hospitals, and what their punishment will be, the department is still operating under a shroud of secrecy. This despite all the national media attention in recent months, the new secretary, the angry speeches by President Obama and members of Congress on both sides of the aisle, and the new law. 

VA still is not saying just how they are dealing with these executives, who of course were on the front lines of the deceit that in some cases lef to veteran harm and even deaths.

The problems at VA absolutely start with the directors of the individual hospitals. That's where the rubber meets the road. And speaking of that, the executive who appears to be among the most corrupt of the bunch, Sharon Helman, the Phoenix VA director who almost comically sped away from CNN reporters in her expensive blue Mercedes Sports Coupe back in May, is still employed.

Multiple sources have told me that Helman knew all about the elaborate scheme at Phoenix VA to cover up long wait times at the hospital. Dr. Sam Foote, a physician who worked at Phoenix VA for 23 years, told me that as many as 40 veterans died at Phoenix VA waiting to see a doctor.

I've spoken to numerous additional sources who worked at Phoenix VA who say the same thing: the problem was deep and wide and Helman knew everything.

VA keeps citing due process. But if anyone should be disciplined right now in this scandal, it should be Helman, who resided over a hospital whose staff lied about wait times and where patients died waiting, and waiting, to be seen.

Rep. Jeff Miller, chair of the House Veterans Affairs Committee, continues to be frustrated by VA’s lack of accessibility. He's gotten no response from VA or VA's Office of Inspector General to letters demanding that the department disclose just who is being punished and for what. 

All this of course leaves veterans with the same deep frustrations with VA that they have had for so long. There have been legitimate efforts by McDonald to address the wait times. But what about accountability? What about all these unquestionably corrupt VA executives? When are we going to see some real disciplinary action? 

Frankly, any director of a VA hospital who knew about these manipulations of wait times should be fired. Immediately. Anything less is unacceptable. The point of the bill passed by Congress and signed by President Obama is to cut through all that red tape and make it easier for VA to get rid of corrupt officials. 

But apparently there are still piles of red tape, and probably dozens of corrupt officials, at the Department of Veterans Affairs.