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Healthcare lessons from Captain Carmine Marceno

July 10th, 2014

by Scott Kashman

In a prior blog, I asked what our obligation to role model healthier living is in our respective health systems. Not a right or wrong answer, just a philosophical approach.

This week, an 89-year-old women and the sister of a 10 year old who is currently going through cancer treatment approached me. They were surprised we do not focus more on nutrition across our nation's healthcare system. We think it is wide known "food is medicine;" however when it comes down to it, they felt hospitals and care providers focused more on pills and diagnostic testing than food's impact on their health.

I have an upcoming meeting with some of our key managers and physicians to focus on--you guessed it-- nutrition. As a management team, we want to know how we could help practice with nutrition education. Some challenges include their time constraints, our payment system and the provider and patients' interest in learning more. One physician shared with me that he would love to focus more on nutrition and has many patients who simply just want the quick fix--a pill. After all, that's what we have essentially taught society: There is a pill for everything. And while the pendulum seems to be slowly swinging back, we have a long ways to go towards a balanced nutrition discussion and integration.

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How do we make the change?

No doubt, it will not be fast. I'll take a conceptual model just shared with me by Captain Carmine Marceno of the Lee County Sheriff's Office, a friend and law enforcement professional.

He drew a triangle with 3 words: Desire on top. Ability in the left corner. Opportunity in the right corner.
He let me know we cannot stop someone's desire. In his world that meant crime, drug use, etc. Specific to nutrition, this means the desire to eat sugar, fat and salt.

By changing the ability to access these desires you limit the opportunity. For example, if someone has a desire to steal, and you leave your car door open, they have the ability to access your car more easily and the opportunity to steal your possessions. By locking your car, you limit their ability to access the inside of your car and therefore limit the opportunity to break in and steal your belongings.

By comparison, as we increase the ability for people to access healthier and tastier food alternatives, we will see an increased opportunity for people to live healthier lives. There may still be a desire to seek out more salt, fat and sugar infused items. We do not have to be the providers. After all, when is the last time you went into a gym and they offered you potato skins and fried chicken behind the counter. How about walking into a spa and being offered wings and soda. You will not find this because they represent health, wellness and well-being. So do our healthcare systems.

As healthcare providers, we took a stance to reduce the nation-wide increase in people seeking pain medications through our emergency departments. When should we take a similar stance with the food we offer our patients?

Captain Marceno put a stake in the ground and shared what he represents and role models. So, as you think about our obligation in healthcare, how are you increasing the ability for people to access healthier choices and have the opportunity to live healthier lifestyles?

I look forward to hearing from you.

Scott Kashman serves as the Chief Administrative Officer of Cape Coral Hospital, part of the Lee Memorial Health System in southwest Florida.

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