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Info You Can Use: Arts in Medicine

July 12, 2011

by:

Joe Patti

A commentary by Dr. Gary Christenson on the Minnesota Medicine website offers the most complete listing of the benefits of arts in medicine I have yet seen. Whether the piece inspires you to partner with medical services or not, it provides evidence of the benefits of the arts to use alongside illustrations of the intrinsic, economic and educational values.

The commentary starts out relating an anecdote about an actual emergency “stat” call for musicians in a hospital. While acknowledging that such an incident is a rare occurrence in medicine, Dr. Christenson shows that the arts are already playing an important role in the practice of medicine:

(my apologies for the length of the citation. While I did pare it down to a large degree, there were just so many exciting and compelling examples, it was difficult to decide what to excise.)

“Although some might be inclined to dismiss the arts as a triviality, luxury, or unjustified expense in a time of concern over rising health care costs, research is showing that use of the arts in health care can be cost-effective. For example, a recent study done at Tallahassee Memorial HealthCare demonstrated that using music therapy when preparing children for CT scans significantly reduced use of sedative medications, associated overnight stays, and nurse time, and resulted in a cost savings of $567 per procedure. It also decreased the need for repeat CTs because of poor-quality scans. When extrapolating those numbers to all pediatric CT scans done in the United States, researchers estimated a potential savings of $2.25 billion per year.”

1. Studying the arts makes medical students into better doctors.

“In our state, storytelling and theater have been used to teach students how to effectively take a medical history. Last year, for example, Mayo Medical School and the Mayo Clinic Center for Humanities and Medicine partnered with the Guthrie Theater to offer the one-week selective “Telling the Patient’s Story,” which drew upon improvisation and storytelling to teach students to take and report patients’ medical history.”

“Harvard Medical School has found that training medical students in the visual arts can help them develop their clinical observational skills. Students who participated in formal training consisting of art observation exercises, didactics that integrate fine arts concepts with physical diagnosis topics, and a life-drawing session demonstrated better visual diagnostic skills when viewing photographs of dermatological lesions than students who only received conventional training.”

“The arts also can convey lessons in ways traditional lectures cannot. It isn’t surprising that the top-rated lecture by first-year medical students on the University of Minnesota’s Twin Cities campus for seven consecutive years was a reading of physician and playwright David Feldshuh’s Miss Evers Boys by Guthrie Theater actors. The play, about the Tuskegee syphilis experiments, illustrates ethical issues related to informed consent and human experimentation.”

2. The arts have therapeutic benefits.

“Museums such as the Museum of Modern Art in New York and the Minneapolis Institute of Arts have programs for patients with Alzheimer’s disease and memory loss that use visual and cognitive stimuli to evoke memories. Dance has been shown to improve the mobility of patients with conditions such as fibromyalgia and Parkinson disease.”

“Storytelling has been noted to improve the quality of life for cancer patients,10 increase lung function associated with asthma, and reduce symptoms and doctor visits. One report noted that regularly playing the Australia didgeridoo decreased apneic episodes for patients with obstructive sleep apnea.”

3. The arts can help prevent disease.

“..a campaign to decrease heart disease in England found that people were much more responsive to the message, “Dance makes the heart grow stronger” than to “Exercise makes the heart grow stronger.” Dance is one of the best ways to improve health on a number of levels. In addition to its physical benefits, dance enhances social engagement, which is important to overall health and well-being, and it’s one of the best activities for delaying the cognitive decline associated with Alzheimer’s disease.”

4. The arts can improve the patient experience.

“…a body of research has shown that patients tend to be less stressed, less anxious, require less pain medication, and ready for discharge earlier when their environment includes views of the natural world.”

“Bedside visits by musicians and artists also distract children from pain and help them explore their feelings about their illness.”

5. The arts can promote physician well-being.

“…Although many physicians were involved in the arts before entering medical school, they put those activities on hold during their training. University of Minnesota medical students have an opportunity to keep those interests alive… The program…provides students with a small financial award to pursue and develop their interests and skills in such diverse areas as painting, drawing, singing, clowning, photography, and playing an instrument as a way to find relief from the rigors of medical study.”

Using the arts to reduce costs, provide relief and focus to patients and produce more effective doctors, what isn’t to love? As with all things, arts are only one part of bolstering well-being and providing better medical care. There is certainly a potential for it to become a much more important element in providing better medical care if employed and studied to a greater degree.

Dr. Christenson provides 20 footnoted references for his commentary which seems a good place to start for those looking to develop programs and partnerships to integrate the arts in medicine. The research is also obviously a good basis for advocacy about the value of the arts.

Advocacy, Info You Can Use, New Initiatives

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Building Cathedrals, One Budget At A Time

July 11, 2011

by:

Joe Patti

In something of a complement to my post on Wednesday regarding the factors influencing decisions about providing arts classes in higher education, Friday I attended a retreat on budgeting with the rest of the college leadership.

Now if that sounds like something you would dread attending, I was right there with you. I had a copy of The Economist in my portfolio just in case things got too boring. However, it was really a very engaging and educational experience. I have a feeling that the facilitator that was hired to run the session probably anticipated the dread with which we were approaching the day because she started out by telling us we needed to change our perception of what we were doing.

She began with a story/parable about walking along a road and seeing two emaciated men banging away at blocks of stone. Asked what he was doing, the first man sighed that he was chipping stone. The second man seemed to be working with a greater spirit than the first and when asked what he was doing, the second answers with a beatific look on his face, “I am building a cathedral.”

I had heard that one before, but I had to admit that it did pretty much describe how most of us probably approach budgeting–as a burdensome chore. The fact is, we can approach it thinking about what doing a good job on the budget can enable us to accomplish. Its hard work, but no harder than constructing, painting and lighting a set for a play.

The problem for most of us is that no one admires what a good job we did on the budget like they will for the set. Few of us had the guidance of experienced people in crafting a budget. I have clear memories of the different areas of knowledge imparted to me by technical directors and master electricians and carpenters. My memories of practical instruction in budget and finance by mentors is a bit more hazy.

And, of course, it is easier to dream of building cathedrals when you actually have money to budget toward that goal, small as it may be.

In any case, inspiring parables aren’t going to keep morale high very long if things turn mind numblingly boring. Fortunately, this wasn’t the case. We soon broke up into groups. By luck of the draw, (actually, they had us count off by fives), I ended up in a group with the two people whose decision making most impacts my budget. The topic was–what aspects of the process most impact your budget and operations.

Since the theatre does a pretty good job of supporting ourselves with earned revenue compared to other areas, I don’t receive much of my budget from them. However, some years they will take money from our revenue, some years they won’t. But I never know. I said this sort of thing made it very difficult to plan and gave me no incentive to have money left over at the end of the year. Fact is, we could actually be more self supporting and engage in an equipment replacement program that would not require us to ask them for money if our surpluses were allowed to accumulate.

No sort of action or solution was suggested. Nor did I expect one. It was good to have a fairly safe forum in which to address this situation. It probably helped that I was relating a “building a cathedral” opportunity where I envisioned our small annual surplus being used toward a bigger goal.

The day was full of shuffling around to other groups to address other aspects of the budgeting process. One particularly interesting session had us looking at the strategic plan which is what is supposed to be guiding funding priorities. We were tasked to boil each section of the plan down to a sentence that provided a helicopter view of the section so that anyone in the organizational chart could read it and understand how their work contributed to the plan. One of the results was that the language we used to describe our section was similar to that of a couple other groups. This was encouraging because obviously, you want a degree of unity between parts of the strategic plan.

The problem was, that the facilitator was initially unclear about the significant differences between three of the sections. There was something of a suggestion that parts of one section really should be organized under the umbrella of a different section. I was rather impressed by the effectiveness of the exercise in revealing that some clearer delineation might be needed so that everyone in the organization understood their place.

The last phase of the day was creating a common set of criteria for funding that would be shared across the organization as budget requests were passed up the ladder.

These criteria were:

-Aligns with strategic goals
-Leverages resources, strengths and opportunities
-Possess motivation and capacity to implement
-Has data justifying the need and plan to assess the impact

One of the biggest problem faced in the current budgeting process is apparently the lack of supporting data. Requests were being passed up without sufficient rationale based on numbers, industry needs, etc

Then we looked back at the problems with the budgeting process we identified at the beginning of the day and tried to determine if the criteria we had created would help address them. In the end, the problems we felt they couldn’t address were the result of either external factors we didn’t have control over (i.e. the way the overall state system operated and things they required). The other general area was the mysterious process by which things that never even entered the budgeting review process got funded. A working group was formed to address how to make that process more transparent and perhaps more aligned with the common criteria. I am optimistic about the ultimate outcome of the efforts. I don’t think we will ever be rid of funding that circumvents the process, but I am fairly confident there will either be more transparency or less of it occurring.

Most of all I was quite pleased with the entire experience. It is certainly an exercise an art organization might use in order to get everyone invested in the budgeting process and discover the problematic areas related to the practice. It definitely needs a skilled facilitator to lead it. Money has great potential to be a contentious issue and it is easy to get side tracked by specific issues rather than working to identify the root causes.

Info You Can Use, Management Philosophy

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To Cut Or To Keep Arts Classes

July 6, 2011

by:

Joe Patti

I am starting to wonder if the same forces that are seeing the arts disappear from K-12 schools are starting to encroach upon university level education to the same effect. There have been recent articles about eliminating the liberal arts degree. Given the amount of debt you get into going to a 4 year university, there is a concern about having a degree in practical fields like business or science one can translate directly into a job.

But I am seeing first hand that there are pressures to even retain arts classes. We just had an acting faculty member retire and I was talking to the chair of his division about when the ad to replace him might go out. Unfortunately, replacing him is not going to be automatic because there are a number of factors the upper level of administration considers before giving approval for a search.

The first is whether the class can pay for itself. It isn’t a surprise to anyone that instruction in the arts is more expensive than in other disciplines because the student – teacher ratio has to be smaller in order to be effective. One professor to 16-20 students instead of 30+. When it comes to arts classes then, general arts classes like survey world music are preferred over specialized classes like piano, voice, violin, etc because the ratio can be higher.

I should also mention for those who aren’t aware, my facility is located on community college campus so the price per credit is $95 versus $350 a credit at the system’s 4 year campus. It’s much more affordable for students to take classes here, but the college has to serve a lot of students to generate appropriate levels of revenue.

The decision to replace the acting teacher won’t entirely be made based on money. The fact is, many students who take performing arts classes are apparently not graduating. No one is suggesting there is causation in that. It looks like the type of student that are taking the courses aren’t persisting.

The courses aren’t filling up until nearly the end of the registration period which means that many in the classes may not have the organizational skills and motivation to be there that other students in the college have. Whether they have procrastinated their decision to enroll or just recently moved to the area, they may be in the class because their first preferences were full. They may not be fully invested or even able to commit to pursuing a course of study through graduation due to personal motivation or external forces.

Whatever the reason, if you are an administrator making a decision about what courses to offer and you notice that even if people have done well in a course, they aren’t likely to persist in their studies, it may not be entirely unreasonable to ponder if resources were better directed.

Some of the solutions mentioned in my conversation with the chair were not unlike those suggested for the arts in general. One was having the value of the class to students redefined in the course listings–what skills are you going to come away with, what requirements does this course fulfill, etc. Just as we talk about the value of the arts to communities.

Another was basically just increasing word of mouth advertising. Essentially talking to the counselors about steering students toward the classes earlier in the enrollment process. One potentially promising development is that the college had made orientation mandatory for all students recently and the process starts with an hour long presentation in the theatre. Since many attendees have appointments with counselors soon after their orientation, hopefully the presentation with its goofy skit will result in students being more inclined to want to register for arts classes.

At the very least, I hope the orientation sessions will end my experience where alumni tell me they graduated from the college and didn’t know there was a theatre.

This situation has been the cause of a lot of thought for me. It is easy to damn people who make decisions to cut the arts purely on the basis of return on investment. Saying a course in the arts can’t help a person get a good job will raise a chorus of howls as people reach for studies that may show otherwise. For a lot of college arts programs across the country, this may be the prime criteria for cutting or keeping.

I have a harder time finding an argument against a fairly loose definition of success like is the person likely to graduate. Talking about the value of the arts to bolster creativity and learning capacity will fall flat against that.

These students aren’t the ones getting caught up in the arts lifestyle devoting all their time to their art rather than attending to their other classes. Those guys are familiar to me because they are always hanging around the theatre. I know which ones have started getting Ds and Fs. Which ones are doing well. Which ones had to remove themselves from that life so they could turn their lives around. Which succeeded and graduated and which failed.

There are a whole bunch of others that I never really see until they get up on stage for the final performances at the end of the semester and perform before an audience for the first time in their lives. No matter what their motivation for registering for the class in the first place, they are up there now demonstrating what they have learned. If they aren’t graduating, I hope they are at least taking something constructive away from the experience.

Art(ist) Education, General Musings, State of the Arts

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What’s Good For The Grágás Is Good For The Arts Organization

July 5, 2011

by:

Joe Patti

I was reading that Iceland is in the process of updating it constitution and is soliciting feedback from its citizens. The constitutional council is posting drafts of each section online and are integrating some of the responses into the constitution. Actually, because so much of the activity is occurring online, they have suggestions from an international audience via their Facebook page. I am not sure if they have implemented international suggestions, but the people running their Facebook account seem to be doing a pretty good job of responding to those who post about the process.

I was thinking that this might be an approach that an arts group looking to serve a community might use as they began to generate an organizational structure. There seems to be some wisdom in getting everyone involved at the point of constructing the framework and having them continue to feel invested in the organization years into its operation because it has taken the community’s needs into account. A barn raising of the Internet age, if you will.

Of course, the tricky question is the degree to which you involve everyone. Trying to please everyone on a committee doesn’t end up pleasing anyone as we well know. There has to be a small group of people deciding what the focus of the discussions will be about. That is the function the 25 member constitutional council in Iceland serves.

On the other hand, going into the process with a lot of pre-conceived notions around which you will plug in community suggestions might also yield a product that no one really gets excited to be involved with. Deciding from the outset the organization will do Shakespeare when the community indicates a live music and visual art center is needed, for example.

Crowd sourcing feedback is probably never going to be a substitute for the good judgment based on hard work and research that starting any business requires. A serious look at demographics may show that the population can’t support a music and visual arts center for more than five years versus the prospects of a destination Shakespeare festival. However, using social media tools to disseminate information about why a music and visual arts isn’t going to viable may garner a good deal of faith and respect in the burgeoning organization when the community clearly sees they have done their homework.

Obviously, the same process can be used by existing organizations to strengthen their place in their community or even realign themselves with the existing needs. Iceland isn’t starting from scratch, after all. But there has to be real conviction in the organization to effect change. There can be a lot of organizational inertia trying to keep things from truly changing. If the change is coming due the realization that the faith and investment of the community has been lost, there could be a lot of resistance to overcome before truly constructive conversations about changes can transpire.

By the way, Grágás refers to the Grey Goose laws of Iceland that were in use until the 13th century. Therefore, I took some poetic license in the title of the entry to make it fit the goose-gander saying. The constitutional council using social media is known as Stjornlagarad.

Audience Relations, Leadership, Management Philosophy, Terms and Ideas

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