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Seeking Out Escape Fires

By Kathryn Crimmins | Monday, September 24, 2012

During the past week, thousands of students, professors, doctors, residents, nurses, and average people like me marched to more than 50 health professional schools and universities with one common aim - to start a discussion on the state of the American health care system. And our talking points were not all that positive:


- The average cost of health care per person, per year in the United States is about $8,000. That is $5,000 more than the rest of the developed world.

- The average American hospital visit costs $1,666 per day. That’s four times more than the rest of the world.

- According to the Centers for Disease Control, about 75% of health care costs in America are spent on preventable diseases.


- And in America, 30% of health care costs do not improve health. That means our country is wasting over $765 billion annually on care.


Where did I get these facts, and what got us talking? Along with thousands of others, I attended an advanced screening of “ESCAPE FIRE: The Fight to Rescue American Healthcare,” a new documentary that’s already made the festival circuit and is set to premiere nationwide in less than two weeks. The film tells the story of American health care through the eyes of its varied participants: doctors, researchers, journalists, and most importantly, its patients.


The film opens with Dr. Don Berwick, former president of IHI, recounting his 1999 address to the IHI National Forum. He explains that “we are in Mann Gulch,” the site of the 1949 wildfire where Wag Dodge lit his escape fire. It’s up to us – professionals and patients alike – to blaze ahead with a new status quo in the health care system.


The film suggests many ways to do this: If you’re Dr. Dean Ornish, you can dedicate your career to fighting preventable disease such as heart failure. If you’re Sgt. Robert Yates, you can embrace an army-led exploration of Eastern Medicine to kick your reliance on prescription medication. If you’re me, you can start a conversation with friends and family around their escape fires – what are they going to do to improve America’s health care system?

Here’s how some IHI Open School students answered that call:


The Portland State University and Oregon Health and Science University IHI Open School Chapter presented a screening of Escape Fire to more than 100 individuals – from their interdisciplinary academic community and the community at large. After the screening, four health professionals, including Dr. Erin Martin-Weeks, who was featured in the film, had a candid discussion about the film with attendees. The film was screened in conjunction with the University’s Student Alliance for Integrative Medicine and the National College of Natural Medicine.


ohsu EF panel

 Leaders of the IHI Open School Chapter at Portland State University and Oregon Health & Science University with panelists after their Escape Fire screening.


Students at Harvard Medical School joined a diverse group of faculty to screen the film with Harvard’s student group Improve Healthcare (IHC). Alexander Ryu, leader of IHC, welcomed around 50 attendees – including myself – to the Tosteson Medical Education Center amphitheater for the two-hour screening.


As an IHI Open School Chapter, here’s how you can recreate the momentum on your own campus:


- Screen a film. If you missed out on screening Escape Fire on your campus, that doesn’t mean you can’t bring another film to your Chapter members. This Tuesday, September 25th, PBS will be airing Money & Medicine, a documentary focused on overspending in the American health care system. You can also explore films for rent or purchase on iTunes, Netflix, and other film providers. Book a room, invite your Chapter members, and bring along some popcorn or health snacks for people to enjoy during the film.


- Invite speakers. Not everyone will be able to get director Matthew Heineman to their screening of Escape Fire. Look into your immediate network to see which faculty you can invite to speak on such an important cause. If you’re watching a documentary film, see if anyone involved in its production is local – it never hurts to ask for their support!


- Encourage people to do more. At the end of each Escape Fire screening, students handed out small postcards encouraging viewers to describe their personal Escape Fire. It’s easy to do the same with a little creative thinking. Challenge your attendees to bring others into your movement, whether that is by reaching out to a patient to share their story about the health care system, supporting a health-related charity on a site like Thunderclap, or canvasing your campus with need-to-know information for students.


After the Harvard Medical School screening, I reached out to some students and faculty from across the country to see how they plan to change American health care with their own escape fires. Here’s what they had to say:

“My Escape Fire starts simply within my own lifestyle.  Exercise more, eat healthier, and stress less so that my telomeres don't shorten, making my life longer!”


Joseph Finton, student at the University of California – Berkeley

“I tell my pharmacy students to ask themselves throughout their careers and every day on the job, “Am I providing a service that’s one of the 2/3 that improves health or one of the 1/3 that wastes it?”  But even more importantly, “What am I doing that a robot/lower paid professional/family member/patient could not do at least as well?” All healthcare professionals should ask themselves those questions, I think.”


Dr. Jill Lavigne, leader of the IHI Open School Chapter at St. John Fisher College

My escape fire, both as a member of the IHI Open School and as an undergraduate student passionate about my health and the health of others, is to support the education of next generation health professionals.



ihi OS escape fire



What’s your escape fire?

ESCAPE FIRE: The Fight to Rescue American Healthcare will be publicly released on October 5th and will be screened at the IHI National Forum this December. Thanks to all the IHI Open School Chapters that participated in these screenings, with a special thank you to Alexander Ryu for welcoming me and my colleagues to his screening at Harvard Medical School.

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