Back to the Futures

Abstract

As the Futures Program celebrates its 20th anniversary, I’m inspired to go “back to the future” when an invitation to the Futures Program from the Colorado state chapter of AMDA – The Society for Post-Acute and Long-Term Care Medicine arrived in my inbox. I was introduced to the Society as a geriatrics fellow after being instructed by my fellowship director to attend the monthly medical director meetings at the state health department (yep, medical directors and surveyors all in the same room). I was consistently struck during these meetings by the unique challenges and highly specialized skill set required of those working in nursing homes. So, when presented with an invitation to learn more and spend a few lovely days in San Diego in the middle of winter, I was in. Who could have known this truly would be my future? Cheryl Philips, MD, CMDR, the senior vice president of public policy for LeadingAge, was the first Futures Program presenter, and she had us doubled over with laughter. Two decades later, I still associate her with one of her amusing yet thought-provoking slides. The slide featured a picture of a baby in a kitchen sink, surrounded by bubbles and piles of dirty dishes. The slide was titled, “How did nursing facilities get the way they are?” The slide’s caption read, “... a grand plan ... or something else?” Dr. Philips made a compelling argument that there never was a grand plan but geriatrics training would be valued as nursing homes faced “something else” — pressures to care for increasingly complex patients and declining margins. I was intrigued by the potential to use my geriatrics training in the care of nursing home residents. Over the course of the next few days, I realized I was in terrific company, with kind people who were in this work for all the right reasons. As I get back in a time machine and arrive back from the future, it’s obvious that I found my professional home that day. Sadly, the “something else” Dr. Philips described is more shocking than any plot we could have imagined: the COVID-19 pandemic has devastated our communities and spirits. Fortunately, the features that attracted me to the Society 20 years ago are proving to have enduring value as we rebuild. As an example, those state chapter meetings at the health department have continued to facilitate natural collaborations with our health department during the COVID-19 pandemic. Similarly, the kind people I met in San Diego who were in it for all the right reasons have come together to create strike teams, lead COVID-19 Action Network ECHO networks, advance legislation, and appear on news programs, all while supporting one another as we look forward. Any depletion from the pandemic has been buoyed by the unflinching commitment of these colleagues. With over 1,000 participants to date, the Futures Program is slowly but surely introducing trainees into post-acute and long-term care. Where will we all be another 20 years from now? Will it be a grand plan ... or something else? I’d like to believe that the pandemic will allow us to step back and finally develop a grand plan. A plan that values the input of those working and living in nursing homes. A plan that dramatically expands programs such as AMDA Futures to develop leaders who are in it for all the right reasons. As I travel back to the future and consider the value of that invitation, I’m deeply grateful. I encourage all of us to extend an invitation, to support the Futures Program, and to continue to pursue a grand plan full of futures. Dr. Levy is a geriatrician board certified in hospice and palliative medicine, and is co-director of the Seattle-Denver Center of Innovation for Veteran-Centric and Value-Driven Care. The COVID-19 pandemic has devastated our communities and spirits. Fortunately, the features that attracted me to the Society 20 years ago are proving to have enduring value as we rebuild..