This week during the #HCLDR tweet chat (complete transcript here) the topic focused on gambling, seniors, and public health. In fact, the very first question was as follows: @PracticalWisdom T1: Do you see gambling as a public health concern? #HCLDR
The dialogue of the conversation went down a natural progression. However, it did make me begin to think about the situation slightly differently. When Marie Ennis-O’Connor (@JBBC) made the quoted the following statement, ““It removed me from reality. I was anonymous. I could lose track of time.” Lonely seniors go gambling.” The light bulb went off.
Instead of focusing on the bad aspects of casino’s, gambling, and potentially taking advantage of elderly populations, is there lessons that can be gained from casino’s?
Why do people go? Are there things that naturally occur within the casino industry that make it appealing? What can healthcare learn from casino’s?
I recall going to a casino and remembering they way they greeted me. I was met with a smile, someone asking me my name, and then asking me if I needed anything. It made me feel important, cared about, and that my needs would be met.
The last time I went to see my physician, I was met with, “Why are you here and what time is your appointment?” Followed by the, “Can I see your insurance card and here is some paper work to fill out. Please sit down and bring it back when completed.” No smile, no first and last name greeting, no thank you.
Perhaps a bit more focus on my name versus my medical record number and insurance policy number and I may enjoy my experience a bit more???
If there is a population of people that frequent a casino, such an elderly population, or perhaps even an at risk population, then is there an opportunity for healthcare to go out and meet them where they congregate?
I mean if WalMart, Shopko, Target, CVS, Walgreens, and other retails sites have clinics, why not a casino? Why not have a rewards program that combines the money you spend at the casino (which they already have) and have them give you a 3-5% bonus if you walk 10K steps, 5 days a week? Or if you join a gym and workout 3 days a week? Why can’t we place educational information at the one arm bandits? (Slot machines)
I notice a lot of group outings that combine church groups, senior centers, or other community outings in which a bus will pick up and drop off a group of people for a day at the casino. Is there a reason we can’t make a hospital or a clinic a bit more fun to have people congregate for the day and have a slice of healthy and wellness too? Could the cafeteria’s go gourmet and employee a culinary expert to make people living in the community want to go there and eat?
Could the gift shops become Hallmarks? Could you place a smaller version of a WalMart or a Target inside of a hospital?
The lights, the interaction, the free soda, the oxygen being pumped into the air, the temperature, the attention to the small details such as the comfort of the seating, the location of bathrooms, the carpeting versus the hard floors, the lack of clocks and forgetting about the amount of time one spends inside….are these all things that healthcare can adapt into their design?
Some of this may seem far fetched, yet when I was in Billings, MT one of the things we did was approach several Tribal Nations to help serve their populations with increasing access to education and screening on cancer. One of the things we needed to do to gain their buy-in was provide a symbolic gesture of offering to the Tribal Council, which is typically tobacco. Ironic, huh?
We want to discuss smoking cessation, but in order to do so, we needed to offer tobacco.
Well we did, we gained buy-in and creditability within the Tribal Council, and we developed on site specific programs that allowed us to meet their populations where they congregated, one of the most important sites, the casino. In a 6 month period of time, we increased overall screening for cancer risk by 45%. We maintained that increase over the time I was in Billings, MT and extended it to other parts of MT and WY.
We brought physicians, nurse practitioners, nurses, and educators to them. We brought the mobile screening mammography to their sites. We made packages for colorectal screening. We educated on smoking cessation, signs of lung cancer, prostate cancer, breast cancer, colorectal, and other cancers. We used their language, their images, and we met them in their location.
We made accessing healthcare simple, easy, and we made it personal.
We took their story, added a bit of healthcare to it, and in the end, we all won.
So we need to again ask ourselves, what can we learn from the stories of casinos?
As always, you can feel free to contact me at: CANCERGEEK@GMAIL.COM or follow me on twitter @cancergeek
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