Healthcare Reform by House

In a recent episode (“Epic Fail”) of the TV series “House,” the hospitalized patient, Vince, posts details of his case online. One of his attempts at online self-diagnosis is based on “the wisdom of crowds,” as he explains “studies show the collective decision of a group can be more accurate than any individual’s decision.” This effectively put the team of doctors in competition with the Internet. Eventually his online quest did work, but I won’t describe that here. My important takeaway was the possibility of using “the wisdom of crowds” in healthcare. It doesn’t take many trips to a doctor to realize that medical care is just like any other undertaking. There will always be those who are better than others. The writers of House have proposed one method of reforming healthcare which could provide every patient with the absolute best possible care. It was thought provoking at the very least.

While this episode was not my favorite, if you are into IT and a follower of the series, you should be sure to '>watch. I doubt any video game programmers will be impressed, but it certainly addresses the collision of modern day healthcare with the Internet.

Marketing of Extension

[this post is primarily aimed at fellow ACES employees]

The number one thing we need to do to make campus (and the public) aware of Extension is the same as any other organization…take advantage of free public opportunities to make a positive impression.

Seems generic and simple enough, but making it happen is different. It seems that administrative folks spend so much time worried about budgets and programs and personnel that they become institutionalized (thanks Jason). So when there’s a meeting by department heads and administrative leadership where there is the potential to promote “Auburn” or “Extension” it is tough to get visionary, fresh, promotional ideas. How to fix that long-term is a problem for later. There are things we can do today.

Auburn University will have some sort of a ribbon cutting ceremony for new buildings and green spaces near the new student union building on Sept 23, 2009. As I understand it, the theme will be “Green on Green.” It will be an opportunity for Colleges and departments on campus to make displays and recruit students, while promoting environmentally friendly projects. Seems like a great place for a display about Extension, and a nice warm-up for the Sunbelt Ag Expo on Oct 20-22, 2009—where Auburn’s theme will be “Sustainability” (this is still open to some debate, since it isn’t necessarily good to jump on the buzzword bandwagon).

So what would make a good display, promote Auburn, and invite people to learn more about Extension? [Biosystems Engineering has already committed to both events with the gasifier, a photovoltaic demo, and the biotruck. It is expected that Fisheries will again bring the fish tank.] Couldn’t Extension, Agronomy, Master Gardeners, and others combine to make a very nice display? Perhaps a water cycle demo, with new low pressure irrigation, plants, a mini-lawn, a rain barrel, a sand filter, and a re-circulating pump? (with related publications about each) Last year AU had a stationary bicycle powered generator, where you pedal to light up various electrical things (light bulb, fan, TV, etc). The generator is expected to be back.  How about a flip-flops display? That was the hottest AU story of 2008.

The question is, who is willing to promote what they do in Extension in an organized, coherent fashion, as part of a group project? What are you doing for local fairs, shows, events, etc? How could you contribute (that?) to a University/ACES sponsored display? What can you do to remind college students of the good times they had in 4H? How could you relate that something you are doing now, or to something they’d like to do?

Assuming that our University is training leaders for tomorrow, all we’d have to do to connect Extension with main campus (and beyond) is take advantage of opportunities like the “Green on Green” ceremony to (re)make the connection for students. After that ceremony the Sunbelt Ag Expo is a tremendous opportunity to be seen and heard. Since preparing displays for these expos normally seen as drudgery, I think any and all Extension personnel would be more than welcome to contribute. If you’ve got ideas, please contact me or your supervisor, or department head, or someone. Your administration isn’t going to pull an idea out of thin air and expect you to do it. Maybe sometimes, but probably not this one.

Extension in Transition?

Any sizable review of Extension is ill-fated if it does not seek review and input from University leadership. The Smith-Lever Act formally established Extension in order to get University research out to the
people. At the time it was primarily for Agricultural research, which would explain the widely used term "Agricultural Extension." On the other hand, federal guidelines now require Extension to also provide education in other priority areas as well. If the Alabama Cooperative Extension System is to remain viable, it will have to improve its ability to educate in other areas. The current budget crises make it an appropriate time to address some critical problems related to this. The most critical is the lack of integration with the rest of Auburn University's faculty and mission. The lack of integration isn't isolated to Auburn and has led multiple authors to refer to Extension as the "Extinction Service." Lest anyone doubt that "Extension" is being pushed aside as a historical term, note our own Faculty Outreach Guide (http://www.auburn.edu/outreach/events/publications/faculty_outreach_guide.pdf) which describes Extension by saying, "This historical term reflects work performed in designated programs by faculty specialists affiliated with the Alabama Cooperative Extension System." This is not the only reference to Extension as a historical term within that document. In my view, "Outreach" is simply a new marketing term used to describe what Extension has been doing for nearly a century, yet multiple colleges have created departments and positions to focus on Outreach...instead of bolstering a system which works well, but has far greater potential than has thus far been realized.

Extension does a good job of keeping in touch with communities. Based on results of marketing studies it is clear that Extension could do a better job of identifying itself to the people, but it is already far superior to any other form of University Outreach due to the connections with county governments, school systems, businesses, and etc.

Extension is able to communicate with residents by breaking research and statistics down into real people terms and providing it directly to real communities to have a direct effect on lives. Academia is ill-suited for this task. Professors who deal with college students and other researchers on a daily basis have a very difficult time providing understandable training for the general public…especially children and the uneducated. Extension has the experience to make that connection.

Extension should be the primary conduit for Outreach, as stated in the "see also" section of Auburn University's Wikipedia page
(http://en.wikipedia.org/wiki/Auburn_University#See_also). The term "conduit" is critically important because it defines what
Extension is...or should be. It should be the primary delivery medium for the research and knowledge of the Land-Grant system to the people. The terms Outreach and Extension need to become synonymous, since the missions are already the same.

In order to capitalize on the strengths of Extension, Land-Grant Universities must make clear our formal commitment to Outreach since 1914. It is also essential to eliminate the duplication of effort which has already begun. One way to promote this intrinsic cooperation is to provide Academic credit for Extension publications in the promotion and tenure process. The Alabama Cooperative Extension System will have to make changes to handle the workload, and I suspect Extension at other states would also, but it is the right thing to do. That makes it worth the effort.

This doesn’t even scratch the surface of the things which could be done to merge Extension into the mainstream of University activities. Some might even argue that we should not attempt cooperation outside of Agriculture. Nonetheless, I hope this sparks some thought into how Extension fits into University functions, and how to save money while providing a greater community impact.

Your Opinion Matters

I love "Play-Doh." When I was six I created snakes, dogs, pigs, cups, buildings, and complete landscapes out of the stuff. I'd show off my creations, then smash them up and start all over again. Occasionally we'd keep a cup & saucer until it turned into a brittle piece of clay that no longer could be re-used. Today if I created a cup & saucer I'd probably use modeling clay or potter's clay. I'd probably go with a potter's wheel and try "throwing" the items as they spin. What's remarkable is the vastly different end result. Today I'd be left with a "piece" or "work," regardless of how misshapen or unusable it might be. If I used "Play-Doh" today to create a cup it would be laughed at as a joke if I displayed it as a "work." But why the difference? If you say "Because it's Play-Doh!" then we should ban Play-Doh and only sell potter's clay. That would make every six year old into an artist! If that's not true, then why the difference?

Have you ever heard, "If he jumped off a cliff would you jump too?" If enough people think something is worthy of being called "a work of art," then so it is. How unfortunate that gang mentality could affect something as moving as art. Art is based on your personal experiences and perceptions. Art is created as someone puts their own emotions, skills, and pride into the creation of something of beauty. When others experience it, that emotion and sense of pride is transferred by our appreciation. But "beauty is in the eye of the beholder." My sense of beauty has been shaped by my experiences. The things for which I have greatest appreciation are likely very different from yours. In other words, art is individualized.

If you tend towards negativity, you might immediately conclude, "This guy has no culture. He's one of those people who would think Picasso's work was a general mess." You'd undoubtedly be correct, but you should know that it is possible to appreciate something  based only on the fact that others find it intriguing.

The art that I find most attractive is that which moves me personally. It is based on my experiences and those things which I value most. And why shouldn't you? Art is created as someone puts their own emotions, skills, and pride into its creation. If witnessing that moves you, doesn't that make it "art" for you?

The fallout from this is far reaching and very satisfying. Aside from allowing me to appreciate a car or truck which has been modified in ways the casual observer would never notice, it also means that you too can find art in the most mundane of places. A field of beans planted around the contour of the earth by a skillful tractor driver is a beautiful thing. Sheetrock, hung and mudded so it turns into one giant wall without a seam, can be a thing of beauty because of what you *don't* see. A lawn, so perfectly manicured that it looks as if each blade of grade were individually cut by hand, can be so beautiful as to stir emotion. Taken to the extreme, anything and everything you do is art. The pride and skill you use becomes evident to the knowledgeable audience. Take pride in what you do and appreciate the job you've done. Chances are someone else will too. For the two of you, you'll connect on an artistic level. Witness the world around you and let "art" stand on its own merits. Your opinion matters too. In fact...it is really the only thing that matters.