Change Begins with You


Bud Hammes was the catalyst for change in La Crosse, WI – a city of 52,000 people.

If one man could trigger change in the mindset of 50,000+ people, why do some think they are too “small” to trigger significant change in their organizations?

When I hear comments like “That’s above my pay grade,” or “He’s the boss, let him deal with it,” or “I just work here, what do I know?” – I cringe.

However, when I come across stories like the one featured on WABE (Atlanta’s NPR station) about La Crosse, WI – I am reminded that everyone is not complacent, or that easily discouraged.

As a medical ethicist, Bud Hammes is often in the room with families who have to make tough medical decisions on behalf of loved ones unable to make decisions themselves. Should they pull the plug, or not? Is the additional treatment worth it, or not?

In the past when Hammes asked, “‘what would your Dad want,’ ‘what would your Mom want?’ the answer was the same again and again.” No one knew what their loved ones wanted.

He’d had enough of witnessing this painful conversation. The hospital distributed living wills to patients during routine visits but most people put off completing them – probably because they didn’t want to think about death, and many thought they had time to worry about that later down the line. But Hammes knew better.

The hospital where he worked started training staff, ministers, lawyers and others in the community on how to understand and make these tough decisions. During routine health visits, the living will discussion became a regular part of the process. It was difficult at first, but eventually more and more people became at ease with it.

Today, 96% of La Crosse residents have completed a living will – way higher than the national percentage of 30. Death is now a comfortable conversation, and everyone from young children to spouses know and understand the wishes of their loved ones. Should something tragic happen, they know what to do.

Hammes implemented the Respecting Choices program because he thought it was the right thing to do. As a result, families no longer have to guess what the people in their lives want.

Another result, however, has been decreased costs for end-of-life health care. “It turns out that if you allow patients to choose and direct their care, they often choose a course that is much less expensive,” says Jeff Thompson, CEP of Gundersen Hospital.

Dartmouth Health Atlas reported that La Cross spends less on patient health care at the end of life than any other U.S. state.

With the recent changes in health care, many facilities around the country have been reaching out to Bud Hammes and Gunderson to learn more about what they are doing. The facility managed to impact not only people’s lives, but also the hospital’s financial standing by implementing one new procedure that started with one person’s idea.

Bud Hammes could have easily said: “Oh well. It’s not my problem.” He could have decided that this issue was beyond his control. But he didn’t. Instead he led from where he was and impacted the people around him.

The lesson here is that things are never out of your control. You may not be able to make major changes immediately, and you may not have freedom to make all of the decisions, but focusing on the things you can impact is enough to make real change.


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