THE "CHARGE"

   BY

C, EVERETT KOOP, MUD,, Sc,D,
    SURGEON GENERAL

         OF THE

     US, PUBLIC HEALTH SERVICE
LS, DEPARTMENT OF HEALTH AND HUMAN SERVICES

            PRESENTED TO THE
SURGEON GENERAL'S WORKSHOP ON HEALTH PROMOTION AND AGING
           WASHINGTON, D,L
           MARCH 23, 1988


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(GREETINGS TO HOSTS, GUESTS, FRIENDS, ETCJ

WE'VE HEARD MUCH GOOD INFORMATION LAST NIGHT AND THIS

MORNING AND NOW WE OUGHT TO GET TO WORK , , m IN OUR WORK GROUPS,

   I'VE HAD THE PLEASURE OF CONVENING 7 WORKSHOPS DURING MY

6-l/2 YEARS AS YOUR SURGEON GENERAL, SOME HAVE BEEN VERY LARGE

WITH A HUNDRED OR TWO HUNDRED PEOPLE mm, SOME HAVE HAD FEWER THAN

50 PEOPLE ATTENDING,

   BUT THE SIZE HAS NO RELATIONSHIP TO THE ULTIMATE

EFFECTIVENESS OF THESE WORKSHOPS , em AND MANY OF THEM HAVE BEEN

EXTREMELY EFFECTIVE,


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WHAT'S THE SECRET?

  NOTHING VERY ESOTERIC, BELIEVE ME, THE FIRST REtXlIREMENT IS

THAT EACH PERSON ATTENDING A SURGEON GENERAL'S WORKSHOP UNDER-

STANDS THAT HIS OR HER ACTIVE PARTICIPATION IS ESSENTIAL AT EVERY

STEP OF THE WORKSHOP PROCESS

IF WE DIDN'T THINK YOU WERE IMPORTANT TO THE OUTCOME OF THIS

WORKSHOP ON HEALTH PROMOTION AND AGING , , , YOU WOULDN'T BE HERE,

   so  I I I PLEASE o,, JUMP IN AND HELP PULL TOGETHER THE KIND OF

OUTCOME OF WHICH WE CAN ALL BE PROUD , ,m AN OUTCOME THAT WILL

HELP MAKE A REAL DIFFERENCE IN THE LIVES OF OLDER AMERICANS TODAY

AND IN THE YEARS TO COME,


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THE FIRST REQUIREMENT FOR SUCCESS, THEN, IS YOUR

PARTICIPATION.

  THE SECOND REQUIREMENT IS TO STAY WITHIN THE GENERAL

FRAMEWORK OF MY "CHARGE" TO THE WORKSHOP, AND THAT'S WHAT I

INTEND TO DELIVER RIGHT NOW,

  THE "CHARGE" IS MEANT TO KEEP EVERYONE GENERALLY ON TRACK IN

SOME REASONABLY ORGANIZED WAY SO THAT -- WITHIN THE TIGHT TIME-

FRAME WE HAVE BEFORE US -- WE CAN PRODUCE A SET OF SOUND AND

SOLID RECOMMENDATIONS THAT CAN FOCUS AND ENERGIZE THE WORK IN

HEALTH PROMOTION AND AGING,


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THIS, THEN, IS MY "CHARGE" TO THIS WORKSHOP,

  FIRST, PLEASE KEEP IN MIND THAT OUR WORK IS DIRECTED TO THE

ATTENTION OF THE HEALTH CARE COMMUNITY,  WE WANT THEM TO BEGIN

DOING SOME NEW AND DIFFERENT THINGS -- OR TO START DOING SOME OLD

THINGS BETTER,

  SECOND, WE NEED TO REACH THE HEALTH CARE COMMUNITY THROUGH

DIFFERENT AVENUES,  I WOULD THINK, FOR EXAMPLE, THAT SOME

ATTENTION OUGHT TO BE GIVEN TO THE ROLE OF PROFESSIONAL AND
EDUCATIONAL ASSOCIATIONS AND INSTITUTIONS IN THIS WORK, WHAT DO
WE WANT THEM TO DO? WHAT KINDS OF PRE-SERVICE AND IN-SERVICE

EDUCATIONAL PROGRAMS WOULD WE WANT THEM TO CARRY OUT?

  MAYBE THERE ARE OTHER WAYS TO TELL THE STORY OF HEALTH

PROMOTION AND AGING TO HEALTH PROFESSIONALS NOW IN THE AT-WORK
HEALTH SYSTEM, LET'S GET THOSE IDEAS OUT ON THE TABLE AND LET'S

TALK ABOUT THEM,


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   THIRD -- AND IT'S RELATED TO ONE I JUST MENTIONED -- WE NEED

TO THINK NOT ONLY ABOUT THE HEALTH PROFESSIONALS ALREADY AT WORK

BUT ALSO ABOUT THE YOUNG MEN AND WOMEN WHO SHOULD BE ENTERING

THIS FIELD ,,a THOSE BRIGHT AND DEDICATED YOUNG PEOPLE WHO WOULD

BE MOST RECEPTIVE TO A RECRUITMENT MESSAGE THAT TALKS ABOUT A

REAL CHALLENGE nmm ABOUT OPPORTUNITIES FOR GROWTH .m, AND ABOUT

THE TANGIBLE AND INTANGIBLE REWARDS OF PERSONAL AND COMMUNITY

SERVICE.

  AGAIN, I'M DELIGHTED WE HAVE 6 GRADUATE STUDENTS WITH US,

THEY'VE ALREADY CHOSEN A CAREER IN GERIATRICS, I HOPE THEY'LL

HELP US CONVINCE OTHER BRIGHT YOUNG PEOPLE TO DO THE SAME THING,


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  FOURTH, I'M VERY, VERY IMPRESSED BY THE BACKGROUND PAPERS

PREPARED FOR THIS WORKSHOP. AND I WANT TO EXTEND TO EVERY AUTHOR

OF EVERY PAPER MY OWN PERSONAL THANKS FOR TAKING THE ASSIGNMENT

VERY SERIOUSLY AND HELPING US GET OFF TO A STRONG, RUNNING

START,

   BUT THERE'S SOME "BACKGROUND" WE STILL DON'T KNOW ABOUT

HEALTH PROMOTION 11, ABOUT AGING us, AND ABOUT BOTH OF THEM

TOGETHER,

  AT THIS WORKSHOP, WE SHOULD ZERO IN ON THE KINDS OF RESEARCH

THAT OUGHT TO BE ON OUR AGENDA FOR THE FUTURE, THIS HAS BEEN

TOUCHED ON BY SEVERAL OF THE SPEAKERS ALREADY, BUT LET'S DO MORE

THAN JUST "TOUCH ON" THIS ISSUE,


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   LET'S TALK ABOUT THE AREAS WHERE NEW KNOWLEDGE IS VITALLY

NEEDED -- IN THE NATURE OF THE AGING PROCESS, THE HEALTH CARE

NEEDS OF THE ELDERLY, OR WHATEVER,  BUT LET'S GET THEM DOWN ON

PAPER, ALSO,

  FIFTH AND FINALLY, WE NEED TO SPEAK CANDIDLY ABOUT THE

STRENGTHS AND WEAKNESSES OF OUR NATION'S SYSTEM FOR DELIVERING

HEALTH SERVICES, WITH REFERENCE TO THE ELDERLY -- AND ESPECIALLY

WITH REFERENCE TO THE PROMOTION OF THE HEALTH OF THE ELDERLY,

  IF THIS TASK WERE BEING EFFECTIVELY ACCOMPLISHED TODAY,

THERE WOULD BE NO NEED FOR A "SURGEON GENERAL'S WORKSHOP ON

HEALTH PROMOTION AND AGING," BUT IT IS NOT --- AND WE ARE HERE,


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  LET'S LOOK, THEN, AT THE KINDS OF SERVICES WE NOW HAVE a, a

THE KINDS OF SERVICES WE OUGHT TO HAVE , , , AND THE WAY THESE

SERVICES DO -- AND SHOULD -- RELATE TO EACH OTHER IN THIS MATTER

OF HEALTH PROMOTION FOR OLDER AMERICANS,

  AT 9 A,M, ON WEDNESDAY MORNING, WE WILL BEGIN TO HEAR THE

RECOMMENDATIONS OF THE MANY WORK GROUPS, THESE WILL BE THE

CULMINATION OF OUR WORK HERE THIS WEEK.

WHAT SHOULD THESE RECOMMENDATIONS LOOK LIKE OR SOUND LIKE?


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  AGAIN, GOING BACK TO THE FIRST "CHARGE" I MENTIONED A FEW

MOMENTS AGO, THE RECOMMENDATIONS OUGHT TO BE DIRECTED TO THE

HEALTH CARE COMMUNITY AND OUGHT TO BE RELATED SOMEHOW TO THE ROLE

OF THAT COMMUNITY IN PROMOTING THE HEALTH OF OLDER AMERICANS,

   PAST WORKSHOPS HAVE BEEN ABLE TO HANDLE SOMETIMES DOZENS OF

RECOMMENDATIONS BY ARRANGING THEM UNDER ONE OR ANOTHER OF THREE

HEADINGS: RESEARCH, EDUCATION, AND SERVICE, I WOULD ENCOURAGE

YOU TO DO THIS, ALSO, BECAUSE I GATHER, FROM TALKING WITH MANY OF

YOU, THAT WE'RE GOING TO HAVE BOTH QUALITY AND QUANTITY IN THE

RECOMMENDATIONS OF THIS WORKSHOP,


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   TRY TO KEEP YOUR RECOMMENDATIONS TIED AS CLOSELY AS

POSSIBLE TO SPECIFIC, DO-ABLE ACTIONS BY PARTICULAR INSTITUTIONS,

PROFESSIONS, LEVELS OF GOVERNMENT, OR OTHER RESPONSIBLE ELEMENTS

IN OUR SOCIETY,

  FINALLY, WHILE COMMISSIONER FRASER FISK, DIRECTOR WILLIAMS,

AND I WILL BE FORMALLY RECEIVING YOUR RECOMMENDATIONS TOMORROW,

DO NOT LIMIT YOUR RECOMMENDATIONS JUST TO THE WORK OF OUR OWN

RESPECTIVE AGENCIES OR EVEN OUR DEPARTMENT,

   KEEP THEM ON AS BROADLY APPLICABLE A PLAIN AS YOU CAN,

REMEMBER, WHILE YOU MAY HAVE BEEN CONVENED BY THE SURGEON GENERAL

FOR A "SURGEON GENERAL'S WORKSHOP," THE ACTUAL SCOPE OF AUTHORITY

OF THE SURGEON GENERAL -- AS WITH ANY OTHER PUBLIC OFFICIAL --

IS CAREFULLY CIRCUMSCRIBED BY LAW, REGULATION, AND TRADITION,


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  MAYBE SOME OF THESE OUGHT TO BE CHANGED, THEN SAY SO, BUT

PLEASE DO NOT BECOME MIRED IN THE DETAILS OF LIFE IN THE

BUREAUCRACY,

SPEAKING FOR MY OWN LITTLE "NEWCASTLE," I HAVE QUITE ENOUGH

COAL OF MY OWN, THANK YOU,

NOW, LET ME CLOSE BY INDICATING WHAT WE PLAN TO DO WITH YOUR

RECOMMENDATIONS

  AS WITH PREVIOUS WORKSHOPS, WE INTEND TO PUBLISH THEM ALL --
THE GOOD, THE BAD, AND THE INDIFFERENT -- WITHOUT ANY FURTHER

EDITING FOR CONTENT OR SUBSTANCE,


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  OUR STAFF WILL CLEAN UP THE GRAMMAR AND SYNTAX, WHERE SUCH

MIGHT BE NECESSARY: THIS IS THE GOVERNMENT AND WE DO HAVE SOME

STANDARDS, BUT WE WILL NOT "CLEAN UP" THE THINKING THAT'S

EXPRESSED BY THAT GRAMMAR, IN DEFERENCE TO ANY POLITICAL OR OTHER

INTEREST.

SO, PLEASE DO YOUR VERY BEST, AND WE WILL RESPECT THAT

EFFORT,

  THE FINAL PRINTED DOCUMENT WILL BE DISTRIBUTED TO THOSE VERY

ASSOCIATIONS, INSTITUTIONS, AND AGENCIES -- PUBLIC AND PRIVATE --

WHO CONSTITUTE THE "HEALTH CARE COMMUNITY" IN AMERICAN LIFE,


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  MANY OF YOU MAY BE CALLED UPON FOR ADVICE, AS WE PUT

TOGETHER OUR DISTRIBUTION PLAN, WE WANT TO MAKE SURE THAT THE

PEOPLE WHO SHOULD ACT UPON THE MESSAGE OF THIS WORKSHOP ACTUALLY

GET THAT MESSAGE IN THE FIRST PLACE,

   I'M PLEASED TO SAY THAT WE PRINT AND RE-PRINT THOUSANDS OF

COPIES OF REPORTS FROM THESE WORKSHOPS THEY TEND TO BE

BENCHMARK DOCUMENTS AND OF GREAT VALUE FOR POLICY-MAKERS,

DECISION-MAKERS, TEACHERS, STUDENTS, AND INVOLVED PERSONS FROM

AMONG THE GENERAL PUBLIC.


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  I AM SURE THE DOCUMENT YOU PRODUCE HERE THIS WEEK WILL HAVE

THE SAME ACTIVE LONGEVITY, APPEARING IN EVERY OFFICE AND

MEETING-ROOM AROUND THE COUNTRY, WHERE PEOPLE ARE SERIOUS ABOUT

PROVIDING BETTER HEALTH SERVICES FOR OUR OLDER CITIZEN%

  THAT, LADIES AND GENTLEMEN, IS MY "CHARGE" TO YOU, I'VE

MADE IT SOUND SIMPLE AND STRAIGHTFORWARD wm, BECAUSE WE NEED

THAT MORE THAN WE NEED JARGON, RIGMAROLE, AND HOT AIR,

I KNOW YOU AGREE, AND I KNOW YOU WILL BE TERRIFIC,

THANK YOU,

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