1. Oliver, Molly Finnan BSN, RN

Article Content

Heineman M, Fromke S (directors). United States: Aisle C Production and Our Time Projects; 2012.

No caption available... - Click to enlarge in new windowNo caption available

If you don't do anything else for professional development this year, watch Escape Fire: The Fight to Save American Healthcare. This compelling documentary film is marketed to the general public and the healthcare community, especially students. Directors Matthew Heineman and Susan Fromke assemble an impressive cast of patients, administrators, politicians, researchers, journalists, and providers to tell the story of the US health crisis. The audience is treated to statistics most healthcare workers are familiar with: the United States spends about a trillion dollars a year on healthcare, yet our outcomes are not on par with the rest of the developed world: shorter life expectancy, more chronic diseases, and 167,000 deaths each year from preventable medical errors. Sometimes it feels like the increases in cost and acuity are par for the course. Heineman and Fromke's film suggests that we cannot afford to continue the status quo; without significant change, healthcare costs will bankrupt the United States.


It was surprising to learn that the military has been running a pilot program using acupuncture, yoga, and meditation to treat pain, addiction, and posttraumatic stress because there is a sizable body of research that supports these interventions. It was also a shock to learn that the Centers for Medicare & Medicaid Services did not reimburse for Dr Dean Ornish's diet and lifestyle interventions to prevent and reverse cardiovascular disease until 2010, despite 30 years of research showing that the program was more effective and cost way less than invasive procedures.


Sometimes documentaries can feel preachy, boring, and annoying. Escape Fire is brilliantly produced, engaging, and inspiring. The personal stories of people stranded within the system supported by nonpartisan experts telling the story of how we got to this place of high-cost, poor-outcome care are full of hope for change and celebrate the strength of those working for innovation, within and outside the system.


As the Affordable Care Act ramps up, there is an opportunity for large-scale change in healthcare. Escape Fire looks quite critically at our current system, referring often to healthcare as a "disease management" system. Anyone who has spent any time working at the bedside can attest to that theory.


The only bone I have to pick with this film is the lack of nursing perspective. Nurses have so much to offer to the conversation. Many of the proposed innovative ideas for physicians: nutrition and exercise counseling, addressing psychosocial needs, patient education, and follow-up, are all tried and true nursing interventions. It is sad that the makers of the film neglected to feature nurses. As the largest number of healthcare workers in the United States, nurses have a pivotal role in implementing changes in care and culture of health.


Don't let this lack keep you from viewing this movie! It is a great resource for nursing instructors, unit educators, and anyone interested in quality improvement. The film is supported by a robust Web site, The film is in limited release nationally and available on iTunes. Screenings for larger groups can be coordinated through the Web site.


Molly Finnan Oliver, RN, BSN


Staff Nurse


University of Rochester Medical Center Highland


Hospital Rochester, NY