The Talmud, the Yogic Edge and Death

In the workshop I teach called 'The Yogic Edge' I assert that 'business is the most spiritual of pursuits'. This morning, reading this post by teacherken, which references this article about the Madoff scandal I came upon this writing about the Talmud. I think it makes the point....

The Talmud teaches that when we die and account for our lives before our Creator, each of us will be asked four core questions that determine whether we have lived a worthy life.

Were you honest in business? The first question we are asked in heaven is not a ritual question, but an ethical one: How were you in the marketplace? In this age of financial scandal, an ancient voice rings true: Business integrity is of paramount importance.

Did you make time to study sacred texts regularly? Our own instincts for authenticity, integrity, and compassion need to be recharged and renewed by studying, regularly, the words of the greatest ethical minds.

Did you do your part to nurture the next generation? Raising children affords us the grace of loving somebody more than we love ourselves.

Did you do your part to make the world a better place? Home and hearth, our own health and happiness, are crucial. But they are not enough for a worthy life. The broken world beckons. At the end of our days, what can we say we did to fix it?

Even if we can answer each question "yes," the Talmud teaches that there is still one last element to a worthy life: yirat hashem, a sense of God's presence. What does this mean in 2008? That we wake up in the morning and realize: it is not about us. We are not the center of the universe. We are not even the center of our own universe. There is God. However much we wrestle with God, however much we argue with God, however much we doubt God, it is God to whom we turn in the depths, and it is God whose service gives our life meaning.

I've been taking the chance to slow down and reflect these last few days as the year comes to an end. These words remind me that the values I have come to embrace as I've engaged the marketplace, the values that I seek to live into as I engage the marketplace, these are values worth living into. While I am surrounded by the 'din' of 'money is all that matters', I am grateful to be one of many who is engaged with the deeper integrity of the marketplace, the integrity of community as important as oneself, in balance. Teacherken's diary is about death. As he notes, more and more of those we have shared this path with are now finding themselves at the end of this journey. For me, as one of those still in our bodies, I am present to the beauty, the importance and the significance of paying attention to how we live, how we might answer these 4 questions. For me, it is not that I will answer them before God, so much as I must live with the fruits of the answers each day.

Raghurai (Rich)

Money. Dehumanization, and the 'Healthcare' System

As some who read this blog know, one of the writers I consider most enlightening is John Bloom, who writes 'Reimagine Money'. John posts infrequently, and I am always eager to read what he has to say. This last post is no exception. Here's how it concludes, in a way that I think we all must take to heart with regard to how we relate to all systems, and most definately as we relate to the 'healthcare' system.

Any invention of the mind (in this case money and debt) that is managed in order to dehumanize its users needs a new set of ethical practices that might take a cue from the ancient temples and the origins of money in Western civilization. There can be a quality of offering in and through every financial transaction. I can become more conscious of the intentions in my financial behavior, or more aware of the work and economic efforts of others to make the transactions possible at all. But first I, and others who have not already suffered enough, have to wake up to the pain and inequity that have grown within the system even as I have participated willingly, if not wisely, in it.

If you replace the references to finances and the financial system with the healthcare system you will see how clearly we have allowed ourselves to be blind and numb to the inequities we live with. Why should someone who is less fortunate than one of us suffer the consequences of no health insurance, and hence often less care, simply because our culture has chosen to capitalize the profit of delivering health care, but socialized so many of the costs. A chosen few profit, yet as a society we all bear the costs, both financial and energetic of allowing reactive care to prevail over prevention in virtually every circumstance in our healthcare system.

We have alot of work to do!

Back at it!

As has been the case time and again as I've written this blog, I have been through a slow writing period. What's interesting to me, is that there seems to be a direct relationship between how busy I get at Yoga Yoga, and how little time I have to write. Of course, it really isn't that I don't have the time, its more that the kind of time that this sort of writing takes is just more than I can do when I am way full in my 'day job'!

Well, much has been happening!

We opened a new yoga center in over the course of 6 weeks, Yoga Yoga 360. Its seems like this was ages ago, but in fact it was only 7 weeks ago that we actually opened our doors!

We're also going to start classes in partnership with Seton/ Good Health Commons in Round Rock in January.

And our newest project, YogaSolve(tm) is going to roll out shortly.

For us at Yoga Yoga this time has been challenging and exciting. We've managed to get the new center open, and really not 'miss a beat' with our end of year plans, projects and actions. The team is fabulous, and I'm learning what it really can be to work with a group that has begun to 'find itself'....what a pleasure!

More to follow as we head into '09!
Raghurai

Wow!! That's Writing Worth Reading about Social Entreprenuership!

Do you ever read something and think 'awesome!"? Sasha Dicther, who is the Director of Business Development of the Acumen Fund, inspired by Seth Godin's new book, Triibes, wrote this absolutely awesome manifesto. (You can read it in html on this post).

For a few years now, I have been moving my focus more and more towards how do we take all of the great work we have done at Yoga Yoga, and explore what is next? My thoughts often settle around the focus of social entrepreneurship, patient money and creating 'organic' social change directed towards making yoga even more accessible, and how to not lose the knowledge, technology and wisdom of the 'yoga' as it reaches a larger audience, something that is a concern as the yoga 'industry' is increasingly associated with 'stuff' and 'sweat' versus knowledge and a lifetime of patient practice.

Recently I found this page about the Acumen Fund's approach to lending, and was greatly impressed by the breadth as well as the depth of their thinking about how to bring funding into the world of social change.

As I explore various initiatives for bringing yoga into the mainstream of the marketplace, hoping to support the change that this practice brings to individual lives day in and day out, my primary focus is how to 'scale' without losing our heart. I am convinced that the creative use of capital is at the heart of this issue, and I am inspired to continue to explore this when I read work this thoughtful, cogent and persuasive!

I hope you take the time to read it. Especially now, in these economically confronting times, we can be well served by taking the time to question our current beliefts in capital, economics and what it means to foster genuine well being in our communities. I think money and capital can be part of the 'perscription' for community health, but it is time to reinvent the rules. I think Acumen can help, and other groups like Ashoka, and the RSF Social Finance are moving this entire concept more and more into the mainstream of our culture every day.

The Yogic Edge - Extended Version on December 6th

Last Saturday I presented the current version of 'The Yogic Edge', a workshop for yoga teachers and students to explore how to integrate their yoga practice and their professional experience in the marketplace. As part of the Southwest Yoga Conference, I had the chance work with a few folks from out of town and that was great. I met studio owners, yoga teachers new and old, and had the chance to continue to develop this body of material I have been working with.

The comments had a consistency to them. Folks wanted more details, more 'what to do'. Unfortunately, in just 2 hours, it is all I can do to get some of the basic concepts into the discussion, much less try to cover more specifics. Luckily though, in less than 2 months, on December 6th, I'll be doing a 5 hour version of 'The Yogic Edge' here at Yoga Yoga, and in that workshop I intend to get more specific, to give folks a more developed structure to work with when then get back home.

Please join us in Austin!

Raghurai

Integrative Medicine - Riding a Cultural Wave

The last decade has seen a substantial shift in the awareness of all forms of 'alternative' approaches to health and wellness in our culture. For the first part of the decade I had been almost exclusively focused on growing Yoga Yoga and building a unique organization - focused on delivering classical yoga with respect for lineage, while making this yoga more accessible to a larger portion of society. Then, a few years ago the role we could play - in fact were already playing - in the context of health care became more apparent.

Students were (and always had) taken yoga for their own reasons along the spectrum of wellness. Some were healthy and wanted to expand their experience of being well into other dimensions of health (in mind or body or both), some were not well, but not yet of need of medical intervention and heard yoga might help, so they tried it and it worked. Others had already sought the intervention of a health care professional, who recommended yoga as an adjunct to the care they were providing, or who sought out yoga in order to complement the care of a more traditional provider. And occasionally individuals seek to use yoga in lieu of medical intervention as a purely personal choice.

Now, as society moved towards a 'perfect storm' which just might be a harbinger of change....

• A health care system clearly failing from overwhelming cost and massively unacceptable results
• Explosive growth in the use of 'alternative' approaches
• Growing scientific evidence for the benefit of these alternative approaches
  

In the context of this 'storm' I've been exploring what this all means for yoga, how it is taught, how it is defined in our culture, and what the future might bring.

Recently I had the chance to attend a conference on the emerging field of Yoga Therapy, and participate in this ongoing discussion and exploration. Its an important area of growth for our profession, and I'm especially curious how it will emerge in the coming decade. In fact, in March of next year I will be presenting at the SYTAR conference on 'The Economics of Yoga Therapy'.

I'd encourage all of us to stay informed as this field evolves, matures and adapts to the needs of our communities, the knowledge of our professionals, and the development of structures that make it possible for yoga to reach ans serve more and more people.

Rich (Raghurai)

How Far Can We Scale Communication and Retain our Humanity?

For years our organization has shrived to 'be human.' It almost sounds silly, how could we (over a hundred yoga teachers and committed practitioners) 'be' anything else? I believe the issue is 'scale', that subtle affect of going so far past the past the 'tipping point' in the paradigm structuring relationships that you aren't even aware that there was such a point.

Earlier in the week, as I heard a commentator saying that a particular event was ' staged' (and they meant it in a derogatory manner). I was struck by the absurdity (as well as the lack of intention to genuinely serve) in the comment. Of course, when we are talking to individuals, small groups or large groups we need to be thoughtful of what we say. I would call this bringing consciousness and awareness to a relationship. In a one to one I can relate consciously in a way that simply won't work in a much larger group. When on the stage in front of millions of people, it is probably a more responsible thing to be aware of what one is saying ahead of time, and VERY thoughtful about delivery, phrasing and pace. However, simply by virture of this consciousness brought to the interaction one cannot doubt the authenticity of the moment. It is up to us to us to decide, to 'be with' the moment if you will, to trust our perception. We humans can perceive other humans acting with integrity even in extreme situations, if we are willing to be conscious and aware.

Recently Seth Godin wrote this:

Organizations will work tirelessly to de-personalize every communication medium they encounter.

You can read the entire post here. I think what we have consciously done, and consciously do day by day is to violate this law. We strive to put our 'humanness' into each and every communication, piece of paper and conversation. Its hard. It may cost more. But it feeds us, and allows us to retain a level of humanity and satisfaction that drifts away in most organizations. And its simply because we insist on being human. We insist on being conscious. And we insist on being aware. And in the presence of that insistence is where we begin to communicate from. And then we trust our audience - one person or many - to listen with open hearts and hear the subtly from which we speak.

So far, its working out ok. I think you can scale communications just fine, as long as you are aware and as long as the conscious heart felt intention is there from the beginning, and steadfastly insisted on throughout.

Join Me at UT Informal Classes - October 7th

Thsi should be fun. I'm going to teach a class at UT Informal Classes entitled "Socially Responsible Business Practices". Here's the course description in the catalog:

This class will cover both practical and philosophical aspects of the current business environment and practices which can be thought of as "socially responsible" business practices. Participants will learn how to bring these practices into their own work lives and businesses. The course will cover marketing to the "Lifestyles of Heath and Sustainability" market, and how to explore reworking your business strategy to incorporate this set of dynamic, successful business principles. This material is appropriate for business owners and employees at any stage of their career, if they want to learn these competitively superior business foundations of the emerging socially responsible economy. Rich Goldstein is the managing partner of one of Austin's premier yogic learning centers that supports and contributes to the unique and diverse culture of Austin. He practices combining strategic business management, marketing and operations with a deep respect for each individual's commitment to living with a more heart-centered work experience. Seating is limited. (2 meetings)

The class will meet on Oct. 7th and 14th, from 6:30 to 9:00 pm. My plan is to use examples from around the economy of success stories (and some not so successful stories) illustrating the power of this conceptual approach to business. In the second session we'll be developing action plans specific to your business or career. If you are reading this and here in Austin, come join us and help make these 2 nights interesting, exciting, challenging and fun.

Here's a link to the class in the course catalog. (Its in a frame, so you may need to click here to get to the home page of the catalog). The class is in the Business & Personal Finance Section.

'Framing' Consciousness & Business in the Cultural Dialogue

I'm an advocate for business as a spiritual endeavor. Three decades of participation in the marketplace have allowed me to experience the unique 'edge' that business introduces into the path towards enlightenment, self realization and fulfillment. It has many aspects of a 'path'...challenge, connection to self, connection to others. By design it allows you to take your attention off of yourself, a key aspect of growth. I am confident that business engaged in consciously has a substantial role to play in both solving many of societies current wants and desires (energy, health care to name just two) WHILE moving individuals and entities towards more awareness and well being. It is just this dual affect which is so compelling about committing to bringing consciousness into one's work life.

(In fact, modern science is now documenting why this is the case, in new studies that prove the power of consciousness to manipulate DNA...more about this in a post later this month)

We can be participants in bringing a new contextual frame for business into our society. 'Frames' can be very powerful. Frames like 'conscious entrepreneurship', 'conscious capitalism' and 'socially responsible business' can begin to impact our culture, simply by virtue of their use. In fact, authors and historians acknowledge the importance of framing and it's capacity for directing action and focus towards either the individual or a societal focus. Framing creates the 'ground' on which we all get to stand as we engage our friends, families and co-workers in discussions about the choices we make about our work and its significance in our lives.

Here's another example of the challenge so many writers and publications have in 'framing' this conversation about conscious business. In 'Its Not Easy Picking a Path to Enlightenment' the NY Times' Andy Newman writes about Kripalu, a retreat center (once ashram) which hosts 30,000 guests each year. While its wonderful to have this great facility promoted, I'm left with the missed opportunity of 'short changing' the view into the business operations. Here's how Andy misses the opportunity to frame this more powerfully (my bold):

“We’re constantly re-examining,” said Kripalu’s president, Ila Sarley. “What are the needs? What are the needs of the market, and what are the needs of society?” In the end, everything comes down to what will bring bodies in the door. “What we’re looking at,” Ms. Sarley said, “is what will someone pay to take a vacation to do.”

You can see that this is NOT part of the quote. It is, in fact, the frame that the author brought to this. I would assert that for the Kripalu organization everything does NOT come down to bodies in the door. That is a completely reductionist view of the much more complex balancing of bodies in the door, meeting our mission, working with the psychologies of how to entice people at all levels of their personal paths, making sure the staff is enthusiastic about the offering, etc, etc. But, rather than point out this complexity of the 'edge' we must navigate as conscious business people, the Times chose the frame that is easy and obvious - it must all be about bodies in the door.!

It is NOT just about bodies in the door. This is one aspect of the challenge that a business faces. It is up to the owners and staff if that is all their business will be about, or if they will declare it to be more than than, and strive, in each and every conversation, choice, and decision to design a business that is conscious to its core.

Accessibility, Scope and Quality of Yoga in America

There is an ongoing conversation about yoga in our society. This conversation happens in studios, among teachers, and most importantly between students, day in and day out. The conversation is about what is yoga, who should do it, why, and how to learn what one 'should' learn. While many of us are actively having this conversation, I think we all have to strive to keep the conversation deep, not trivialize it, and recognize the importance of honoring both the roots of our traditions and the realities of the western marketplace. Unless we succeed in honoring both realities, I am of the opinion that only the more superficial offerings will be widely available, we will find that yoga, like so many other aspects of our society will be 'MacDonald-ized'.

Here's an article in the NYTimes about yoga classes, finding advanced classes and the ramifications on a society-wide basis of the rapid growth of yoga in America. The author - Joelle Hann - does a nice job at the beginning of presenting the problem - lots of lower level classes, economic 'drivers' for this status quo - but then trivializes the state of the solution, and the issues around 'what is an advanced class'. My guess is that she just didn't have enough space to do the issues justice.

Its really quite important for us all as a community of yoga practitioners to be aware of this dynamic, and I applaud the Times and Joelle for fostering this conversation. If we are going to develop a more sophisticated body of yoga students and teachers it is vital that we be truthful about the state of our teachers, classes and programming.

As a studio, at Yoga Yoga we are always striving to balance the needs of the students with the economics of the business. When we have to, we choose to live with a lower return, and make the teaching available. In fact, we are excited about adding 4 new teaching rooms, which will let us add the sort of programming that Joelle refers to in the article - prime time advanced classes for small groups.

As yoga's role in our country continues to evolve, these conversations are ciritical. The International Association of Yoga Therapists (IAYT) is doing a great job in fostering powerful conversations. John Kepner, the current executive director had arranged for this series, done through the Integrator Blog, about the future role of yoga therapy. This is a critical conversation about the role yoga may play in the future. How available & accessible will yoga therapy be?

These two 'threads', how advanced yoga is taught in studios and the evolution of yoga therapy are both aspects of this same conversation. How can we best involve ourselves in this conversation, and do we really have the time, energy and commitment to do the conversation justice?

Balancing Being Effective AND Trusting Our Intution

It is the balance between intuition - something that is innately quite human - with effectiveness - getting done what you have chosen to focus on - that makes us successful. Especially if we define success as more than how much money we have in the bank. Success for you is more likely defined in 'richer' terms....balance, happiness, a sense of peace, contribution....you know...how YOU really think of success, deeply and with consciousness.

I've found, especially in working with yogis, yoginis and generally folks who have a deep intentionality to live a balanced, heart centered (and ofttimes spiritual) life, they allow the balance we learn on the mat to be ignored in our work lives.

Balance is just that - allowing for effectiveness AND including your heart. Remaining cognizant of your intuition even as you track your time.

I've often notices over the years that folks who are well intentioned caring beings, who want very much to accomplish regrettably resist the tools that work. Here's a great article by Melissa Raffoni about how to use your time effectively. Apparently she works only with CEOs, a group who value their time highly, so we might learn something what she has to say. She quotes some material from Warren Blank in The 108 Skills of Natural Born Leaders

1. Break your responsibilities into categories

The categories will vary depending on your job function, but they must be both strategic and tactical—identify not more than six.

2. Ask yourself what percentage of your time you should be spending in each category

Before you assign percentages, Blank advises that you ask yourself this question: “Given what I truly want to accomplish today as a leader, what will be the best use of my time?

She goes on to talk about managing your time and auditing your time. These are such important skills if we want to learn to be effective AS we learn to live a heart centered work life. Balance requires work.....on and off the mat! These practices are the basics. Use them.....your work life will be more successful, and a successful work life COMBINED with a deeply gratifying inner life is a wonderful design!

The Audacity for a Company to Care

Okay, so I borrowed a word from Obama's book. Forgive me. As I began to write this, I wanted to engage about the nature of caring as a company, and the more I read, the more I was struck by how audacious it is for any company to attempt to care. A bit of history...

The company I work with (Yoga Yoga) was started with a commitment to bring more yoga into the world. Mehtab, Guru Karam and Kewal Kaur were looking to teach and to share. Making money was not primary, but it was important...they did have to pay the rent, and pay utilities, and eventually anyone who would wind up working at the company. In short, they were small enough to decide to care, rather than focus on making money. Their decision, and theirs alone.

However, as Yoga Yoga has grown, we now have different constraints, different needs, and different demands. Instead of 3 folks, other jobs, and no employees, we now have over 150 people who earn money from Yoga Yoga each month, and 4 landlords to pay rent to, and many many other bills. Now, we get to focus each day on 'can we care'? Can we make the decision to care on an equal (or sometimes senior) footing to 'is this profitable'?

Riane Eisler's newest book (she wrote the Chalice and the Blade) , The Real Wealth of Nations: Creating a Caring Economics, altering the value we place, as a society, on caring work. Here's a quote:

An economics based on caring may seem unrealistic to some people. Actually, it’s much more realistic than the old economic models, which strangely ignore some of the most basic facts about human existence..

In some ways, Yoga Yoga is simply an experiment in economics...'is it possible, on a level scaled up from a one room studio, to offer a high quality experience of yoga - steeped in lineage, respectful of all, honoring of tradition, yet accessible to all levels of students - AND be economically viable?

I say it is audacious to try, but it makes our work teaching yoga to thousands of people each week a joy and an adventure. As a team, those of us who work at Yoga Yoga know that we can put caring above profit (as long as we are skillful enough to succeed), and that we are working with a group of folks who are committed to seeing if we can make this work. We are really a bunch of audacious yoga-economists!

Listening, Networking and Finding Deep Inner Peace: TED Talks & Social Networking

Like many of us, I have enjoyed the gift of establishing a network of connections with a wide range of folks around the country, and around the world through the omnipresent infrastructure of the internet. For our parents, their input was limited by physical proximity...ours is not. Every day, most of us receive input from our own personalized information system. Many of my connections are biological - living folks sifting through their own structures, and sending items along, either directly or through their blogs or other constructs. I also use automated tools - blog readers, keyword searches, and other 'content sifters'. This sifted information influences my reality, and who I am, since who I am evolves in a 'dance' with the inputs available to me. I had a teacher once who said 'be careful who you listen to' for just this reason. In our new socially networked world, we now get to create 'who and what we listen to' in a powerful new way!

Recently I have been even more enamored and curious about social networking as it relates to our yoga studios, so I am paying more attention to my own input through these channels. This talk, Stroke of Insight: Jill Bolte Taylor on TED.com, was sent to me by at least 6 diverse players in my personal network. Folks who don't usually send material over (they are mostly not in that role, they are just too busy). How fascinating, if we want to promote something, to notice how promotable a talk is that so deeply touches our wants, desires, connections as human beings. If you have not yet watched the video, just go watch. It will be the most moving 18 minutes you've spent in a long time. Then, give some thought to 2 things:

1. Do you have a message that merits awareness and promotion? Without merit (in whatever context you choose to engage) you will not have the emerging social network opportunities available to you. These networks are ruthless in recognizing value (which is defined in the background, and ONLY in the context of the network!)

2. What are you doing to enhance your social network and your own, personalized information 'funnel'? Your 'edge' is a function of your connections. And your connections have to be growing and 'informed by' the ever changing flow of the market. You must be participating in the networks that are emerging if you want to benefit from them.

Which structures do you use to create your personal information 'funnel'? Blogs? Searches? Facebook friends? Share the most powerful ones in the comments.

Army Seeks Out the 'Yogic Edge'

We are all living with the societal cost of our country's war on Iraq, and as yoga instructors from time to time - depending on our locations and proximity to military bases - we find families of military personnel and both active and retired military in our classes.

We also know that yoga is extraordinarily powerful in reducing stress throughout many systems in our bodies. Here's a post from the Mayo Clinic about yoga and stress).

Now, the military is seeking out help from all avenues (a good thing) to address the growing crisis our soldiers are facing - PTSD. More about PTSD here (Wikipedia), here (VA), and here (NIH).

The military is scrambling for new ways to treat the brain injuries and post-traumatic stress of troops returning home from war. And every kind of therapy -- no matter how far outside the accepted medical form -- is being considered. The Army just unveiled a $4 million program to investigate everything from "spiritual ministry, transcendental meditation, [and] yoga" to "bioenergies such as Qi gong, Reiki, [and] distant healing" to mend the psyches of wounded troops.

While this is an extreme example, those of us who are actively involved with thousands and thousands of individuals and companies striving to solve their health concerns through yoga see, day after day how powerful this ancient technology is. Its great to see the entrenched military establishment seeking out help in this area. Some great work is already being done...if you haven't seen Richard Miller's iRest program, take the time to find out about it.

The government is looking for proposals:

But many of these treatments haven't been held up to much rigorous scientific scrutiny before. So the Army is looking to hand out $4 million in "seedling grants" to "conduc[t] rigorous clinical studies" into all sorts of "novel approaches." Projects "containing preliminary data" will be eligible for up to $1 million. But even "innovative but testable hypotheses without preliminary data" could get as much as $300,000. Proposals are due May 15.

Read the entire article on wired!

The "Bonsai" Organization

Bigger isn't always better for business according to Drucker School of Business Professor, Charles Handy. Here's an interview with Handy from NPR's Marketplace. I like a number of things he says, including that

"if we are not careful, organizations can become the prisons for our souls"

This very much speaks to the challenge we have in building organizations that incorporate yogic values along with strong business acumen and skill. We attract people who want life entwineed with work, in a dynamic, nurturing way, and it is our challenge as managers and business people in this arena to solve this problem and feed people's souls, even as we accomplish powerful results for our organizations.

One other writer who has chronicled this area well is Bo Burlingham in his book, Small Giants, which is a MUST READ for folks wanting to be validated in their search for a poerful, more human work place.

Growing interest in yoga as health therapy

Here's an article that in NY Newsday about yoga therapy.

The article does an adequate job talking about what yoga therapy is, but then towards the end of the article, here's a paragraph that I think is just 'off' in the way that yoga therapy is finding it's way into the marketplace (my bold):

As to where she's going, Page admits it'd be easier to make a living teaching downward-facing dog to dues-paying health club members instead of to patients in hospitals or clinics, or students at schools in low-income communities. Still, she believes in the "healing power of yoga" and is confident that eventually doctors will refer patients to a yoga therapist as routinely as they do a physical therapist today.

If we are not going to ensure that our yoga therapists are compensated more highly than yoga teachers in gyms, then how can we expect them to get trained at a high enough skill level to offer quality care?