As Americans we spend more money on healthcare per capita than any other nation in the world. We have the latest medical innovations and for decades have been able to provide cutting edge therapy without regard to cost. However, as a profession, doctors are not doing nearly enough when it comes to prevention of disease. Certainly, costs will be reduced if we are able to prevent chronic illness and associated complications. By focusing on better health on the front end, we may be able to significantly impact cost on the back end.
An article in the New York Times highlights the issue with the American lifestyle and the widespread lack of individual responsibility when it comes to health and wellness. In the article, author Sabrina Tavernise explores the change that immigrants experience in their health status after living in the US for an extended period of time.
Research has shown that the longer immigrants live in the US, the higher their rates of high blood pressure, heart disease and diabetes becomes. Scientists have looked at these data and have postulated that much of the change in health status for immigrants is related to the adoption of common American habits such as smoking, drinking, high calorie/low nutrient diets and sedentary lifestyles. In addition, areas where large populations of immigrants reside often contain large numbers of fast food restaurants–providing easy access to poor food choices.
I believe much can be learned about preventative health from lifestyle research. Most importantly, studies such as the ones discussed in the New York Times emphasize the significant impact lifestyle choices can have on the overall health of a populations. As a nation, we must work diligently to reinvent our healthcare system and contain costs. It is readily apparent that physicians must spend more time providing preventative counselling and promoting better health choices. Here are my 5 points of emphasis for prevention:
1. Education. It is imperative that we educate patients on risk factors for illness and how they may go about modifying risk. Patients need to understand the consequences of poor health choices and how these choices may negatively impact them and their families
2. Assessment. Physicians must spend time in the office with each patient and carefully assess their individual risk. Diagnostic testing and screening for disease in high risk individuals is warranted. Once testing and assessment is completed, a frank discussion with patient and family is required in order to promote positive lifestyle changes.
3. Empowerment. Healthcare providers must empower patients to take control of their own healthcare. Patients must become active engaged participants in the journey to better health in order to impact outcome. Patients must understand that they must take individual responsibility for poor lifestyle choices and work to effect individual change.
4. Encouragement. Changing lifelong habits can be incredibly difficult. Patients may resist change and deny risk. However, physicians must help patients to set reasonable goals, cheer them along their journey and celebrate victories–no matter how big or small. We must work hard to promote a positive attitude along the way.
5. Reassessment. Certainly, once lifestyle changes have been made and goals met, it is important to reassess risk. This may require follow up testing and may result in new goals and other potential therapeutic changes. However, it is essential to communicate with the patient and continue to motivate them to make positive lifestyle choices.
It is clear that as a nation, we make poor lifestyle choices that may significantly contribute to the development of chronic diseases and increase healthcare costs. Studies such as the one discussed in the New York Times demonstrate the powerful effects of culture and lifestyle on one’s health and susceptibility to disease. When citizens from other countries or cultures move to the US, it appears that our lifestyle has a negative impact on their health. Individual responsibility and patient engagement are critical to prevention of disease. It is essential that we begin to focus more on prevention in order to gain control of healthcare costs and ensure that all Americans have access to care.
Kevin R. Campbell is a cardiac electrophysiologist who blogs at his self-titled site, Dr. Kevin R. Campbell, MD.