If a core goal of our nation is to have the healthiest population possible, then we need to rethink, regroup, and restore our commitment to health practices and processes that are aligned with this mission. We are currently investing our precious social and economic capital into a health care system that is wildly inefficient, too expensive, confusing, and failing most of us. As costs continue to spiral upward, the patient population is suffering from the growing burden of chronic disease (heart disease, diabetes, cancer), deaths of despair, the opioid crisis, and declining life expectancy as we are overfed and undernourished. To be fair, medical science has made technological advances, which has improved the lives of many individuals; however, for the broader population, we are failing miserably. The doctor-patient relationship is frail, strained, and continues to fray as “the system” weakens the bonds of trust. Doctors are time-starved (with the average patient visit being six minutes) as the promise of technology has not quite delivered on patient satisfaction nor outcomes. Procedures pay, and patient education does not. We have rising mental health issues, and physician and patient suicide rates are both at an all-time high. To say the least, we need a radical reboot to restore the health and wellbeing of our nation.
The good news is that science can guide us towards a better prognosis for our future. We know that 80 percent of chronic disease is preventable with lifestyle choices (food, sleep, exercise, and stress management). These social determinants of health have a great impact. As a New York City-based practicing physician for over 30 years, I regularly perform one-hour lifestyle risk assessments for disease and injury and “prescribe” food and exercise as ”medicine,” thereby saving my patients from unnecessary pills and procedures with simple, cost-effective life-saving and life-changing results. These best practices should be at the core of our health care system by cultivating a true culture of health – all without side effects!
The challenge and complexity of following this approach reside within our collective thinking about choosing to prevent and reverse disease from the core rather than simply managing symptoms. Current reimbursement models also present a challenge as high tech medicine and procedures are more lucrative than time spent on patient education. Medical students carrying a high debt load are choosing procedure heavy subspecialties. If we are serious about supporting the optimal health and well being of our nations’ patients and physicians, we need to start believing and implementing the science across the public and private sectors. We need to recognize that at its core, the practice of medicine is a human science. We need to allocate and deploy resources to the people and programs in health care doing the work of healing our nation. We need to provide a “self-care as health care” optimal health system, which is educative, accessible, preventative, and patient-centered.
This is what a successful health care system looks like.
Lillie Rosenthal is a physiatrist.
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