VISION

HEALTH AS A MOVEMENT

 

The health care system is not broken. The current United States “health care system” is not a health care at all. It is a highly lucrative sick-care system that functions for the main purpose of coding and billing for disease and prescribing pharmaceutical drugs and surgical procedures at prices determined by a predetermined formulary. Doctors are now the subcontractors of insurance companies and are extremely limited in what they are able to practice because they are paid according to what is offered by insurance plans. Many doctors are in an unfortunate state of Stockholm Syndrome. Without them the system would not work, but they cannot leave as they are trapped in golden handcuffs as employees of large health care groups, which dictate when they work and how many patients they can see. The goal of the sick care system is not health, but ruling out disease and dysfunction, alleviation of symptoms, and discharge from the hospital. Not surprisingly, 9 out of 10 MDs wouldn’t recommend the profession to others and 81% of doctors say they are over-extended or at full capacity. 

We need to create a new health care system that aims for giving people what they truly want: real health. This means, “The ability to adapt and self-manage, in the face of social, physical, and emotional challenges.” To achieve this goal, we must cultivate global wellness consciousness and transform medicine from a reactive, pharma & surgical based industry focused on pathogenesis (origins of disease) to a personalized, predictive, preventive and participatory practice focused on salutogenesis (origins of health). How will we do this together? First, we need to open people’s minds to what medicine could be and could do. To create healthier habits and change patient behavior we have to give doctors the ability to prescribe the exercise as medicine, sleep as medicine, community as medicine, food as medicine, apps as medicine, wearables as medicine, love as medicine, psychedelics as medicine, and clean air & water as medicine. If we can move the dial from 5% of people to 50% of the population following best practices of wellness we will be healthier, more productive, more fulfilled, live longer and be wealthier.

Reducing the burden of chronic disease and extending healthspan of our population would save society trillions of dollars by reducing the cost of health care and adding millions of healthy, vigorous individuals to the workforce. With more money available for scientific research we would be better funded to find cures for cancer, rare genetic diseases, tissue regeneration, and aging. The doctor-patient relationship would be transformed from paternalistic to a copilot arrangement. Physicians would have sophisticated tools and ample time to spend with their patients. With less chronic disease to care for doctors would more energy to care for themselves and their patients and as a result, patients would have a better experience when they get sick. Together we can create a movement making health optimization a national priority that enables billions of people to live longer, more fulfilling and healthier lives. We envision a world where people live without disease through prevention and proactive measures to maintain health and happiness. In this world chronic disease is no longer our destiny, our growing children are nourished, our young find their path to purpose, we thrive in middle age, our elders are valued, and death is respected. Humanity will come alive and shine.

ENVISIONING THE FUTURE

2017

Sick Care

Paternalistic

Pathogenesis (origins of disease) orientation

Reactive focus

Aims for absence of disease 

Identify risk factors & problems 

Identify signs & symptoms

Late detection, delayed diagnosis

Minimal testing

Labs defining sick or not sick

Episodic care

Continuous monitoring when hospitalized

Expensive & little ROI

Fear of health debt 

Health expense that rises as we age

Self-sacrificing providers

Disengaged, health illiterate patients

Exhausted staff 

Wellness starting in middle age

Lack of access to primary care

High costs of chronic illness

Cultural, guidelines-based medicine

Closed, pay-walled health data systems

Public health focus

Aim to get from sick to not sick

Technology impairs doctor-patient

Drug, surgical & psychiatric interventions

Food as the cause of disease

Sedentary behavior as the cause of disease

Ignores impact of nature on health

Stress as a cause of illness

Economic catastrophe of aging

Disrespect for the dying & fighting death

Disease as an existential threat

Deterioration of doctor/patient relationship

Lifespan extension via drugs & drastic measures

Achieves symptom management

Medicine aims to prevent death

Managed care

Dystopia

2027

Real Health Care

Maternalistic

Salutogenesis (origins of health) orientation

Preventive, predictive focus

Aims to promote health

Identify abilities & wellness goals

Uses systems biology to scan for patterns & trends

Early maintenance & surveillance 

Maximum testing to gather data clouds

Nuanced view of lab ranges of bad, average, good, & optimal

Multiple times a year

Continuous monitoring of stress, hydration, CGM

Health investment with compounding interest

Desire to spend on personal wellness

Health maintained as we age & chronic disease avoided

Self-care becomes new physician culture

Engaged, activated, educated, responsible patients

Invigorated workers

Wellness starts in the womb

Healthier population & pressure relieved on primary care 

Investing in predicting & avoiding disease

Individualized healing plans enabled by data & tech

Open access to all health data enabling deep        

Personalized health Focus      

Aim to improve function, performance, & abilities

Technology enhances doctor/patient relationship

All of the these PLUS behavioral & digital medicine

Food as a cure of chronic disease

Exercise as medicine for the mind and body

Normalized circadian biology as medicine

Stress states measured, addressed to prevent illness

Economic benefits of decoding scientific wellness

Respect of the death process

Assistance with existential medicines

Doctor/patient as copilots

Longer lifespan via healthspan extension

Achieves human potential actualization

Medicine that aims to cultivate life

Self-management

Utopia

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