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