True Prevention is the Solution to Our Healthcare Crisis

"An ounce of prevention is worth a pound of cure", noted Benjamin Franklin. Too bad the founding father is not here to help clarify and guide us with our much needed healthcare reform.

The fact is unless you've been living under a rock for the past decade or so, we all know prevention reduces disease rates and promotes good health. Yet surprisingly a mere 2-3% of today's healthcare expenditures are directed toward prevention. We are painfully aware that America is obese, stressed, sedentary and doesn't get enough sleep yet, we don't spend money on improving the situation and preventing diseases caused by these problems.

Instead of expanding true prevention programs, our present healthcare system is focused on diagnosing and discovering more diseases, testing ad nauseam, creating new and highly expensive technologies and developing an infinite array of drugs.

Conventional medical training and treatments are solely aimed at searching for disease. Success in our healthcare system is achieved when the patient, spends their life caught in the spin cycle of doctor visits and never ending testing leading to finding the disease that will eventually "express" itself and give the system a raison d'etre.

Providing true prevention is not even a consideration -- our present healthcare industry is programmed to swing into action with its high-tech, high-cost arsenal of disease "fighting wars". Peace and cooperation is not part of this equation.

No wonder the system is costing us $1.8 trillion a year -- and is certain to get more expensive. There's an army of special interests in Washington -- drug companies, hospitals and the medical establishment -- lobbying like crazy to make sure Congress doesn't disturb the status quo. Too bad if the country goes broke! Too bad if instead of enjoying life, we spend our time terrified of being sick.

The discussion about prevention has been going on for decades, but it has nothing to do with early diagnosis of disease which is what most conventional doctors and patients have been taught it is.

A patient of mine went for a physical at her local internist last week. As a courtesy, the doctor sent me the report from her chart. In a newly developed section under the heading Prevention, the doctor recorded the following list of tests he recommended for the patient:
• Mammogram
• Pap smear
• Colonoscopy
• Bone density
• Immunizations for pneumonia and influenza

Not one of these tests will prevent anything. They are all part of the health care system's early diagnosis of disease branch. My patient was scared that if she didn't do all the tests immediately, she would further endanger her health.

Another of my patients brought me a report from her annual physical conducted by an expensive executive physical company. The report was a five page list of everything done to the patient in the exam and panoply of scary recommendations of possible dangers awaiting her due to her rising age of 42, borderline cholesterol, possible high blood pressure and of course weight problem (10 lbs overweight). Recommendations included more testing and follow up with more doctors. If she did not follow the advice, implied threat of serious disease was found in every paragraph. Nowhere in sight was there mention of diet and exercise lifestyle and sleep recommendations that would really help her stay healthy.

Both patients came to see me asking for reassurance in the face of scare tactics and lack of direction for prevention.

Prevention is about staying healthy and not being scared into having tests done just for the sake of doing them. It is about spending fewer dollars on health care and more on good, clean, healthy living.

For people who are focused on prevention, much of their personal health care dollars are spent outside the conventional system. People and physicians focused on prevention spend money on supplements, organic foods, bioidentical hormones, acupuncture, gyms and even yoga classes. These expenditures are not even considered in the healthcare system budgets we are trying to fix.

This bird's eye view of our present healthcare leaves us in a quandary. How can we fix a system that is about increasing technology, drugs and people all focused on disease when the answer is clearly outside the system and in the area of prevention?

The answer is: you cannot.

The way to fix the system is to take a more in depth look at what works for the people who are healthy and stay healthy.

Health isn't about early diagnosis of disease. It is about teaching every one of us to take responsibility for leading healthy lives before there are any problems. Spending less money on looking for disease and focusing on eating right, exercising and leading healthy lifestyles is the real solution to the healthcare crisis.

May be we should listen to Benjamin Franklin who also said: "A penny earned is a penny saved."

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Comments

[LordMoon]

Try and understand.

There are several industries in this country dedicated to keeping people sick as a way of making money. They are the HMO's, and Giant Agribusiness. Keeping people sick is about the only industry that still makes money in the USA. They have bought our congress and control the FDA, and USDA, they will oppose any change that threatens their profit.

So, even if you want to change, or even if you find a good PCP, it will be very dificult for you to do anything outside of this corupt system that actually provides a chance for health.

Those useless tests lead to useless procedures, also usless and sometimes dangerous medications, but that's where the big money is.

Don't kid yourself, medicine has long ago died, it's just a business now. People are manipulated and herded through their Doctors office, and they honestly don't know who to believe.

[cthielst]

I agree and just posted on the issue of pediatric obesity and the impact of the cost on hospitals. If you think it is bad now, just wait until all of these children are adults. http://thielst.typepad.com/my_weblog/2009/07/impact-of-pediatric-obesity-on-hospital-costs.html

[Conk]

My God, it's refreshing to read an article like this. Thank you! This is the elegantly simple answer to health care costs. If most people understood and practiced the principles of good nutrition and lifesyle, most doctors (and near all of Big Pharma) could just close up shop.

[Clairvaux]

"Health isn't about early diagnosis of disease. It is about teaching every one of us to take responsibility for leading healthy lives before there are any problems. Spending less money on looking for disease and focusing on eating right, exercising and leading healthy lifestyles is the real solution to the healthcare crisis."

Absolutely.

In ancient Eastern cultures, doctors were paid when their patients were HEALTHY, and NOT paid when the patients required medical care.

That approach would certainly revolutionize our outrageously expensive and ineffective health care system.

[lisamh]

I give thanks every time I see a thoughtful physician speaking out. The point about the scare tactics is illustrated by the early comments to this article. The propaganda has ingrained in us the idea that we are just sitting ducks waiting to be attacked by disease. Not true! There is no guarantee. The person pointing out all the different types who got sick, "without warning" i.e. the typical dr visits, symptoms & test results, is just parroting the propaganda. These warnings have been published for decades in the media and spoken by doctors trained in the catch phrases by their medical schools. We're so worried about the possibility of getting sick/diseased that we no longer can see the lies. Genetics are just possibilities, not death sentences. Your health depends wholly upon yourself, how you live your life, and the sum total of your experiences. No test will EVER prevent anything! They only show a snapshot, frozen in time, of an isolated part.

[pros54]

Another very important point early visit and check up with primary care physicians is helpful and leads to early secondary prevention. This fire fighter was at the top of his game. never drank or smoked and as "physically fit" as a fiddle then he suffered a heart attack. After which his cholesterol and triglycerides were found to way off limits and family history revealed an epidemic of cardiovascular events at a young age. He ofcourse at this time needed secondary cardiac surgery which could have been prevented had he had a cholesterol test earlier and been specifically andviced on cholesterol reduction strategies and most likely started on medication. so before this discussion gets carried away by one size fits all prescriptions more rational minds should prevail and acknoeledge that adequate attention to all the levels of care viz primary prevention by good health education, public works and promotion of good health habits and use of vaccines, secondary prevention by seeking to find likely health conditions and treating them, tertiary prevention by treating obseity either by diet and excercise or surgery and treating illnesses that need to be treated like diabetes, hypertension, the differnet cancers PVD etc in a timely and efficient manner is how to achieve our healthcare goals.

[pros54]

Prevention and healthy life style is an important component of staying healthy but early intervention and treatment are not lesser components and anybody who attempts to diminish any one of them is being untruthful. People who never smoked develope lung cancer and people who never drank develope liver cirrhosis and two people may be on the same diet and one of them will become obese. Not all obese people become diabetic and not all skinny people avoid diabetes. So people while we tout the importance of prevention and healthy lifestyles we should not over do it.

[RMankovitz]

Great article!

Roy Mankovitz, Director
http://www.MontecitoWellness.com

[KathyinCT]

WHY no comments?

Huffington Post, THIS should be your lead article.

The best way to reduce health care costs is to use less health care --- NOT by rationing, but by having people NEED less health care because they are HEALTHY, as this wise physician says.

However, I would add that in addition to people living healthy lifestyles, there also must be access to primary care, for two reasons.

1) A good primary care physician helps you STAY healthy, and

2) Sometimes even the healthiest­-lifestyle people can get sick, develop a health condition or have an injury -- and then prompt and good primary care can make a big difference between regaining health or getting sicker.

SO it takes both -- personal commitment and a personal physician.

But with those two things in place, the need for expensive tests, treatments, surgeries and things to FIX sickness would decline, and so would costs.