"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:
• Pap smear
• 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."