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Fixin' Healthcare

Sunday, April 06, 2014

Practice Is Changing

Yes, practice is changing and it has been for quite some time. But one has to wonder about the orientation and direction of that change. Small gains come at great cost and do nothing to prevent or reduce the disease. That does not mean the treatment is unnecessary but it does question the orientation and direction of health care with its emphasis upon the medical industrial complex.    

Yes, practice is changing. The patient was always the key to achieving optimum health. Perhaps medical care was too self-centered to recognize that aspect of their task but maybe we were training the wrong kind of practitioner. It takes a teacher and a motivator to mobilize the patient and keep them going. Family Medicine tried to do this but fell short of their goal with some exceptions. The potential for community and population health far exceeds that of traditional medical care. Schools of public health should lead the charge to design and implement models of community wide health care. Collection and analysis of health data will become more sophisticated but using the information to educate and motivate the public is the frontier of practice. For that task we will need fewer physicians, a better concept of HEALTH insurance and less domination of the system by hospitals. Time to redesign the county health department and introduce marketing of health rather than CAT scanners and MRIs. The highest level of technology in health is contained within the human body and we still know so little about it. Saturated fat, anyone? Or nutritional supplements? Walk everywhere you go and cover at least four miles each and every day! Now, that is something you can believe in.

Wednesday, March 26, 2014

Saturated Fat

Here we go again. As more information becomes available, it appears saturated fat is not necessarily bad for health. But lifestyle and nutrition are complex and it is impossible to know everything that we need to know. I suspect this "new" perspective on saturated fat will hold up with some twists and turns along the way. Stay tuned.

Saturday, March 22, 2014

Diminishing Returns For Medical Care

Small gains in outcomes and health for "advances" in medical care are coming at greater cost. But don't worry medical care is a business and someone, somewhere be it corporation and/or individual is making money in the process.

Wednesday, February 26, 2014

The Right To Be Healthy

Sooner or later the right to be healthy takes precedence over the right to an unhealthy lifestyle but it may take waiting for the 2 to 5 year old children to grow up. People want to feel better but they have trouble resisting temptation. Perhaps the little children can lead them. Let's hope so.

Wednesday, February 12, 2014

Commonly Held Assumptions In Health

It dose not take long to recognize that many commonly held assumptions about health are not accurate. Two examples are mammograms and vitamin supplements. In the past there was not enough information to counter such practices and the assumptions were extrapolations based upon reasonable facts. In health there is great pressure to do something but cause no harm. Physicians are especially susceptible to such pressure. A technology oriented world places value on the latest technology and it is often widely distributed before it can be fully evaluated. But in some cases utilization of technology becomes the evaluation. Not to be overlooked is the business side of medicine creating pressure to maximize utilization and revenue. Direct advertizing to the public by pharmaceutical companies comes to mind but hospitals and health professionals are also caught in this web. Some of this will be countered by the increased use of sophisticated information systems and data bases. The cost of business as usual prevents continuation of business as usual, especially when many previous practices do not lead to better health.   

Monday, February 10, 2014

What We Eat

People eat what they are accustomed to eating. Furthermore, salt and sugar have a way of capturing the taste people desire. Preparing food may be time consuming and convenience plays a major role in what we eat. Did anyone think it was going to be easy?

Nutrition Is Confusing

Nutrition is confusing because nutrition, life, metabolism and health are complex. There are a multitude of factors to be considered and putting them all together is difficult. One problem with understanding is the various theories professing to provide a magic bullet. But there is reliable evidence indicating pathways to weight control and better health. American society has made it difficult to follow some of the pathways but that may be slowly changing.

Monday, January 20, 2014

Develop Healthcare To Reform Medical Care

There was never a time I considered the possibility of reforming medical care. That is a task beyond me and I have no faith it can be accomplished. I recognize medical care for being what it is, a process to evaluate and treat sickness, disease and injury, and perhaps rehabilitation. Medical personnel are trained to provide those services and there are people who need them. Yes, medical care is inefficient and costs way too much. But it is also ineffective for curing most of the health problems that exist in the US and that is the core problem. A chronic disease is a lifetime of medical care and that is way too much medical care when many of these diseases can be prevented.
A public and political focus upon medical care detracts from creating the culture to prevent disease and improve health. Developing a healthcare system committed to community health and reducing the need for medical care is the most effective pathway to reform. It will take time but it can be done. Notwithstanding the cost of medical care, people are tired of being sick. Changing the culture is a personal and a community effort. The process has already started. President George H. W. Bush called such a process a “thousand points of light”.