Cardiovascular and cardiometabolic disease continue to devastate the lives of patients, families, communities and the US healthcare system at large. The sad truth is, a solution already exists. If healthcare systems could figure out how to implement therapeutic lifestyle change, nearly 80% of the world’s medical problems would either be prevented or reversed. Over the last 10 years, I have seen this solution play out in my office and other Functional and Integrative offices around the world. So, why isn’t this already happening? Three things: 1) Provider training, 2) Patient engagement, and 3) Cost.
Step 1: Train the Trainer Despite decades of solid evidence, lifestyle medicine is rarely prescribed as the first line treatment for chronic disease by most physicians. Admittedly, you’ve heard a statin drug commercial mention diet and exercise in passing, but these are rarely given the same priority as procedures and pharmaceuticals in the exam room. We must promote continuing medical education through reputable Functional or Integrative Medicine training programs for foundation and maintenance training similar to the manner in which residency and conventional CME works. Science evolves and so must we. How else could a provider learn the evolving data regarding red yeast rice, a popular ‘non-statin’ therapy used by many of us as a substitute for the standard statin therapy for the treatment of elevated LDL-c levels. (Click here to learn more about RYR.)
Step 2: Engage the Patient The current healthcare structure limits time and partnership between patient and provider. Even if one were trained adequately in the anti-inflammatory, low glycemic impact, Mediterranean diet as a potent treatment for cardiovascular disease, short visit times don’t provide the time and social support necessary for successful behavior change. For years, many savvy physicians have been able to give patients the education and support they need in a supportive visit model that not only increases patient education and improves clinical outcomes, but improves access and practice profitability by 200%-600%. Einstein, a genius on the subject of time, has stated, “Time is relative. Its only worth depends on what we do as it is passing.” (Click here to learn how billable group visits expand your valuable time.)
Step 3: Money Matters In a time where insurance seems to be charging higher and higher premiums in exchange for less and less coverage, patients are feeling the strain of disease physically, financially and psychologically. While conventional medicine seeks to increase access to reactive pharmaceutical and procedural care, Functional and Integrative clinicians understand where money is best spent. It’s the old adage all over again, “An ounce of prevention is worth a pound of cure.” As with any innovative concept or product, the early adopters and initial investors are those people who have the discretionary income to pay for the product or service. Cars used to be a luxury item reserved for millionaires; however, when society valued this innovation, competition and capitalism helped make cars affordable enough for most every 16 year old to have one.
Until all this plays out, the American consumer must make hard choices. Either invest in choices that lead to the #1 cause of death for adults or not. You see, we make choices all the time with our money. The question is, do we (patients, providers, employers and insurers) have the fearlessness and faith to stop merely praising prevention but prioritizing it so high that we actually get it done? I hope so because our future depends on it.
About Shilpa P. Saxena, MD
Shilpa P. Saxena, MD is a Board-Certified Family Practice physician whose passion and purpose come to life through sharing her innovative patient education and practice management solutions in her classic ‘keep it simple’ style. She serves as Faculty with the Institute for Functional Medicine, the Arizona Center for Integrative Medicine, the University of Miami, Miller School of Medicine, and the Metabolic Medical Institute at George Washington University. Dr. Saxena is an expert in the Group Visit medical model, creator of Group Visit Toolkits, and co-author of The Ingredients Matter: India.