Natasha Deonarain, MD, MBA is a board-certified family practice and urgent care physician with 20 years of experience in both Canada and the United States. In her upcoming book, The 7 Principles of Health: Your Call to Health Consciousness, she talks about a new paradigm for optimal health that’s based on a different paradigm than that used in Western medicine. Natasha kindly shares her thoughts on how the US healthcare system needs to – and can become – more patient-centric.
To see where America’s healthcare future lies, we should take a few lessons from the book and music industries.
Corporate giants like Tower Records and traditional publishing houses, once representative of centralized delivery models were and are being replaced by decentralized, niche-oriented communities, powered via online technology and distributed through social media.
Healthcare models have been slow to keep up. But a break-down of the doctor-centric model is rapidly gaining speed, driven by people and technology against a backdrop of a collapsing medical system.
There are several reasons for this. Health advice dictated from a paradigm of disease-orientation in conventional medicine no longer serves integrated healthcare demands. Patients want much more for the premium prices they’re paying; especially when today’s striking epidemics of preventable disease have shaken them up.
In addition, the extreme fragmentation of care, over-specialization of doctors, separation into Eastern and Western medical practice and paternalistic attitude inherent in conventional medicine have taken their toll on patients. Consumers are ready for something refreshingly different; not only as personal health advice but also to serve their growing sense of alienation. A patient- centric, community-oriented, collaborative framework will soon emerge as this new delivery system. (See the July/August 2012 GT Briefing on the Democratization of Healthcare, Education & Retail for some examples.) Providers and institutions that attempt to continue in the old paradigm will soon find themselves going the way of books and music today.
What are some of the problems driving this change?
First, we as a nation are living through very tough times; economically, politically and socially. These last four years since 2008 have been the worst since the depression.
Between 2000 and 2012, unemployment rates have doubled from 4% to 8% while the median household income dropped from US$54,790 to US$50,020. Healthcare costs are expected to consume almost one quarter (20.8%) of the total gross domestic product in America by 2018. Government programs such as Medicare are expected to go bankrupt by 2020 if not sooner. Insert this into a political forum of such contention where even pundits are calling it a ‘knife fight’ and we have the underpinnings of significant societal and social upheaval. Healthcare delivery then becomes simply a sub-component of that drama.
Second, conventional medicine grew too big for its britches. Specialists, heavily driven by profit incentives to fix, cut, test and cure by 2010 outnumbered primary care doctors by 3:1 and have become symptoms of a much larger disorder; a paradigm of healthcare based in disease-oriented practice. In the meantime, patients are living a very different story from the one their doctors believed.
Trends in complementary and alternative medicine (CAM) show that in 2007 people were willing to pay almost US$34 billion dollars a year out of pocket for chiropractic, yoga, meditation, Qi Qong and energy healers, up from US$27 billion in 1997. Despite the traditional view by conventional medicine that these practices are un-scientific or lack validity, it appears patients are simply searching for alternatives which could help them truly heal inside the construct of a seriously broken healthcare delivery system.
Finally, the doctor-patient relationship has been destroyed largely as a result of an at-fault malpractice system which encourages blame and litigation. Doctors have begun to practice defensive medicine, driving defensive practice costs estimated at over US$650 – 850 billion a year. Meanwhile, patients cling to a “right to sue” as a fallback for their fears, willingly intensified by commercials that advocated claims for damages, negligence and bodily harm.
But what these problems have eventually done is destroy an otherwise healing, therapeutic relationship based on trust.
Social movements are born out of situations and events; often oppressive. In the case of healthcare delivery mistrust, alienation, fragmentation and victimization have caused patients to seek or create for themselves a new model based on autonomy, empowerment, integration and collaboration, not only with health providers they choose but with like-minded individuals around the world.
What are the potential solutions?
So what can we expect in the near future for US healthcare? With respect to a new delivery model, the following elements will be critical to the development of a new framework.
First, healthcare communities will be online, powered through technology and social media. They will be driven largely by patients, not doctors or institutions. Investment into bricks and mortar for disease care in an environment that is rapidly shifting towards healthcare cannot ensure survival of these expensive institutions. It’s estimated that by the year 2020 one-third of America’s hospitals will close.
A patient’s first point of reference is the internet. Social media has become king. We are already witnessing a migration to websites that offer healthcare advice such as WebMD.com and memd.com. These sites, however, are often doctor-centric and disease-oriented. With the new healthcare model, patients will demand fully integrated sites. This means more online interaction, more of a community spirit, more social connection to friends or peers, and a wide variety of expert opinion on many different topics, not simply advice from a narrow collection of conventional experts. It may mean that a cardiologist’s opinion is presented along with that of a spiritualist, acupuncturist or energy healer’s, each given equal weight – something that may not sit too well with some conventionally-trained practitioners.
Second, it’s going to be important to keep health and not disease as the main focus. While there are currently online communities which center on a particular disease such as multiple sclerosis, new healthcare models will operate from a viewpoint that begins with health. Unfortunately, Western medicine emphasizes the prevention of disease rather than a practice of health. But the absence of disease doesn’t mean you’re healthy. Since the paradigm of disease has been entrenched in conventional mind-set since the 1700’s, it will be up to patients to re-set our paradigm to one which emphasizes total health practice in every aspect of life.
Finally, new healthcare delivery models will have a strong female component. Women are much more in tune with their bodies from an integrated perspective. In addition, they’re much more open to discuss unusual practices such as energy healing, spiritual or angel readers, Reiki practitioners and astrology in medicine. Women therefore, will be the key drivers of these new online healthcare models as they seek a stronger sense of connection, interaction, collaboration and integration while eliminating stakeholders with aggressive self-interest.
A big question is how health insurance companies of today or government programs are going to fare in this rapidly shifting landscape. Given their archaic infrastructure, profit motives, sky-rocketing costs, inefficiencies and inability to deliver real health to a struggling nation will they go the way of books and music? Or can they become part of a true patient-centric solution that makes the pursuit of health accessible, affordable and much more enjoyable for all?
Natasha’s also the founder of the Health Conscious Movement whose vision is to become a massive collaborative online connection to conscious health principles; for the people, by the people. She invites you to join at Facebook@TheHealthConsciousMovement and visit her website at www.7POH.com for more information.
References
- Sentier Research Household Income Trends Report, January 2012 found at http://www.sentierresearch.com/reports/Sentier_Research_Household_Income_Trends_Report_January_2012_12_03_01.pdf.
- Trends in Healthcare Costs and Spending, Kaiser Family Foundation found at: http://www.kff.org/insurance/upload/7692_02.pdf.
- Congressional Budget Office, Medicare Baseline found at: http://www.cbo.gov/budget/factsheets/2011b/medicare.pdf
- Primary Care Workforce Facts and Stats No. 1 (2010) found at: http://www.ahrq.gov/research/pcwork1.htm
- Costs of Complementary and Alternative Medicine and Frequency of Visits to CAM Practitioners: United States, 2007 found at: http://www.cdc.gov/nchs/data/nhsr/nhsr018.pdf
- Defensive medicine adds billions to healthcare costs, November 2011, found at:http://www.healthcarefinancenews.com/news/defensive-medicine-adds-billions-healthcare-costs
- Why one-third of hospitals will close by 2020, found at: http://www.kevinmd.com/blog/2012/03/onethird-hospitals-close-2020.html
