Leading Edge TEST

When Your Patient Asks WHY?

Why make lifestyle changes?

Why not just take the medicine?

Why isn't the way we have always done it good enough?

They are always saying different things, how do I know this won't change next week?

 

There are a few issues at play here, the first is that good science--good research--doesn't change quickly. The news media is not always looking for good science, it is looking for headlines and diet news is often the biggest news so they grab any study they can to promote their marketing. 

 

What is good science? It involves avoiding conflict of interest--if the company that paid for the study benefits by the results they should be very suspect. If there were only a few participants, or the study wasn't well structured to factor out issues that could give false results (for example if smoking is not factored in) or false conclusions are drawn (in science we like to say correlation does not imply causation--just because people who have emphysema also have athlete's foot does not mean one caused the other). If I eat crickets and my cancer goes into remission, does that mean eating crickets cures cancer? It may seem like a joke, but this type of bad science is in evidence all the time--especially on the internet.  

So, how do we convince clients that this "new" way, starting with lifestyle changes, supplements and complementary medicine like acupuncture, meditation and yoga, is worth embracing?

 

By looking at some solid statistics.

 

At the Integrative Health Care Symposium in New York, Tracy Gaudet, MD, the new head of the Veteran's Health Administration (VHA) presented:  Integrative Health: Healthcare Improvement or True Transformation?  While there is no definitive answer to her question yet, she presented some convincing statistics--the solid science type--that are very important to what we are doing. As iRNPAs. we are paradigm shifters. We are bridging the vast divide between the way things were and the way they can, and really must, be. Why? Because the way they were is killing us slowly and very expensively. 

 

One sobering statistic comes from the UC Project for Global Inequality. Of the top 31 industrialized nations, we ranked 27th in life expectancy and first, by a large margin, in costs.  In Japan, ranked #1, the life expectancy averages 81.2 years and the average yearly cost of medical care?  $2100.00 per year.  The US?  Average age at death 77 and average cost of medical care per year? $4500.00--more than double for a shorter life span. The country right next to us in lifespan, neck and neck, only spends 77.00 per year, per resident, on medical care. Care to guess? It is Cuba. We live about as long as Cubans and spend 58 times more than they do. 

 

Right now healthcare in America consumes 18% of our GDP. At this rate that number will be 31% by 2021. That is unsustainable by any measure, it will crush this country under massive debt and lost productivity. For what?

In the US, between 2000 and 2009:

 

    • Heart Disease increased by 25%
    • Diabetes increased by 32%
    • Stroke increased by 27%

 

In just nine years!  (US Dept of Health & Human Services, CDC, data)

 

From 2006 to the end of 2013 the use of dialysis at the VHA doubled! That is a 100% increase in kidney failure. They have already exceeded their capacity and at this rate it will be virtually impossible for them to add services as quickly as they are needed--and that cost alone would overwhelm the budget for all types of care. There is no way to pay for it. 

And that brings us to the major point. Increasing the amount of money we spend on medical care has NOT improved our outcomes. Building more dialysis centers, performing more heart catheterizations,  and passing out more medication has not improved quality of life or longevity.

 

As evidence:

1.3 million angioplasties were done in 2006 at a cost of 60 Billion:

 

Yet angioplasties and stents DO NOT prolong life or prevent heart attacks in stable patients--which are the recipients of 95% of these procedures. (N Eng J of Med, 2007)

 

448,000 bypasses at 100,000 each = 44 billion spent in 2006

 

Yet bypass surgery prolongs life in less than 3% of patients

 

Changing lifestyle could prevent at least 90% of all heart disease! (Lancet, 2004)

 

That is where we come in. Nurses are the most trusted professionals in America, and have been for decades.  The American system of care, and the care itself, is fragmented. The system is outmoded. We must lead the way by following our mandate as nurses to always advocate for the patient--to guide them and fight for them even before they understand the stakes. Our advantage is our training in Functional and Integrative medicine. We can offer meaningful solutions.

 

How do we do this?

 

  • By putting the person at the center of care and not the disease
  • By helping them to create a life worth living
  • Focusing on relationship: ours with them and theirs with others
  • Teaching and encouraging self care, self advocacy and empowerment
  • Providing personalized planning individualized to their goals, needs and beliefs
  • Generously giving positive feedback
  • Finding resources and referrals to meet their unique needs
  • Creating a personal plan in partnership with each client and their healthcare team