Happy New Year, Happy New Decade
January 1, 2010

Blog 1

“Take Charge of Your Chronic Pain” comes to you at a pivotal time in our nation’s history. Few are satisfied with the current state of health care in the United States, yet even fewer seem to have the stomach for creating true wholesale changes to what most believe is so broken. Washington is in the midst of trying to pass legislation to overhaul a system that many believe is too costly, inefficient, and compares less favorably to other developed countries. The other day, I was chatting with a fellow dad of one of the players on my son’s soccer team. He and his family recently moved here from Denmark where they have a public health system that covers everyone. It took him months to figure out the complexities of how to navigate his new American system, which includes private insurance, co-pays, deductibles, and pre-authorizations, just to get his kids updated immunizations. For whatever it is worth, the whole thing seemed like nonsense to him.

Yet many stand by, disgruntled and shaking their heads out of fear of losing their freedom to make choices about their health care and seeing tax dollars potentially wasted. What I can tell you as a physician who has only experienced our modern era of health care delivery, is that Washington is ignoring the two biggest culprits in our health care crisis. And none of us, not the politicians, patients, doctors, pharmaceutical companies, or insurers want to acknowledge the two pink elephants in the room that can fix most of what is broken.

Who are these two pink elephants? Well, simply put they are you and me. Specifically, I mean our citizens and our doctors.

Not nearly enough Americans take adequate responsibility for creating their own great health. So much of what clogs the arteries of our health care system and creates such turbulence can be prevented by better lifestyle habits. We must change ourselves before this mess will ever get better. Simple things like being vigilant about what we eat and making sure we get enough physical activity each day can go a lot farther in healing our diabetes, cardiac disease, and stress levels than any policy change. There is a reason why health expenditure is estimated to cost $2.5 trillion or 17% of the Gross Domestic Product. We ask it to do too much and don’t do enough to maintain our own health. This trend can only mean that we will stifle our growth and prosperity as a nation by devoting so much of our resources toward illness management.

The other group that must stand up and be accountable is our doctors. We must be the leaders of change, yet we seem driven toward complacency and wanting to keep the status quo. Sure, we can sit back and blame the insurance companies and politicians and we can continue to overcompensate by seeing more quantity and providing less quality. It is time physicians become the leaders of creating and maintaining great health, not just conduits for treating disease. In order for our citizens to take a bigger responsibility in managing their health, physicians must be the ones to show them the way and demand that they do so. It can’t continue to be about writing a prescription or ordering a test and moving on to the next one. Now is the time to think out of the box and change processes and flow charts.

Above all, we need to better educate our patients and our communities in ways that will create positive behavior changes. The word educate comes from the Latin educe meaning to draw out from within. If we take advice from the great philosopher Socrates, who felt teaching is a drawing forth rather than a telling, then we physicians as well as all health care institutions need to adopt the primary responsibility of educating everyone down a path of optimum health. The challenge before us is to engender change and stop just herding cattle through our offices and operating rooms each day.

Doctors, if we fail to continue to take a leadership role for change, then special interest groups will continue to manipulate the way health care is delivered.
What a great time to take charge America. We can’t afford not to.