Monday, March 26, 2012

Chat and Challenge vs. Test and Treat

As the Supreme Court begins their debate on PPACA (aka health reform) today, I thought I would challenge us to think about how our healthcare system can be different. The health reform legislation doesn't go far enough to transition our disease-care system into a system which takes care of people's health. We need a self-care system which uses our health and medical professionals to help each person learn how to take the best possible care of their own health.

Our current "disease focused" system is all about treating the ill. When most of us visit our doctors, we do so to share a complaint and seek relief. Pain in the knee. Digestion issues. Trouble sleeping. For many of these issues, the standard operating procedure is to run a few tests and then write a prescription. In 2010, Americans spent over $300 billion on prescription drugs. I call this the "Test and Treat" system and it won't help us get healthy.

I am not blaming the doctors here. In order to cover the costs associated with complying with the rules of the disease-care system, doctors must see as many patients as possible each day. Most doctors did not go into medicine to become a manufacturing plant (see my earlier blog on the factory of medicine), they went into medicine to take care of people. But in our "test and treat" world, the patients want quick relief (without changing their habits) and the doctor needs to get onto the next patient.

There is another way. I call it the "Chat and Challenge" approach to health. As we all know, most of what ails us stems from lifestyle choices. Poor food choices and lack of exercise top the list and this isn't the focus of most of our doctor visits. We need to redesign the system so each person belongs to a wellness community. The wellness community includes personalized coaching, implementable plans for getting more exercise and eating well, classes to fill the gaps in personal health knowledge and medical professional (doctors, nurses, etc.) to take care of medical issues. During a visit, each person engages in a conversation with the members of their wellness team. The wellness team chats with the person and then challenges them to make small, specific, personalized and positive changes in their health (ala Tiny Habits by Dr. BJ Fogg).

Everyone's life is different and people, by and large, want to feel great. Let's have a chat and challenge ourselves, and each other, to imagine a different world.

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