OPINION

Fill in the Gaps: Health Care Solutions Beyond the System

Americans spend the most money on health care in the world, and yet health care outcomes are not optimal, and it is not accessible to everyone.

The United States ranked last of 11 countries — behind Australia, Canada, France and others — on overall performance, access, equity and health care outcomes, according to a 2017 report from The Commonwealth Fund.

In a recent study from CEOWORLD Magazine, results show of the 89 countries surveyed, the U.S. ranked 30th in the overall quality of the health care system. This includes health care infrastructure, health care professionals’ competencies, cost, quality medicine availability and government readiness.

Health care is a central concern for individuals, as well. In a September Kaiser Family Foundation Health Tracking Poll, results show about 70 percent of Americans stated that lowering costs related to health care and prescription drugs as well as maintaining the Affordable Care Act’s pre-existing condition protections are top priorities for members of Congress.

Perhaps the problem is not only funding but education, as well. Lifestyle choices that people make can have a profound impact on their health care outcomes. If health care dollars were invested to improve the quality and focus of our health care for all people and provide better education about healthy lifestyle choices, more chronic diseases such as obesity, type 2 diabetes and high blood pressure could be prevented or reversed.

I am a physician double board-certified in obesity medicine and family medicine. I believe in the value of both modern and ancient medicine. From my experience with patients, I have seen that nature has designed the human body to heal when there is a stimulus and the appropriate environment. However, without effort, it falls into decay.

In my practice, I have seen the amazing ability of the human body to adapt to meet new challenges, perform, heal and recharge in all kinds of patients. It is expected in people who otherwise appear to be healthy, for example, those who train to run a marathon, run the marathon and then recover and recharge for the next event.

This ability to adapt, perform, heal and recharge can be available to everyone. My patients come to see me to learn how to create that healing stimulus and environment for themselves.

Sometimes, the body needs a medical intervention to facilitate healing — an intervention such as antibiotics and IV fluids for bacterial infections and dehydration, or surgery to pin a fractured bone so it can heal in the correct position.

At other times, we need to remove impediments that prevent the body’s natural tendency to heal — like removing a poisonous or allergic food from the diet. In all cases, we are optimizing the environment for the body to heal and recover as quickly and as perfectly as possible.

If doctors had time to spend talking with their patients about health goals, improving health and quality of life, and then explained why the body is doing what it is doing, perhaps outcomes would be different. If there were a doctor-patient dialogue on ways to promote health or treat concerns without medications or invasive procedures, perhaps outcomes would be different.

As physicians, it is our duty to continue to study various ways that impair and also allow healing to happen. While medical interventions are often helpful and necessary, ultimately it’s the body’s healing capacity that restores a person’s body to health.

Unfortunately, many people have come to believe that medical interventions are solely responsible for healing patients rather than understanding that they facilitate a healing environment. In my practice, each patient and I work to create that environment to allow for their body’s healing.

For instance, for people with type 2 diabetes who are told their blood sugars are too high and who may have infections that are slow to heal, their doctor will explain that high blood sugars prevent the body’s immune system from effectively resolving the infection. Often, by eliminating sugars and starchy carbohydrates from the diet, blood sugars improve, diabetes improves or resolves and the immune system cleans up the infection.

Another example is people seeking treatment for osteoarthritis of the knees, a debilitating condition. In the 2014 Osteoarthritis Research Society International Guidelines for non-surgical management of knee osteoarthritis, results show that exercise, strength training, self-management education and weight management were each effective for improving pain and physical function.

Osteoarthritis, or degenerative joint disease, is the number-one cause of disability in the United States and the second-most expensive disease treated in U.S. hospitals. By 2040, an estimated 78.4 million adults in the United States will have a diagnosis of arthritis. Given these staggering statistics, patients and policymakers need to be educated about non-surgical, non-medication interventions, and they need to be increasingly available and accessible.

Of course, there are physical problems that the body may not be able to heal, such as Parkinson’s and Alzheimer’s disease. Finding ways to prevent or cure these commonly fatal diseases are important areas for medical research.

I advocate for patients to appreciate the self-healing nature of the human body and learn to work with their physicians to create an environment to allow for that self-healing. By investing in educating people about making informed health care and lifestyle choices, we can improve outcomes, save health care dollars, provide knowledge and empower patients and providers.

 

Dr. Naomi Parrella is assistant professor in the Department of Family Medicine and the Department of Surgery and the medical director for Rush University Center for Weight Loss and Lifestyle Medicine, and she is board-certified in family medicine and obesity medicine, holds a certification in Chinese herbal medicine, and is a public voices fellow through The OpEd Project.

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