Just noticed that Adam Bosworth posted a nice summary of the Aspen Institute conference — which had a multitude of intriguing panel summaries such as:
“Cracking the Code: Life and Wellness in the Genomic Age,” “The Emerging Science of Mood,” and “The Hospital of the Future.” Other sessions will explore health reform and the presidential campaigns, international models of science funding, personal stories of scientific discovery, the rise of medical tourism, and what Americans expect from their medical research and healthcare as evidenced by a new national poll slated for release at the Forum.
I found several of Adam’s comments interesting, especially since i too met Dr. Frist while traveling [of course, it was here in the Nashville airport as i was on my way to Mayo Clinic in MN].
I’m sure that Bill wouldn’t remember meeting me nor my son’s heart issues that we discussed while waiting in line together at the snack bar. What i thought would be a passing “hello” turned into a 10 minute conversation.
Alas, i digress. I wanted to follow-up on some of Adam’s well documented summary. More specifically, I wished that i could have been there when the conversation focused on:
But there was a thoughtful discussion about how this, all by itself, isn’t a solution, and we need to alter the system to actually reward people for good overall care and wellness of patients and good outcomes rather than paying doctors for procedures. It short we need the system to help keep people well rather than only treat them (at best) when they are sick.
Preventative care and the notion of rewarding/incentivizing wellness care and behaviors is definitely the “right” thing to strive for, but that will require centuries of emotional de-programming. Humans hate change and are unwilling to do work nor expend effort unless forced to. This can be validated/evidenced by the multitude of stereotypical american towns full of obese and de-motivated citizens (yes, Nashville was voted as the FATEST city in the U.S… sigh) who are all answering get rich quick ads in newspapers and calling the 800 # for those “no money down” real-estate investment infomercials [this is my poor attempt at sarcasm]. As one of my old employers used to say, “People don’t do what you expect, they only do what you inspect.” How ever sad a statement that is, it has proven itself to ring true in my experience time and time again.
Enough with the “nay-sayer-isms” though. Having been in healthcare for quite some time and leaving my jaded perspective at the door – what i do know from experience is that patients and individuals are most influenced to change a behavior (a la behavior modification) and stick to aforementioned change when patients are perpetually communicating and connected to other individuals who are dealing with the same issue and hold each other either directly or informally accountable.
Whew! So all of that gobbly-gook can be translated into the following analogy…
Obesity is a social epidemic. If you are obese and have obese friends, then there is a much higher likelihood of remaining obese. If you are obese, but interact, surround yourself with friends and activities that are activity/exercise related [healthy lifestyle-focused], then there is a higher likelihood of you undertaking a weight-loss program and sticking to it.
Patients and individuals want to be – nay – need to be connected. I suspect that innate human need is why social-networks, blogs, and other forms of 2–way communication (the oldest being the infamous water-cooler conversation). We depend on neighbors and friends to help us with our decisions. We use linkedin, and facebook, and over-the-fence conversations to figure which doctor to see, what to do about that brown spot on your tummy, and whether so-and-so’s friend had a good experience at Hospital X down the street. I would also propose that when it comes to healthcare and healthcare decision making that the use of social-network applications would provide tremendous benefit when coupled with an employer-based disease management effort.
I am not suggesting that a health-focused social network alone is a silver bullet solution. Instead, i believe that a social network platform used as a communication/dialogue platform and coupled with web-based educational tools and call center-based disease management services group would make a VERY powerful behavior change management approach and would most like provide the BEST return on investment for a self-insured employer.
Though in the above described uber approach – there is one core element that would be required to make it effective – price and quality transparency.
Fortunately, we’re about to address that issue in a significant way. Change for the better is coming.
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You’re correct. Behavior change is hard and most people won’t attempt it unless severely motivated. Oddly enough though, when you’re talking about health and healthy behavior, there’s lots of research that shows that tangible improvements become the motivation. You need something to break the inertia initially (ie. money, in our model) but once most people start to see the real change in their health, that takes over and keeps them engaged. That’s the point where I think communication and peer support becomes crucial. To keep people from regressing into bad habits.
Ironically, I think people spend more time/energy/tools researching buying a car or a stock than they ever do in procuring health care services which have a far greater impact on their lives. Some of this is because the tools don’t exist in as mature a form as say, Morningstar. But a lot of that is because most people don’t think of health care in the same way as other services. Hopefully, that will cease in the very near future en masse.