Archive for Holistic Health Economist

Today I was reading a study called ‘Gut Dysfunction and Chronic Disease‘, which gave insight to an exciting, growing trend. This trend is science confirming what holistic medicine has been saying forever, dis-ease starts in the gut. ‘Research has shown associations between compromised GI function and conditions as varied as rheumatoid arthritis, asthma, metabolic bone disease, and eczema. Therefore, assessment and proper support of GI function may provide benefit for patients with a variety of chronic complaints.’

Needless to say, the cost of ‘fixing’ these secondary conditions  is much more expensive than the rudimentary gut support. So, why are we catching these issues so far downstream?

The answer is two fold. Firstly, science is  only just starting to catch up to the importance of gut function; Even serotonin, long known for its use in regulating not only mood in the brain is also being seen as part of interesting secondary issues like bone density where 95% is created in the gut. Secondly, we do not have the health care systems in place to be able to correct sub-optimal gut function as it arises. And this happens for a number of reasons.

  1. Lack of understanding from physicians Two to three bowel movements a day is normal, any less is sub-optimal. Yes, sub-optimal. If your “normal” is a lot less  than that you have dis-ease, it just may not be chronically symptomatic… yet.
  2. Lack of education in this field. Books like ‘What is your poo telling you?’ have sought to shed light on this most important subject, with some exciting results. Where is the education coming from?
  3. Poor testing Functional Medicine testing is starting to catch us up to a place where we can test effectively for gut function, but only a small % of doctors are using them and they can be expensive.
  4. Embarrassment and shame concerning defecation. There, I said it. As an Englishman with an armory of Blackadder inspired ‘toilet-humor’ it pains me to say it, but this is a HUGE issue. Seemingly no one is comfortable talking about their own bowel movements, never mind just saying the words!

Even anthropologists have come unstuck trying to get to the root of this conundrum. For whatever reason, humans are embarrassed and shameful of their bodily functions when it comes to feces. Although this may seem sad, strange or even hilarious on the surface, when we are faced with the kind of fiscal timebomb that America faces, we need to start looking outside the box, and preferably upstream.

Most holistic practitioners I have met, in their extensive intake, always look at bowel movements as a core fundamental to overall health. Looking at this objectively can make a huge difference to the patient’s health, and more importantly the cost of their  health care over their life time. So what ideas for changing this?

Social Media provides an opportunity for information to go viral, and if there was one trend that I could initiate that could have the greatest leverage over health, it would be to make people more comfortable about talking about their bowel movements. So, to this end, we created ‘Colin the Colon’.

Colin talks about his bowel movements on the Twitter account @mycolonsays and he wants you, and your patients, to join the conversation. Some of the best ones we have had so far are

#mycolonsays I like to move it, move it!

#mycolonsays Don’t drink the water in Mexico, it makes me crazy.

To join the conversation you can

1) Retweet, direct message (@) or hashtag (#) mycolonsays.

2) Tell your patients about it and encourage them to participate

Can’t wait to hear what your colon is saying, and we would love to hear your thoughts on how we can shift this important paradigm.

Today I was reading a study called ‘Gut Dysfunction and Chronic Disease‘, which gave insight to a growing trend. This trend is science confirming what holistic medicine has been saying forever, dis-ease starts in the gut. ‘Research has shown associations between compromised GI function and conditions as varied as rheumatoid arthritis, asthma, metabolic bone disease, and eczema. Therefore, assessment and proper support of GI function may provide benefit for patients with a variety of chronic complaints.’

January is a poignant time look to the future, and one area of continuing concern is the cost of health care in the United States. Not only are record numbers without insurance, but the astronomical costs of Medicare and Medicaid threaten the financial underpinnings of our society. Some projections show that by 2050, when I turn 70, ” government health care spending will claim one-third of GDP.”

By the time we reach those kind of numbers,  the American economy will have bigger problems than health care provision. Ridiculous debt? A default on the dollar? Unfortunately for the rest of the world, the US economy and it’s dollar are too big to fail without dramatic repercussions.

When looked at from that perspective, it shows how superficial and, frankly, irrelevant that whole health care sideshow of 2009 and 2010 was. You want single payer? You want a public option? Neither of those get close to looking at what will be required for the bigger picture, it’s just fiddling on the edges. Furthermore, the sheer divisiveness and ugliness of the process may end up being the highest societal cost in the long run.

The word holistic gets quite a battering in popular culture, but the concept of holism could not be more apropos in this particular discussion, as holism is the bigger picture. So over the next year, a series of special blogposts in a seperate section of our website, will look at health care economics from a holistic perspective, and we will see how we can incentivize the right shifts that will give America the underlying fundamentals that will be necessary for sustainable health care.

MEASURING CHANGE

One of the most easily understandable tools for deduction used by health care economists is a “Quality Adjusted Life Year”

A quality-adjusted life year (QALY) takes into account both quantity and the quality of life generated by healthcare interventions. It is the arithmetic product of life expectancy and a measure of the quality of the remaining life years.

A QALY places a weight on time in different health states. A year of perfect health is worth 1; however, a year of less than perfect health life expectancy is worth less than 1. Death is considered to be equivalent to 0, however, some health states may be considered worse than death and have negative scores.

With QALYs, we now have a method to be able to start making numerical calculations for best patient outcomes. We will use this methodology show where the different forms of medicine are used most effectively and hopefully come to an economic, rather than clinical, rationale for integrative medicine.

We hope those of you interested in this topic will share your thoughts in the comments. This is a salient issue and we need to start to have a serious conversation about the sustainability of our health care model.

James Maskell

CEO HPd