Primary Care is Evolving to Treat Patients Instead of Sickness
Most people aren’t surprised when their $5 headphones break after the third song—after all, you get what you pay for. Benjamin Franklin once said, “The bitterness of poor quality remains long after the sweetness of low price is forgotten.” Unfortunately for Americans, healthcare in the United States often provides neither quality nor affordability.
Hamstrung Healthcare
Despite having the most expensive healthcare system in the world, the United States performs worse than 11 other similar industrialized nations, according to The Commonwealth Fund. Not since WWI and the Spanish influenza has the U.S. seen a continuous decline in life expectancy such as that we’ve been experiencing since 2014. Life expectancy provides a snapshot into the nation’s overall health, and these statistics speak to the need for change, especially paired with the fact that often-preventable chronic diseases (such as heart disease, cancer, stroke, or diabetes) are not only the leading causes of death in America, but are also a leading driver of ballooning health care costs.
The Commonwealth Fund’s president, David Blumenthal, believes that our healthcare system is hamstrung by “a very disorganized, fragmented, inefficient and under-resourced primary care system.” On top of a lack of investment in primary care, “we don’t invest in social services, which are important determinants of health,” Blumenthal said in an interview with The Atlantic. Things like home visiting, better housing, and subsidized healthy foods could extend the work of doctors and do a lot to improve chronic disease outcomes.
Re-Imagining Primary Care
Since the inception of our current system, general healthcare practice has largely fallen under the umbrella of pathogenesis, a reactive approach which treats symptoms as you feel them (ie, "sick care"). A pseudo-revolution quietly taking root in the United States swaps this for a more proactive approach to personal healthcare, termed salutogenesis, which places focus on holistic health measures meant to promote both mental and physical wellness in the hopes of preventing illness altogether and bringing about an overall healthier lifestyle. Across the country, Direct Primary Care practices (Cloud Medical is our go-to) are leading the charge into a more collaborative primary care space, and it’s helping to reshape what we expect from our healthcare providers. A reformulation of concierge medicine, DPC not only has intrinsic appeal to overworked and overburdened physicians, but also to patients thanks to a monthly fee structure that covers all (or most) primary care services. Compared to traditional fee-for-service insurance billing, DPC can provide patients with substantial savings and the freedom to visit their healthcare provider as needed without fear of the inability to pay.
Similarly, practices with a focus on functional medicine, such as Parsley Health, seek to build a new operating system by fostering a close, long-term doctor-patient relationship where both parties are committed to addressing the underlying reasons for our health woes. According to the CDC, roughly 70% of diseases in the US are chronic and lifestyle-driven, and nearly half of the population has one or more chronic health conditions; a 2016 Mayo Clinic study found functional medicine to be effective in treating such issues. In a healthcare climate where doctors give patients just 11 seconds to explain symptoms before cutting them off, a comprehensive approach to health is a welcome change. And while some people may not be enthused by the prospect of hour-plus consultations with their doctor, if 90% of health is dependent on social determinants, then shouldn’t your doctor know what is going on in your life? After all, an hour with your doctor may feel like a long time, but a lifetime of chronic illness and misdiagnoses is far longer.
The Future is Holistic
As this focus on holistic wellness continues to permeate our healthcare system, here are some of the most exciting new ways that the industry is innovating to place a focus on human wellness.
In 2018, we saw Telehealth shift from a “nice-to-have” service to an essential component of the way healthcare is delivered. According to a recent medical survey from Kantar Media, 2 out of 5 physicians participate in telemedicine or plan to within the next year. Improved access, cost efficiencies, and improved quality are just a few of telemedicine’s toted benefits. Recognition of the return on investment and Telehealth’s ideal position to disrupt the healthcare industry even helped to fuel CVS’ 2018 foray into telemedicine, but they’re far from the only ones. Niche-focused D2C brands such as TytoCare, Roman, and PRJKT RUBY each have their own unique approach to Telehealth as well, helping to break down barriers and bring wellness to your door. With significant progress in consumer acceptance, reimbursement, and legislation, 2018 signaled a turning point in the way Telehealth services are utilized and perceived.
As the digital wellbeing movement continues to gain traction, more and more tech companies are making it easier to form healthy online habits and focus on what matters most. Our screens aren’t the only things we’re trying to get away from though: Consumers are increasingly retreating from life’s daily stressors and seeking to relax, heal, and get inspired through wellness tourism and wellness communities. One-stop-wellness-shops (see: The Well) have also exploded in popularity as consumers seek a proactive rather than reactive approach to personal health and wellness.
Wearable tech has helped us to track our physical activity, but as new tools develop and existing technologies become more widely adopted, 2019 will undoubtedly allow us better insight into what is going on inside our bodies. Novel and innovative new technologies (such as Soma, the swallowable robotic capsule that injects insulin once it lands in the stomach) allow a glimpse into what is possible in the not-so-distant future. Providing information on your personal biomarkers, wellness genomics and precision medicine can help with everything from the early detection of common diseases to hormone imbalances and vitamin deficiencies.
As we continue to gain further insight into our holistic health, primary care physicians will be increasingly able to treat patients rather than sicknesses.
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