Lifestyle Medicine- The Wave of the Future?
Lifestyle Medicine is defined as the application of environmental, behavioral, medical and motivational principles to the management of lifestyle-related health problems in a clinical setting. In practice it means that by improving overall healthy living, the patient can prevent, manage, or even reverse a wide variety of diseases. It is not a new concept for many alternative healthcare providers, but in the world of allopathic medicine it is a relatively new idea.
Only recently has there been a big push to prevent diseases by the medical establishment. There has been no incentive for doctors, or anyone in the medical field, to prevent diseases or manage them through lifestyle changes. The first attempt to influence overall health was, and is, through the campaign to prevent or stop smoking. Very recently there has been an increased push to educate the American public on a healthy diet and reduce the number of calories in the typical diet in order to fight and prevent obesity.
Traditionally, medical doctors have treated patients when they come to the office for treatment of a specific physical problem. As a result, doctors have been reimbursed for specific tests or medical procedures and the traditional fee-for-service has become the standard way that doctors get paid by patients and insurance companies. In reality, the sicker a doctor’s patient base, the more the patients come in to see the doctor and the more money the doctor makes. While most medical doctors have given lip service to improving health through proper diet and exorcise, this approach has always been a low priority because of obvious financial reasons.
I am always amused by the ads for drugs that claim that taking drug X “along with proper diet and exercise” will reduce whatever malady that drug X is supposed to treat. In almost every case, jumping over a stick “along with proper diet and exercise” will improve the original condition. Obesity, heart disease, type II diabetes, and practically every other degenerative disease can be treated or prevented through “proper diet and exercise”. The sad part is that drug companies, who make their money through the sales of drugs, are at the forefront of the movement toward “proper diet and exercise”.
With the shift toward the prevention and treatment of many lifestyle diseases, the challenge for the medical doctor is to stay at the forefront of the movement, while still being able to survive in private practice financially. This will require a complete change on how doctors bill for their time and services. If you become a successful Lifestyle Doctor, then your patients will become healthier, will not require as many tests, procedures, or medication and your patient visits will decrease and your income will be reduced. While your patients will have improved health, better lives, and overall well-being; you, as their doctor will suffer financially, even though you are doing a terrific job of being a doctor (‘teacher’ in the original Latin).
Lifestyle Doctors will have to change the way that they bill for their expertise, and insurance companies will have to change the way that they reimburse doctors for their treatment. Lifestyle Doctors will spend more time educating their patients, more time talking to their patients, and more time managing their patient’s lifestyle decisions. In order for this type arrangement to work for the benefit of the patient and the doctor; reimbursement will need to be more for time rather than for procedures. Every doctor should be reimbursed for their expertise and the best way for Lifestyle Doctors to get paid is by time increments. While this may be strange for most medical doctors, there is precedence for this type of practice. Psychologists, psychiatrists, lawyers, and even the highest paid specialists--plumbers and electricians have traditionally been paid for time, not procedures. The trick will be determining how much a Lifestyle doctor’s time is worth and are some doctor’s time is worth more than others.
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Tuesday, 27 March 2012
Dr. Ruginis. I love the new moniker "Sick Insurance"
Thursday, 15 March 2012
Thank you for this great insight into the future trends in medicine, but I think we have to go even further and talk about paradigms. Steven Covey says, "The problem is the way we see the problem." When in comes to medicine, the entire healthcare system has been set up to focus on disease. We’ve been thinking disease, talking disease, approaching ways of health practice in order to prevent disease, trying to fix and cure disease and we get paid for disease care, as you’ve mentioned. When we’re all so focused on disease rather than thinking, acting and practicing in health first, regardless of disease, what do you think happens?
Thursday, 15 March 2012
posted by Dr. Raymond Ruginis
This is what many chiropractors have been doing for years. It would be nice for the medical profession to realize this is what it best for the patients.
You are also right about drug companies not liking the fact that a wellness movement could hurt their business.
Last comment: It is a joke for insurance to be called "Health" insurance because it truly is sickness insurance. If it were health insurance then it would pay for things like weight loss clinics, gym memberships, etc, etc...
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