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As the entire healthcare industry is undergoing major reforms, maybe it is time that we look at updating one of the foundations of healthcare. The Hippocratic Oath has been is existence for centuries as an ideal on which a physician’s ethics has been based.
Even though everyone has heard of the Hippocratic Oath, there are very few physicians, let alone lay people, who have actually read it or know what it contains. For instance, the Hippocratic Oath doesn’t actually contain its most quoted part: “first do no harm.”
The answer is “Yes”, depending on how the question is worded, or who you are asking. There are so many variables concerning the Patient Protection and Affordable Care Act (PPACA or ACA) that no one really knows the answer to this question. But, you can provide your own answer to the question, based on the following assumptions:
An estimated 10-15 million new Americans will qualify for Medicaid due to the passage of the ACA
The ACA will cut the Federal deficit by $500 billion
Who do you think will have to pickup the tab? Now, personally, I don’t believe any of the figures that are bandied about by either side when it comes to the actual dollar amount that the ACA will cost or save to implement. The truth is that no one knows how it will shake out. But, just relying on past history, the government projections have consistently vastly underestimated the cost of any social program.
The Patient Protection and Affordable Care Act of 2011 (PPACA or ACA) will have a dramatic affect on every insurance company in America. How these changes will ultimately affect Americans and healthcare providers will depend on how insurance companies adapt to meet all the requirements of the ACA while they attempt to remain profitable.
Let’s be perfectly clear on one item: The purpose of the ACA is to force insurance companies out of business, so that the only option available for Americans is to depend on the government to provide healthcare insurance. Get ready for Medicare/Medicaid type coverage for patients and reimbursement levels for healthcare providers.
There is a watershed philosophical decision that is being debated in America. At issue here are two diametrically opposed world viewpoints. On one hand is individual freedom and responsibility on which this country was founded. On the other hand is what is determined to be the best course for society in general as determined by the government. And further more, are these ideals mutually exclusive? We are talking about Individualism vs. Socialism.
The issue? If American taxpayers are paying for part of certain American’s food through the food stamp program, should the government be allowed to dictate which food items can be bought with the food stamps? As of 2008 over 46 million Americans receive some dietary assistance.
Once you realize that many of your patients will benefit from dietary supplementation, the next step is to make sure that your patients get supplements that actually benefit them. It's not my intent to make this article a seminar on nutritional supplements, but there are several pertinent facts that should be emphasized so that you and your patients get the maximum results of any supplements that you recommend. If your patient’s don’t see results from your recommendations then they will lose confidence in your abilities and you will lose confidence in dietary supplements, even though your patient’s would benefit from them.The controversy over the advantages of natural supplements vs. synthetic supplements has been raging since chemists first discovered the chemical structure of organic compounds and began synthesizing them in the lab. The chemists were able to synthesize vitamins, enzymes, and hormones with chemical formulas identical to those found in nature. They were able to manufacture these substances at a significantly lower cost than it took to isolate them from natural sources. The assumption was, and is, that these synthetic supplements are just as effective as natural supplements, because they are chemically identical.
When you discuss improving your patient’s health through dietary changes there are a couple of things that you should consider. The most important one is the difference between dietary information and nutritional information. To most patients and far too many healthcare providers the terms are synonymous. While there is some overlap of the two terms, they do not have the same meaning.
Strictly speaking, dietary information and dieticians refer to and are concerned with macro-nutrients: calories, proteins, carbohydrates, fats, and perhaps hydration. Dietary counseling refers to counting calories, balancing carbohydrates with proteins and fats, and determining the best way to achieve these goals through food choices. The four basic food groups, the food pyramid, and now the nutrition plate have all been attempts to ensure that Americans get the proper amounts of macro-nutrients, as defined by the best understanding of nutrition at the time.
Nutritional counseling and supplementation is a vital component of a Lifestyle Medicine (LM) practice. But it is much more than just prescribing a multi-vitamin supplement for your patients.
Proper nutrition is best achieved through proper diet, knowing what to eat and, just as importantly, knowing what not to eat. The field of nutrition is still in its infancy and there is so much more that will be discovered in the future. That doesn’t mean that you shouldn’t include nutritional products in your treatment program. By applying what we already know about nutrition to your patients you can greatly improve their health.
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.
Since ‘preventive’ care and procedures is the buzzword of the day in healthcare, now is the time to increase nutritional supplements used in your practice. Vitamins and other nutritional supplements will improve your patient’s health and improve your bottom line. But, you need to be knowledgeable in the use of nutritional supplements, or have someone on your staff who is an expert in the field.
Over the next several weeks I will discuss how utilizing nutritional supplements in your practice can benefit your practice and your patient’s health. There will be difficulties and challenge that you will face if you decide to make this transition, but the rewards will be well worth the effort.
As you look for additional areas to increase the revenue for your practice, look to include retail sales of nutritional supplements to your existing patients. When you prescribe (recommend) nutritional support to your patients, you can make it convenient for your patients by stocking vitamins and other dietary supplements right in your office. Alternative healthcare providers have been doing this for years to increase their revenue and to ensure that their patients take home the appropriate nutritional supplements. Whether they actually take the supplements is another matter, but at least you’ve done what you can as their doctor.