Jan 11 2013
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Morphing Medical Practices into Health Practices

Liana Orsolini-Hain, PhD, RN, ANEF,FAAN, is an alumna of the Robert Wood Johnson Foundation (RWJF) Health Policy Fellows program (20112012), through which she worked at the U.S. Department of Health & Human Services Immediate Office of the Secretary. This post is part of the "Health Care in 2013" series.

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My New Year’s resolution for the U.S. health system involves all of us. During my tenure as an RWJF Health Policy Fellow in the Immediate Office of the Secretary of Health, I learned how a small percentage of Americans use up a majority of health care resources.  The percentage of individuals who consume a high volume of resources will likely increase as we age, with little regard for our own level of health. 

We all need to be a part of the solution to making access to health care and access to health sustainable for current and future generations by caring about and for our own health. Do we exercise regularly? Do we get enough sleep? Do we eat fruits and vegetables every day? Have we stopped smoking? Do we manage our stress levels? Do we practice what we preach?

I have reflected on these questions while serving on the advisory board of the Million Hearts Initiative, a Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services effort to prevent 1 million heart attacks and strokes in five years. How do we prevent 1 million hearts attacks and strokes unless we leverage health care providers and communities to increase motivation to engage in healthy behaviors? How can we get others to care about their health and especially their high blood pressure? If we are struggling with motivating ourselves, we can appreciate how difficult this is for others, especially for those who struggle to financially survive and in underserved populations.

Murray Ross, PhD, vice president and director of the Kaiser Permanente Institute for Health Policy, is greatly concerned about the cost and sustainability of providing health care in the future because almost one-third of our children are overweight or obese. I agree with Dr. Ross that if we cannot find a solution to the childhood obesity epidemic, we will likely be greatly challenged to prevent multiple chronic conditions as these children age.  

We must all take the health of the nation seriously by working on initiatives that aim to keep our communities healthy. How many of us with school children or school aged grandchildren are working to get their schools to partner with Let’s Move, a program from the Office of the First Lady to get children to be more active and to eat  healthier? How many of us are making the goals of Healthy People 2020 the goals of our health institutions and implementing the National Prevention Strategy at the local level? How many of us implement primary and secondary prevention strategies such as the ABCS (appropriate aspirin use, blood pressure control, cholesterol control, smoking cessation) listed in the Million Hearts Initiative?

While some might be doing this, 14 million Americans still have no idea that they have high blood pressure. Do we ask ourselves, “Why, for everyone in the U.S. who dies of a smoking-related illness do two adolescents begin to take up smoking, and what does this mean in terms of future health care expenses?” While we respect individual freedom in this country and are loathe to outlaw tobacco products and high calorie, nutrition-free foods, we must role model healthy living to our patients, our families and to those in our communities.

We must not rely on education alone to inform others about healthy behaviors. We must engage in evidence-based ways to help people make healthy choices such as motivational interviewing and other modes of support. Most people want to live long, happy and healthy lives. If we all do our part to increase the health of Americans, then medical practices will morph into health practices. Health systems will need bundled regional payments instead of fee-for-service to stay in business since the volume of sick care will decrease dramatically.

Everyone agrees that the current ways of doing health care business are not sustainable. If we make a serious movement toward promoting population and preventative health measures, we can assure that despite such efforts, there will be plenty of health care resources for those who will need it in our future. And as a result, many will have a long and healthy future.

Tags: Access and barriers to care, Childhood obesity, Health Care in 2013, Health Policy Fellows, Healthy communities, Human Capital, Voices from the Field