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Health & Fitness

The future of healthcare: Patient Choice

Despite the passage of healthcare reform legislation, the basic problems with our system still remain. In order to fix them, patients will have to lead the way with out-of-the-box ideas.

My wife and I recently saw the powerful documentary, “Escape Fire – the fight to rescue American healthcare”.

The film portrays a healthcare structure that’s designed for quick fixes rather than prevention or cure and is profit-driven rather than patient-driven.  One message that came through loud and clear to us is that healthcare needs to be rescued from lack of choice – for doctors and especially for patients.

The “Escape Fire” phrase refers to a 63 year-old true story of wildfire fighters known as “smoke jumpers.”  Several of them were trapped by a rapidly spreading fire and escape the top of the ridge appeared impossible.

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Their crew chief, Wag Dodge, had an idea that was the perfect answer – but it was counter-intuitive.  He actually started a fire, so that when the main fire reached that point there would be nothing left to burn.  The others were either too frightened by that concept or misunderstood it and tried to run to safety.

Most of them perished.  Dodge’s escape fire enabled him to hunker down in the already burnt area and survive.

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Escape fires are now an established technique used by wildfire fighters.  But in 1949, it was out-of-the-box thinking.  Our healthcare system needs this kind of innovation in order to lift it from what the movie calls “a disease management system” to where disease can be prevented and people can receive real healthcare.  A lot of the new thinking may need to come from patients themselves.

With online health insurance exchanges becoming available in each state under the Affordable Care Act, it would seem that there will be more choices.  And yes, there certainly will be a variety of health plan coverage options.  But based on criteria set up in the law, the exchanges will only be able to offer new variations of medical care payment options.

That traditional model is what we’ve been educated in this country to believe is the best avenue for reliable care.  Yet it’s the same system that the movie shows is so broken, ineffective and sometimes harmful.  In order to improve it, patients will have to take an active role in helping healthcare providers understand their needs.  And the healthcare industry will have to listen.

Large numbers of Americans are already searching for better answers online, in what’s been called “peer-to-peer” healthcare.  Just like sharing comments and reviews of other products, internet health seekers listen to each other’s experiences with prevention and treatments and use those accounts to help shape their decisions about what might work best.

Last summer, Mayo Clinic’s Center for Innovation hosted a forum of tweet exchanges with patient advocates, healthcare professionals and journalists and came to the conclusion that patients must have a voice in the system.  And that patient-centered care is the wave of the future.

Here’s an example of how patient-led care can work, actually initiated by a doctor.  Dr. Pamela Wible in Eugene, Oregon completely redesigned her practice.  She tells of getting off a patient treadmill similar to the story of one doctor from “Escape Fire”.

Because Medicare reimbursement rates for doctors are tied to the number of patients they see, quantity is rewarded over quality.  Dr. Wible explains that our system produces an assembly line situation that doesn’t allow time for real care but just for pill pushing.  It was having a negative effect on her own health as well as not giving patients the depth of care they needed and she desired to give.

In her book, Pet Goats and Pap Smears, she describes holding town hall meetings where she listened to potential patients tell her what their ideal community clinic would be like.  Following their lead, she built a clinic that embodied many of the ideas she heard.  And the core of her practice is a compassionate, caring relationship with her patients that began with listening to their needs at those town hall meetings.

About 30 years ago, I made a major change in my healthcare program.  My health needs had reached a crisis point which was not being addressed by conventional means.  Instead of using more standard medical or even alternative therapies, I decided on a spiritual approach involving prayer.

I remember the first time I chose to rely on prayer for my health.  It wasn’t for anything life-threatening, just a cold.  And yet I was terrified.  I’d never used anything but regular medical treatment before.  So trusting a higher power felt like walking off a cliff.

From all I’d learned and experienced, turning to prayer for help with my health was totally counter-intuitive.  It took courage for me to be open to something so new and different.

But after being healed of that cold through prayer, I discovered that there really was another way to go that brought good results.  I continue to choose that path today.  And the higher power I turn to in prayer – I call it God, or divine Love – has never let me fall off the cliff.

My hope is that patients will speak out, be heard, and be able to choose what works best for them.

Joel Magnes blogs on spirituality and health and is a Christian Science practitioner. He lives in Edina with his wife, Brenda, a canine behaviorist (think dog whisperer). They have a charming Havanese dog, Rafi, and a chubby orange tabby cat, Wally. See more on his website, called “HealthThoughts.”  Follow Joel on Twtter @CSinMinnesota

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