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A Sick Health Care System
Posted by Dr. Ben Kim on Jun 27, 2011
Originally published on September 23, 2006
One of the main goals that I have for this web site is to encourage our readers to learn how to be their own best doctors.
Clearly, there are some wonderfully caring and competent doctors in our world. Unfortunately, most health care systems don't encourage providers to emphasize disease prevention with daily food and lifestyle choices.
Take, for example, the health care system here in Canada. I often hear leaders of other countries tout the universal health care system in Canada as being the ideal model, one in which every resident has access to free health care.
While on the surface, the Canadian system appears to be an effective one, it just isn't designed to have providers spend quality time with patients discussing diet and lifestyle as they pertain to preventing and addressing chronic, degenerative diseases.
To be more specific, medical doctors in Ontario, Canada, are paid an average of $27 per routine office visit. Initial visits that involve a more detailed physical examination are usually billed at $60 per visit.
Put another way, for routine office visits, medical doctors in Ontario have no financial incentive to take their time and consider their patients' food and lifestyle choices.
If a patient comes in with a chief complaint of a chronic headache, the doctor could spend an hour gathering critical information on the patient's diet and lifestyle, and then go on to address any changes that could be made to address the chronic headache.
Alternatively, the doctor could spend five minutes going through the motions, asking a few questions and taking vitals, and then write out a prescription for a pain killer.
Either way, the doctor gets paid $27.
So which route do you think most doctors take?
There's another reason why many doctors have a tendency to address most cases with a prescription for a drug: the pharmaceutical industry makes it well worth their while to do so.
Here's how a pharmaceutical sales representative recently summarized his work for me:
"I take the doctor out to dinner at a fancy restaurant, all expenses paid. As dinner winds down, I ask the doctor to recommend my company's brand for certain health conditions among his patients. Sometimes, the doctor will say that his office needs new equipment. I say how much? The doctor says $5,000. I say fine, but only if you write 100 prescriptions for a specific drug made by our company each month. The doctor agrees, and we get him his new $5,000 machine."
Out of curiosity, I asked the pharmaceutical sales rep how he and his company can be sure that the doctor will follow through on his word to write out 100 prescriptions of their drug each month. Can't the doctor just take his $5,000 machine and not follow through on his promise?
"No, all pharmaceutical companies pay big money to a huge global corporation called IMS that tracks this type of data," was the rep's instant reply.
For a fee, IMS can provide date-specific data to pharmaceutical companies that breaks down exactly how many prescriptions of each drug that every licensed doctor has handed out and how many of them have been fulfilled at licensed pharmacies.
In other words, the managers at pharmaceutical companies who approve $5,000 gifts have a way of verifying that their gifts are properly reciprocated. And I think we can all safely assume that this regular exchange of gifts is a profitable program for the pharmaceutical industry. Just in case you don't want to make this assumption, consider that the IMS reports that in 2005, global pharmaceutical sales amounted to 602 billion dollars; mucho dinero, n'est pas?
So let's pretend for a moment that you're a doctor who now has to write 100 prescriptions per month for a specific drug that helps to regulate blood glucose.
When a patient walks into your office and shows a moderately elevated fasting blood glucose level, would you take a half hour to an hour to explain what he or she can do with food and lifestyle choices to have a solid shot at lowering blood glucose to a healthy level? Or would you write a quick prescription for a blood glucose-regulating drug to bring your target for the month down to 99 prescriptions? (To be fair, some patients prefer the quick prescription, and doctors are generally aware of this.)
This is one of the most powerful ways in which big pharmaceutical companies have helped create a sick health care system; they provide strong financial incentives for doctors to choose drugs over health education for patients.
The bottom line: putting your health entirely in another person's hands, namely, your doctor's, is never as good a choice as learning how to be your own best doctor.
Self health care involves consistently choosing nutrient-rich foods and avoiding foods that are high in calories and low in nutrition (highly processed items like cookies, chips, and soda). It also involves being mindful of how you use your body, how much rest you get, and how much fresh air and sunlight you expose yourself to. And perhaps most importantly, learning to be your own best doctor requires that you become skilled at managing emotional stressors, as few things in life will destroy your health as steadily and as predictably as unmanaged chronic stress and anxiety.
If you're just beginning the journey of learning how to take care of your health with your daily choices, you might find our full body cleanse series to be helpful; part one of this series can be found here:
Please also feel free to start browsing through our archives of articles and healthy recipes, where you'll find plenty of support for a healthy lifestyle.
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