There was a great essay in the Wall Street Journal recently that highlighted a big problem in health care. In spite of the many advances in detecting and treating illnesses, patients just don’t want to change their lifestyles and that spells trouble.
It seems that every day we read about some new device or discovery that has the potential to change our lives for the better. Maybe it is wearable technology that allows us to keep track of our steps or our sleep. Maybe it is pills that tell the doctor if we have taken them. Maybe it is artificial intelligence that can read CT and MRI images. The suggestion is that when doctors and patients can track changes in real time, a health care nirvana will be achieved. Unfortunately, it seems that all the advances in the world are of no benefit if patients won’t take advantage of the information they provide. Patients must cooperate in their own care in order to become or remain healthy.
The essay discusses various studies in which high tech methods of encouraging patients to take their medications or follow orders to increase exercise were tested against either lower tech methods or nothing more than encouragement to follow the doctor’s recommendations. Both studies found very little difference between the high tech reminders and no reminders. Patients, it seems, just don’t want to cooperate.
The only thing that seems to make people change is to pay them to change. When patients are provided money incentives to change their behavior, they are much more likely to do so than when other methods are used to encourage change. As in so many other areas of life, money talks. In those studies which showed people responding to money incentives to increase exercise levels, when the money incentives were taken away, the study participants went back to their old, sedentary ways.
According to the Centers for Disease Control (the CDC), 86% of all health care spending in the United States is for the care and treatment of chronic illnesses. The effective treatment of these illnesses requires that patients comply with the orders of their providers. Right now, that is not happening. In the long run, we need younger people to adopt healthier lifestyles that will make it less likely they develop these illnesses in the first place. That means lowering smoking rates and better eating and exercise habits. These changes alone would make a huge dent in chronic illness. The most recent data on obesity shows that 1 in 3 Americans is obese and that 1 in 6 children and adolescents is obese. Obesity predisposes people to heart disease, kidney disease, diabetes and high blood pressure as well as other nasty diseases.
I often say, “Physician, heal thyself.” when discussing problems in the medical profession. Here it seems more appropriate to say, “Patient, heal thyself.”
