Please take a moment to reflect on a few facts from the Centers for Disease Control:
Over 133 million Americans live with chronic disease That’s almost half of us!
70 percent of our deaths are from chronic disease.
75 percent of our multi-trillion dollar medical care bill is spent on chronic care.
Millions of Americans do not get adequate treatment for chronic disease because they are among the ranks of the uninsured.
Now the other staggering side of this story--much of this individual pain, suffering, and cost is preventable! The CDC puts it simply: “Although chronic diseases are among the most common and costly health problems, they are also among the most preventable. Adopting healthy behaviors such as eating nutritious foods, being physically active, and avoiding tobacco use can prevent or control the devastating effects of these diseases.” (Learn more at http://www.cdc.gov/nccdphp/ )
The implications for us in healthcare are enormous. While we have focused our resources on the sophisticated medical services that are the source of so much pride, we have not effectively shaped ourselves, our institutions, our technology, our incentives, or our determination to address our biggest healthcare problem. Fighting chronic illness requires the will to change institutional behavior, to devote more resources to primary care and teamwork.
Of course, we can’t do it alone. We need people who suffer from chronic illness to address the situation, too. This can be as simple as a walk in the park, a romp with the dog, a trip to the vegetable stand (all repeated several times a week or daily). Granted it’s not always that simple, but the consumer responsibility side of the equation is essential.
Once again, some very smart people have joined us in Frontiers to share their insight, ideas drawn out of years of practical experience on the front lines of chronic care. Dr. Steven Towner of the Intermountain Medical Group explains how his organization committed resources and energy to address a growing problem with diabetes care. They turned to the basics of teaming (including physicians, clinicians, and others), education, registries, and dedicated clinical support in the design of their system--and they accomplished measurable results.
Dr. Marc Pierson of PeaceHealth walks us down his group’s path to improved chronic care. His conclusion: It takes a “village.” This village consists of the community, the healthcare organizations, the public health organizations, and, at the center, the patients, all working together.
If we are to address the problem of chronic care and its overwhelming impact on our society, our productivity, our economy, and, at a personal level, on the quality of our individual lives, we need to turn our medical delivery model (or at least part of it) on its head. We must find the will to recreate the system with the patients at the center, surrounded by the support they need to manage their chronic conditions.