Letters from Dr. Jonas
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Dear Friend,

What our hospitals, health systems and individual clinicians have been able to do in the face of this crisis is nothing short of heroic. Major medical centers in the United States shifted their entire health care delivery system to be ICU-ready in a valiant attempt to save lives.

“We were built for this,” noted a health care leader I spoke with about the meaningful work his front line was doing. He is right. Our healthcare system is built to deliver rescue medicine, and it is amazing. But it is not enough.

We need to simultaneously focus our energy on helping our patients reduce their risk factors by developing healthy habits, and by preventing and reversing the very chronic diseases that make people more likely to need rescue medicine if they contract the virus.

The Triumph and Tragedy of U.S. Healthcare is Now on Display

The COVID-19 crisis is shining a dramatic light on both the triumphs and the tragedies of the U.S. Healthcare System. The heroes of health care risking their lives on the front lines, our ability to keep people alive in intensive care units, our creative and chaotic research industry, and the dedication our country has to ER-style rescues is now in full view. These are the triumphs.

Equally on display are the tragedies. Long before the pandemic outbreak, we have seen the need to keep people healthy, to better address chronic diseases, to correct racial and economic disparities, to respond to rising health care costs and to stop our nation’s declining health and life expectancy. Health care desperately needs new models and modalities that the industry is not providing. COVID-19 is now flaying those flaws open at record speed. These are the tragedies.

We need to focus on whole person approaches that improve health, reduce risk factors, alleviate chronic illnesses, and prepare our populace to better withstand the next viral attack. If we had been doing that, the death rates from COVID-19 would be much less and our system would be less likely to be overwhelmed with the need for intensive care.

Lessons Learned from the Opioid Epidemic

Let’s not make the same mistake we made with the opioid epidemic. In the 1990s, while some leaders at NIH were advocating an increase in research on drug-free treatments for pain, including acupuncture, yoga and mind-body practices, mainstream medicine eschewed such concepts and embraced the use of medications such as opioids for the treatment of pain. This resulted in the opioid epidemic that we have today.

Now we are scrambling to find and deliver non-drug approaches to treat pain and major health organizations such as the American College of Physicians offer guidelines encouraging the use of acupuncture and mind-body practices in lieu of opioid prescriptions. But our system was not built to deliver or pay for these approaches. Hundreds of thousands of people suffer and die because of that delay in research and we are scrambling to operationalize these guidelines.

We preferred opioids in the 90s because it was easier than retooling the healthcare system to promote health and support behavior and lifestyle change. We chose to believe that opioids could be made safe and non-addictive rather than face the challenge of helping patients make changes in the way they eat, move, sleep and manage stress.

Rethinking Care

The U.S. military and VA have already embraced a whole person, integrative health approach to care because they have a vested interest in cost avoidance and having resilient, healthy populations. The time has come for the civilian sector in the U.S. to embrace a large-scale investment in person-centered, integrative health care that can reduce chronic illness and promote health and wellbeing leaving us better prepared for the next public health crisis.

Let’s not look back 25 years from now and find we have made the same mistake around pandemics that we did with pain. We need to rethink how care is delivered. We need to build a system where high-quality primary care and public health are supported and integrated with practices that address lifestyle and the social determinates of health.

It is essential that our healthcare system adapt in response to this crisis to deliver not just life-saving heroics in emergencies, but to sustain health and wellbeing year-round and throughout the lifespan of each person so that we are better prepared to survive the next crisis.

In health,
Dr. Wayne Jonas

P.S. I am available for virtual talks on health and wellbeing, self-care and reducing burnout from the COVID crisis. Book me as a Speaker now.

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