The U.S. Healthcare System - A Tough Pill to Swallow

By Diana Hoppe, MD

I entered medical school dreaming of being a doctor – helping my patients maintain their health and prevent chronic diseases.  At that time, being a doctor meant respect, financial stability and a balanced life.

Well, times have changed and it’s a tough pill to swallow for many of us, both physicians and patients.

Here are a few of the staggering, and depressing, statistics:

1. Physician burnout is at its highest. From 2011 to 2014, the rate of physician burnout increased to 54.45 percent from 45.5 percent, with the most common burnout symptom being emotional exhaustion.
2. The rate of suicidal ideation among physicians jumped from 4.0 percent to 7.2 percent, an increase of 80 percent.
3. Physician work-life balance is completely awry – with 44.5 percent of physicians lacking adequate time for their personal and/or family life.
4. The United States faces a shortage of as many as 90,000 physicians by 2025, including a critical need for specialists to treat an aging population that will increasingly live with chronic disease.
5. The health care costs in the United States are higher than any other country.
6. Eighty-six percent of all health care spending in 2010 was for people with one or more chronic medical conditions.
7. Approximately 70 percent of chronic conditions could be treated with lifestyle changes.

Pretty depressing right?  Well, one option would be to put your head in the sand and ignore the entire medical plight.  Another option would be to take charge of practice as a physician/practitioner and empower your patients to start taking responsibility for their health.

Did you know that the most common chronic and costly medical conditions in the United States today are preventable?  Heart disease, stroke, cancer, diabetes, obesity and arthritis are all conditions that could be treated with simple changes in patients’ behavior.

Four of the most common health risk behaviors that cause chronic disease are:

1) Lack of exercise or physical activity: In 2011, more than half (52 percent) of adults aged 18 years or older did not meet the recommendations for aerobic exercise or physical activity.  In fact, 76 percent did not meet recommendations for muscle-strengthening physical activity.

2) Poor nutrition: Ninety percent of Americans consume too much sodium, increasing the risk for heart disease.  More than one-third ( 36 percent ) of adolescents and 38 percent of adults said they ate fruit less than once a day, while 38 percent of adolescents and 23 percent of adults said that they ate vegetables less than once a day.

3) Smoking: More than 42 million adults – approximately one of every five – said they currently smoked cigarettes, with cigarette-smoking-accountable deaths reaching 480,000 each year.

4) Drinking too much alcohol: Approximately 88,000 deaths each year are due to drinking too much alcohol; more than half due to binge drinking.  About 38 million U.S. adults report binge drinking an average of four times a month and have an average of eight drinks per binge.

Twenty-one years after entering medical school, I am definitely less naïve and a bit disheartened.  But not distraught enough to stop believing. Believing that there are ways to improve the health care system and belief in patients’ desire to change. As providers, we are the ones that need to lead our patients to health – putting responsibility and accountability back on our patients. Rather than handing them a list of prescription medications, give your patients a weekly nutrition and exercise journal. Keep them accountable with the use of ancillary staff. The health care system may be broken, but its pieces can still be repaired.

Dr. Diana Hoppe, an obstetrician and gynecologist, is the founder of Amazing Over 40 Inc. (www.amazingover40.com), a health coaching certification program for women. She also is an author and speaker who has been featured on a number of TV shows, including “Dr. Oz.”