Mainstream healthcare model: a failing paradigm

Healthcare systems the world-over are in trouble. The junior doctor’s dispute in Britain’s NHS is one expression of this. While the current dispute, let alone the long-term viability of the National health Service (NHS) itself, is seen to be more about money and funding than it is about the type of healthcare being offered, the two are actually inseparable. That’s because the current, mainstream system of healthcare costs too much and, for many diseases, especially chronic ones affecting older populations, as well as many diseases affecting mental health (e.g. autism, bipolar disease, schizophrenia), it just doesn't work well enough, enough of the time.

Among the fundamental problems with the existing healthcare system is that disease prevention is not tackled earlier enough in our lives. Once disease is diagnosed, there is then an over-reliance on pharmaceuticals, most of which treat the symptoms rather than the causes of disease.

There are also insufficient resources allocated to multi- and inter-disciplinary primary care teams equipped to deal with prevention, early diagnosis as well as support for dietary and lifestyle modification. The latter is recognised by health authorities, including the World Health Organization, as being strongly linked to reduced risk of the diseases that cause the primary disease burden.

Presently, it’s our view that the field that may be described as ‘integrative medicine’ or ‘functional medicine’ represent the most relevant models of a healthcare system for Western societies that are splitting at the seams given the sheer burden of chronic diseases. In many other parts of the world, traditional systems of medicine, such as Ayurveda and traditional Chinese medicine (TCM), have evolved as patient-centred, multi- and inter-disciplinary systems of healthcare delivery that emphasise both disease prevention and treatment of the causes (vis-a-vie the symptoms) of disease. But one wonders if there’s the will even in these non-Western countries to downgrade the importance of pharmaceutical healthcare as China and others increasingly adopt Western diets and lifestyles.

Despite the existence of sustainable models of healthcare as well as growing evidence of their clinical effectiveness, there is yet to be a political appetite for them among the Western mainstream. It’s a problem that is exacerbated by vehement rejection of them by Big Pharma and its influential political supporters who are wedded to the failing pill-for-an-ill model that generates profits for the few, at the expense of both the public and the tax payer.

Adding further to the challenges we face, Big Pharma doesn't operate on its own. There is increasing evidence that Big Food plays at least as big a role in creating the chronic disease burden, as well as manipulating research and public opinion.

As Stuckler and Nestle (interesting surname!) indicate in their 2012 PLoS Med review, “Big Food, Food Systems, and Global Health”, “food systems are not driven to deliver optimal human diets but to maximize profits…….What people eat is increasingly driven by a few multinational food companies.”

Let’s talk about it

It is this dilemma that fuelled our own interest, along with our colleagues at Yes to Life to organize an international think tank just over a year ago in London under the banner NuHealth2.

In anticipation of the release of a White Paper that will provide a blueprint and a charter that defines a truly sustainable healthcare system that provides the kind of healthcare needed for 2020 and beyond, we have taken this opportunity to release a teaser video of last year’s event.

We’d like to thank all those who contributed to it, including Thomas Meadmore who did the filming on the day, and Charlie Jones who edited it.

We will inform you as soon as the White Paper is ready for release. In the meantime, let’s keep the conversation going….

Watch teaser video excerpts from some of the participants:

Some memorable quotes from the NuHealth2 think tank:

Dr. Rangan Chatterjee, NHS general practitioner (GP) and functional medicine practitioner:The conditions that we're seeing day in, day out that are threatening to clip the NHS and other healthcare systems are chronic disease. We know that these are preventable conditions, yet lifestyle and nutrition are still not taught in medical schools. People are getting their information from doctors, yet doctors are not taught in lifestyle and nutrition. This has to change”.

“So I think the way we are trained in medical school needs to change. We are trained to diagnose a disease. That's what happens at the medical school, you got, you know, a pat on your back from your professor, a whole list of symptoms comes up, and then what's the diagnosis? If you made the diagnosis, that is what makes a good doctor, apparently. But that's the end of it. The diagnosis has been made, then you come up with a course of treatments. Obviously that would be pharmaceutical medications, and I think we need to think about these sort of problems in a different way… a lot of these problems are caused by diet and lifestyle, yet we do not have much training at all in diet and lifestyle”

“We need to change — the way we deliver medicine has to change. We've got to change what we do because what we do is simply not working. I'll leave you with this quote which many of you will be familiar with, from 1903, I believe, "The doctor of the future will give no medicine, but will interest his patients in the care of the human frame, in diet, and in the cause of prevention of disease. ”Well that was over 100 years ago. I think that doctor of the future should be the doctor of today. Whether we call this functional medicine, lifestyle medicine, nutritional medicine or integrative medicine, to me it really doesn't matter. This is simply good medicine.”

Michael Ash, Functional Medicine Practitioner, Managing Director, Nutri-Link and Nutri-Link Education:Well, the driving force really is chronic diseases, non-communicable diseases and a cost-effective solution to them because they're going to bankrupt pretty much every health system in the world unless they're combated more effectively. Heart disease, cancer, depression, and problems associated with increased life expectancy including dementia”.

They (The Institute of Functional Medicine) developed a strategy that provides an effective operating system and a robust clinical model to allow you to assess, treat, and intervene in the prevention and reversal of chronic diseases, which is more effective than the somewhat outdated acute care model that's been carried forward from the 20th century to deal with these non-communicable diseases”.

I don't work inside the NHS but it's quite clear that the model is very geared for acute care, primarily. It isn't really geared for what we're facing, 60% of the population are dying because of non-communicable diseases”.

Dr Vijayendra Murthy,

Holistic health practitioner, academic and researcher in complementary and alternative medicine:My professor told me one thing, "Vijay, one thing you haven't understood, you may be a practitioner for 20 years. One thing you haven't understood is that never was healthcare for the welfare of people - it was always for profit." And the biggest fight will be about us trying to fight this monster that's been created for profit under the excuse of healthcare, which we believe is noble”.

“The solution to me is comparative effectiveness research because these are pragmatic, then you are estimating the benefits and harm of different interventions and strategies to prevent, diagnose, treat and monitor health conditions in real world settings”.

“When you consider Ayurveda, 5000 years ago, they looked at it as a whole system, and that's why the practice-based evidence in Ayurveda, to a large extent, can be much more relevant than evidence-based practice, to which we are highly devoted to today”.

Prof Karol Sikora, Dean of Medicine, Buckingham University UK; Medical Director, Cancer Partners UK :The problem with the technology-based future is it gets costlier and costlier, you get an escalation of costs for cancer and for other diseases. Some of the new drugs for diabetes are incredibly expensive… And if you talk to commercial marketeers, they say, "A drug you have to take for the rest of your life is fantastic because the amount of money you're going to make out of that is tremendous." So the problem with the technology box is we're going to run out of money, and that's what's happened to the N.H.S.”

Ralph Moss PhD, Principal, Cancer Decisions, USA (Re: unpatentable natural products that are promising for cancer): “We're talking about small amounts of money that can be made, but for the private, you know, monopolistic drug companies, they want profits in the hundreds of thousands, the hundreds of millions, basically. Billions. A billion dollars a year is now considered to be almost necessary in profits, and some of these have earned more. I mean, Avastin, $6.6 billion a year in sales last year”.

Ben van Ommen PhD, Principal Scientist at TNO, (Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek or Netherlands Organisation for Applied Scientific Research):Healthcare doesn't exist. It's disease care. I'd like to see a shift from a patient to a self-empowered individual that knows how to deal with his health optimisation”.

Robert Verkerk PhD, ANH-Intl founder and think tank co-organiser: “When the World Health Organization recognises that the primary burden on healthcare systems around the world are preventable and are related to nutrition and lifestyle, it's still an extraordinary fact that nutrition and lifestyle remain the poor cousins of healthcare”.