'For wellness, I'm going elsewhere.'

  | June 19, 2017

In today's healthcare, we are increasingly asking patients to seek out wellness. But where can they go to do so? Sadly, it's often not the doctor's office.

Our healthcare system is still far too divided from the emerging market of wellness opportunities: Weight loss programs, gyms and trainers, alternative medicine, mindfulness techniques. And while many of us agree that we need to incorporate wellness into our patient interactions, it is frequently the patient who has to drive this integration.

Most people would like their primary care physicians to help lead and guide the entirety of their care, but right now, PCPs are not set up to perform that function. They're not compensated to sit down and talk with a patient about wellness. We're just at the beginning of payment reform that will compensate a provider's time and energy toward the important work of managing wellness.

So, in the interim, many patients who want to proactively manage their health have left the doctor's office behind. They're saying, “If I ever really get sick, I'll come and visit you, but for wellness, I'm going elsewhere."

You find factions of people who believe they've found the Holy Grail: yoga, meditation, Whole30. All of these programs are helpful. But what patients still need is someone acting as a coach, helping to decide which techniques are right for them, developing a plan, figuring out how to stick with it, when to meet again, and how to measure the progress.

In short, we need a restructuring of the physician's role to meet the patient's wellness needs.

Technology will be an important piece of this process going forward. Eventually, it will become normal to have a device that takes blood pressure readings and vital signs, tracks exercise patterns, record mental health scoring, and sends that information back to the physician's office. I can imagine an app that will tell you, “Hey, you're about to walk into a donut shop. Be careful and think about your serving size." An engaged patient would pay attention and heed that advice. That will be the patient's role in healthcare's future.

Some people will still have trouble pursuing wellness due to illnesses, education level, or socioeconomic status. Yet the ability to act on health data would help even the sickest and neediest patients be less sick, spend less, and have better lives. Those patients may need nurse navigators or health coaches to help them get started.

With that support, even the most challenged patients I see would be absolutely capable of taking the next steps. If they're already FaceTime-ing their grandchildren, they can figure out how to use a blood pressure monitoring app, understand the reading, and interact with someone who can help them make healthy choices.

Healthcare in the future should look like a lot of other aspects of society. We'll need a system that addresses those in immediate need of help. We'll need to empower healthy patients to continue on the right path. We'll need incentives for providers to keep people healthier, motivate them, and engage them.

The patient of the future will want to engage in setting health goals; be willing to meet, and measure, and change behaviors to reach those goals; and accept the help that keeps him accountable for his own care.

To make that patient a reality, we'll need to work together.

Kevin Spencer, M.D., is a primary care physician in Austin, Texas, and chief medical officer of GreenLight.

'For wellness, I'm going elsewhere.'