Transform, don’t tweak                               

            During a medical career that began more than a half-century ago I have been awed by the technical and pharmacologic advances in the field. Yet I have watched as chronic diseases that were almost non-existent a few decades ago inflict their misery on ever-younger patients. It has been said that genetics loads the gun, lifestyle pulls the trigger. To that I have added: doctors stop the bleeding. Wouldn’t it make more sense to put a lock on the trigger? A century ago heart attacks were uncommon. The first medical journal report describing myocardial infarction, or heart attack, was published in 1912. Nearly one thousand Americans will die today of sudden cardiac arrest, almost all of it brought on by a heart attack.  Type 2 diabetes did not appear among Native Americans until the 1930s; it is now the second-leading cause of death in that group. The rest of us are not far behind; type 2 diabetes is a galloping epidemic, especially among the youngest generation. Cancer researchers tell us that at least 80 percent of all cancers are lifestyle-related. In my oldest medical textbook, published in 1917, the term lung cancer isn’t even mentioned but it is now the leading type of cancer.

            We must change the way we attack disease, not the way we pay for it. For starters, obstetrician’s offices must become educational centers for pregnant women. Obesity, hypertension, type 2 diabetes, kidney disease and osteoporosis have their start in the womb. From kindergarten through college, course material in most subjects should incorporate topics related to health. Some corporations have excellent programs to encourage good health among their employees. This results in lower health premiums, greater productivity and fewer sick days. Every company should follow their example.      There are other steps that we can take to limit the chronic diseases that are overwhelming our resources but if we were to implement only these few it would dramatically reduce the $2.6 trillion that this nation spends on health care – an egregious misnomer. It has taken only two generations for us to quadruple the rates of obesity and type 2 diabetes in this country. If we can transform the will of the populace, the courage of politicians and the willingness of physicians to become teachers, not just healers, we can reverse those trends in a couple more generations. To fail is to cripple our already ailing economy.