My name is Jack Kruse and I am a neurosurgeon. I would like to share with you some ideas I have. Humans evolved the attributes of a large brain and the ability to speak, in order to form intricate social networks that can use many aspects of technology. Our biggest attribute is the ability to think. This allows us to radically change the environment that we are ideally adapted to. It has allowed us to dominate all habitats and create havoc in most of them as well. The real human miracle of our minds is not that we can see the world as it is……but that we can see it as it is not, and then change it. If we think and act incorrectly, we can quickly recalibrate and overcome it. Conversely, we seem to be a prisoner to our paleo-cortex (older less evolved brain), and resist change even when we know it must occur. Many times we will subjugate the best interests of our survival to suit our emotional needs or desires. The real paradox of humanity is that our reasons for the things we do are often weak but our sentiments to do them remain quite strong. Interestingly, we have overcome that liability as a species many times so far. Some of us even find comfort in that ability at times.
I believe today we are now mismatched with our environment because of our own doing. We all know that when we eat badly we are making a decision that could ultimately kill us, albeit slowly. I watch “serial suicide” daily at the fast-food drive-throughs and in the hospital cafeteria. That irony is not lost on me, either! I think food is very insidious and sinister because it allows our minds to not be self-aware to the implications of our particular choices. How else can you really justify a lifetime of the Standard American Diet when your countrymen are dying of chronic diseases that now occur in teenagers? I recently read an answer on Paleo Hacks that motivated me to write about this human ambiguity. Here was her comment: “My parents eat more prescriptions than they do food. They do not think their food choices ultimately affect their health. They bought a Wii for exercise, and only play Jeopardy on it. They BOTH work in the medical field, too.”
This thinking must change and eventually it will when patients mandate they want better than what they have.
My goal is to start the dialogue of how to evolve healthcare using patients as foot soldiers. I am hell bent on changing the process of how medicine is practiced and healthcare delivered in this country. Right now my sphere of influence is small and I can affect my patients and family with my thoughts. Thinking about how to do this is a messy process when the end point is not well defined. I do know that it must change, but for now I am going to trust the process. Some paradigms change slowly and to others change comes like a tsunami. I have decided to embrace change and try to become the change I want to see in medicine now. I realize I cannot control it, but I know I can work in harmony with it and even cultivate the vision I see for it. I used to worry about healthcare reform and how it might end up after Washington DC tried to control it, but I realized that if I could not control it, neither can they. I found some solace in that.
My own personal story of change led this transformation in thinking for me about 5 years ago. My before and after pictures may surprise some but my thought evolution was far greater. That change has allowed me to focus on what really matters, and that is health, biochemistry, and evolutionary medicine to mold the future of healthcare. It was what I used to guide my own personal change. Patients want results and they are now mandating that it happen on their terms. I love this change in thought. Patients who embrace this concept are now using technology to allow them to “quantify” themselves against metrics they know promote health based upon these evolutionary principles. They reject the dogma that has been healthcare for the last 200 years. They realize that they can no longer afford to abdicate the decision process to someone else. They no longer want to feel helpless. They want some degree of control back.
Medicine has left these concerns unaddressed for too long. The gaps between recommendations and results are widening every day. Patients sense it. We ignore it in hospitals and offices. Some of us recognize it and try to do things to close those gaps in order to remain competitive and up to date. Big companies and government will try to bridge these gaps with tangible action plans. Most will be lead to incremental change with limited success. The reason that success is often limited is because they underestimate the personal behavioral aspects that often result in ultimate failure of their plans. My belief is that if we construct a paradigm that incorporates the tangible (costs and services) aspects of change and the best personal needs of patients, then we will have the ability to effect change in both spheres, simultaneously allowing for massive benefits on both sides of the equation.
My vision for healthcare is to focus on health promotion to allow people to adopt thoughts that immediately change their health. Organizational changes in the food-agricultural complex will need to adapt with the current vertically- and horizontally-integrated healthcare delivery system. We need to adapt our service industry in healthcare much like the American government was able to morph our industrial complex in the 1940’s to fight a World War. That campaign was successful because it allowed for change in both the tangible and intangible areas. The public and business sectors adapted for the betterment of citizens. I believe my QUILT allows for the same change. My question is, will you join me in that thought experiment? Will you become the patient to help me change our current environment? We are human after all, and we are perfectly capable of altering our environment, are we not? My patients in my practice are now chasing change with me. They understand that quantifying their healthcare experience is actually giving them back the control they seek.
I hope this blog can provide some leadership by opening up a dialogue between physicians and their patients so that the organizations within the healthcare arena will embrace an entirely new culture of what healthcare should really be about, health and not disease.