It’s a backbone-brilliant concept that actually produces better healthcare, and better health, for significantly less money—and a concept that America may be too politically hypnotized to ever put into wide practice. “Evidence-based” means it’s about what really works, “health” because that’s the goal.
Dr. Pauline Chen, in her blog on the NY Times website, profiles the emerging concept of “evidence-based health.”
“Medicine” is not the goal, it’s a tool. “Evidence-based medicine” doesn’t get you there. “Evidence-based health” hooks up advanced “medical home”-style primary practices with community health, behavior health, and other staff right in their office, to help patients do what they need to do to get healthier. Most interventions in chronic disease fail for reasons that have nothing to do with medicine. To make them work, you have to get out there in the community and deal with what gets in the way of health. This concept re-brands and sharpens the ideas of “community determinants of health” and the “healthy city/healthy community” initiatives that derive from Dr. Len Duhl, ideas that I’ve been talking about for 20 years, and connects them directly to the medical world.
By Joe Flower
Dr, Chen’s article resonates with “The Hot Spotters” article, no?
It does. The winning combination is: advanced “medical home” primary care practices + behavioral and community and health assistants in the office to help people get and stay healthy + direct connection between primary care and public health and “healthy communities” work + “hotspotting” the heaviest users of emergency care.
Make that a common template across the healthcare economy, and you can expect greatly improved health, and 30%, 40% or greater drop in healthcare costs.
“…+ behavioral and community and health assistants in the office to help people get and stay healthy + …”
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Totally agree. But, cue the GlennBeckistan-ies now. The paranoid pushback lines just write themselves.
Even “Hot Spotters” alluded to the concern:
“…people were slowly realizing, would be involved in their lives—a medical professional would be after them about their smoking, drinking, diet, medications. That was O.K. if the person were Dr. Brenner. They knew him. They believed that he cared about them. Acceptance, however, would clearly depend upon execution; it wasn’t guaranteed. There was similar ambivalence in the neighborhoods that Compstat strategists targeted for additional—and potentially intrusive—policing…”