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30/8/2017

The Changing Face of Medicine Part 2

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Medicine Emerging

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By addressing root cause, rather than symptoms, practitioners become oriented to identifying the complexity of disease. They may find one condition has many different causes and, likewise, one cause may result in many different conditions. As a result, Functional Medicine treatment targets the specific manifestations of disease in each individual.
Welcome to part two of this special feature The Changing Face of Medicine - Medicine Emerging. For part one please follow the link: the-changing-landscape-of-medicine.html
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QUESTIONS

Our Australian Healthcare system is considered to be one of the best in the world, it came shy just after the U.K. Second best. Countries that provide their citizens with universal healthcare not surprisingly, sit at the top of the list. The USA with its failing and ailing system came at the 11th hour, just making it. Our Aussie system offers generally really good healthcare to all Australians.

That being said; there are a few factors that hinder our wonderful health care system:
  1. One in ten Australians cannot access healthcare due to cost. That will inevitably translate into even more people not accessing all available subsidised and otherwise, healthcare services. This is hard to imagine, but 1 in 10 means 10% of Australians.
  2. For chronic diseases, conditions that develop over time, we are only eligible for disease management rebates. The healthcare system is set up in a way that allows very little pre-emptive intervention. Since Chronic diseases are mostly attributed to lifestyle and environmental factors, this means that there are little to no protocols set up in the system to ensure people don't get sick in the first place. Yes, we have some preventive elements slowly being patched in but these are often based in the disease management paradigm. Another important factor in pre-empting disease is the relationship between primary carer and consumer and the quality of continuity of care exchanged. This is another aspect that our system can sometimes hinder, with short appointments and an active discouragement of an investigative style approach. 
  3. We are most likely not getting the most up to date evidence-based medicine available. Very little money is spent on dissemination of research compared to the money spent on the research itself. If and when research does finally reach the institutions and practitioners it still lingers until fully implemented.  “Practitioners and investigators have long known that it takes years for medical research findings to translate into practices, with some estimating an average of 17 years for the translation into medical care”     Follow the link (on our website) to Wiley Online Library for the full report:   Dissemination and Implementation Research in Emergency Medicine.
  4. And finally, being considered one of the best in the world is awesome, but it only guarantees a comparative best, not an ultimate best.
Vaccines. Anesthesia. Penicillin. Bypass surgery. Decoding the human genome. Unquestionably, all are life-saving medical breakthroughs. But one breakthrough that will change the face of medicine is being slowed by criticism, misunderstanding, and a reluctance to do things differently. That breakthrough is value-based care.     ​- Toby Cosgrove, Harvard Business Review

CURRENT SYSTEM  ​

Globally, If feels like medicine is finally emerging from the stupor of teenage-hood.. what with reckless behaviour in its past (performing lobotomies on women in the 1950s), and a new found awareness of the consequences of its actions in the present (handing out antibiotics like they were candy, is all over), medicine is finally growing up. But just like any evolving young adult where the frontal cortex may be finally finished its long-awaited construction, it will take years of practical actual practice and varied degrees of success depending on the environment & previously acquired conditioning, to determine which of these "teenagers" will end up on top of their game and which will be fumbling in the dark. Those that seek and receive support and implement change systematically with a clear plan, will be more likely to survive than their counterparts. 

As mentioned by James Maskell in part one of this special feature, the US is a fertile ground for change in Medicine specifically because how messy the system is.  Aussie practitioners and consumers are less likely to want to make hefty changes, and this is mostly due to the ease of access to services and comfortability of the system.

BUILDING VALUE BASED CARE

Toby Cosgrove in The Harvard Business review covered value based care back in 2013: “Vaccines. Anesthesia. Penicillin. Bypass surgery. Decoding the human genome. Unquestionably, all are life-saving medical breakthroughs. But one breakthrough that will change the face of medicine is being slowed by criticism, misunderstanding, and a reluctance to do things differently. That breakthrough is value-based care” 
"I can make diseases disappear"  The wonderful Rangan Chatterjee starts his popular Ted Talk with this sentence. 
Rangan Chatterjee | TEDxLiverpool

THE PROVIDER + THE MICROPRACTICE

Sounds pretty wild   what he’s claiming but not only has his talk been listened to over 600,000 times, BBC UK is already in its second series following Dr Chatterjee around seeing how his approach to healthcare is changing the lives of his patients, using Functional Medicine style interventions first - spending a considerable time investigating the upstream causes of disease, before deciding on a course of action.  

Another place people get information about health and healthcare is from the media. As you will hear on the podcast Pilar Gerasimo discusses the impact of the media, in informing and misinforming the public on healthcare and medicine, leading to further confusion for the consumer.

Pilar Gerasimo is founding editor of Experiance Life, an award winning whole-lofe health and fittenss magazine that reaches nearly 3 million people across the USA. Speking at a Functional Forum confernec on the Evolution of Primary Care Panel back in May 2017.

Patient Zero On the podcast, we will be hearing from four health care providers on the topic of what is now coined Patient Zero - that is that the physician or practitioner themselves become a patient and get to experiance the health oriented appriach and what it is like on the other side of the table. Naturopathic Doctor and Director of Medical Education at the Institutre for Functional Medicine Kristi Hughes highlights the importance of physican work-life balance. Australian GP Dr Tom Rolley asks the question - can a GP be unhealthy? Dr Sachin Patel models healthcare through his own health and  Dr Thomas Salt, talks about operating as Micropractice and the  essence of being a healthcare practitioner. 

DEPRESSION IS NOT PROZAC DEFICIENCY

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Dr Mark Hyman
Depression    can be caused by many things, many of them easily treatable. The current system of medicine operates as a disease management system, which under its care, depression is treated with either psychology or prozac or both. Yet a psychologists' appointment cannot cure a vitamin D deficiency and prozac does nothing for finding the upstream cause of the patients symptoms. In acute care, when we focus on the problem at hand (a heart attack, severe asthma, car accident patients etc), we are doing the right thing. We are looking at the problem at hand and fixing it with the immediacy it deserves.
​In primary care, when we focus solely on disease, its symptoms and manifestations and how to curb/manage/mitigate these symptoms - we are neglecting the very causes that created the disease in the first place and we end up accumulating dust under the rug.
Functional Medicine does Chronic Disease better. It looks at the root cause or upstream source of disease rather than attempting to nearly manage symptoms, or manage disease. It is also proactively involved in health promotion, health creation and health maintenance. Practitioners take into account everything that is going on for the patient, as well as treating organ imbalances and disease as part of a whole system, not just within the system of that organ.  See the tables below for further clarity.
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WHERE TO FROM HERE / THE  THIRD OPINION

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Dr Mark Hyman distills the essence behind the principles of Functional Medicine, you can read and watch the video at www.ifm.org/functional-medicine/ 
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Dr. Hyman is a practicing family physician, a ten-time #1 New York Times Bestselling author, and an internationally recognized leader, speaker, educator, and advocate in his field. He is the Director the Cleveland Clinic Center for Functional Medicine. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post, and was a regular medical contributor on many television shows including CBS This Morning, Today Show, Good Morning America, CNN, and The View, Katie and The Dr. Oz Show
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The Institute for Functional Medicine's website received over one million individual searches for a Functional Medicine practitioner just this year (cited May 2017).
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As discussed in part one of this 2-part special feature, I am exploring The Changing landscape of Medicine around the world and how Australian physicians and consumers are inspired to ask better questions about our healthcare system.

Doctors and practitioners around the world are finding new ways to practice medicine in a sustainable patient-centred and health oriented way. Those that have taken the leap can attest to the success of their approach and are seeing change in their patients and the systems around them. It would be virtually impossible for a huge system like the current medical system to change overnight, in fact it may never change to incorporate the changes it really needs to be sustainable. James Maskell, whom i was very fortunate to interview recently on his trip to Australia and who is featured throughout part one and two of this special feature, often quotes the wonderful Bucky Fuller with his insightful:  “You never change things by fighting the existing reality.
In Australia    Functional Medicine is slowly catching on as more people hear about it, more consumers are looking for physicians and other healthcare practitioners that practice Functionally and physicans and practitioners are reassessing the way they deliver healthcare.
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Responsibility in reinventing healthcare to be the glorious sustainable and equitable service we all want it to be lies in all our hands - from the institutions that train healthcare professionals, to the governments that design and build them, to the consumers that inform and use these services, and beyond. Revisioning Medicine is a humankind project - taking into account everything we have learned and believing we can do better.   We ALL need to start telling the new story of healthcare. As Yuval Noah Harari stated in his Sunday Times bestselling book; Sapiens: A Brief History of Humankind; “The ability to create an imagined reality out of words enabled large numbers of strangers to co-operate effectively. But it also did something more. Since large-scale human cooperation is based on myths, the way people co-operate can be altered by changing the myths – by telling different stories”.

To change something, build a new model that makes the existing model obsolete.

Listen to "The Changing Face of Medicine - Part2" on Spreaker.

INTERVIVIEWEES / APPEARING IN THIS EPISODE


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JAMES MASKELL, has been looking for levers to create significant positive change in healthcare for a decade. Following education in healthcare economics, James has played a part in building a number of successful businesses in the integrative medicine space.James has lectured to audiences of physicians on three continents, including four years on faculty of “Heal Thy Practice”, Integrative Health Symposium and George Washington University’s Metabolic Medicine Institute.
James has been featured on platforms at diverse at TEDMED, Huffpost Live, TEDx and more, as well as writing for blogs like Huffington Post, KevinMD, thedoctorblog and MindBodyGreen. He sees a unique aperture to help fuse the massive potential of digital health and functional approaches to accelerate the evolution of medicine.

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DR THOMAS ROLLEY  is a GP working in a lareg medical centre in rural Northern NSW. His focus is Western medicine with integrated Eastern modalities where available. 

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SALLY CUSACK, has been a consumer representative for over 7 years with Maternity Choices Australia, Australia’s peak maternity consumer represnting body. She is the founder of Pregnancy, Birth and Beyond radio and works tirelessly supporting mothers and their families in her local community and communities across Australia for better outcomes in healthcare.

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PILAR GERASIMO  is a pioneering healthy-living advocate and innovator who writes, speaks, and consults on topics related to her central passion: helping people cultivate “healthy deviance.”  As the founding editor of Experience Life, Pilar has oversee seen the growth of the magazine’s national circulation to more than 650,000 and it reaches an estimated 3.2 million health-motivated men and women.  Pilar also authored  A Manifesto for Thriving in a Mixed-Up World,  a richly illustrated, award-winning chapbook about the guiding truths of the emerging healthy revolution.
The manifesto yielded itself to RevolutionaryAct.com, a health advocacy site serving as a grassroots movement created to inspire and motivate people to live healthy, happy, satisfying lives.

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DR THOMAS SULT Thomas Sult, MD, completed his undergraduate education in chemistry at California State University-Chico. While spending two years at St. George’s School of Medicine in Grenada, West Indies, he was introduced to the herbal and shamanistic customs of the Grenadian “bush doctor.” Upon transfer to UCLA School of Medicine, Dr. Sult was introduced to Norman Cousins and the division of psychoneuroimmunology. Mr. Cousins became a close mentor to Dr. Sult and helped him form a scientific foundation for the broad, open, “natural” healing techniques he had witnessed in Grenada. Dr. Sult maintains a private practice in St. Cloud, MN, and is board certified in family medicine and holistic medicine. He is assistant clinical professor of medicine at the Department of Family and Community Medicine, University of Minnesota, and is the Medical Director of “A Chance to Grow,” a multidisciplinary rehabilitation clinic for brain-injured children in Minneapolis.

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DR RANGAN CHATTERJEE  "I’ve worked as a doctor for 16 years and I'm taking a stand. The way we practise medicine is wrong….well, half wrong at least! It all started when I began to realise that I was genuinely only helping about 20% of my patients in my busy GP surgery.
I was lucky to receive an incredible education at Edinburgh University Medical School. Even so, for the majority of problems I see daily in my GP surgery – headaches, joint pain, gut problems, depression, weight gain, stress, diabetes and skin problems – truth be told, my training was not really that useful. 
The sad fact is, as doctors, we’re largely taught to ‘cure illnesses’ by suppressing symptoms and to practice a type of medicine that’s suitable for acute or emergency care. Our training is not as useful for the current epidemic of chronic lifestyle-related conditions that are now flooding our surgeries.
I focus on finding the root cause of diseases and help my patients make their illnesses disappear."

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KRISTI HUGHES, ND, founded the Center of Natural Healing Arts over a decade ago with a vision of providing integrated healthcare solutions for the public as well as healthcare providers both locally in Minnesota and internationally. Dr. Hughes attended the University of Minnesota Duluth and then graduated from the National College of Naturopathic Medicine in Portland, OR, in 1997. While in medical school, she worked at the Fibromyalgia and Myofascial Pain Clinic under Dr. Carolyn McMakin, learning advanced strategies for managing chronic pain naturally through the use of frequency-specific microcurrent. She became Associate Director of Medical Education for IFM in early 2010 and Director of Medical Education in 2014. Her role at IFM includes working with the development and teaching teams in the Functional Medicine Certification Program and Functional Nutrition Course. She has been lecturing internationally on lifestyle and Functional Medicine for more than a decade and has been instrumental in providing Functional Medicine resources for clinicians and nutrition professionals in South Africa.

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SACHIN PATEL  Sachin Patel is a guardian of truth and a warrior of light. His superpower is taking complex ideas and distilling them down to their essence with easy to understand analogies. Sachin uses this gift to help transform the lives of thousands of people around the world through his organization, The Living Proof Institute.  Sachin founded The Living Proof Institute as part of his own personal transformation. When he couldn’t find answers through conventional medicine he began to explore functional and lifestyle medicine and it dramatically changed his life.

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Author

This episode of Pregnancy, Birth and Beyond podcast & Live to Air radio was produced, written and presented by Annalee Atia.   Annalee is a Producer and Growth Manage at PBB Media.  She has worked in the fields of health, production and entertainment for over 15 years.  In her private practice she is a Health Coach specialising in the support of women during the reproductive years and a Producer, Production & Brand Consultant with a personal mission to adding positive content.

View my profile on LinkedIn

COPYRIGHT PBB Media, Annalee Atia 2017

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