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Post details: Change Agent 101: Why Preventive Health doesn't work
Change Agent 101: Why Preventive Health doesn't work
Okay, so the previous posting on obesity & lifestyle is a long, but perfect set-up to say that preventative health has been cited as a promising strategy to deliver us from our healthcare woes. People say, "if we just get people to take care of themselves, make better lifestyle decisions, blah blah blah, the entire health care system would cost xx% less."
Kaiser Foundation Health Plan and Hospitals CEO George Halvorson wrote a tremendous article in HFM on the coming "tipping point in healthcare." He cited how taking care of 1% of the sickest among us makes up 30% of the cost. Not all of those are lifestyle-driven, but some surely are. As quoted in Fast Company, Dr. Raphael Levey, of the Global Medical Forum, noted that "even as far back as when I was in medical school [Harvard, 1955], many articles demonstrated that 80% of the health-care budget was consumed by five behavioral issues." Yeah, you guessed it: too much smoking, drinking, eating, and stress, and not enough exercise.
I love the beauty and simplicity of these ideas. Just think: if everyone in America decided to eat right, exercise, refrain from smoking, how many trillions of dollars would be chopped off?!?
Sigh... I hate bursting my own bubble. As much as I would love to see this happen, I don't have much faith in this strategy at all. People are people, and I am constantly amazed at how most people (yours truly included) never change no matter how badly we need to. The Fast Company article continued,
"Some 90% of heart-bypass patients can't change their lifestyles - even at the risk of dying."
This inability to change people's behavior has tremendous implications on our health and our hospitals.
(1) Any preventative health program rolled out at any level has to do battle with this inertia/complacency. Simple websites sponsored by the government at best are a weak start.
It might be good PR, but it isn't making any kind of impact.
(2) Related, but in a different way, any change management initiative rolled out at your hospital requires staff to work/think/act in a new way. How will you get your organization to care about / re-align towards [fill in the blank]? In fact, isn't this how you would describe leadership? Being able to influence others to change? How do we become effective change agents in our organization and in our society?
We covered some of this in the If Disney Ran Your Hospital series (book by Fred Lee). But, I think there is still quite a bit to cover. In the next few weeks, let's dissect Fast Company's article on Change or Die by Alan Deutschman. While you're there, also check out Fast Company's 5 Myths about changing behavior.
Change Agent Series:
101 Why preventative health doesn't work
102 Give people a new frame (not a new picture)
103 Revolutions easier than evolutions
104 Learn to play the accordian
Comments, Pingbacks:
but when they look at the eating disordered ...they say "oh, how sad, get them treatment"
Why is it any different?
Someone who is facing a by pass, and is going to die if they don't change their eating habit, is no different than the 80 lb anorexic or the bulimic
Change, is easier said than done, and when there are psychological issues at the base of it ... makes it even harder. If they don't replace the food with something, they can't change.
I had an eating disorder for over 25 years, started at 14, I'm now 40 and still in treatment.
No behaviors ... but still paying the price ... and still having to resist the temptation of slipping back into old habits on a weekly if not daily basis inspite of therapy.
05/04/05 @ 18:07 you might be on to something here - a double-standard for overweight vs. underweight people. I think most would probably say that bulimia & anoxeria are driven by psychological factors, more so than obesity is? I think that's where obesity is more complex - lifestyle choices, willpower, and surroundings play a larger role in some cases? tell me if I'm completely off base here.
05/04/05 @ 21:44 Some obesity is driven by simple bad habits. They eat the way their mother taught them to eat (there are starving children in India! Clean your plate! Here, have seconds! )
And those are the ones that can change by changing habits, but ... you have to replace the bad habit with something good, you can't just change it.
But those who have used the food as a replacement for an emotion or to deal with emotions (good or bad) those are the ones that are hardest ...some are taught that way (brought home an A ..her have a bowl of ice cream! Your boyfriend broke up with you, here's a spoon and the half gallon of icecream)
They've been taught to celebrate and mourn using food. Those are harder to change because they don't know how to properly manage their emotions without using food. It's boardering on disorder (compulsive over eating or binge eating disorder) but may not be full blown disorder.
Then there are the ones who ARE full blown compulsive overeating or those who have binge eating disorder ..and they are just as pschologically ill as the anorexic or bulimic. They want to feel no emotion whatsoever ..so they eat the food to kill the emotion.
Then you get the group, that could be in any one of the groups above ...
those with metabolic imbalances ..thyroid disorders, metabolic syndrome, insulin resistance ... that make those already problem issues ..more difficult to deal with.
Pk
05/06/05 @ 22:41
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