A Softer Side of Health Care

By John D. Clague, Christian Science Committee on Publication for Oregon

Not long ago I had an email exchange with Dr. Pamela Wible, a physician in Eugene, about the recent documentary Escape Fire. The movie examines the problems with health care in the United States, and possible solutions.

Unhappy with the “conveyor belt” system of medicine that she had found herself in since medical school, “pushing pills into patients as they flew past me,” Dr. Wible got off the racetrack and stopped to consider what kind of health care system she wanted to work in.

The first step towards building her new medical practice was holding town hall meetings to see what patients wanted in a community health clinic. She describes her experience in building her practice around patient values for health in her recent book, Pet Goats and Pap Smears.

Because Escape Fire points out systemic issues that confronted Dr. Wible, I thought it would be instructive to discuss these with a physician in the trenches.

John: Several prominent physicians were interviewed in the film: Andrew Weil, Don Berwick, Dean Ornish, and Steven Nissen. They are pretty critical of our current health care system. Do you agree with their assessment?

Pamela: Yes. We have a disease billing system, not a health care system.

John: It was said in the movie that “conventional medicine suppresses symptoms which just keeps disease going. Do you agree with this view of conventional medicine?

Pamela: Yes, but conventional medicine is fabulous with trauma and tertiary care. We fail at chronic disease and certainly we lack the training to deal with the most prevalent health problem in America: Despair. Despair is at the root of self-destructive behaviors such as overeating, smoking, alcohol and drug abuse.

John: How do you measure health outcomes?

Pamela: By helping patients become self-actualized and fulfilled human beings. I don’t spend my time forcing them into algorithms that conflict with their values. I invite patients to define their own health goals. I align my care with their goals, not mine, and certainly not the system’s goals. We have an innate ability to heal ourselves.

John: It was also said that the interventions we depend on in our health care system depend on expensive technology (imaging etc.), and that includes pharmaceuticals. Do you agree with this?

Pamela: Yes. We have a high-tech, low-touch model. When I ask citizens in town halls to describe ideal health care, they describe the reverse. They prefer high-touch, low-tech care when possible. We breed dependency on a high-tech, complex system. The basic message to patients is that the answer to their problems is outside of themselves (in pills, doctors, machines). This is disempowering and dangerous. When I listen long enough, patients will reveal their real core issues. Unfortunately, we do not take the time to get to the root of their problems in ten-minute visits.

Dr. Pamela Wible
Photo used with permission

John: Seems to me that primary care physicians as the hub around which specialty care is provided would be the ideal model.

Pamela: YES!! YES!! YES!! We spend far too much time caring for the system, caring for profits, caring for insurance companies and third parties. Caring for patients and doctors is no longer the priority. 1) We need a simplified model. 2) We need ethical human beings at the helm. WITHOUT these elements, all models will fail. We need a spiritual awakening in health care. We are holistic human beings, not reductionist robots. Escape Fire, reveals the failure of our patriarchal, reductionist medical model. Though holistic therapies are suggested as the solution, the film primarily interviews male physicians and fails to showcase female physicians or innovative health care solutions developed by women in medicine.

The film was heavily focused on the “problems” we face in health care, yet did not offer a balanced perspective on solutions. We know the problems.

Dr. Wible makes quite a few important points about health care. I found her perspective on what female qualities can bring to health care interesting, especially since my own health care system was discovered by a woman, Mary Baker Eddy.

Even though Dr. Wible associates the qualities of nurturing, love, and compassion with women, I’m wondering if perhaps this is a way of highlighting these qualities. In her book she mentions men whom she respects, and who embrace a balance of male and female qualities.

It appears to me that problems in life arise when complementary elements such as male and female are divorced. Perhaps the whole nature of health care in this country could be readjusted and aligned by the recognition and reintegration of this balance. Caring, nurturing qualities are important to health care delivery, but not confined to one gender or the other.

In my reading of the Bible I’ve found it intriguing that the ‘great physician’, Christ Jesus, seemed to possess tough qualities, and yet expressed compassion and love in his healing ministry.

Pamela Wible is a doctor exploring these important issues and taking them seriously, introducing them into her practice with very positive results.

Health Apps, or an Inner Spiritual Sense?

By John D. Clague, Christian Science Committee on Publication for Oregon

@Glowimages

Simplifying our life seems to be getting more complicated. But never fear, there is an app for everything nowadays. Managing each aspect of the most intimate everyday details is being digitized through applications running on ever faster and smarter devices in astounding numbers.

Almost everyone I know owns one of those ubiquitous smartphones or tablets. They seem to be able to do everything a computer can, and then some.

The technological wonder of these devices is surely one reason for their popularity. They can perform more commands per second than the computers in Apollo 8 by an order of magnitude in the thousands. They are cheaper and have far more memory. And you can easily carry them in your pocket.

And then the proliferation of software written specifically for mobile devices has a lot to do with their popularity.

Individual applications, or “apps”, exist for every conceivable function and service. And there are thousands of them. Apple has approved for download more than one million apps. Consumers have downloaded apps from their store more than 25 billion times. The Android download numbers are impressive too.

Managing health has not escaped this trend.

According to Research2Guidance, a global market research firm, nearly 247 million mobile phone users worldwide are expected to download a health app by the end of 2012. There are as many apps to manage health functions as there are health issues: losing weight, monitoring blood pressure or diabetes, exercising and so on.

There is even a proliferation of apps to assist physicians in making quick and accurate diagnoses and prescribing indicated treatments.

Are all these apps on our mobile devices the ultimate in making us healthier?

One person who might not think so is Dr. Marc Siegel, MD. Through a personal crisis he discovered a phenomenon he calls the inner pulse. It’s an awareness, or “sense”, about what’s happening with one’s body. He says it’s :

“… the fulcrum of a person’s life force, the place where the physical and the spiritual combine. It is the link between your body’s life force and your soul, tangible proof of your connection to a larger reality and of that reality’s strong presence in your body.”

“The inner pulse is more than just instinct and intuition.”… “Clearly, being aware of the inner pulse can change your life dramatically in a positive way.” (pg. 15)

Perhaps, though, the inner pulse, as Siegel describes it, goes beyond being aware of what’s lurking in our body. The inner pulse may not just tell us what condition the body is in, but may be able to affect health in a dramatically positive way, if we know how to access it.

Olympic skier Janine Shepherd tells the story of her remarkable return from a biking accident that left her paralyzed, yet she went on to a whole new life as a pilot. Told that she would never walk again, she asked, “Why me?” But at her lowest point she began to realize that it wasn’t just about her life. It was about life itself. She began to see that she was not her broken body. In the uncertainty of her circumstances, she found that she was free to explore life’s infinite possibilities. She felt she was responding to a spirit that was bigger than she was.

One day she looked up and saw an airplane flying overhead and said, “That’s it! If I can’t walk, I’ll fly.” She started by taking a flying lesson and went on to learn to walk again, to fly a plane and then to become a flight instructor.

Janine’s experience shows that there is an unmeasurable spirit that can bring out strength and ability far beyond what an app would be able to measure in the body. I call that God, and don’t ever want to underestimate the power it can have to restore a measure of health when human hope is gone.

The Bible says:

“There is a spirit in man, and the inspiration of the almighty gives them understanding… Whither shall I go from thy spirit? or whither shall I flee from thy presence? If I ascend up into heaven, thou art there: if I make my bed in hell, behold, thou art there. If I take the wings of the morning, and dwell in the uttermost parts of the sea; Even there shall thy hand lead me, and thy right hand shall hold me. (Job 32, Ps. 139)

Janine may know nothing about these Bible passages, but her life certainly embodies the energies of what I call a spiritual sense. I believe this spirit is available for everyone to tap into and receive an impulse like Janine did. Perhaps Dr. Siegel’s “inner pulse” is another way of naming this resource.

I haven’t yet found an app to make that link, but when I do, I will definitely let you know.

Does the health care system know best?

Americans are an independent lot. It’s rooted in the very fabric of this country. We are accustomed to having a choice and making our own decisions. That’s what we expect in our homegrown version of democracy.

We can choose virtually any product or service we want. Any size, shape, color, or model. Except when it comes to our health care.

It seems to me from much of what I’ve read that the patient-doctor relationship is mostly unbalanced. The doctor tells the patient what’s wrong, and what needs to happen to fix it. Our health care system forces doctors to quickly address the offending symptoms and move on.

In the United States more is spent per patient on health care than in any other developed country in the world.

For all the wonders of our nation, its unparalleled standard of living and freedom of choice, does this ensure that we are the healthiest country with the longest lifespan?

The United States came in at 37th place in the World Health Organization’s assessment of overall health outcomes of all nations in 2010. According to the CIA World Factbook, the U.S. currently ranks 50th for life expectancy. In 1950 we ranked 5th for women and 10th for men.

According to Gallup Polls, “Americans’ evaluations of healthcare coverage…show that much less than a majority of Americans are positive in their overall evaluations of coverage and cost of their healthcare.”

@ iStockphoto/Tom Hahn

Could it be that people are not satisfied because they don’t have much voice in their health care? Are their care expectations being met?

Shannon Brownlee makes the point in her book Overtreated. Why Too Much Medicine is Making Us Sicker and Poorer, that:

Strengthening the patient’s role in choosing a particular treatment or test is an important aspect of moving toward more efficient care. (pg.. 297)

A health care system allowing a more responsive patient-doctor relationship could provide for more effective two-way communication. The doctor could better understand the underlying causes of the patient’s symptoms and the patient could actually choose treatment options that fit better within his or her values.

Emerging aids to facilitate this process are decision tools that help patients make their own choices about health care. As Brownlee points out:

“…informing patients better, will very likely decrease overutilization rates:…clinical trials show that the use of decision aids leads to a decline in demand for surgery ——- about 25 percent overall.” (pg. 298)

Fewer tests and invasive procedures would lower costs and reduce the risk of adverse consequences.

This appears to be a central theme in shifting our health care delivery system. In her paper Emerging Patient-Driven Health Care Models Melanie Swan makes the observation that “The growing presence of patient-driven health care models may be central to the evolving health ecosystem. Individuals are starting to better manage their health.”

Within those models can be included all manner of alternative and integrative care. The whole patient needs to be attended to, including mental, emotional, physical, and spiritual needs.

In the late 1800s spiritual healer Mary Baker Eddy introduced a form of health care that puts the patient’s needs at the center of their care. She explains in her major work, Science and Health:

“Give sick people credit for sometimes knowing more than their doctors. Always support their trust in the power of Mind to sustain the body. Never tell the sick that they have more courage than strength. Tell them rather, that their strength is in proportion to their courage.” (pg. 417)

Patient-centered health care starts with our thoughts, whether they’re using a decision aid regarding the conventional health care paradigm, or addressing the connection between thinking and bodily health. Certainly better decision-making in a medical system is a good thing.

Is it reasonable to conclude that spending more time discovering the patient’s mental state and behaviors determined by their thoughts, and encouraging and strengthening the healthier thoughts, could be the basis for improved health?

Originally published on OregonLive

John Clague is a retired sheriff’s office captain, father of two grown sons, and husband. He now works with the media to ensure accurate representation of Christian Science.

Chronic Pain, we don’t have to depend on it.

We seem to be creatures of habit. Most of us feel comfortable when at least a portion of our lives is predictable and our relationships are dependable. That’s certainly true for me. I get comfort in knowing that from day to day my life won’t change dramatically.

There are some parts of our life, however, that we might not want to stay the same.

Perhaps we’d like to get rid of those extra pounds we’ve been lugging around. Or maybe we feel a change in employment would be a good thing.

Some people would like to change their relationship with chronic pain. Unrelenting pain that they come to expect day in and day out. It has become an integral part of their life.

©iStockphoto/Squaredpixels

Maia Szalavitz reports in TIME Healthland that “…serious, chronic pain affects at least 116 million Americans each year, many of whom are inadequately treated by the health- care system..”

There are many kinds of pain people may suffer from: headache, low back pain, arthritis pain, and pain without any identifiable source.

Another form of pain is “Fibromyalgia… a common syndrome in which a person has long-term, body-wide pain.

In the quest for relief from this national epidemic, many remedies have been offered, such as drugs (including marijuana), acupuncture, electrical stimulation, brain stimulation, and surgery. Placebos have been used, which sometimes have resulted in a lessening or elimination of pain. Psychotherapy, relaxation therapies, biofeedback, and behavior modification are also on the list of tried solutions.

Try as we may, nothing seems to adequately solve this public health problem. It results in millions, if not billions of dollars in lost worker productivity and health care costs.

Are these the only options for treating chronic pain?

Marilyn Baetz and Rudy Bowen looked at regular church attendance and spirituality as factors in treating chronic pain and found that they were associated with better psychological well-being. They conclude that frequency of religious worship attendance should be considered in the development of interventions to address pain.

Amy B. Wachholtz and Francis J. Keene of Duke University Medical Center support these conclusions in their own research into managing pain from migraine headaches.

“One recent study found that by using positive spiritual meditation [or prayer] twenty minutes a day, patients with frequent migraine headaches were able to improve their pain tolerance and reduce their frequency and severity…. This research indicates that patients with chronic pain conditions can be taught to use their existing spiritual resources in novel ways to reduce the negative impact that pain has on their lives.

Nineteenth century spirituality and health innovator, and founder of the Christian Science Church, Mary Baker Eddy explains in her book, Science and Health:

Whatever guides thought spiritually benefits mind and body. [page 149]

Baetz and Wachholz, seem to be finding, through research, what Eddy pointed out a century and a half ago. Spiritualization of thought can benefit the body, the seat of chronic pain.

Of all the research conducted on treating chronic pain, spirituality and prayer might be a fertile field with opportunities to uncover just how critical a role they play in treating this far too common condition.

Previously published in the Oregonian

John Clague is a retired sheriff’s office captain, father of two grown sons, and husband. He now works with the media to ensure accurate representation of Christian Science.

Essentials for better physical & financial health

How does an insurance company keep a positive bottom line and still provide real customer service? That’s an important question.

I suppose It’s a delicate balance, deciding what benefits to provide at what cost, and still be competitive in the market. After all, everyone needs to make ends meet.

Here’s an interesting piece showing how one managed care plan found that including spiritual care actually benefitted them financially.

My colleague in Texas recently talked with its chief medical officer.  Very interesting discussion.

By Keith Wommack, Corpus Christi, Texas

How often do you better your health and save money at the same time? I know. Never.

Yet, through some health care plans, it seems possible. Some plans include unique programs that will reward you for taking meaningful actions toward enhancing health.

Within good-health-behavior reward plans, an individual can earn up to $300 a year for participating in a coaching program or for meeting recommended health guidelines.

Eat healthy foods, get regular physical activity, abstain from tobacco use, — these are some of the suggested steps often recommended to stay healthy. However, there may be pieces of the puzzle missing from health care plans and healthy lifestyle choices that you could benefit from.

©iStockphoto/Igor Dimovski

Last September, Robert P. Faraci, MD, a principal with Medical Care Consultants, gave public testimony about health care before a Health System Reform Task Force of the Utah legislature. Faraci suggested that he may have stumbled upon a missing puzzle piece to the health care delivery equation. His testimony centers on his discovery that when it comes to health care, an important element is spiritual care.

Faraci practiced general surgery for 20 years. Later he became the Chief Medical Officer for a managed care plan in Denver, Colorado. Faraci was one of the executives of the plan who began investigating the mind-body aspects of disease and health care. His investigation directly led this plan to becoming the first HMO in the United States to offer spiritual care as a benefit.

Faraci stated before the Utah legislature, “In the course of my research, I discovered that spiritual beliefs have profound effects on patient outcomes. Furthermore, my own anecdotal experiences as a surgeon supported this conclusion.”

“Our research indicated that people with strong spiritual beliefs often had better medical outcomes than those who did not have such beliefs. Subsequent studies at Duke and Harvard Medical Schools and a comprehensive review by the Mayo clinic have reinforced these findings.”

Faraci continued, “We also discovered that people wanted this benefit. A John Templeton study revealed that 55% of Americans said they would choose a health plan that included spirituality and religious healing practices over a plan that did not. Finally, we felt that the addition of spirituality to our members’ care might lead to better clinical outcomes and, as a result, lower utilization of other resources.”

When other resources were utilized less, the company would save money. Therefore, they were able to offer the plan at a reasonable price, enabling members to keep their dollars in their wallets.

If you learned that there was a beneficial plan that acknowledged your spiritual beliefs and practice, wouldn’t you want to sign up for it?

Dr. Faraci quickly found that there was a huge demand for this spiritual benefit plan and the demand exceeded anything this managed care group could have imagined. It resulted in a doubling of their plan membership in the first year and doubling again in the second.

Faraci closed his testimony by sharing with the Utah legislature the likely results if a spirituality benefit were to be included in health plans of state Health Exchanges:

It could be added to the health plans at little to no increase in premium
It could potentially improve clinical outcomes
It will give members a stronger sense of well-being
It will make members happier with their health plans because mind, body and spirit have been addressed.

Perhaps, recognition of the bonuses spirituality brings to the health care table will bring an even greater interest in how spirituality heals minds and bodies. The care of each individual is of the utmost importance. And spiritual treatment has been shown not only to improve health but also to give relief from the tremendous financial burden imposed by other forms of care.

When examining the essentials needed to better health and to do it in a financially prudent way, don’t forget to consider spirituality. Many feel that it can provide you with the best rewards.

Keith Wommack is a Syndicated Columnist, Christian Science practitioner and teacher, husband, and step-dad. He has been described as a spiritual spur (since every horse needs a little nudge now and then).

Keith’s columns originate at: KeithWommack.com

(reprinted with permission)
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John Clague is a retired sheriff’s office captain, father of two grown sons, and husband.  He now works with the media to ensure accurate representation of Christian Science.