Returning to an Old Medicine- A Wellness Rx LLC ReportReturning to an Old Medicine- A Wellness Rx LLC Report
RETURNING TO AN OLD MEDICINE
Health care today in America continues to disappoint. While we are spending close to 20% of our economy on health care, insurance premiums are back to double-digit increases, employee deductibles are at a record high and health outcomes remain unimpressive especially in these important areas: infant mortality, obesity, depression, anxiety management, sleep deprivation, pain management (Americans utilize 90% of the worlds opioid production and are experiencing a serious heroin epidemic) and end-of-life health care spending. According to the New England Journal of Medicine, life expectancy in the United States ranks a cold 36th among industrialized nations and many experts now agree that it will even decrease for the next generation of Americans.
While the Affordable Care Act (ACA) gave us a flicker of hope (expansion of benefits; underwriting restrictions, isolated cases of innovation & Medicaid expansion/exchanges that reduced our medically uninsured rate from 15.8% to 10.5%), it also led to over 60% of health care spending now publicly-funded and to a consolidation of more power and control in the hands of large corporations (many are publicly-traded entities) and regional health care systems with survival agendas. It may or may not be fair, but these companies and their CEOs must answer to their shareholders and stakeholders. They never signed-up for making health care a human right, for universal care, regional health care planning or the creation of a new medicine built around wellness. They are simply doing what our government and modern medicine has asked them to do: “fix” the health of our nation by tests, drug therapy and medical interventions and then insure this care under the power of market forces. If this feels like a top-down system where the patient or consumer of care comes last, well it is. And as health care providers are finding out, they are slipping fast on the health insurance food chain.
Certainly, this is not a healthy or sustainable model. I make this observation as a student of health care and government. Over a course of 43 years or since 1973 when President Richard Nixon proposed universal care as the answer to America’s “health care crisis”, I’ve seen our country’s health care evolution as a licensed pharmacist, HMO founder/CEO, county mental health director, legislator and studier of natural and world medicine. I’ve seen the best we have to offer in Kaiser modeled-HMOs especially in the West, the creation of powerful medications, advanced diagnostic testing, robotics, gene therapy and public health successes. Many of our regional health centers like the Mayo Clinic often provide the best health care in the world. I’ve also seen the waste of our system in the form of defensive fee-for-service medicine, the lack of accountability for outcomes and the squeezing out of excellent health care providers by the pressures of market consolidation.
Times like these present a great opportunity for transformation, especially the creation of new paradigms for the delivery of health care that acknowledge the interconnectedness of mind, body and inner well-being. This new health care must remain local, be patient-driven and must provide patients tools and support to become their own best advocate for maintaining their health. This new medicine must incorporate the wisdom of other cultures and explore natural treatments that are used successfully throughout the world. Several years ago I decided to return to what author E.F. Schumacher referred to as a “Small Is Beautiful” way of living to effect positive change. I observed that many in our country had a thirst for a more authentic way of connecting with each other and that our health care systems were traveling in the opposite direction.
On this premise, Wellness Rx was created in the upstate New York Mountain-Top community of Tannersville as a unique patient-centered pharmacy that incorporated natural medicine and space for clinical services and student training. A platform to test our ideas for returning to an old medicine in America. After our first 2 & ½ years of operations, we began to establish some “truths” for moving forward. First, we discovered that people really resonate with a culture that is committed to being of “service to others”. A culture that is patient-centered and really cares about the healing of another human being. This commitment leads to trust and trust leads to positive outcomes. We then discovered that the environment that we operated in must be safe, friendly, accepting, colorful and allow staff to do their best work. This led to the creation of an old- apothecary feel throughout the store, private clinical & ample training rooms, resting areas, an art gallery, a high-quality sound system and little extras like fish bowls to best connect with kids. Then we slowly watched ourselves become a true community “Wellness Center” rather than a transactional center where you just went for illness.
As a “Wellness Center” we had the ability to think creatively and to partner with patients as they explored ways to heal themselves. This allowed us to observe that close to 80% of all patients were open to natural medicine and would increase their compliance to wellness if they could afford it. This awareness helped us to understand that everyone had to have an opportunity for wellness regardless of race, religion, gender or income. This led to the creation of a “Patient Assistance Fund” to allow for providing wellness services and products to patients when they needed it. A philosophy of “people helping people” or “let the fund help you today and you can contribute back to the fund when you are able.” We also discovered that patients loved a team environment that allowed for multiple assessments of a specific case, and an environment that was ever changing with new interns, fresh ideas, Research and Development (R & D) projects and new natural health products and services. Patients especially liked it when a product was compounded specifically for them.
Finally, in our first 2 ½ years, we observed that patients expected you to make a profit in order to survive and to expand the Wellness Center. The perfect marriage was when a patient received a great service or product at a fair price and the Wellness Center maximized its return on investment.
We will soon complete our 5th year of operations on the Mountain Top and the adventure continues. We have added to our “truths” the understanding that patients need to feel connected in order to heal. Connectiveness leads to trust, respect and being listened to in a non-judgmental way. We have also learned that patient compliance appears to improve when more services such as counseling are provided within the same environment or within a supportive community.
The most rewarding and moving experiences to date, however, have been the “stories”. Real stories about real people. It’s been as authentic a way of living as it gets. From the intern that writes “that this wasn’t a pharmacy rotation, but rather a wellness rotation that changed my life” to the stories of the woman whose ulcerative eye cyst was removed after twenty years by natural mineral water; or the bi-polar patient that for the first time feels that she has a team that loves and understands her; or the patient that is helped transitioning back home from in-patient or psychiatric care; or the patient that receives a free wheelchair from another patient’s mom who died; or the cancer patient that receives encouragement to keep going; or the chronic Lyme Disease patient that finds hope for the first time after years of suffering; or the teenager who breaks his clavicle and experiences rapid healing with daily doses of calcium & vitamin D; or the high-strung patient that just comes in to talk and rest.
Every community in America should have their own Wellness Center. The model that we are creating is flexible, easily replicable, can be for-profit or not-for-profit, and over time will obtain the scale needed to produce sustainable profit and outcomes to prove performance. In today’s marketplace, health care providers must diversify income sources away from insurance reimbursement to survive, or be prepared to join a larger health care system or partnership that is better prepared to “buy time” as the uncertainty of America’s health care system sorts itself out. Not the most rewarding of options.
Wellness Rx’s returning to an old medicine offers great hope. A perfect alliance of patient and provider. A philosophy of care that thinks “small” and ignites the spirit. The future is world medicine. The future is rewarding providers, health systems and patients for reducing total health care costs while improving patient outcomes. The future is risk-sharing reimbursement arrangements between insurance companies, government and health care providers. The future is health care teams committed to common goals and a culture of “service”, and the development of new centers of care that help their patients heal themselves.
We invite you to join us on our journey.