The Missing Link...

A new physician survey has just been completed that shows quite starkly the missing link in our current healthcare system. (see: http://www.rwjf.org/vulnerablepopulations/product.jsp?id=73646&cid=XEM_2809280). It seems that 80% of physicians surveyed understand that the social needs of patients is just as important as any medical therapy. After all, if the patient can't afford the medicine, has no place to store it (because they're homeless), does not have a stable life, then it will be next to impossible to be compliant and adherent with any prescribed therapy. This is the missing link in healthcare. It's one of the glaring holes in the ACA legislation. That is, it's one thing to cover everyone with health insurance, but if many of those 50 million are homeless or semi-homeless then they can not eat properly, get sufficient rest, etc. There will be no overall improvement in health, or if there is, it will be incremental not transformational. A long time ago, a researcher named Maslow developed a heirarchy for human behavior that noted unless foundational needs are addressed and taken care of, no development happens. Analogously, if basic needs for health (good quality food in sufficient quantity, adequate rest, safe place to live) are not addressed, then people will not be optimally healthy. The really good news is that the Robert Wood Johnson Foundation (RWJF) has invested money into a program called Health Leads that trains colege students to work in physician offices to provide basic social service needs. In this model, a physician can write a "prescription" for any social service that a patient needs, and the Health Leads person in the office will help to "fill" it. It works really well and has grown over the last few years from its humble beginnings in Boston to now up and down the East Coast. What a fabulous leveraging of a renewable resource (college students) to meet a real need in the system. More of this transformational thinking is necessary if we are to overcome a healthcare system that is often not about health, and more often doesn't seem to care. This week, look for those things that could be changed in your life. What change, large or small could you develop that would transform what happens in your world? Really beneficial to spend some time discerning about things like this. I'd love to know what you find. Peace for the journey, Dan