Chronic

I’ve had a year blessedly full of work, but that volume has caused me to let my own blog mostly lie fallow. To make up for this, I’m going to try for a post a day in December. About just about everything. Funny. Serious. Anything goes. Here is Day 10.

(No, not that kind of chronic.)

My industry saves people’s lives. I’ve met these people. I’m friends with these people. I AM one of these people.

When I joined this industry in the late 1990s, direct-to-consumer advertising was new. So were “lifestyle” drugs. Blockbuster drugs were still exciting concepts. The idea of chronic quality-of-life drugs was pretty new. But man, did it get popular fast.

For many years, my job focused on direct-to-physician communications. Primarily, this meant reading medical journals and clinical trials until I was able to understand them well enough not only to speak to physicians about them, but also to be able to explain them to reporters – both ones who were physicians themselves, but also ones who knew nothing about medicine – who had been on a non-health beat last month and were trying to come up to speed. 

And so while I’m not a scientist I’m comfortable with scientific papers. The scientific method is vital to our success and evolution as a species. Western medicine has made an enormous positive difference in the world. Vaccines are good. These are such self-evident statements that I hate even saying them. But they need saying because we live in a moment when it’s acceptable to be hideously anti-intellectual and anti-science. I believe in the promise and the efficacy of Western medicine. This is another self-evident statement. I’ve seen it work; I understand its basics; it’s saved my life. 

But I also work in the fitness industry. I’m certified to instruct in several types of fitness. And, while I was interning in the pharmaceutical industry in college, I (a firm believer in the hustle) was also working for a pharmacist in Western medicine who specialized in alternative treatments too.

So while I believe in Western medicine… I also believe that American society, in particular, overdiagnoses maladies that are societally caused, and overtreats them with medication instead of lifestyle change.

We talk more about medications for obesity-related conditions than we do about food intake, sleep hygiene, stress management, talk therapy, meditation, hydration. We do that because that’s where the money is. 

Except it isn’t. Prevention is far more cost-effective. (In addition to being a much nicer life experience for the person in question.)

But our healthcare system isn’t predicated on that long-term of a financial outlook. The ROI that matters is that which changes by the next quarterly analyst call, not the ROI over your lifetime.  

I am absolutely not any kind of medical professional. But I’d certainly class myself as a person who works in healthcare and is passionately devoted to constantly learning more about it from all sides. I love writing about health. I love working with experts to convey complex concepts simply and convincingly. 

I just wish we could figure out how to get the factions together. So often it seems like there is no “healthcare” industry. There are payers. There are drugmakers. There are fitness professionals. There are healthcare professionals (and their innumerable factions). You’d think they all want the same thing. And, at bottom, I think they do. But they see each other, so often, as the enemy, not as different specialists. 

So often the metaphor is war. War on cancer, war on drugs, etc. I think that’s the wrong metaphor. It presumes a fully functional opponent. What if the effort, instead, was on preventing disease by building healthy humans from the start?

Not entirely, of course – prevention can’t prevent everything. But obesity alone, for instance, drives US healthcare costs up by 29%. Healthcare costs have a lot of other causes. But that’s one enormous chunk of the pie. I wonder what it’s going to take to get us to start looking at it honestly.