Updated: Jul 9, 2020
I am a functional medicine physician and I work with people who have multiple chronic diseases. Navigating the health care system can be very complex and confusing for patients. Identifying a provider who can help to identify the root cause of disease for people who are suffering from chronic illness, and finding real solutions is hard enough, but then just getting all the things you need to do the things you are supposed to do is yet another barrier patients face.
I want to say that there is a better way. And we need to scale this kind of care to make this more accessible to the broader population. Let me illustrate what I’m talking about. I’ve changed some identifying features to protect their privacy, but the issues described in the patients below are very real.
One of my patients is an older man who is just starting to have memory issues. He is very health conscious and extremely motivated but not very tech savvy, as many older adults are. I am using the Bredeson Protocol to help him with his goals to improve his memory, but the protocol itself is complex. He was valiantly trying to follow the instructions in my care plan receiving it by snail mail after our phone visits and then waiting on getting his still working busy wife or children to help him order what he needed or take him shopping to find them at a store. All very labor intensive and none of which happened very easily or quickly. Even though he clearly has a very loving and supportive family, I got the sense that he felt it was an imposition on his family to ask them each time to help him and I sensed some reluctance and sadness that he couldn’t do this himself anymore. He had actually successfully ordered some things himself on Amazon that I had recommended but had inadvertently ordered the wrong thing, since selecting the correct product from among so many choices can be confusing. This again further delayed his implementing his care plan and he also wasn’t happy wasting money. As he struggled he became sadder and more depressed and my heart just broke for him.
Taking it upon myself to help him, I offered to order what he needed for him during our next meeting and arranged to have everything delivered directly to his home and he gratefully accepted. I ordered a variety of things from Amazon.com for him (since they often have the lowest prices which he likes) and I ordered other things from a specialty functional medicine farmacy called Fullscript where I had set him up with an account but which he hadn’t ever used. Fullscript sells specialty prescription grade dietary supplements that are high quality and has a searchable database of products that can be filtered according to product, food allergy needs, and brand. Acting as a concierge physician, I did this for him and he was so grateful. It sped up his being able to implement his care plan and he was happy to receive the things in the mail that I sent him. Not unexpectedly, his mood improved as he felt he was better able to take back control of his health in this way. Implementing the Bredeson Protocol can take time and although he is still struggling with memory issues, he seems happier and both he and I feel like we are now making better progress. I also feel more comfortable, knowing that he is actually receiving what I recommend, which sometimes seems like an impassible hurdle. Intuitively I also just know that this is better health care.
Another patient of mine is a young woman who is very tech savvy but is again also suffering from debilitating chronic disease. She has a chronic autoimmune disease and is suffering from chronic fatigue. Although she was once a competitive athlete her chronic disease has left her struggling to continue to work and take care of herself and her child. She is the sole provider and a single mother, having just recently gone through a divorce. She had been to see many different providers and was very motivated to change but fatigue limited her ability to do much of what she was previously able to do. Fatigued, overworked, and overwhelmed, she needed more time to care for herself and rest at a time I was asking her to make a lot of changes and buy more things and to also change her diet and prepare nourishing food. In her case, instead of our discussing over the phone and my ordering what she wanted right then, she felt more comfortable reviewing my recommendations, thinking about them, and then purchasing them on her own later, or messaging me to have me do it for her after she thought about it. Before, she had lots of questions and was anxious about not getting the right thing. Having the ability to make specific product recommendations, providing instructions, and integrating this with distribution and sales simplified the process and alleviated the anxiety and the uncertainty she had. Moreover, I am finding that when patients receive their products in the mail from you it serves to reinforce their positive health behaviors and further legitimizes the healing relationship. Automating the ability to prescribe everything my patients need is something I am working on for our clinic Integrative Path and store Whole Farmacy. I am calling it Health Product "Prescription" as a Service (HPPaaS).
The irony of suffering from chronic diseases is that the sicker you are and the more chronic diseases you accumulate, the more complex the investment in care and the more complex the expectations from the patients become at a time when they are less able to do the things they need to do. Back when large multigenerational families used to live together, I think patients were better off, because there was usually someone available to help care for them. So many patients are struggling now without the care or resources they need, even those that have the financial means to afford help. Meeting a practitioner who can help and getting the right evaluation and care plan is critical but it’s just the start of the journey.
Better solutions for caring for patients with chronic disease and helping them care for themselves are needed if we are going to reverse the chronic disease epidemic. We can begin by designing processes and technologies that simplify our clients journeys and that support them along the way. These cases are just an example of the kind of care people need. When people say this is too expensive, it is less expensive than paying for lifelong disability insurance for a young woman, or Medicare paying for memory care for an older man with Alzheimer’s disease. Preventing and reversing chronic disease is cost effective in comparison. Health plans that pay for this type of care and that incorporate these technology innovations are needed.
Dr. Ruth Lininger is committed to changing the way health care is delivered and paid for. She is the founder and medical director of the functional medicine clinic, Integrative Path (www.integrativepath.com), an online store Whole Farmacy (www.wholefarmacy.com), and she is also the founder and CEO of Duchess Health (www.duchesshealth.com), whose mission is to scale consumer directed whole health care.