In 2017, the Canadian medical healthcare system cost us approximately $264 billion. That cost equated to over 10 percent of our Gross Domestic Product. In 1975, the total cost of healthcare was below $25 billion, representing about 7 per percent of our GDP. Has this substantial increase in spending led to better health outcomes. If we take a glance at the latest statistics on chronic diseases, then the simple answer is no.
It would appear that despite spending vast amounts of money, the Canadian medical healthcare system is failing to tackle chronic diseases effectively.
The question is why?
I would argue that there are three main reasons that our healthcare system is failing and is destined to fail.
The three reasons are:
Let us examine more closely each of these three problems.
1. Our modern diet and lifestyle are out of alignment with our genes and our biology.
The first reason is that conventional health care is destined to fail is that there is a considerable mismatch between our genes and the modern environment. Our genes contain programming that determines how our physiology works. This programming takes thousands and thousands of years to change. Our environment has changed dramatically over the last 200 hundred years, and our bodies have not had time to adjust.
The evolutionary biologist Theodosius Dobzhansky once said, “Nothing in biology makes sense except in the light of evolution.”
What he implied was that all living organisms including human beings developed in a distinct environment. Our genes and our biology adapted over tens of thousands of generations to allow us to survive and thrive in that environment. However, if that environment changes faster than our genes can adapt, a mismatch occurs. It is this mismatch that is the primary driver of the chronic disease epidemic.
Conventional medicine appears to be oblivious to this concept and as such is ill-equipped to deal with the repercussions.
2. Our Conventional medical paradigm is not well suited to tackle chronic disease
The most prominent challenge we face in healthcare is chronic disease, and conventional medicine is not well suited to it. Conventional medicine is astonishing for acute care. If a bus hit you, you would want someone to take you to a hospital.
Conventional medicine is starting to be able to restore sight to the blind. Surgeons can reattach limbs and even clone human stem cells. And we need oncology surgeons who can remove cancerous tumours.
However, I think we can all agree that conventional medicine has been terrible for chronic disease. Consider the following statistics from a Government of Canada publication, "Preventing Chronic Disease Strategic Plan."
Back at the beginning of the 20th century, the top three causes of death were all infectious diseases such as typhoid, tuberculosis, and pneumonia.
In the 1900s, you may have visited a doctor for a broken bone, a gallbladder attack, appendicitis, or maybe an infection. Treatment for those ailments back in the 1900s was comparatively simple. The doctor would remove your gallbladder or appendix, set a broken bone in a cast or give the patient medicine for an infection, notably with the invention of antibiotics. There was a single problem usually, a single doctor, a single treatment, and the person would begin to feel better. But unlike these acute problems, chronic diseases are challenging to manage. They are expensive to treat with drugs, and they usually last a lifetime.
Chronic diseases do not lend themselves to this one-problem, one-doctor, one-treatment model that worked so well in the past. Today’s patient instead has multiple problems, they see numerous doctors, and they require various treatments that go on for years, if not indefinitely. We need a new approach that is better suited to address our primary challenge of chronic disease.
3. Conventional Medicine does not prioritise investment in diet and lifestyle interventions
The third reason is that our model for delivering healthcare does not support the most important approaches for preventing and reversing chronic disease. The approaches that we need to tackle chronic diseases require investing far more resources in promoting health, which is just the inverse of what we are doing today.
In 2014, total health spending in Canada was $215.8 billion.
Guess how much the government spends on public health measures that would educate people on diet or lifestyle behaviour changes that could reverse chronic disease and prevent it in the first place? The answer is six percent. It appears our priorities are misguided.
Back in the 1980s, during the sequencing of the human genome, it seemed like genetics might hold the solution to solving chronic disease. However recent studies have discovered that 84 percent of the cause of chronic disease is not genetic, but due to diet and lifestyle factors. Our genes do play a role in determining which diseases we are predisposed to developing, but the choices that we make about diet and other lifestyle factors turn out to be far more influential determinants of our health.
Is Better Health Education The Answer?
It is tempting to think that we can resolve this predicament by better educating people about the adjustments they need to make to their diet and lifestyle. However, it is now well established that knowledge is not enough to sustain permanent behaviour modification. Most people understand that eating badly, not exercising, not getting enough sleep, and engaging in other unhealthy lifestyle habits is not good for them. However we continue to follow those behaviours anyway, or we look for immediate fixes that do not last.
Could Conventional Family Physicians help?
The simple answer is no. Firstly, we do not have enough primary care doctors to fix the problem.
Where I live in Ottawa, there is a real shortage of family doctors, and many people rely on walk-in clinics. Still, even if we did not have a lack of doctors, most doctors don’t have the education or the time that is essential to aid people in making necessary diet and lifestyle modifications. We could begin training physicians and other healthcare practitioners in this field, but that still would not resolve the dilemma because our conventional medical system is not designed to deliver this type of care.
What do I mean by this?
The average visit with a family doctor in Canada lasts for just 10 to 12 minutes. The average length of time that a patient gets to speak before they are interrupted in a visit is 12 seconds.
It is impossible for doctors to deliver high-quality healthcare in eight to 12 minutes. Especially if a patient has multiple chronic health problems, is taking several medications, and then comes in presenting with new symptoms. These short appointments leave no time to delve into the critical diet and lifestyle issues that are provoking the patient’s symptoms. Furthermore, when a doctor has as many as 2,500 patients on their list, it is challenging for them to develop the kind of relationship with their patients that would support those changes.
In conclusion, our conventional medical system is not intended to deliver the brand of healthcare that we require to halt and reverse chronic disease.
What are we going to do about this problem?
In short, we need a new model of healthcare. We want a new model of healthcare that addresses the three reasons why our current system is destined to fail.
In his new book, Unconventional medicine, Chris Kresser Functional Medicine Practitioner outlines such a model. In his book, he identifies three elements of this new healthcare model. Firstly, realigning our genes with our environment by using an ancestral diet and lifestyle approach. Secondly, addressing the root cause of disease and shifting to a genuinely patient-centred healthcare model with Functional Medicine. Thirdly, developing a collaborative practice model to support patients make changes that can prevent and reverse disease and promote health rather than just managing illness after it occurs.
This collaborative model would put licensed providers like medical doctors, chiropractors, naturopathic physicians, and acupuncturists, together with allied providers like health coaches and nutritionists so they can provide a much more complete, holistic, and a higher level of healthcare.
Disclaimer
This article is not intended to provide medical advice, diagnosis or treatment.
