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Is Our Current Medical System
In Critical Condition?
225,000 deaths per year occur fromiatrogenic causes (12,000 from unnecessary surgery,7,000 from medication errors, 20,000 from hospital related errors,80,000 from hospital contracted infections and 106,000 from non-error, negative effects of drugs).
third leading cause of death followingheart disease and cancer.(JAMA)
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Costs are projected to reach 3.14trillion by 2012 (Webb,2003).
The U.S. government spends $5,035
per person on health care annually We are rated #1 by WHO for chronic
degenerative diseases and next to last
place for industrialized countries in 14indicators for health.
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Drug Therapy
Americans are on an average of 9.9
medications per person.
Americans spent $208 billion in2001 for prescription drugs, double
that of 1996.
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Satisfaction? 1 in 7 Americans report being dissatisfied
with conventional care.
Patient satisfaction surveys reveal that less
than 80% of people feel their initial
complaint was satisfactorily resolved when
they left the office.
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Cost
We spend more money than any othernation (13% of the GNP) on healthcare.
Only 2% of healthcare budget is currentlydevoted to prevention though we know thatevery dollar spent on prevention saves
$10.00 in eventual treatment costs.
Health insurance is the #1 burden ofbusiness (Forbes, 2003)
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How is our Heath Report Card? Diabetes is now at epidemic proportions (17
million with diabetes, 157,000 under 20 years old.
Between 1990 and 1998 diabetes increased by70%.
Two thirds of Americans are overweight, obesitycosts $118 billion annually.
Poor nutrition habits linked to 146 billion inmedical costs annually.
Sedentary habits cost 76.6 trillion per year
Cost of chronic disease more than 1 trillion/year
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One in six cancer deaths could be preventedby losing weight.
Arthritis afflicts 1 in 3 U.S. adults (CDC)
40 million Americans suffer from chronic
pain, 66 million from arthritis, 5 millionfrom low back pain, with an average of 93lost workdays per person for those withchronic pain (NIMH)
Musculo-skeletal conditions cost anestimated 254 billion each year.
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50 million have heart disease. Each year
729,000 people die from stroke or heart
disease.
Asthma has doubled.
Autism is the fastest growing disability in
America with about 400,000 currently
diagnosed (NIH, 2003)
Health industry estimates the total # ofcancer cases by 2020 at 15 million, about
50% more than we have today.
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What Are We Missing? 75% of what doctors typically see in the
office are complaints related to nutrition,
lack of energy, weight control, sleep,
chronic digestive issues, depression, anxiety
60-90% of reasons people seek care are
because of human elements, (stress-relatedproblems (Lown, 1996).
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Are We Even Listening? The patient is interrupted in an average
of 23 seconds after he or she begins totalk
There is no reimbursement for talking,
or guidance, only for procedures, testsor prescriptions
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Universal Human Needs
significance
competence
power
integrity, a sense of belonging
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Universal Processes of Healthy
Systems
Expansion Expression
Equilibrium
Exchange
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Current System versus Ideal Bureaucratic/paternalistic/dependent
Practitioner based
Illness orientation (especially acute)
Healing as science
Linear thinking
Specialties and separation
External approaches
Reactive/fear based
Practitioners untouchable
Treating the heart
Repetitive maintenance costs Sense of community absent
Symptom suppression
Healthcare as business
Democratic/ autonomous
Partnership based
Wellness orientation
Healing as art and science
Spiral thinking
Wholistic
Internal and external approaches
Proactive
Wounded healer concept
Treating matters of the heart
Savings on wellness Sense of community vital
Symptoms are signals
Healthcare as viable service
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Current: Ideal: Billable services for procedures
Quick fix
Values doing over being
Values producing over thinking
Values tangible over intangible
Diagnosis focus
Rushed/ less time to do less
Research outside of paradigm
discounted Illness has person
Billable services include talk time
Lifestyle fix
Values being and doing
Values thinking and producing
Values intangible and tangible
Innate healing focus
Time taken
All research considered and
examined Person has illness
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Singular Evolution of Medicine
Circa 4000 BC
First recorded historyIllness was seen as a result of angering
the gods
The healer was seen as possessingmagical abilities
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Circa 500 BC for over 800 years- Greekinfluence (Hippocrates- father of medicine)
Humanism movement
Partnership based
Healing journeys
Medical spas
Environmental issues (Treatise on Air,Water and Places)
Physician heal thyself
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Middle Ages
Monks were more scholars than
experimentalistsMythic and dogmatic thinking
Little reward for independence and
curiosity
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Dark Ages
BlackDeath in 1300s killed 1/3
of population, faith in doctorswas lost and the supernatural once
again reigned
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Renaissance (rebirth)
inspired by civic pride
permeated by a revisitation of humanism
(humanists were opposed to superstition and
favored critical observation)Greeks (with their historical record keeping)fled to Italy and continued their scientific
inquiry in an atmosphere of artistic andliterary development
Blend of mind, body and spirit
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Scientific Revolution
During the 1500s and 1600s scientific
method became the new god.
Heavily influenced by the ideas of:
Rene Descartes
Francis Bacon
Isac NewtonBeginning of the separation of mind-body-
spirit
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The dogma of any tightly controlled
group, (in this case, the scientificcommunity), has a history of being as
capable of hindering the development
of knowledge as promoting it.
There is no danger in unanswered
questions, only in unquestioned
answers
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Age of Enlightenment
New permission to engage in detachedobservation as the constraints of religioustradition were lifted
Inventions of microscope, stethoscope,ophthalmoscope, pathology, etc. (the abilityto see within) led to the rapid expansion of
pharmacology and surgery and to formal
training for physicians.Medicine began to become mechanistic andreductionistic as the body was seen bit by
bit, piece by piece.
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18th Century
Medicine raised to godlike status with thedevelopment of the smallpox vaccination(Edward Jenner). As promised in the bible the
blind were made to see, only not by faith butby cataract surgery (Benson, 96)
This was a time that life expectancy was 30years and of all children died before theirfirst birthday.
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Pasteurs germ theory would go along way toextend life.
In 1859 Darwins treatise on Survival ofthe fittest set the stage for life being in a
constant struggle with potential invaders(germs).
The marriage of these two ideas created theage of magic bullets (anti-toxins, anti-inflammatory, anti-bacterials, anti-tussives,anti-cholesterol, etc.
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Technical Revolution (1900s)
Further separation as body is seen as a
machine that can be fixed with machines
Field of psychiatry split off (by the 1930s
the Index Medicus had not one reference tothe patients emotions and mental state).
Schools of naturopathy, homeopathy,
osteopathy, chiropractic no longeraccredited
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Nutritional education removedInstitutions organized by diseases andorgans
(American Lung Association
National Cancer Institute
National Institute of Infectious Diseases
Faster information led to more
specialization (knowledge=power)Problem orientation (Problem charting)
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The individual isevaluated but scarcely
encountered.
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The Human PotentialMovement