Lyle Hurd: Welcome Doctor Roizen, after having the opportunity to interview you on the radio, I’m really pleased to introduce you to our readers.

Recently, Time magazine did an extensive piece on you and the Cleveland Clinic, and what they talked about was this doctor doesn’t want to see you. Now I’ve met a lot of doctors and I’ve always found that they would like to see patients for a couple of reasons, and one is that it helps support the whole business that they’re in. You are Chairman of the Wellness Institute at the Cleveland Clinic-

MR: Correct.

LH: -and Chief Wellness Office, correct?

MR: Correct.

LH: Please explain what that covers.

MR: What the mission of the Wellness Institute that I help lead or that leads me, if you will, is to make preventive care, there’s a key phrase in there, to make preventive care, and I’ll come back to what I mean by that because in the current health care reform debate that term has been hijacked by people who don’t know what it means. But to make preventive care a driving force in medicine for our employees, our physicians, our patients and our communities, and what that means is we want to decrease the burden of chronic disease in our workforce, amongst our physicians, amongst our patients and in the greater communities.

What do I mean by that? Well, it is seventy-five percent of the total cost of health care in the United States, we’re twice as expensive as Europe, three times that of Asia, but it is seventy-five percent of our costs are due to chronic disease that is preventable with four activities: getting rid of tobacco, being physically active, choosing the right foods and portion size, and managing stress. So those four things make us less competitive for jobs and lower our standard of living. So if we could get rid of those four, in three years we could drive our costs down from roughly seventeen percent of gross domestic product to eight and a half percent. That’s a huge thing. It would change our competitiveness. It would also allow us to give care to everybody who doesn’t have it about ten times over. That’s how huge we could do it and not have a deficit. We would readily change the entire cost structure of government in Medicare and Medicaid and state governments as well if we as individuals took responsibility.

So what we have started here at the Cleveland Clinic is a model of how we can capture our patient’s imagination. Why do I say that? Because everyone knows you should exercise, everyone knows you should eat healthier, everyone knows they shouldn’t smoke or be around secondhand smoke, and a lot of people know they should manage stress, yet we don’t do it. So what we’re doing here is saying we make each of those things easy by having the right leadership. Toby Cosgrove (Delos M. “Toby” Cosgrove, MD, is the chief executive officer and chairman of the Board of Governors of The Cleveland Clinic) is a brilliant leader at being able to teach people why this is important for us, why it’s important for our society, and get the “aha” moments that get them to do the things for three weeks so they feel so much better. Then they continue it so that we don’t have the burden of chronic disease. And that’s why I want to get back to preventative care.

Yes, preventative care can be doing screening tests, however those aren’t always worthwhile. Everyone knows that screening tests in lowest populations don’t make sense. You want to do, if you will, high risk finding tests. The mammogram in the woman over forty-five, that’s a high risk finding test, or specific tests with people with risk factors for disease. But really what preventative care is it’s taking the person who has a risk for diabetes or who has metabolic syndrome and hasn’t been hospitalized yet and reversing that disease so they don’t ever manifest it as a burden to themselves or to society.

LH: So if we practice a wellness paradigm from preconception to a hundred plus then we very likely won’t have to worry so much about health care costs and how healthy people are; it’ll be wellness and that’s what we’re all working towards.

MR: If we do that and even if we pay primary care physicians three times what they’re making now to do lifestyle treatments, we lower the total cost of care in the United States by something on the order of 1.9 trillion over ten years. What that means is we can reduce the cost of care by clearly twenty-five percent without hurting anyone and with actually helping you feel healthy. And if we did that throughout society, we could reduce costs of care, and the burden of chronic disease care, by seventy-five percent. Also, we could avoid losing all of the health care jobs to Europe and Asia because we would be highly competitive in providing the care here.

LH: Thank you Dr. Roizen. I look forward to further conversations on how we can achieve our health care reform and health care cost goals.

MR: I look forward to it, Lyle.

The Cleveland Clinic is a non-profit academic medical center that integrates clinical and hospital care with research and education. Founded in 1921, the Cleveland Clinic vision was to provide excellent patient care on the basic principles of compassion, cooperation and innovation. There are over 1,800 physicians and scientists working for the Cleveland Clinic and over 40,000 total employees. The Clinic has over three million patient visits each year. The Cleveland Clinic serves the community in a variety of ways. The Clinic provides free health care to the poor, and engages in extensive medical research, education and training programs, and also supports various public health initiatives. The Cleveland Clinic places a large emphasis on maintaining wellness for both its patients and employees. Maintaining wellness and preventing chronic disease is a goal that the Clinic strives to achieve. The Cleveland Clinic hopes to teach patients how to be healthy and hopefully prevent them from needing to come back for future treatments.

Cleveland Clinic is located at 9500 Euclid Avenue, Cleveland, OH 44195 For more information on the Cleveland Clinic, visit the Web site at ClevelandClinic.org

TotalHealth editors