These days it seems like everyone’s got a “solution” to the health care crisis. There are the political fixes, of course, ranging from President Obama’s “universal mandate, universal insurance” agenda, to presidential hopeful Ron Paul’s “personal choice, personal consequence” approach, along with a dozen other proposals for everything from single-payer to total laissez-faire.

All sorts of corporate players are now getting into the health care game, too, many of which have no prior history of involvement with health care or health policy. Perhaps the best solutions, though, are coming from community-based physicians. You can decide for yourself.

In terms of corporate players, the wonder-workers who make Disney’s theme parks the happiest places on Earth are trying to put some Magic Kingdom mojo into the medical world, by teaching hospital administrators how to apply Disney leadership principles to the health care domain. While Disney tries to make better hosts out of hospital administrators, FICO, the nation’s leading credit rating auditor, hopes to solve the health care crisis by making sure everybody takes their meds.

Over the summer, FICO announced its new “Medication Adherence Score,”a system for monitoring and rating consumers’ medication compliance. FICO uses “predictive analytics” to determine a person’s likelihood of filling a prescription and using the drug(s) as directed.

Some health care pundits claim that non-adherence to drug regimens causes thousands of unnecessary, preventable deaths and disabilities each year and wastes billions of dollars.

A big problem is that FICO’s system does not recognize that someone’s “noncompliance” with a drug prescription may reflect a conscious decision to go with a non-drug alternative (herb, nutraceuticall homeopathic, etc.). So, the MAS could unjustly penalize people who seek legitimate options outside conventional drug-based medicine.

These are just a couple of examples of how corporate America is trying to “solve” health care problems. The deeper problem is all these tech “solutions” and top-down management changes have more to do with corporate well-being than with people’s actual health. Fortunately, we’re also seeing some very creative, health-focused innovations emerging from the ground up, as clinicians and patients take it upon themselves to reform health care.

For example, there’s Dr. Pamela Wible, a family physician in Eugene, Oregon, who is spearheading a movement toward community-based clinic design. Dr. Wible had worked in a wide variety of settings, and by 2005 she found herself, like many doctors, burnt out and utterly dismayed by the constraints, conflicting incentives and heartlessness of insurance- based practice. Rather than resign herself to more misery, she asked herself: what would “ideal” health care look and feel like?

Then she asked her neighbors the same things in a series of town-hall community meetings. She gathered 100 pages of input from community members about what they actually wanted and needed from a primary care clinic.

The result? A thriving, patient-friendly health center offering a range of holistic options at affordable prices. Dr. Wible keeps her accessibility high, her overhead low, and her attention on the main thing: her patients’ well-being. She’s taken the frustration out of medicine, and put the joy and compassion back in.

Dr. Wible’s clinic is no fluke. Over the last six years, she has traveled all over the country helping individual physicians as well as large medical centers remake themselves based on input and innovation from the communities they serve.

“This happened so effortlessly, so simply and so easily,” she said. “People hear my story, and say things like, ‘That’s great! Keep up the good fight!’ But in reality, it hasn’t been a fight. I’m not fighting against any system, or any other doctors, or any other mode of practice. It’s about bypassing what we know doesn’t work, and dreaming into being what does work.”

Dr. Wible will be a featured speaker at the upcoming Heal Thy Practice 2011 conference, November 4–6, in Long Beach, California. The meeting, produced by Holistic Primary Care, is focused on new practice models that enable practitioners to focus on prevention and holistic therapies.

There are literally thousands of practitioners all over the country who are saying “no, thanks” to the protocol-bound, actuarial approach to medicine promoted by the health plans, and who are working directly with their communities, small businesses and other practitioners to develop practice models that actually meet peoples’ health care needs. I’ll be there!

There’s Dr. Vern Cherewatenko, a Seattle-area doctor who founded a system called SimpleCare that frees both doctors and patients from the burdens and costs of insurance-based medicine. Eliminating insurance overhead reduces the costs of basic primary care by a huge margin and enables physicians to actually focus on the needs of the person in the room—the patient—and not the imperatives of his or her insurance plan.

While patients do have to pay out of pocket for SimpleCare, Dr. Cherewatenko says many find it gives far greater value, especially if they’ve been bouncing from doctor to doctor within their insurance plans, and are fed up with long waits, five-minute visits and ineffective treatment.

Dr. Cheretwatenko will describe the SimpleCare model in detail at the Heal Thy Practice conference. The conference faculty includes pioneers in the holistic/ integrative field like David Perlmutter, Steven Masley, James Gordon, Kent Holtorf, JJ Virgin, Philippa Cheetham and many others.

Dr. Mark Logan, a Rutland, Vermont physician, whose embrace of nutritionbased approaches to managing serious disorders led him to found not only an integrative clinic but also of an artisanal locovore restaurant! By teaming up with a friend who is a chef, Dr. Logan was able to create Roots, where his patients—and the general Rutland—community, can enjoy delicious meals made from locally sourced produce, while also sticking to their eating plans. It gives new meaning to the term “doctor’s orders,” no?

The place has become so popular that Dr. Logan has difficulty getting a table on a Saturday night. In his clinic, he’s been able to make nutrition-based strategies a first-line approach for the care of people with significant chronic disorders like obesity, diabetes and heart disease, and he’s been getting great clinical outcomes.

These are just a few examples of the sort of health care transformations that are quietly happening all over the country when ordinary people of goodwill put their heads together and figure out healthier ways to solve common problems.

They don’t make the nightly news the way all the political ranting does, and they don’t have the hypnotic blue glow of the latest health app. But in the long run, it’s approaches like this that are likely to have a greater impact on our public health and well-being.

For a more personal and long-term P.S. to this laudable movement: I would like to see sweeping changes in our health care system. Canadian born and bred (and educated), I have been appalled at the fact health care is not government supported as it is in most of the civilized world. Yes, this costs the taxpayer, but without covered care, we end up with poor health, overcrowded emergency rooms, bankrupt individuals who were unfortunate enough to become ill, and lowered standard of living for many. How about single payer government-supported coverage, without the insurance companies as middle-men, and with emphasis on self-care, prevention, and overall health education? A more holistic approach would save money in the long run.

For more information on alternatives, especially or healthcare practitioners,

Heal Thy Practice: Transforming Primary Care.
http://www.holisticprimarycare.net/news/1307-practitioners-sound-off-on-health-care-reform-hearings

Hyla Cass, MD

Hyla Cass M.D. graduated from the University of Toronto School of Medicine, interned at Los Angeles County-USC Medical Center, and completed a psychiatric residency at Cedars-Sinai Medical Center/UCLA School of Medicine. She was an Assistant Clinical Professor of Psychiatry at UCLA School of Medicine until 2005, and is in private clinical practice in Pacific Palisades, CA.

Website: www.cassmd.com