Spending the extra time and effort to address a patient’s body, mind, and spirit is a good business practice for physicians. We need to achieve this in our own practices and at a systemic level – but how?
Over the past four years, the Veterans Administration has quietly piloted a remarkably successful new model of care, shifting from its traditional disease-based transactional system to a team-based, whole-person model that addresses patients’ physical, emotional, and social wellbeing.
Evaluating more than 130,000 veterans at 18 sites, the VA program not only reported improved health outcomes, but yielded substantial cost savings up to 20% per patient.
The findings from the VA are a message to all providers: We can build abetter mousetrap in healthcare. We can create a system that improves health, increases satisfaction for both patients and providers, and at the same time, controls costs. To achieve this, however, we must be bold enough to rethink and redesign our practices.
These findings demonstrate that we can better serve our patients and improve our own bottom line with an approach that combines conventional medicine, non-drug treatments, and evidence-based complementary methods that promote self-care.
A new white paper released this month by the Family Medicine Education Consortium and Samueli Foundation, The Case for Delivering Whole-Person Health Care, offers real-world examples of the health and economic benefits of integrating team-basedcare, health coaching, group wellness visits, and a wide range of evidence-based modalities including nutritional counseling, acupuncture, yoga, meditation, therapeutic massage, stress reduction, and much more.
The report details numerous examples of the benefits of whole-person care: A large Pennsylvania health system provided free healthy food along with nutrition education, yielding tangible decreases in patients’ weight, HA1C, blood pressure, and triglycerides. A University of Arizona clinic practicing integrative health reported increased trust and satisfaction among 90% of patients. A Chicago multi-center whole-health clinic reported significant drops in hospital admissions, surgeries, and drug costs.
Last year, the National Academy of Sciences, Engineering, and Medicine recognized that high-quality whole-person health care could be the foundation for changing the U.S. primary care system. This acknowledgement aligns with what providers already know: pills and procedures are ultimately a small part of achieving health – up to 80% is attributable to socio economic and behavioral factors outside of a doctor’s office.
The surprise in our report is that spending the extra time and effort to address a patient’s body, mind, and spirit is also good business practice for physicians. We need to achieve this in our own practices and at a systemic level – but how?
A few practice design changes can go a long way. In the primary care setting, the key changes involve additional training in health coaching, adding non-drug treatments, offering group visits, and access to mental and behavioral counseling. These services can be reimbursed by many insurers when used and coded in the right way and even make money under full risk contracts.
Health system transformation can occur when leadership and incentives align to create medical teams that connect more deeply with our patients to make high-quality, whole-person primary care the new foundation of a strong U.S. healthcare system.
When the VA piloted its whole health approach, not only did its patients benefit; its own employees reported higher engagement, job satisfaction, and intrinsic motivation, yielding reduced turnover and burnout. These lessons can be applied by healthcare providers and health systems more broadly. Adopting a whole-person care model can enable overstressed practitioners to achieve the goal that brought them into medicine in the first place: becoming a healer.
Wayne Jonas, MD, is the executive director of Integrative Health Programs at Samueli Foundation and is a board-certified, practicing family physician.