Optimistic Futurist: We can slim down health-care costs

Published 12:00 am Sunday, July 14, 2013

According to the CIA, we rank 51st in the world for life expectancy. Citizens of the number one spot for life expectancy, Monaco, live on average 11 years longer than we do! Even worse, University of Wisconsin researchers announced in March that life expectancy is falling in almost half of U.S. counties! This has been traced back to obesity.
Being overweight is the single largest cause of diseases that kill people early. One-third of our population is obese, and another third is overweight (and headed toward obesity). Obesity alone adds almost $200 billion annually to America’s direct health-care costs. In North Carolina, when you add in the costs of lost productivity, obesity costs our state economy $17.6 billion (not million).

This is a big problem.

The medical profession is in a bind on this one. It is one thing when doctors tell you that you have cancer, and they can help — they become heros. It is another when the doctor says you are obese or overweight, and the cure is largely up to you. The doctor goes from hero to villain instantly. Each patient they should confront with unpleasant news becomes a risky situation, because the patient may switch doctors or report them on some website for lacking manners.
A study in the journal Obesity done last year uncovered a dreadful statistic — only a third of normal weight doctors would bring up a conversation about weight during a heavy patient’s visit! Worse, only about a sixth of overweight doctors would start such a conversation.
Additional problems surface if a doctor or nurse is overweight themselves.
If an overweight doctor is seeing an obese patient, the doctor is likely to record a diagnosis of obesity only 7 percent of the time. A normal weight doctor will record that same diagnosis 93 percent of the time! In other words, the more overweight doctors we have, the less the records will show how overweight our nation is.
Nurses play a major role in this situation as well. More than half of American nurses are overweight or obese. Nurses surveyed report that they are aware of the problem but are so stressed and overworked they cannot take time to eat a healthy diet, relying instead on calorie-loaded fast food. Many work a rotating schedule, including working nights, which further disrupts eating patterns.
If the nurse is not a good role model, two things happen. First, like the doctors, research shows that hefty nurses bring up patients’ weight only one-fourth as often as they should. Second, the patient tends to disregard any advice because the nurse is not “walking the talk.”

This is a problem because patients need to know their weight impacts how their medicines work, how it impacts other diseases the patient has and how the added weight increases the chance of birth defects. This is clearly a threat to our nation’s future we can, and should, do something about.
Some healthcare professionals have started successful programs to help fellow caregivers lose weight.
John Brackle, a physical therapist at Overland Park Regional Medical Center in Kansas, helped the organization set up an 11-week program that enrolled 138 employees who collectively lost more than 700 pounds! A similar program at BayCare Health System in Florida found that each dollar spent on its program saves $3 in downstream health-care costs to the institution for their own employees — and this does not count the increase in effectiveness in delivering care to patients!
Some lessons have surfaced in these pioneer efforts that can help others imitate success. First, people lose more weight if they are in teams, whether in competition or not. The teams offer valuable mutual support and celebrate as the pounds melt away. If prizes are awarded to the teams, turns out that time off is the most valued reward. Sending program participants texts during times of the shift when a healthy snack should be taken helps reduce binge eating later.
Unless we clean up our act, the meaning of the phrase “the greatest nation on earth” will have a whole new, bad meaning. We can do better than rank 51st in the world for life expectancy! Let’s applaud Overland Park Regional Medical Center and BayCare Health System for showing us the path to a better future.

Francis P. Koster lives in Kannapolis. His “Optimistic Futurist” column appears every other Sunday. To see the sources of facts in this article and learn of other successful programs that can be implemented locally to create a better future, visit www.TheOptimisticFuturist.org.